Browsing by Subject "Implementation"

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  • Heusala, Anna-Liisa; Koistinen, Jarmo (2018)
    The article illuminates the dynamics of bilateral cross-border cooperation between two vastly different legal-administrative partners. The analysis utilizes empirical findings of a case study on bilateral Finnish–Russian crime prevention cooperation. Currently, both the differences in national legislations and the fast-changing administrative environment make this cooperation challenging. The case study showed that bilateral cooperation, which is the dominant form of cooperation between EU member states and Russia, is currently affected by disjointed and even competing multilateral and bilateral structures, differences in criminal law and procedure, gaps between international treaties and national legislation, local and regional variations of practices, weak institutional trust and abrupt policy changes. The results indicate that the effectiveness of cross-border networks cannot be assessed strictly in terms of quantitative outcomes. Further long-term development of the cooperation requires both realistic understanding of legal-administrative constraints and strong commitment at the national and supranational political levels.
  • Kareksela, Santtu; Aapala, Kaisu; Alanen, A.; Haapalehto, Tuomas; Kotiaho, J. S.; Lehtomäki, Joona; Leikola, Niko; Mikkonen, Ninni; Moilanen, Atte; Nieminen, E; Tuominen, S; Virkkala, Raimo (2019)
    Conservation resource allocation involves a complex set of considerations including species, habitats, connectivity, local to global biodiversity objectives, alternative protection and restoration actions, while requiring cost-efficiency and effective implementation. We present a national scale spatial conservation prioritization analysis for complementing the network of protected mires in Finland. We show how spatial prioritization coupled with regional targets and expert knowledge can facilitate structured decision-making. In our application, discussion between experts was structured around the prioritization model enabling integration of quantitative analysis with expert knowledge. The used approach balances requirements of many biodiversity features over large landscapes, while aiming at a cost-effective solution. As a special analytical feature, mire complexes were defined prior to prioritization to form hydrologically functional planning units, including also their drained parts that require restoration for the planning unit to remain or potentially increase in value. This enabled selection of mires where restoration effort is supporting and benefitting from the core mire areas of high conservation value. We found that a key to successful implementation was early on structured co-producing between analysts, mire experts, and decision-makers. This allowed effective multidirectional knowledge transfer and evaluation of trade-offs related to the focal conservation decisions. Quantitative trade-off information was seen especially helpful by the stakeholders to decide how to follow the analysis results. Overall, we illustrate a realistic and applicable spatial conservation prioritization case supporting real world conservation decision-making. The introduced approach can be applied globally to increase effectiveness of large-scale protection and management planning of the diverse wetland ecosystem complexes.
  • Tero, Jussi (Helsingin yliopisto, 2019)
    Aikuispotilaiden hoidossa sairaalansisäisiä ensihoitoryhmiä eli MET-yksiköitä on perustettu laajalti sairaaloihin ympäri maailmaa, ja viime aikoina niitä on perustettu myös lapsipotilaiden hoitoon keskittyneissä yksiköissä. Tämä systemaattinen kirjallisuuskatsaus tarkastelee lapsipotilaiden hoitoon keskittyneiden MET-yksiköiden sekä kliinisen tilan arviossa käytettävien pisteytysjärjestelmien (PEWS) perustamisessa esiintyneitä tuloksia sekä ongelmakohtia. Kirjallisuushaku suoritettiin online-kirjastoista OVID Medline, Cochrane sekä Scopus, ja kaikki tutkimukset, jotka ovat julkaistu 03/2019 mennessä, käytiin läpi. Yhteensä 628:sta julkaisusta karsittiin katsauksen kriteerien perusteella 611, jolloin tarkasteltavia tutkimuksia