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Über dieses Buch

This book constitutes the refereed proceedings of the 5th International Conference on Well-Being in the Information Society, WIS 2014, held in Turku, Finland, in September 2014. The 24 revised full papers presented were carefully reviewed and selected from 64 submissions. The core topic is livability and quality of (urban) living with safety and security. The papers address topics such as secure and equal use of information resources, safe and secure work environments and education institutions, cyberaggression and cybersecurity as well as impact of culture on urban safety and security.



Finnish Health Journalists’ Perceptions of Collaborating with Medical Professionals

Doctors are important collaborators with journalists specializing in health issues. A survey was conducted among Finnish health journalists about their views on doctor-journalist relationships, their opinions of source reliability and what sort of prejudices doctors and journalists might have of one another. In general the respondents had positive experiences of such collaboration. Most respondents identified more strongly with medical science than alternate therapies. Respondents considered scientific publications and research centers to be the most reliable information sources and considered online discussion forums and alternative therapy providers to be unreliable. Most common experiences of collaboration were positive or varying between individual doctors, although doctors’ busy schedules sometimes make collaboration challenging. According to the respondents, not all doctors recognize the need for clarification of difficult topics for laypeople instead of favoring accurate scientific language. Potential prejudices that respondents felt doctors might have towards their profession was a sensationalist approach and inaccurate reporting of facts. Our findings could benefit both doctors and journalists in terms of fruitful collaboration.
Ulla Ahlmén-Laiho, Sakari Suominen, Ulla Järvi, Risto Tuominen

Perceived Need to Cooperate in the Creation of Inter-organizational IT Governance for Social Welfare and Health Care IT Services – A Case Study

How to establish IT governance for social welfare and health care IT is an issue faced by organizations within this sector. Needs to establish inter-organizational IT governance arrangements have increased. They facilitate data sharing, pooling of development efforts and IT purchases, etc. This research investigates the creation of inter-organizational IT governance involving over 100 organizations. They provide specialized medical care, basic health care and/or social welfare services. Attention is placed especially on the role of perceived need to cooperate in the creation of IT governance. Empirical data range from notes, emails and project documents to survey data. Results achieved suggest that the perceived need to cooperate is necessary to the creation of inter-organizational IT governance arrangements. This finding augments the knowledge base of both IT governance research and best practice standards.
Tomi Dahlberg

Aggression Management Training at Schools

Behavioral problems, such as, aggressiveness and disregard for the rules are common in adolescence. Inappropriate behavior may disturb learning and disrupt the atmosphere in the school. Within the Satakunta Hospital District, a project was implemented to introduce the Aggression Replacement Training (ART) method in schools. In the schools involved in the project, staff members were instructed in this method and ART courses were arranged for students. The ART groups provided the participating students with training in anger control, social skills and moral reasoning. According to the feedback, the behavior of the participants improved and the students learnt how to control themselves better. The schools gained a calmer work environment. The results of this project indicate that it may be useful to further expand the use of the ART method at schools.
Kirsi-Maria Haapasalo-Pesu, Tiina Ilola

FirstAED Emergency Dispatch, Global Positioning of First Responders with Distinct Roles - A Solution to Reduce the Response Times and Ensuring Early Defibrillation in the Rural Area Langeland

FirstAED is a supplement to the existing emergency response systems. The aim is to shorten the first responder response times at emergency calls to below 5 minutes. FirstAED defines a way to dispatch the nearby three first responders and organize their roles in the hope of reducing response times, ensuring citizens safety and equal possibility to early defibrillation.
First aid is provided by first responders who use their smartphone (iPhone 4S/5). FirstAED Global Positioning System GPS-track the nine nearby first responders and enables the emergency dispatcher to send an organized team of three first responders with distinct roles to the scene.
During the first 21 months the FirstAED system was used 588 times. Three first responders arrived in 89 % of the cases, and they arrived before the ambulance in 95 % of the cases. FirstAED entailed a significant reduction in median response time to 4 minutes 9 seconds.
Finn Lund Henriksen, Per Schorling, Bruno Hansen, Henrik Schakow, Mogens Lytken Larsen

Tweeting about Diabetes and Diets – Content and Conversational Connections

The aim of this paper is to analyze 1) the semantic content of tweets discussing diabetes and diets, and 2) the conversational connections of those tweeting and those being mentioned in the tweets. The content analysis of the tweets aims at mapping what kinds of diets are mentioned in conversations about diabetes and in what context. Our data consists of 9,042 tweets containing the words “diabetes” and “diet”. The findings indicate that analyzing Twitter conversations can be an efficient way to map public opinions about diabetes and diets. The results also showed that many private persons act as diabetes advocates spreading information and news about diabetes and diets. Surveying these topics can be useful for healthcare practitioners; as these are in contact with patients with diabetes, it is important that they are aware of both the most discussed topics and the most common information sources, who are often laymen.
Kim Holmberg, Kristina Eriksson-Backa, Stefan Ek

