Hoivayrittäjyys ikääntyvien palveluissa - nyt ja tulevaisuudessa

Raportissa kuvataan ikääntyvien palveluihin keskittyvää hoivayrittäjyyttä. Tietojen kerääminen tehtiin osana EU-rahoitteista CarePrise-projektia vuosien 2011–2013 aikana. Tavoitteena oli löytää ja kuvata erilaisia hyviä käytäntöjä eri maista – niin hoivayrittäjyyden kuin sosiaali- ja terveysalan yrittäjyyskasvatuksen alalta. Käytäntöjä etsittiin kumppaneiden, saatujen vihjeiden, tiedotusvälineissä esiin tulleen tiedon sekä internetin avustuksella. Hyvien käytäntöjen toimintaympäristöä kartoitettiin jotta saatiin tietoa käytännöt mahdollistavista erityispiirteistä, jotka mahdollistavat kyseisen toiminnan. Raportoidut hyvät käytännöt toimivat erilaisissa hyvinvointiyhteiskunnissa, joissa julkisella, yksityisellä, kolmannella ja epävirallisella sektorilla on erilaiset roolit. Toimintaympäristön kartoittamista tehtiin myös tulevaisuuden näkökulmasta. Tulevaisuuskuvia rakennettiin yhdistämällä delfoi-tekniikkaa hyödyntävää kyselyä sekä aikaisempia jo olemassa olevia tutkimuksia. Hyvien käytäntöjen ja tulevaisuuskuvien valossa ideoitiin uudenlaisia palveluita, joille ehkä vielä ei ole markkinoita, mutta jotka tulevaisuudessa voisivat olla haluttuja palveluja. Tällä hetkellä hoivapalveluiden markkinat ovat murrosvaiheessa. Siellä missä liikkuu suurimmat volyymit ja rahat, liikkuvat myös suuret yritykset, jotka valtaavat parhaillaan markkinoita. Osa hoivapalveluiden markkinoista on kilpailtuja, mutta monet yritykset ovat löytäneet oman tilansa markkinoilta tarkoituksenmukaisen konseptin tai hyvin kohdennetun tarjonnan avulla. Markkinarakoja tulee olemaan myös tulevaisuudessa. Pienet yritykset voivat rajata ja kohdistaa palveluita entistä enemmän joko alueellisesti tai kohderyhmänsä puolesta.The report describes the market-based care of the elderly. Data collection was done during the years 2011 –2013 as part of an EU co-funded project called CarePrise. The goal was to find good practices in Finland, Germany, Austria, Poland, and the Netherlands. Such practices were sought with the help of international partners, received clues, and media, including the Internet. The good practices found in the field of social and health care were described. In addition, the operational environment was charted, in order to find out if there were special features that made a particular activity possible and good. The good practices were found in countries with different kinds of welfare models. The countries put different emphasis on the public, private, non-governmental and informal sectors. Changes in society also make the need for entrepreneurship education visible. Future professionals will work in an environment where cooperation between different actors is part of everyday work. The future perspectives were also analyzed. Future scenarios were developed utilizing the Delphi technique in an enquiry, and on the basis of the existing research. In the light of good practices and future scenarios, new service ideas were developed. The authors thought of such service concepts for which there may be no market at the moment but which might be desired services in the future. At the moment, the private market of elderly care services is under transformation. Where the largest volumes and money are, there are also the big companies, which are trying to take over the market. There are market segments with much competition, but, on the other hand, many firms have found their space on the market thanks to a well-designed business concept or well-targeted supply. Niches will also exist in the future. Services provided by small and mediumsized enterprises may become more targeted than before, either locally or by target group

