ASIAKASKOMEMUKSEN JOHTAMINEN Analyysi prosessijohtamisen merkityksestä asiakastyytyväisyyteen ja -kokemukseen terveyspalvelualan case-yrityksissä

Tässä tutkimuksessa on tutkittu, miten prosesseja johtamalla voidaan parantaa asiakastyytyväisyyttä ja kokemusta palveluyrityksessä. Tämä tutkimus sai alkunsa halusta selvittää hammaslääkäripalveluja tuottavien terveyspalveluyritysten palveluprosesseja ja prosessien johtamista. Palveluiden tuottamisprosessi ja asiakkaiden tarpeet ovat muuttuneet alalla merkittävästi poliittisten päätösten ja asiakkaiden valveutumisen myötä. Lisäksi kilpailu alan asiakkaista on kiristynyt viime vuosina merkittävästi, minkä vuoksi asiakastyytyväisyyden merkitys palveluita tuottavissa yrityksissä on kasvanut. Tämän tutkimuksen tarkoituksena oli selvittää case-yritysten teemahaastattelujen avulla asiakastyytyväisyyttä lisääviä tekijöitä palveluorganisaatioissa ja voidaanko näitä prosessijohtamisen kautta parantaa. Lisäksi haluttiin selvittää mitkä palveluprosessien osat vastaavat asiakkaiden tarpeita ja mitä osia kehittämällä voidaan parantaa asiakastyytyväisyyttä ja luoda onnistuneempia palvelukokemuksia. Tutkimuksen tavoitteena on antaa hammaslääkäripalveluita tuottaville yrityksille tietoa nykyisestä terveysalan palvelukulttuurin tilasta ja asiakastyytyväisyyden ongelmakohdista terveyspalveluja tuottaville palveluorganisaatioille. Tässä tutkimuksessa tutkimusmenetelmänä käytettiin laadullista tutkimusta, jossa aineisto kerättiin teemahaastattelumenetelmällä. Aikaisempaa tutkimusta etenkään hammaslääkäripalveluita tuottavien terveysalanyritysten asiakastyytyväisyydestä ja asiakaskokemuksesta on tehty hyvin vähän. Työn teoriaosuudessa tehtiin kirjallisuuskatsaus keskittyen tärkeimpien termien ja teorioiden selvittämiseen. Aluksi lähdettiin liikkeelle asiakas ja palvelukäsitteiden avaamisesta ja selventämisestä, jonka jälkeen syvennyttiin asiakastyytyväisyyden ja kokemuksen tarkoitukseen ja merkitykseen palveluyrityksessä. Tämän jälkeen avattiin prosessien ja johtamisen käsitteitä, joiden avulla asiakaskokemusta ja asiakastyytyväisyyttä voidaan johtaa ja sitä kautta tyytyväisyyttä palveluyrityksessä ja itse asiakkaassa. Itse empiriaosuus on kvalitatiivinen ja aineisto kerättiin teemahaastatteluilla. Kohderyhmäksi valikoituivat yksityiset hammaslääkäriasemat ja näitä palveluita tuottavat isommat yritykset. Haastateltavaksi valikoitui kuusi yritysten johto- ja vastuuasemassa olevaa henkilöä. Teoriakeskustelun mukaan onnistuneen asiakaskokemuksen pohjana on asiakkaiden tarpeiden tunnistaminen ja niihin vastaaminen. Tutkimus osoitti, että asiakastyytyväisyyttä voidaan parantaa yrityksissä prosessien määrittelyn ja prosessijohtamisen avulla. Prosessien tunnistaminen lisää yritysten mahdollisuuksia vastata asiakkaiden tarpeisiin. Prosessijohtamisen kautta yritys pystyy tunnistamaan palveluketjun ongelmakohdat ja reagoimaan niihin työntekijätasolla.fi=Opinnäytetyö kokotekstinä PDF-muodossa.|en=Thesis fulltext in PDF format.|sv=Lärdomsprov tillgängligt som fulltext i PDF-format

Influence of EU policy on agricultural nutrient losses and the state of receiving surface waters in Finland

