Utilizing Data Analytics in Private Healthcare Companies’ CXM: A Multiple Case Study

The customer experience and its management have become the focus of business in the intensifying competition. Thanks to the development of technology and the increase in data, companies have more insights and options than ever before for developing their customer experience. Also in the healthcare sector, competition is emerging and customer awareness is constantly growing. Therefore, industry players need new ways to develop their operations towards more customer-oriented and personalized services. This study aims to find out what kind of customer data Finnish private healthcare service companies collect to support the management of their customer experience and how this data is utilized in concrete decision-making. Data is collected through four interviews from different companies. The interviews sought to find out the current state of case companies' data-driven customer experience management. The results identified that case companies collect a lot of diverse customer data. Also the importance of the customer experience has been actively raised at the center of thinking. However, interviews showed that there is still very little knowledge-based customer experience management in case companies compared to their potential and available opportunitie

Lihastasapainon arviointi Functional Movement Screen (FMS) -testipatteristolla : Kartoitus Lapin urheiluakatemian 16 - 19-vuotiaille maastohiihtäjille

Opinnäytetyömme tavoitteena on kerätä tietoa Lapin urheiluakatemian 16 – 19-vuotiaiden maastohiihtäjien lihastasapainosta Functional Movement Screen (FMS) -testipatteristolla mitattuna. Tarkoituksena on mittausten kautta tuottaa tietoa, jota toimeksiantajamme Lapin urheiluakatemian valmentajat ja fysioterapeutit voivat hyödyntää valmennustyössään hiihtäjän kehittymisen tukemiseksi ja loukkaantumisten ennaltaehkäisemiseksi. Myös fysioterapia-ala voi hyötyä tiedosta Functional Movement Screen (FMS) -testipatteriston käyttömahdollisuudesta urheilijoiden lihastasapainon kartoittamisessa ja loukkaantumisten ennaltaehkäisyssä. Opinnäytetyön tekemisen myötä syvennämme myös omaa osaamistamme lihastasapainon merkityksestä ja sen kartoittamisesta. Opinnäytetyömme on kvantitatiivinen tutkimus, jossa pyrimme vastaamaan kysymykseen: Millainen on Lapin urheiluakatemian 16 – 19-vuotiaiden maastohiihtäjien lihastasapaino Functional Movement Screen (FMS) -testipatteristolla mitattuna? Tutkimusjoukkomme koostui kymmenestä tutkimushenkilöstä ja heidän lihastasapainoa havainnoimme Functional Movement Screen (FMS) -testipatteriston avulla. Mittaukset suoritimme huhtikuun 2014 aikana, minkä jälkeen analysoimme tulokset IBM SPSS Statistics 21-tilastointiohjelmalla. Tutkimuksessamme Lapin urheiluakatemian 16 – 19-vuotiailla maastohiihtäjillä ilmeni lihasepätasapainoa kuten kompensatorisia liikkeitä, liikkuvuusrajoituksia, kehon hallinnan heikkoutta sekä epäsymmetriaa. Näiden tekijöiden on osittain todettu olevan yhteydessä loukkaantumisiin ja siksi niihin tulisi kiinnittää huomiota harjoittelussa. Lihastasapainokartoituksilla ja niiden seurantakartoituksilla sekä jatkotoimenpiteillä on saatu loukkaantumisten määrää vähennettyä.The aim of this thesis was to collect information about Lapland Sports Academy 16 to 19-year-old cross-country skiers’ muscle balance by using the Functional Movement Screen test. The purpose of this thesis was to produce information which our commissioner Lapland Sports Academy coaches and physiotherapists can take advantage of in planning cross-country skiers exercises and preventing injuries. Our thesis gives information to other physiotherapists on how to use the Functional Movement Screen (FMS) test as a screening tool of muscle balance and injury prevention with athletes. The purpose of our thesis was also to learn more about muscle balance and how to screen it. This thesis is a quantitative study with the attempt to find out what kind of muscle balance the Lapland Sports Academy cross-country skiers have, measured by using the Functional Movement Screen (FMS) test. The research sample consisted of ten cross-country skiers and their muscle balance was assessed by using the Functional Movement Screen (FMS) test. The measurements were conducted in April 2014 and after that analyzed with the IBM SPSS Statistics 21 tool. The results of this study showed that the Lapland Sports Academy cross-country skiers have muscle imbalance, for example compensatory movements, limited range of motions, weaknesses of stability and asymmetries. Previous studies have shown that these factors are connected with injuries and should therefore be noticed in exercises by the coaches. Screening muscle balance regularly and applying corrective exercises have decreased injuries