Päänsärkypotilaan kivunhoito : esimerkkinä migreenipotilaan hoito

Opinnäytetyö on toteutettu yhteistyössä Helsingin ja Uudenmaan sairaanhoitopiiriin kuuluvan Hyvinkään sairaalan päivystyspoliklinikan kanssa. Työhön saimme idean HUS:n opinnäytetöiden aihepankista. Opinnäytetyö on toteutettu systemaattista kirjallisuuskatsausta tutkimusmenetelmänä käyttäen. Kirjallisuuskatsauksessa käsittelimme migreenipotilaan ohjausta sekä lääkkeetöntä että lääkkeellistä hoitoa tutkimuskysymysten avulla. Työmme tavoitteena oli oman ammatillisen kasvun kehittäminen sairaanhoitajina sekä terveydenhoitajana ja lisäksi vastaaminen Hyvinkään sairaalan päivystyspoliklinikan tarpeeseen, joka koskee päänsärkypotilaan kivunhoitoa. Aineistohaun perusteella mukaan kirjallisuuskatsaukseen valikoitui 17 tieteellistä tutkimusta sekä tutkimusartikkelia. Tutkimusten valintakriteereinä oli, että tutkimukset vastasivat sisällöltään tutkimuskysymyksiin ja että tutkittu tieto oli riittävän ajantasaista. Tuotimme Hyvinkään sairaalan päivystyspoliklinikalle ohjelehtisen kirjallisuuskatsauksen perusteella. Tutkimusten mukaan ohjaus migreenipotilaan hoidossa koetaan tärkeäksi. Ohjauksen onnistuminen vaatii hoitohenkilökunnalta paljon osaamista sekä resursseja. Yhdessä tutkimuksessa potilaiden kokemukset olivat negatiivisia ja ohjaus oli koettu liian vähäiseksi. Potilaan ohjaaminen perustuu myös lakiin potilaan asemasta ja oikeuksista. Laissa kerrotaan, että potilaan on saatava selvitys terveydestään, hoitovaihtoehdoista, hoidon merkityksestä ja myös hoidon vaikutuksesta. Tutkimusten perusteella tärkeintä migreenin lääkkeettömässä estohoidossa on migreenikohtauksia ärsyttävien tekijöiden välttäminen. Yleisimpiä laukaisevia tekijöitä ovat stressi tai stressin laukeaminen, kuukautisten alkaminen tai nälkä. Monet migreeniä sairastavat ihmiset tarvitsevat myös lääkehoitoa lääkkeettömän hoidon rinnalle. Akuutin migreenin hoidossa tehokkaimpia ensilinjan lääkkeitä ovat ibuprofeeni sekä triptaaneista tsolmitriptaani sekä sumatriptaani. Aspiriini erityisesti pahoinvointilääkkeeseen yhdistettynä vaikuttaisi olevan myös tehokas lääke migreenipäänsäryn hoidossa. Migreenin aiheuttaman päänsäryn lääkehoidossa tulee huomioida yksilöllisyys.This thesis was made in cooperation with Hyvinkää Hospital which is a part of the nursing care district of Helsinki and Uusimaa. The idea for this thesis came from the thesis topic bank of HUS. The thesis was made using a systematic review of the literature as an examination method. In the review of the literature we dealt with the control of a migraine patient as well as medical and non-medical treatment with the help of the research questions. Our goal was to develop our skills as nurses and to answer Hyvinkää Hospital’s need for management of a headache patient’s pain. According to the research we made we found 17 scientific research related articles. The criteria used was that our research answered the questions by their content and that the examined information was updated enough. We produced an indication sheet of the most essential results to the Hyvinkää Hospital. According to the research the control in nursing of a migraine patient is important. Success in control requires the staff to have a great deal of knowledge and resources. In the used research the patients´ experiences were negative and the control was experienced as too minor. Controlling the patient is also based on the law and the rights of the patient.The law states that a patient has the right to get a clear picture of the state he/her is in, treatment options, meaning of the treatment and the effect of the treatment. Based on the studies the most important thing in non-medical treatment of migraine is avoiding stimulus. The most common reasons that cause a migraine to burst are stress, periods and hunger. Many of the people suffering from migraine also need medical treatment together with non-medical treatment. The most efficient medicine in treating acute migraine are Ibuprofen, Tsolmtriptane and Sumatriptane. Aspirin combined especially with antiemetic seems to be an effective medicine in treating a migraine headache. In the medical treatment of migraine it is important to take notice of the different individual circumstances