In Finland, the first large-scale efforts to control nutrient loading from agriculture got under way with the introduction of the EU Agri-Environmental Program in 1995. We examined whether these efforts have decreased agricultural nutrient losses and improved the quality of receiving waters. To do so we used monitoring data on fluxes of nutrients and total suspended solids in agricultural catchments in 1990–2004 and on the water quality of agriculturally loaded rivers, lakes and estuaries in 1990–2005. No clear reduction in loading or improvement in water quality was detected. Hydrological fluctuations do not seem to have eclipsed the effects of the measures taken, since there was no systematic pattern in runoff in the period studied. The apparent inefficiency of the measures taken may be due to the large nutrient reserves of the soil, which slowed down nutrient reductions within the period studied. Simultaneous changes in agricultural production (e.g. regional specialisation) and in climate may also have counteracted the effects of agri-environmental measures. The actions to reduce agricultural loading might have been more successful had they focused specifically on the areas and actions that contribute most to the current loading

Predicting aboveground biomass in Arctic landscapes using very high spatial resolution satellite imagery and field sampling

Remote sensing based biomass estimates in Arctic areas are usually produced using coarse spatial resolution satellite imagery, which is incapable of capturing the fragmented nature of tundra vegetation communities. We mapped aboveground biomass using field sampling and very high spatial resolution (VHSR) satellite images (QuickBird, WorldView-2 and WorldView-3) in four different Arctic tundra or peatland sites with low vegetation located in Russia, Canada, and Finland. We compared site-specific and cross-site empirical regressions. First, we classified species into plant functional types and estimated biomass using easy, non-destructive field measurements (cover, height). Second, we used the cover/height-based biomass as the response variable and used combinations of single bands and vegetation indices in predicting total biomass. We found that plant functional type biomass could be predicted reasonably well in most cases using cover and height as the explanatory variables (adjusted R-2 0.21-0.92), and there was considerable variation in the model fit when the total biomass was predicted with satellite spectra (adjusted R-2 0.33-0.75). There were dissimilarities between cross-site and site-specific regression estimates in satellite spectra based regressions suggesting that the same regression should be used only in areas with similar kinds of vegetation. We discuss the considerable variation in biomass and plant functional type composition within and between different Arctic landscapes and how well this variation can be reproduced using VHSR satellite images. Overall, the usage of VHSR images creates new possibilities but to utilize them to full potential requires similarly more detailed in-situ data related to biomass inventories and other ecosystem change studies and modelling.Peer reviewe

Modeling Above-Ground Biomass Across Multiple Circum-Arctic Tundra Sites Using High Spatial Resolution Remote Sensing Data

Non peer reviewe

Long-term results of surgical resection of lung metastases from soft tissue sarcoma : A single center experience

Background A single-institution experience of pulmonary metastasectomy in soft tissue sarcoma (STS) was retrospectively reviewed. Our specific aim was to examine, whether the resection of pulmonary metastases could be curative. We also compared overall survival (OS) of patients after complete or incomplete pulmonary resection and nonsurgical treatment. Methods Between 1987 and 2016, 1580 patients were treated for STS with curative intent by Soft Tissue Sarcoma Group at Helsinki University Hospital, Finland. Three hundred forty-seven patients (22%) developed advanced disease and 130 STS patients (9%) developed pulmonary metastases as first systemic relapse. Seventy four patients (5%) were operated for lung metastases. Results Fifty-five patients (42%) had a complete and 19 (15%) incomplete resection. Fifty-six (43%) were unoperated. Median OS after complete or incomplete metastasectomy, chemotherapy, or best supportive care was 22, 18, 8, and 5 months, respectively. Twelve patients (9%) developed no further metastases and are alive with no evidence of disease. Disease-free survival (DFS) for completely resected patients was 17% at 5 years. All long-term survivors had oligometastatic disease and they underwent one to three complete metastasectomies. Conclusions Complete pulmonary metastasectomy in STS results in 5 years DFS in nearly one-fifth of patients. Most of these patients are probably cured.Peer reviewe

Peatland leaf-area index and biomass estimation with ultra-high resolution remote sensing