Review article : Systemic consequences of coeliac disease

Background The best-known symptoms of coeliac disease are related to the gastrointestinal tract, but the disease may also present with various systemic manifestations outside the intestine. Some of these consequences may remain permanent in undiagnosed individuals or if the diagnostic delay is prolonged. However, for many of the systemic manifestations, the scientific evidence remains scant and contradictory. Aims and Methods We conducted a narrative review of the most thoroughly studied and clinically relevant systemic consequences of coeliac disease, especially those that could be prevented or alleviated by early diagnosis. The review is intended particularly for physicians encountering these patients in daily clinical practice. Results The possible systemic consequences of coeliac disease extend to multiple organ systems, the best studied of which are related to skeletal, reproductive, cardiovascular and neurological systems. Furthermore, the disease is associated with an elevated risk of psychiatric comorbidities, non-Hodgkin lymphomas and intestinal adenocarcinoma. Conclusions The various systemic consequences of coeliac disease play a significant role in the overall health of patients. Early diagnosis and treatment with a gluten-free diet appear to be beneficial for most, but not all of these conditions. The possible negative metabolic and psychosocial effects of the diet should be acknowledged during follow-up.Peer reviewe

Lack of long-term follow-up after paediatric-adult transition in coeliac disease is not associated with complications, ongoing symptoms or dietary adherence

Background Follow-up of coeliac disease is recommended to prevent complications associated with unsuccessful treatment. Objective The objective of this article is to evaluate the implementation and significance of long-term follow-up. Methods Medical data were collected from 585 and follow-up questionnaires sent to 559 current adult coeliac disease patients diagnosed in childhood. Diagnostic features and adulthood health outcomes were compared between those with and without adulthood follow-up. Results Of paediatric patients, 92% were followed up 6-24 months after diagnosis. A total of 235 adults responded to the questionnaires a median of 18 years after diagnosis, and 25% of them reported regular follow-up. They were diagnosed more recently than those without follow-up (median year 2001 vs 1995, p = 0.001), being otherwise comparable at diagnosis. Those with follow-up were less often smokers (5% vs 16%, p = 0.042) and relatives of coeliac patients (48% vs 66%, p = 0.018), and more often students (48% vs 28%, p = 0.005) and type 1 diabetics (19% vs 4%, p = 0.001). Lack of follow-up was not associated with complications, ongoing symptoms, poorer general health or dietary adherence. All completely non-adherent patients were without follow-up. Conclusions Most coeliac disease patients diagnosed in childhood were not followed up according to recommendations in adulthood. The individual effect of this on long-term treatment outcomes varied markedly.Peer reviewe

Significance of low ferritin without anaemia in screen-detected, adult coeliac disease patients

Background Low ferritin without anaemia has been linked to adverse health effects. Objectives To investigate the prevalence and clinical significance of low ferritin in screen-detected coeliac disease. Methods Seventy-six screen-detected coeliac disease patients were enrolled in the prospective collection of comprehensive clinical, laboratory and histological data at diagnosis and after 1-2 years on a gluten-free diet (GFD). All variables were compared between patients with different ferritin levels. Results At coeliac disease diagnosis, six patients had anaemia. Of the 70 nonanaemic patients, ferritin levels were = 100 mu g/L in 24%. Those with lower ferritin were more often females, had lower body mass index, haemoglobin and villous height-crypt depth ratio and also had higher intra-epithelial lymphocyte CD3+ levels in duodenal biopsies. The groups did not differ in neurological or gastrointestinal symptoms, health-related quality of life, bone mineral density, liver values, vitamin, albumin or coeliac autoantibody levels or the prevalence of comorbidities. Median ferritin levels increased from 41.5 mu g/L to 86.0 mu g/L on GFD (p < 0.001). Ferritin remainedPeer reviewe

Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care

PurposeWe evaluated adherence to a gluten-free diet and associated factors in adult celiac disease patients diagnosed in childhood. MethodsComprehensive medical data on 955 pediatric celiac disease patients was collected and study questionnaires sent to 559 who were now adults. All variables were compared between strictly adherent and non-adherent patients. ResultsAltogether 237 adults (median age 27 years, 69% women) responded to the questionnaires a median of 18 (range 3-51) years after the childhood diagnosis. Altogether 78% were reportedly adherent and 22% non-adherent. The non-adherent patients had more concomitant type 1 diabetes (18% vs. 4%, p = 0.003), whereas the groups did not differ in demographic data or clinical and histological features at diagnosis, or in short-term dietary adherence. In adulthood, non-adherent patients found gluten-free diet more challenging (39% vs. 17%, p < 0.001) and had higher prevalence (39% vs. 19%, p = 0.004) and severity of symptoms. The main motivation factors for dietary adherence were attempts to avoid symptoms and complications, but these were considered less important and price of gluten-free products more important among non-adherent patients. Adherent and non-adherent patients did not differ in socioeconomic or lifestyle factors, comorbidities other than type 1 diabetes, self-reported general health, health concerns, follow-up, or in quality of life. ConclusionMost originally pediatric celiac disease patients reported strict dietary adherence in adulthood. However, particularly those with concomitant type 1 diabetes, persistent symptoms or financial issues may require attention during the transition from pediatric to adult care.Peer reviewe

Frequency and clinical significance of histologic upper gastrointestinal tract findings in children with inflammatory bowel disease

Objective Assessment of the upper gastrointestinal tract (UGI) may enable more personalized treatment strategies in pediatric inflammatory bowel disease (IBD). However, data on the frequency and significance of these findings remain limited. Methods Data on 132 pediatric IBD patients with systematic UGI sampling were collected and the baseline characteristics and presence of complications compared between those with and without histological UGI findings. The control group comprised 162 children who received no diagnoses. Results Seventy-six children had ulcerative colitis (UC), 47 Crohn's disease (CD) and nine IBD unclassified. UGI findings were more common in IBD patients than controls (69.7% vs. 30.9%, respectively, p < .001), particularly in the stomach (62.1% vs. 16.8%; p < .001). Among IBD patients, findings were more common in CD than in UC (80.9% vs. 63.2%; p = .038), particularly in the duodenum (21.3% vs. 2.6%, p = .001). Four patients had UGI granulomas consistent with CD. Hypoalbuminemia (OR 3.22; 95% CI 1.18-8.79) and failure to thrive (2.82; 1.17-6.78) increased the likelihood of UGI findings in IBD. In CD, perianal morbidity was less common in those with than in those without UGI findings (13.2% vs. 44.4%; p = .032) whereas in UC, UGI findings increased the risk for co-morbidities (18.8% vs. 3.6%; p = .059). The long-term outcomes did not differ between patients with or without UGI findings. Conclusions Histologic UGI findings were more common in children with IBD than in children with no gastrointestinal diagnoses. In CD, UGI findings were more frequent than in UC, especially in the duodenum. In UC, UGI findings were associated with more complex disease.Peer reviewe

Differential diagnosis and long-term outcomes of non-atrophic duodenal changes in children

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Persistent symptoms are diverse and associated with health concerns and impaired quality of life in patients with paediatric coeliac disease diagnosis after transition to adulthood

Objective To investigate the prevalence and associated factors of persistent symptoms despite a strict gluten-free diet in adult patients with coeliac disease diagnosed in childhood. Design Medical data on 239 currently adult patients with paediatric diagnosis were collected from patient records. Also, patients completed structured study questionnaire. All variables were compared between those with and without persistent symptoms. Results Altogether 180 patients reported adhering to a strict gluten-free diet. Of these, 18% experienced persistent symptoms, including various gastrointestinal symptoms (73%), arthralgia (39%), fatigue (39%), skin symptoms (12%) and depression (6%). Those reporting persistent symptoms had more often gastrointestinal comorbidities (19% vs 6%, p=0.023), health concerns (30% vs 12%, p=0.006) and experiences of restrictions on daily life (64% vs 43%, p=0.028) than the asymptomatic subjects. The patients with symptoms had poorer general health (median score 13 vs 14, p=0.040) and vitality (15 vs 18, p=0.015) based on a validated Psychological General Well-Being Questionnaire and more severe symptoms on a Gastrointestinal Symptom Rating Scale scale (total score 2.1 vs 1.7, p Conclusion Almost one-fifth of adult patients diagnosed in childhood reported persistent symptoms despite a strict gluten-free diet. The ongoing symptoms were associated with health concerns and impaired quality of life.Peer reviewe