Selling business in portions : strategy for focusing and adapting to the changes

Objectives Although acquisitions and business exits have been studied widely, there are very few studies which concern the business deals as a growth strategy from the perspective of seller. Mainstream growth business research as well as business transfer studies are concentrating on the growth of the firm from buyers’ perspective. However, in practice it has been found that there are firms which are selling portions of businesses, either directly to improve the operating performance or to get resources, by which the remaining activities in the firm evolves and grow. This paper focuses on SMEs and strive to understand, what are the motives of the seller to sell a portion of the business and what is happening in the firm after this. The main objective is to clarify how sales of the portion of firm's business affects the development and growth of the firm. Secondary objective is to find out the process of transfer in three stages, the situation before business transfer, the transfer itself as a process and development of the firm after transfer. The data was collected by interviewing seven managing directors of firms, which have sold a portion of their business during the past 10 years. Prior Work The growth of the firm can be measured by several indicators, such as turnover and/or number of employees. In addition, the growth of firm is the result of the firm’s success, which can be explained and measured by indicators in two areas: financial performance indicators, and indicators of the development of the business. (Sorama et al., 2015). To sell a portion of the business may be a way to seek better profitability, which allows the growth of the firm later on. Steffens et al. (2009) argued that profitability before growth is better path than growth and then a wish to achieve profitability afterwards. The acquisition may have a short term negative impact on the firm’s financial performance (Varamäki et al., 2012b), but sale of a portion of the business may, in turn, affect vice versa. Entrepreneur’s motivation has an instrumental role in creating new business, buying and selling business as a part of a broader strategy on entrepreneurship (Amaral, Babtista & Lima, 2009; Birley & Westhead, 1994; Sto-rey 1989). On the other hand, large firms are buying smaller rapidly growing firms and the owner of rapid growth firm owned other firms, too (Sarasvathy, Menon & Kueche, 2013). For this reason, it is important to distinguish between the entrepreneur, business and enterprise and the strategies: entrepreneurship strategy, business strategy and corporate strategy. The sale of a business portion can be seen as a strategic arrangement. If the firm’s competitive advantage in one business area is not strong enough, the sale of it can strengthen firm’s other business areas. Sale of the business portion might relate the profitability orientation, which consequently, aims to increase the financial resources of the firm for future growth. Approach Research data consists of seven semi structured theme interviews, case descriptions based upon them and the content analysis. As the research seeks to understand the phenomenon and expand the theory, we use a case study strategy and theme interview method. The case study provides an opportunity for diversity with-out trying to simplify it too much. Case study is suitable particularly when the phenomenon is atypical, but the researchers want to generate a new understanding and development targets. We sought for the cases in which the firm has sold a portion of its business and continue operating with the remaining business from different sources. The data was gathered from 7 entrepreneurs in the region of Southern Ostrobothnia in Finland. The themes of the interview were gathered on the basis of researchers pre-understanding, the existing literature and the research group’s previous studies of business transfer. The main themes were the following topics: Activities before and during the sale process • factors that relate to the business • business planning activities • previous experience to purchase or sale the firm • implementation of the business transfer The firm after the sale • the development of business after sale • the future of the firm • the likelihood of new acquisitions • what advice the interviewee give to an entrepreneur who is planning to sell a business. Results In the firms with only one owner, the personal motives for selling portion of the business activities are high-lighted even though they also include elements connected with business and market conditions. In these cas-es, the goals for development are often connected with the needs of the entrepreneur. In the firms with sev-eral owners, the motives for selling are often connected with the corporate strategy. There are often clear growth and development goals after the business transfer. In this study, business transfer as a process is rather quick, especially when the target business activity has been prepared well in beforehand. It seems that difficulty of letting go is not connected to selling portion of firm's business in the same way than it is when the whole firm is sold. Targets set to the sales of business activity seemed to get fulfilled well. The development and growth of the firm has mostly been successful in the cases where they were the targets/motives for selling. The recession has hampered the growth, but there has been some development. Selling portion of firm’s business activities may enable better allocation of resources and allow entrepreneur to concentrate on the more promising business activities. In addition, it may help to exit business activities which are not yielding profit or require unjustified amount of resources. Selling a business activity or selling the firm in portions are options for closing down the firm. Selling busi-ness activities in portions does not to seem be very common, but those who have done it, have positive experiences. Both personal and firm level motives have been fulfilled. Implications and Value Entrepreneur Selling a portion of firm's business activities is a solution to multiple needs and situations. When the entre-preneur is considering retirement, selling business as smaller portions can help to relieve the pain of aban-donment. The gradual abandonment can increase the capacity of the entrepreneur to concentrate better on the remaining business and extend the entrepreneurial career. The sale of a difficult portion of the business may motivate entrepreneur to develop the remaining business. Firm and strategic renewal From the firm’s perspective the capital from the sale will benefit the development and growth of remaining business. Firm may use available resources more efficiently by focusing on more profitable and more ap-propriate business. Instead of terminated and run down portions of the business, they can be packaged into resource bundles which have greater value for buyer than to the seller. Strategic focus and concentrating on core businesses Business sprawl cause resource shortages, which can be discharged by selling off business resource glut-tons. When evaluating the firm’s businesses, it should be kept in mind that the excess of one firm is core business to another. In addition, some may have ability and willingness to invest in to which the other does not have assets