There is fine-scale spatial heterogeneity in key vegetation properties including leaf-area index (LAI) and biomass in treeless northern peatlands, and hyperspectral drone data with high spatial and spectral resolution could detect the spatial patterns with high accuracy. However, the advantage of hyperspectral drone data has not been tested in a multi-source remote sensing approach (i.e. inclusion of multiple different remote sensing datatypes); and overall, sub-meter-level leaf-area index (LAI) and biomass maps have largely been absent. We evaluated the detectability of LAI and biomass patterns at a northern boreal fen (Halssiaapa) in northern Finland with multi-temporal and multi-source remote sensing data and assessed the benefit of hyperspectral drone data. We measured vascular plant percentage cover and height as well as moss cover in 140 field plots and connected the structural information to measured aboveground vascular LAI and biomass and moss biomass with linear regressions. We predicted both total and plant functional type (PFT) specific LAI and biomass patterns with random forests regressions with predictors including RGB and hyperspectral drone (28 bands in a spectral range of 500-900 nm), aerial and satellite imagery as well as topography and vegetation height information derived from structure-from-motion drone photogrammetry and aerial lidar data. The modeling performance was between moderate and good for total LAI and biomass (mean explained variance between 49.8 and 66.5%) and variable for PFTs (0.3-61.6%). Hyperspectral data increased model performance in most of the regressions, usually relatively little, but in some of the regressions, the inclusion of hyperspectral data even decreased model performance (change in mean explained variance between -14.5 and 9.1%-points). The most important features in regressions included drone topography, vegetation height, hyperspectral and RGB features. The spatial patterns and landscape estimates of LAI and biomass were quite similar in regressions with or without hyperspectral data, in particular for moss and total biomass. The results suggest that the fine-scale spatial patterns of peatland LAI and biomass can be detected with multi-source remote sensing data, vegetation mapping should include both spectral and topographic predictors at sub-meter-level spatial resolution and that hyperspectral imagery gives only slight benefits.Peer reviewe

Academic procrastinators, strategic delayers and something betwixt and between: An interview study

Peer reviewe

Caries Experience and Erosive Tooth Wear in Finnish Men Conscripts 2021: A Cross-Sectional Study

Background: In Finland, the development of oral health in young, 19- to 21-year-old males regarding restorative treatment need seems to have slowed down according to cross-sectional conscript studies between 1976 and 2011. At the individual level, the mean number of decayed teeth (DT > 0) has also steadily continued to decline. In Finland, military service is mandatory, and around 85% of males complete it. The aim of this cross-sectional study was to investigate the oral health status of young men at the beginning of the 2020s. Methods: The data were collected in July 2021 in the eight biggest Finnish Defence force garrisons by ten calibrated dentists serving in the ranks. The inclusion criteria for this study were a year of birth between 2000 and 2002 and male gender (n = 508). Third molars were included. Restorative treatment need was evaluated using ICDAS scoring. The study was designed according to the STROBE guidelines. Results: Mean DT value was 1.13 when third molars were included and 1.03 when they were excluded. Mean DMFT value was 3.23 and 2.98, respectively. The proportion of conscripts with DT > 0 was 36.4% and 34.8%, respectively. The prevalence of caries was concentrated among a small number of conscripts. Most (76.5%) had BEWE (basic erosive wear examination) of 0–2. Conscripts in the moderate and severe ETW (erosive tooth wear) groups (BEWE 3–13) comprised 23.5% of the cohort. None of the conscripts fell into the most severe group (BEWE 14–18). Conclusions: The oral health of conscripts has improved over the last ten years, and restorative treatment need has decreased significantly. Compared to previous studies, restorative treatment need was concentrated on an even smaller proportion of conscripts

Caries Experience and Erosive Tooth Wear in Finnish Men Conscripts 2021: A Cross-Sectional Study

Background: In Finland, the development of oral health in young, 19- to 21-year-old males regarding restorative treatment need seems to have slowed down according to cross-sectional conscript studies between 1976 and 2011. At the individual level, the mean number of decayed teeth (DT > 0) has also steadily continued to decline. In Finland, military service is mandatory, and around 85% of males complete it. The aim of this cross-sectional study was to investigate the oral health status of young men at the beginning of the 2020s. Methods: The data were collected in July 2021 in the eight biggest Finnish Defence force garrisons by ten calibrated dentists serving in the ranks. The inclusion criteria for this study were a year of birth between 2000 and 2002 and male gender (n = 508). Third molars were included. Restorative treatment need was evaluated using ICDAS scoring. The study was designed according to the STROBE guidelines. Results: Mean DT value was 1.13 when third molars were included and 1.03 when they were excluded. Mean DMFT value was 3.23 and 2.98, respectively. The proportion of conscripts with DT > 0 was 36.4% and 34.8%, respectively. The prevalence of caries was concentrated among a small number of conscripts. Most (76.5%) had BEWE (basic erosive wear examination) of 0–2. Conscripts in the moderate and severe ETW (erosive tooth wear) groups (BEWE 3–13) comprised 23.5% of the cohort. None of the conscripts fell into the most severe group (BEWE 14–18). Conclusions: The oral health of conscripts has improved over the last ten years, and restorative treatment need has decreased significantly. Compared to previous studies, restorative treatment need was concentrated on an even smaller proportion of conscripts