jäi jäljelle 17. MET-yksiköiden perustamiseen keskittyneistä tutkimuksista kuolleisuuden vähenemisen havaitsivat viisi tutkimusta, sydän- ja hengityspysähdysten vähenemisen viisi tutkimusta ja elvytyshälytysten vähenemisen kolme tutkimusta. MET-yksikön perustamiseen liittyvät ongelmat olivat tutkimuksissa yhtenäisiä. Ongelmakohtia olivat mm. hoitohenkilökunnan puuttuva itsevarmuus ja kokemattomuus sekä sairaalansisäisen hierarkian noudattaminen, joka ilmeni haluttomuutena muuttaa aiempia käytäntöjä. PEWS-tutkimuksien pisteytysjärjestelmissä oli eroavaisuuksia pistekategorioiden sekä pistemäärien suhteen. Herkkyys vaihteli välillä 69.5-90.2 ja tarkkuus välillä 74.4-89.9. PEWS-pisteytysjärjestelmät osoittautuivat helppokäyttöisiksi ja vaativat vain kymmeniä sekunteja hoitajilta laskea. MET-yksiköiden perustaminen oli tutkimustulosten perusteella vaikuttavaa ja PEWS-pisteytysjärjestelmät osoittautuivat käyttökelpoisiksi lapsipotilaiden kliinisen tilan arvioinnissa, mutta lisää tutkimuksia PEWS-järjestelmien sekä MET-yksiköiden yhteistyöstä tarvitaan. Suomen sairaanhoitojärjestelmässä useassa sairaalassa on jo MET-yksikkö, mutta lapsipotilaiden MET-yksiköitä ei vielä ole. Tulevaisuudessa tulisi pohtia, onko lasten MET-yksiköitä tarpeen perustaa myös Suomessa.
  • Moilanen, Atte; Laitila, Jussi; Vaahtoranta, Timo; Dicks, Lynn V.; Sutherland, William J. (2014)
  • Godenhjelm, Sebastian; Johanson, Jan-Erik (2018)
    The delivery of public services in collaborative agency networks has given rise to an increasing use of projects in administering policy and service delivery. Projects are assumed to provide mechanisms by which flexibility can be achieved and innovative solutions produced. The aim of the article is to advance the understanding of collaboration between stakeholders and its effect on innovation. It analyses stakeholders' influence on the creation of project innovations in 275 European Union-funded projects by using content analyses and logistic regression analyses. The results show that projects can act as hubs where valuable information is produced but that few projects produce innovations. Project stakeholder network, knowledge dissemination and project influence, as well as sources of advice, play a role in predicting project innovations. The article concludes that the overly optimistic view of collaboration as a remedy for a lack of innovation in the public sector can be questioned. Points for practitioners The results of the article help practitioners to compose public sector development projects that foster innovation. The results suggest that it pays to include representatives of research and education facilities among project staff as their inclusion predicts the possibilities of achieving innovations. The empirical findings provide insight into project innovation and indicate which practices to avoid. It is suggested that when managed correctly, stakeholder inclusion has an effect on public sector project innovation.
  • Coccolini, Federico; Kluger, Yoram; Ansaloni, Luca; Moore, Ernest E.; Coimbra, Raul; Fraga, Gustavo P.; Kirkpatrick, Andrew; Peitzman, Andrew; Maier, Ron; Baiocchi, Gianluca; Agnoletti, Vanni; Gamberini, Emiliano; Leppaniemi, Ari; Ivatury, Rao; Sugrue, Michael; Sartelli, Massimo; Di Saverio, Salomone; Biffl, Walt; Catena, Fausto (2018)
    Optimal management of emergency surgical patients represents one of the major health challenges worldwide. Emergency general surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital. EGS represents the easiest viable way to provide affordable and high-quality level of care to emergency surgical and trauma patients. It may result from the association of different physicians with other specialties in a cooperative model. The World Society of Emergency Surgery (WSES) has been working on the EGS organization and implementation since its foundation believing in the need of common benchmarks for training and educational programs throughout the world. This is a plea in different languages to all World Prime Ministers and Presidents to support the creation in all nations of an organized hub-spoke system for emergency general surgery to improve standards of care and to save lives.