Documentation of the Clinical Phase of the Cardiac Rehabilitation Process in a Finnish University Hospital District

Cardiac rehabilitation (CR) is an essential part of the treatment and recovery process of cardiac patients by which mortality can be reduced. CR is documented in the patient’s health records to ensure continuity of care. The aim of this study was to describe and evaluate the contents of the clinical phase documentation of CR according to the care notes of physical therapists and physiatrists. The data set used in this register-based study consisted of the electronic health records (EHR) of patients, with any type of cardiac problem admitted to a Finnish university hospital district between 2005 and 2009. The main findings indicate that 1) only a small part of the eligible patients’ records include CR documentation 2) the patients with CR documentation are relatively old when compared to the age distribution of all cardiac patients (p<0,001), 3) the documentation does not systematically follow the national guidelines, 4) the evaluation of treatment is rarely documented, and 5) the most commonly documented therapy concerned walking- and breathing exercises.
Lotta Kauhanen, Laura-Maria Murtola, Juho Heimonen, Tuija Leskinen, Kari Kalliokoski, Elina Raivo, Tapio Salakoski, Sanna Salanterä

Special Features of Counselling Work Carried Out through Interactive TV

Objectives: The purpose of this article is to introduce the special features of professional counselling carried out through interactive TV. Interactive TV is one application of welfare technology. New innovations are needed in social and health care, because the number of elderly people is increasing and their service needs must be catered.
Methods: The main approach of this study is qualitative. The material was analysed by means of qualitative content analysis. The article is based on a survey carried out at Turku University of Applied Sciences. The survey was responded to by some of the students involved in the VIRTU project’s transmissions (n=80). The survey consisted of a total of 25 questions. The article reports on four open-ended questions relating to the special features of counselling work.
Results: The special features of group counselling through interactive TV are particularly linked to the counsellor’s role. The counsellor acts in an environment that differs from a physical, social and symbolic perspective.
Conclusions, practice implications: We present a model detailing the special features of counselling carried out through interactive TV and how they must be observed when providing personnel in the field with training in this.
Sirppa Kinos, Sari Asteljoki, Pia Suvivuo

Evaluation of Intravenous Medication Errors with Infusion Pumps

This paper presents the key issues of the use of intravenous infusion pumps to be able to further develop strategies that will improve patient safety and prevent medication errors. The study was conducted in four wards in a Finnish tertiary hospital. These units included medical intensive care unit, surgical intensive care unit, general medical unit and general surgical ward. Multi-disciplinary team, nurses and pharmacists, performed observations (N=492) on the units. The results indicated that errors were rated as A – B in the NCC MERP harm index. Lack of patient identification bands on some units and inadequate allergy documentation appeared as risk factors. Furthermore medication processes varied within the units especially in administering and documenting. In spite of the Electronic Patient Record system, several overlapping documentation forms were in use. Through this prevalence study, violation errors of hospital policy were found that could potentially place patients at risk.
Eija Kivekäs, Kaisa Haatainen, Hannu Kokki, Kaija Saranto

Experiences on Telemedicine Solutions for Diabetes Care – Case eMedic Project

Diabetes is one of the most common diseases in the world. The optimisation of diabetes treatment would mean remarkable savings in health care budgets. eHealth technology can provide new tools to increase healthcare access, improve care delivery systems, and support individuals in engaging in the treatment of their disease as well as provide new solutions for health care professionals. The aim of this paper is to describe the usability of self-management technological solutions in the eMedic project. A qualitative explorative study approach was applied. During the eMedic pilots on self-management, the usability of the devices and applications was assessed by using the System Usability Scale (SUS) questionnaire. The eMedic project shows that eHealth solutions in self-management can have a successful role in healthcare, but focus and effort must be put on the usability of the applications and technical solutions.
Elina Kontio, Ursula Hyrkkänen, Teppo Saarenpää