Loss-of-function mutation in IKZF2 leads to immunodeficiency with dysregulated germinal center reactions and reduction of MAIT cells

Peer reviewe

Loss-of-function mutation in IKZF2 leads to immunodeficiency with dysregulated germinal center reactions and reduction of MAIT cells

Peer reviewe

InDEx – Industrial Data Excellence

InDEx, the Industrial Data Excellence program, was created to investigate what industrial data can be collected, shared, and utilized for new intelligent services in high-performing, reliable and secure ways, and how to accomplish that in practice in the Finnish manufacturing industry.InDEx produced several insights into data in an industrial environment, collecting data, sharing data in the value chain and in the factory environment, and utilizing and manipulating data with artificial intelligence. Data has an important role in the future in an industrial context, but data sources and utilization mechanisms are more diverse than in cases related to consumer data. Experiences in the InDEx cases showed that there is great potential in data utili zation.Currently, successful business cases built on data sharing are either company-internal or utilize an existing value chain. The data market has not yet matured, and third-party offerings based on public and private data sources are rare. In this program, we tried out a framework that aimed to securely and in a controlled manner share data between organizations. We also worked to improve the contractual framework needed to support new business based on shared data, and we conducted a study of applicable business models. Based on this, we searched for new data-based opportunities within the project consortium. The vision of data as a tradeable good or of sharing with external partners is still to come true, but we believe that we have taken steps in the right direction.The program started in fall 2019 and ended in April 2022. The program faced restrictions caused by COVID-19, which had an effect on the intensity of the work during 2020 and 2021, and the program was extended by one year. Because of meeting restrictions, InDEx collaboration was realized through online meetings. We learned to work and collaborate using digital tools and environments. Despite the mentioned hindrances, and thanks to Business Finland’s flexibility, the extension time made it possible for most of the planned goals to be achieved.This report gives insights in the outcomes of the companies’ work within the InDEx program. DIMECC InDEx is the first finalized program by the members of the Finnish Advanced Manufacturing Network (FAMN, www.famn.fi).</p