Suchergebnisse

This book deals with approaches, sources, and methods in health history from the middle ages to the twentieth century. Individual chapters demonstrate how historians of medicine and health choose their methodological approaches and form interpretations from primary sources. They discuss the practices of writing and show how obstacles in the research process can be overcome. Practical examples of source materials, used methods and research challenges give tools to students for carrying out projects independently and help them to understand different possibilities in the field of health history. In this book, history of health includes but is not limited to medical science. Emphasising medical pluralism, it places (public) health in a cultural and social field encompassing official and unofficial practitioners, medical institutions, and patients. Individual case studies highlight themes in Finnish, European, and African history.

Euroopan komissio luotiin jotta se voisi ajaa yhteisöjen intressiä. Sen vuoksi siitä päätettiin tehdä itsenäinen. Mutta koska Euroopan Unionin vaikutus jäsenmaissaan on hyvin vahvaa, myös talouden kannalta, haluavat jäsenmaat vaikuttaa komissioon mahdollisimman paljon. Tämän vuoksi komission itsenäisyys vaarantuu. Perustamissopimukset koettavat hoitaa ongelman luomalla komissiolle joita-kin suojamekanismeja. Mutta ovatko ne riittäviä? Vaikuttaa siltä, että komissioon pystytään vaikuttamaan liikaa sen jokapäiväisessä työssä. Tämä vaikuttaminen alkaa jo komission nimittämisvaiheessa ja jatkuu koko ajan komission pohtiessa uuden lainsäädännön tarvetta ja komission valmistellessa uutta lainsäädäntöä. Komission lakiehdotelman sisältöön vaikuttavat usein paljonkin muut instituutiot, jäsenvaltiot sekä intressiryhmät. Tämä johtaa siihen, että komissio ei täysin pysty toteuttamaan yhteisöjen in-tressiä. Monin eri tavoin komission päätöksiin voivat vaikuttaa yksittäisten tai use-ampien jäsenmaiden edut, vaikka tarkoitus olisi ajaa yhteisöjen etua. The European Commission was created so that it could work to fulfil the Community Interest. Therefore it was decided to be an independent institution. But because the European Union affects its Member States very deeply, not least in budgetary ways, the Member States seem to want to influence the Commission as much as possible. Therefore the independence of the Commission is at stake. The Treaties try to deal with the problem by setting some protective mecha-nisms on the Commission. But is it enough? It seems that the Commission gets in-fluenced too much in its everyday work. This influencing starts already at the nomi-nation of the Commissioners, continues all the while when the Commission is decid-ing if new Community legislation is needed and while it drafts new legislation. The substance of the drafts are often influenced very much by the other institutions, Member States and interest groups. What this means is that the Commission can't fulfil its task at seeking the best of the Communities. In many different ways the decisions of the Commission may further the good of one or some interested parties instead of the Community In-terest.

The book focuses on intangible and tangible heritage, language and vernacular religion of the Ingrians, Setos and Votes, three Finnic ethnic minorities sharing a long-standing identification with the Russian Orthodox faith. Written by 16 authors, the chapters are mainly based on nineteenth- and twentieth-century materials. The research history and collecting of folklore are also discussed.The historical area of the Ingrians and Votes is located in Ingria, adjacent to St. Petersburg, while the Setos have inhabited both sides of the border of southern Estonia and Russia. All three groups live on the borderline of the Eastern and Western Churches and cultural realms.Currently, the Ingrian and Votic languages are extremely endangered, while the Seto language has approximately 12,000 speakers. There is a high local interest in the maintenance and revitalisation of all three languages and cultural traditions.

This book approaches contemporary migration to Finland from the perspective of everyday security, presenting an alternative view to theories that examine the links between migration and security from the perspective of securitisation. By treating everyday security as a theoretical concept and as empirical lived reality, the book foregrounds migrants' experiences of (in)security, as well as the perceptions of individuals and groups whose lives are touched by migration. Empirical studies investigate the ways in which security is produced at various levels, transnationally, and in multiple locations where encounters between long-term residents and newcomers occur, highlighting the roles of the welfare state, civic society, and the media. The book explores how everyday security is constructed between interdependent actors on personal, community and societal levels, concluding that the production of everyday security is a mutually beneficial, yet at times painstaking, process for all participants.