Problem Limiting the Public Domain -Rawls’s Veil of Ignorance and Time

Information, ideas and new inventions are crucial parts of modern society. Accumulated knowledge is a huge possibility for mankind and information technology has especially made it possible to share resources with all mankind. Nevertheless, the current situation where strong intellectual property rights exists the public domain has been limited and thus the possibilities to use that knowledge is limited especially for people lacking adequate income or property. It seems that the current situation is not well justified because current intellectual property rights are against the two Principles of Justice presented by Rawls. In addition intellectual property rights are a source of inequity towards the people of the future and would not be implemented behind Veil of Ignorance which is the core way to define whether a society is just according to Rawls. This paper shows examples which emphasize the view that new legislation for intellectual property is needed.
Jani S. S. Koskinen, Kai K. Kimppa, Ville M. A. Kainu

Utilising Social Media for Intervening and Predicting Future Health in Societies

Background: The aims of this paper are to describe 1. systematic reviews describing the relation between social media and health and 2. previous research on utilising social media for predicting health on a population level. Method: A literature search utilising PubMed was performed in March 2014.
The inclusion criteria were that the article describes 1. the relation between social media and health or 2. the utilisation of social media in predicting health on a population level. Results: 11 systematic reviews and 4 articles were included in this review. The included articles were published between 2009–2014. There is a lack of knowledge about the relation and outcomes of social media and health. No systematic review on utilising social media to predict health on a population level was identified. Conclusions: Social media may carry crucial yet undiscovered means to predict and interfere in the health of populations. Future research, innovation and development in this area are highly recommended.
Camilla Laaksonen, Harri Jalonen, Jarkko Paavola

Practice-Oriented Safety Procedures in Work Environment with Visually and Hearing Impaired Colleagues

In work places where there are hearing and visually impaired col-leagues, there are safety related issues that are not present in work environment where there are only hearing and sighted employees. For example all the premises and safe routes within have to be precisely memorised by all employees in case there is an emergency during the work day. In an ordinary work place annual safety rehearsals and fire drills are enough to remind all workers about the safe routes and procedures in an emergency, but for the visually and hearing impaired employees this is not enough, but for the dual-sensory impaired employee it might prove difficult just to realise what room he/she is in at a particular moment. This procedure is made easier by so-called body mapping, i.e. drawing a simplified floor plan of the room on the back or on the back of the hand of the worker [1, pp.136-138]. The body map includes the exits, the emergency exit should there be any, and safe routes to the exits. Sometimes, tactile maps can be provided for the same purpose too [2]. Another issue related to fire alarms is that the hearing impaired workers might not be aware of the fire alarm sound. Thus the information must be relayed to the colleagues using other methods. Currently, there is a specialised touch-based social quick message system [3], which is used in some international deafblind meetings and conferences, and it is also taught to hotel staff in venues of Finnish Deafblind Association AGMs.
Riitta Lahtinen, Russ Palmer, Stina Ojala

Revitalizing the Quantitative Understanding of the Digital Divide: An Uptake on the Digital Divide Indicators

Recent advances in ICT research have uncovered several facts regarding the nature of the digital divide. Following the renewed dimensions of the term, the need for universally accepted digital divide indicators has significantly heightened across the academic and policy discourses. Traditionally, researchers have subscribed to the belief that the digital divide is a mere separation between “have” and “have nots”; however, as the digital technology continues to experience innovation in the information age, digital divide is increasingly being understood as a multidimensional phenomena. The research to date has mostly focused on the qualitative rather than the quantitative nature of the digital divide. The few existent accounts of quantitative studies on the digital divide are often criticized for deploying unreliable data in their analysis. Inaccurate predictions significantly derail policymakers’ abilities to form appropriate action plans in combating the digital divide. OECD and ITU have been hitting on front lines with their extensive research in ICT. This paper seeks to emphasize the quantitative understanding of the digital divide by reviewing the relevant literature and acknowledging the top indicators in the field. Apart from OECD and ITU, there is a general lack of research in determining the ICT indicators. Along with reviewing the relevant literature on latest ICT indicators, this study has documented twenty-nine significant ICT indicators and highlighted the need for future research into quantitative nature of the digital divide.
Farooq Mubarak

Information Management Efforts in Improving Patient Safety in Critical Care - A Review of the Literature

Patient safety is the responsibility of all professionals involved in the provision of health care services. The risk of harm is increased in the critical care setting due to complex care needs and frequent procedures. Information management is a contributing factor to a large number of incidents in the critical care setting. The aim of this study was to explore the current research of efforts in improving patient safety in the critical care environment. An integrative literature review was conducted and four databases (Cinahl, Pubmed, Scopus, and Web of Science) were searched. A total of 19 articles were included in the review. A theoretical framework of information management in decision-making in hospitals was used to guide the analysis. The results indicate that most research from a patient safety perspective focuses on means to improve information management on clinical level decision-making and that managerial information management remains vaguely explored.
Laura-Maria Murtola, Heljä Lundgrén-Laine, Sanna Salanterä

