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.
  • Chen, An; Väyrynen, Kirsi; Leskelä, Riikka-Leena; Heinonen, Seppo; Lillrank, Paul; Tekay, Aydin; Torkki, Paulus (2021)
    BackgroundThe importance and potential benefits of introducing patient reported measures (PRMs) into health care service have been widely acknowledged, yet the experience regarding their implementation into practice is limited. There is a considerable paucity of research in adopting PRMs in maternity care routine. This study, which utilizes the PRMs included in Pregnancy and Childbirth (PCB) outcome set developed by International Consortium for Health Outcomes Measurement (ICHOM) as sample measures, aims to elicit Finnish professionals' views on PRMs and to explore the applicability of PRMs in Finnish public maternity care.MethodsThis qualitative study, applying semi-structured interviews, described the local professionals' views towards the application of PRMs in Finnish public maternity care. Professionals were asked to assess the PRMs defined in ICHOM PCB set and provide their expectations and concerns on the implementation of PRMs in Finnish public maternity service.ResultsTwenty professionals participated in the interviews. Participants agreed on the importance and relevance of the PRMs questions included in ICHOM PCB set for delivering and developing maternity care in Finland. However, they criticized the number and length of questions as well as the recommended time points of data collection. In addition, for a successful implementation, various steps like developing suitable questions, redesigning service pathway and protocols, and motivating women to respond to PRMs questions were considered to be important. Also, some potential obstacles, difficulties and risks associated with the implementation were underlined.ConclusionThis study indicates that the implementation of PRMs into Finnish public maternity service is possible, highly relevant and important. However, the adoption of PRMs into routine practice may be challenging and will require a series of efforts. This study shows viewpoints from Finnish professionals who have not participated in developing the ICHOM PCB standard set and provides important insights on the development and implementation of PRMs.
  • 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.
  • Korpela, Ville; Lombardi, Michele; Vartiainen, Hannu (2021)
    The designer's exercise consists of designing a rights structure that formalizes the idea of power distribution in society. A solution is implementable in largest consistent set by a rights structure if there exists a rights structure such that for each preference profile, the largest consistent set of the game played by agents coincides with the set of outcomes that the solution would select for it. In a setting with transfers, every Maskin monotonic solution is implementable. This finding implies that the class of implementable solutions in core equilibria is unaltered by farsighted reasoning. (C) 2021 The Author(s). Published by Elsevier Inc.
  • Teppo, Konsta; Jaakkola, Jussi; Airaksinen, K. E. Juhani; Biancari, Fausto; Halminen, Olli; Putaala, Jukka; Mustonen, Pirjo; Haukka, Jari; Hartikainen, Juha; Luojus, Alex; Niemi, Mikko; Linna, Miika; Lehto, Mika (2022)
    Objective: Medication adherence is essential for effective stroke prevention in patients with atrial fibrillation (AF). We aimed to assess whether adherence to direct oral anticoagulants (DOACs) in AF patients is affected by the presence of mental health conditions (MHCs). Methods: The nationwide FinACAF cohort covered 74,222 AF patients from all levels of care receiving DOACs during 2011-2018 in Finland. Medication possession ratio (MPR) was used to quantify adherence. Patients with MPR >= 0.90 were defined adherent. MHCs of interest were depression, bipolar disorder, anxiety disorder and schizophrenia. Results: The patients' (mean age 75.4 +/- 9.5 years, 50.8% female) mean MPR was 0.84 (SD 0.22), and 59.5% had MPR >= 0.90. Compared to patients without MHC, the adjusted ORs (95% CI) for adherent DOAC use emerged slightly lower in patients with depression (0.92 (0.84-0.99)) and bipolar disorder (0.77 (0.61-0.97)) and unsignificant in patients with anxiety disorder (1.08 (0.96-1.21)) and schizophrenia (1.13 (0.90-1.43)). However, when only persistent DOAC therapy was analyzed, no MHC was associated with poor adherence, and instead anxiety disorder was associated with adherent DOAC use (1.18 (1.04-1.34)). Conclusion: Adherence to DOACs in AF patients in Finland was relatively high, and no meaningful differences between patients with and without MHCs were observed.
  • Heikkinen, Kirsi-Marja; Ahtiainen, Raisa; Fonsén, Elina (2022)
    This article investigates early childhood education and care (ECEC) leadership through the concept of community of practice (COP). The focus is on ECEC leaders’ perceptions regarding their leadership during the educational changes taking place in the context of Finnish ECEC. The purpose is to increase understanding of how leaders see themselves in relation to the ECEC multiprofessional working community and practices of distributed leadership. The data are five focus group interviews of ECEC leaders analyzed with directed content analysis within the theoretical frame of domain, practice, and community forming the core of COP in Lave and Wenger. The results show how all three COP components comprise several dimensions in ECEC leaders’ perceptions of their leadership. For example, the component of the leadership domain consists of ECEC values, ECEC legislation, and ECEC curriculum. The results indicate that a formal leadership role is essential in leading the community and its vision. Moreover, building flexible leadership structures and supporting multiprofessional cooperation in the community augment leadership as a community’s joint enterprise
  • Kaila, Lotta; Ketola, Jarmo; Toivonen, Marjaana; Loukola, Olli; Hakala, Kati; Raiskio, Sakari; Hurme, Timo; Jalli, Marja (2022)
    Researchers globally identify pesticides as one of the main reasons for pollinator decline. In the European Union (EU), extensive legislation is implemented to protect pollinators from harmful pesticide exposure. The aim of our study was to discover whether the pesticide residue levels in honeybee matrices, such as nectar and pollen, exceeded the chronic or acute toxicity levels when beehives were located next to fields treated with specific insecticides. The insecticides were used according to the EU legislation and its national implementation. The experiments were conducted in turnip rape, oilseed rape, and caraway fields in southern Finland during the years 2019 and 2020. The pesticides used in the experiments contained the active substances lambda-cyhalothrin (2019), esfenvalerate (2020), and tau-fluvalinate (2020). However, the honeybee-collected pollen and nectar were analyzed for residues of more than 100 active substances. The results showed that the pesticide residue levels clearly remained under the oral acute toxicity for honeybees, although we found high levels of thiacloprid residues in the pollen collected in 2019. The pesticide residues in nectar were below LOQ values, which was most likely due to the rainy weather conditions together with the chosen sampling method. No statistically significant differences were observed between the insecticide-treated and untreated fields. In light of our research, the EU legislation protected honeybees from oral acute toxicity during the years 2019 and 2020. However, potential sublethal effects of thiacloprid and other pesticide compounds found in the collected pollen cannot be ruled out. In the future, constant monitoring of pesticide exposure of honeybees and wild pollinators should be established to ensure that pesticide legislation, and its implementation across the EU successfully protects pollinators and their services in agricultural environments.
  • Koikkalainen, Saara; Pyrhönen, Niko; Wahlbeck, Östen (Palgrave Macmillan, 2021)
    Palgrave Studies in Sub-National Governance
    This book presents an overview of European migration policy and the various institutional arrangements within and between various actors, such as local councils, local media, local economies, and local civil society initiatives. Both the role of local authorities in this policy field and their cooperation with civil society initiatives or networks are under-explored topics for research. In response, this book provides a range of detailed case studies focusing on the six main groups of national and administrative traditions in Europe: Germanic, Scandinavian, Napoleonic, Southeastern European, Central-Eastern European and Anglo-Saxon.
  • 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.