Information Categories Used to Create Situational Awareness in Emergency Medical Dispatch: A Scenario-Based Study

In emergency medical dispatch it is essential to find out what has happened and what to expect. When this information is collected and processed it creates situational awareness. Dispatchers should have knowledge of relevant, necessary, and missing data to be able to dispatch the right medical response units with right information. The aim of this study was to identify the information categories needed to create situational awareness in emergency medical dispatch. In emergency medical dispatch, the information role and information need are different, depending on the role of dispatch centre personnel. ERC operators use similar types of information, regardless of the incident, whereas for incident monitors the incident affects the use of, and the need for, information.
Teija Norri-Sederholm, Juhani Seppälä, Jouni Kurola, Kaija Saranto, Heikki Paakkonen

Serious Games and Active Healthy Ageing: A Pre-study

This article describes the results of a pre-study that was conducted in a project called Gamified Solutions in Healthcare. The Gamified Solutions in Healthcare project, funded by Tekes – the Finnish Funding Agency for Innovation, develops new services and effective activity solutions to elderly people through gamification. This research project combines the expertise of many different disciplines and is linked to company-driven projects that develop scalable international serious games solutions for healthcare utilisation. The pre-study consisted of mapping existing games for seniors, conducting a pre-test on console games and interviewing potential users of serious games. The purpose of this article is to report these results and to present a research agenda for future research.
Reetta Raitoharju, Mika Luimula, Aung Pyae, Paula Pitkäkangas, Jouni Smed

A Proxy-Based Security Solution for Web-Based Online eHealth Services

This paper presents an idea of using a proxy-based security solution to protect web-based eHealth applications from client-side attacks. In today’s Internet, eHealth services face many challenges related to information security as the users display and input sensitive information using web applications. This information may be spied on or modified by a malicious adversary. By obfuscating the executable code of a web application and by continuously dynamically changing obfuscation, our solution makes it more difficult for a piece of malware to attack its target. We believe it would effectively mitigate automated client-side attacks.
Sampsa Rauti, Heidi Parisod, Minna Aromaa, Sanna Salanterä, Sami Hyrynsalmi, Janne Lahtiranta, Jouni Smed, Ville Leppänen

Case Study: Using Assistive Technology to Cope with Unexpected Blindness

Some people are born with no vision, whereas some lose their vision later in life. It is important to understand the role of assistive technology in improving the quality of life of these people. Since people who lose vision later in life have altered & diminished perception of the environment around them, their attitude towards assistive technology can be different to those that have been blind since birth. This paper aims to understand perspectives of someone who lost his vision later in life. Using insights drawn from interviews and case study of one blind user, this paper discusses and explains his use of assistive technology to cope with unexpected blindness.
Results indicate that adopting new technology to overcome challenges is not easy. However, through willingness and proper direction, it can be accomplished. Results provide ideas that could improve social rehabilitation for people that have faced unexpected loss in vision.
Neeraj Sachdeva

Data Mining in Promoting Aviation Safety Management

Safety is a key strategic management concern for safety-critical industries and management needs new, more efficient tools and methods for more effective management routines. Effective methods are needed to identify and manage risks in both aviation and other safety-critical industries in order to improve safety. Analysing safety related records and learning from “touch and go” situations is one possible way of preventing hazardous conditions from occurring. The eventuality of an incident or an accident may markedly be reduced if the risks connected to it are efficiently diagnosed. With the aid of this outlook, flight safety has witnessed decades of successful improvement. This paper introduces aviation safety data analysis as an important application area for data mining. In this research text mining was utilised to study 1,240 flight safety reports testing three different systems, applying clustering to find similarities between reports, perhaps containing the indications of a lethal trend, without any presumption of their existence. All the different systems produced coherent results, proving that mining could extract information from unstructured data, which might not be possible with conventional methods.
Olli Sjöblom

Safe Community Designation as Quality Assurance in Local Security Planning

This study is written to encourage the Finnish municipalities to apply the Safe Community designation and to improve the implementation of national programmes on a local level. The existing sustainable safety work in Finnish communities was utilized for writing the guidelines. The infrastructure for fulfilling the requirements for Safe Community designation was appropriate in the Finnish municipalities because of the national programmes and the local safety plans. The third Internal Security Programme “A Safer tomorrow” (2012) and the fifth National Target and Action Programme for the Prevention of Home and Leisure injuries 2014−2020 both focus on how to solve the everyday problems of safety and security as well as prevention of injuries. The objectives and measures outlined in these programmes are encouraged to be taken into account in local security plans. The majority of Finns (95%) live in a municipality that has a local security plan. These plans include leadership in sustainable multi-sector safety collaboration, targets and measures that improve safety and reduce injuries of vulnerable groups, both genders at all ages in any environment. Local plans also include preparedness for disasters. Although the national safety and security planning infrastructure already exists in Finland, the benefit of the Safe Community designation is that the implementation of the measures are audited and controlled in the certification process. The national strategy and the local security and safety planning can be combined with the Safe Community designation requirements. Obtaining a designation as a Safe Community can be seen also as quality assurance of the safety management system in Finland.
Brita Somerkoski, Pirjo Lillsunde

Patients Using Open-Source Disease Control Software Developed by Other Patients

Healthcare information systems are traditionally developed within the R&D labs of medical instrumentation providers, software houses, technology consultancy firms, medical faculties and hospitals. Professionals with either medical or IT backgrounds are the perpetual analysts and developers of most health-care information systems on the market. However, we tackle an exceptional variance where patients are themselves creators of their own health-care information systems.
This user-innovation phenomenon was already addressed in academia but mostly by looking at the systems per se or their development. In this paper, we turn to the users by exploring the consumer behaviors of patients using such patient-innovated systems, i.e. we explore the consumer behaviors of patients using open-source disease control software developed by other patients.
In a Netnographic approach we screened the product pages and relevant Internet forums around three open-source projects providing disease control software: GNU Gluco Control, MySHI (My Self Health Information) and PumpDown-load. A rich set of qualitative data was collected from Internet sites and analyzed with the Grounded Theory method. We developed a theory that unveil two key motivations for the use of disease control software: the patients desire for a more active role in managing their diseases, and the patients annoyance with defective by design vendor lock-in mechanisms from the most common products.
Our contributions increase the understanding on the symbolism, meaning, and consumption patterns of this niche consumer group by screening publicly avail-able data on the Internet, with potential implications to the body of theoretical knowledge in healthcare information systems, chronic care management and practitioners within the industry of disease control.
Jose Teixeira

Local Pilots, Virtual Tools - Experiments of Health Promotive and Inclusive Services in Different Settings in the Western Uusimaa Region

In this paper we want to present five concepts for wellbeing related services and activities that have been piloted in the Western Uusimaa region as examples of ways of bringing health and wellbeing to different settings and different user groups. The pilots have been conducted for children in the kindergarten and secondary school, for adults in the health centre and for the unemployed in a variety of every day settings. We also want to present how local experiments can be put into wider use by virtual means and present the concept of the virtual wellbeing backpack family. The paper is based on work done in Laurea University of Applied Sciences (Laurea UAS) in a subproject of a cross regional project Pumppu funded by the European Regional Fund during 2011-2014.
Hanna Tuohimaa, Elina Rajalahti, Anne Makkonen, Liisa Ranta, Ulla Lemström, Aila Peippo

The Influence of Tourists’ Safety Perception during Vacation Destination-Decision Process: An Integration of Elaboration Likelihood Model and Theory of Planned Behavior

Safety has long been an important consideration in tourism industry due to the nature of intangible and experiential of tourism. Despite the fact that tourists’ destination decision-making has attracted lots of concentration, it is noteworthy that few of them touched the relationship between safety perception and destination decision in the perspective of influence process. In order to better understand the influence process of safety perception on travel destination decision-making is still scant, an integrated model based on the two well-tested model, elaboration likelihood model (ELM) and theory of planned behavior (TPB), is proposed in the paper. Cultural dimension of uncertainty avoidance, which related directly to safety issues, are extended to the model. Altogether seven hypotheses are given based on the conceptual framework. Conclusions on the contribution of this paper, and limitations and future research are also discussed.
Ping Wang

Patient Safety and Patient Privacy When Patient Reading Their Medical Records

When patients get access to their personal health information new security demands arise. This paper presents results from a study aiming to improve the understanding of how the patients’ different perceptions of their own personal health and health information preferences can be linked to anticipated positive and negative security concerns. The analysis and discussion focuses on investigating how the security issues and patients’ perception on the benefits and threats of accessing their medical records relate to each other. The results show that a more holistic systemic perspective to information security is needed to support the effective use of medical records in the healthcare in information and data driven society in order to improve both patient safety and patient privacy.
Rose-Mharie Åhlfeldt, Isto Huvala


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