Pro gradu ­tutkielma koostuu seuraavista osista: Rouvinen, Kaisa. Lisääntymisterveydenhuollon haasteet ja naisten hyvinvointi vähiten kehittyneissä maissa. Tampereen yliopisto. Terveystieteen laitos. Kirjallisuuskatsaus. Osasuoritus Pro gradu ­tutkielmaan. 26 s. 2003 Rouvinen, Kaisa. Quality of care in reproductive health services at health posts in Nepal. International EuroQuan Conference on Quality and Nursing Practice. Proceedings. Norsk sykepleieforbund. 1997; 224-231. Rouvinen, Kaisa. Quality of care in reproductive health services at five government health posts in Siraha District, Eastern Nepal. A dissertation submitted to the University of Liverpool (School of Tropical Medicine) in partial fulfilment of the degree of Master in Community Health. 95 pages. 1996 ; 1. JOHDANTO 6 2. LISÄÄNTYMISTERVEYS KEHITYKSEN INDIKAATTORINA 7 3. NAISEN ELÄMÄN TÄRKEÄT JA KRIITTISET VAIHEET 10 3.1. RASKAUS JA SYNNYTYS - TURVALLISEN ÄITIYDEN TAVOITE 10 3.2. PERHESUUNNITTELU JA ABORTTI 15 3.3. HIV JA MUUT SUKUPUOLITAUDIT 17 3.4. LAPSETTOMUUS JA LAPSEN SUKUPUOLI 19 3.5. SUKUPUOLIELINTEN TRADITIONAALINEN SILPOMINEN 20 3.6. KÖYHYYDEN, TRADITIOIDEN JA OLOSUHTEIDEN MERKITYS 22 4. HAASTEET JA MAHDOLLISUUDET 23 LÄHTEET 26 QUALITY OF CARE IN REPRODUCTIVE HEALTH SERVICES AT FIVE GOVERNMENT HEALTH POSTS IN SIRAHA DISTRICT, EASTERN NEPAL ACKNOWLEDGEMENTS 1 TABLE OF CONTENTS III LIST OF TABLES VI LIST OF FIGURES VII LIST OF ABBREVATIONS AND ACRONYMS VIII GLOSSARY IX EXECUTIVE SUMMARY X CHAPTER 1. INTRODUCTION 1 1.1. THE CLIENT AND THE CONCERN 1 1.1.1. Save the Children US in Nepal 1 1.1.2. Save the Children Siraha project 1 1.1.3. Problem statement 2 1.2. THE STUDY 2 1.2.1. Study question 2 1.2.2. Aim and objectives of the study 2 1.2.1. Action plan and accomplishment of the study 3 1.3. STUDY LOCATION 4 1.3.1. Nepal 4 1.3.2. Siraha District 4 CHAPTER 2. LITERATURE REVIEW 6 2.1. GLOBAL VIEWS OF WOMEN'S HEALTH 6 2.2. PRIMARY HEALTH CARE IN NEPAL 8 2.2.1. Safe Motherhood and Family Planning 8 2.3. QUALITY IN HEALTH CARE 10 2.3.1. What is quality? 10 2.3.2. Approaches to assessment of quality in health care 10 2.4. SELECTED ISSUES IN QUALITY OF HEALTH CARE 14 2.4.1. The structure of the health care and its relevance in quality assessment 14 2.4.2. Health care providers' job motivation and its impact on quality of health care 15 2.4.3. User satisfaction 16 2.5. CONCLUSION 17 CHAPTER 3. METHODOLOGY 19 3.1. EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 20 3.1.1. Study location 20 3.1.2. Selection of health posts 20 3.1.3. Issues and variables used to explore the objective 20 3.1.4. Tools and strategies of data collection 20 3.2. EXPLORING HEALTH CARE PROVIDERS' PERCEPTIONS ABOUT THE QUALITY OF CARE 21 3.2.1. Study population 21 3.2.2. Selection of informants 21 3.2.3. Issues and variables used to explore the objective 21 3.2.4. Tools and strategies of data collection 21 3.3. DESCRIBING THE LEVEL OF USERS' SATISFACTION 22 3.3.1. Study population 22 3.3.2. Selection of informants 22 3.3.3. Issues and variables used to explore the objective 22 3.3.4. Tools and strategies of data collection 23 3.4 ADDITIONAL DATA COLLECTION METHODS 24 3.5. PRE-TESTING AND TRANSLATION 24 3.6. DATA HANDLING AND STORAGE 25 3.7. DATA ANALYSIS 25 3.8. QUALITY ASSURANCE AND ENCOUNTERED CONSTRAINTS IN DATA COLLECTION 25 CHAPTER 4. RESULTS 27 4.1. EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 27 4.1.1. Location and accessibility 27 4.1.2. Target population and service statistics 27 4.1.3. Sub-health posts, outreach clinics and staffing 28 4.2.4. Waiting facilities at health posts 28 4.1.5. Rooms for counselling and MCH and FP services 28 4.1.6. Infection prevention 29 4.1.7. Equipment and instruments for use in MCH and FP 29 4.1.8. Availability of contraceptives and essential medicines 29 4.1.9. IEC material and activities 29 4.1.10. Record keeping and reporting 30 4.1.11. Health post management and supervision 30 4.1.12. Conclusion 30 4.2. HEALTH CARE PROVIDERS' PERCEPTION ABOUT THE QUALITY OF CARE 31 4.2.1. Job satisfaction and experience as a health care provider 31 4.2.2. Health workers' perception of what is good quality in health care 32 4.2.3. Health workers' perception about users' expectations 33 4.2.4. Health workers' suggestions for improvement of health care 33 4.2.5. What are the specific reasons for low utilisation of FP and AN services 34 4.2.6. Conclusion 35 4.3. QUALITY OF CARE FROM THE USERS' POINT OF VIEW 35 4.3.1. The sample 35 4.3.2. Perceptions of the quality of care 37 4.3.3. Suggestions for improvement for the quality of care at a health post 40 4.3.4. Conclusion 40 4.4. SUMMARY OF RESULTS 41 CHAPTER 5. DISCUSSION 43 5.1. IMPACTS OF STRUCTURE OF HEALTH CARE ON QUALITY OF THE SERVICE 43 5.1.1. Accessibility 43 5.1.2. Clinical settings and procedures 44 5.1.3. Service arrangements 44 5.2. HEALTH WORKERS' ROLE 47 5.2.1. Users' expectations contradicting providers' perceptions 47 5.2.2. Implications of health workers' perceptions for improvement of quality 48 5.2.3. Job motivation 48 5.2.4. Quality assurance cycle 50 5.3. CONCLUSIONS 50 5.4. COMMENTS ON METHODS USED IN THE STUDY 51 CHAPTER 6. RECOMMENDATIONS 53 REFERENCES 54 APPENDICES APPENDIX 1 PHOTPGRAPHS: WALL PAINTINGS AND TBA TRAINING 58 APPENDIX 2 MAPS OF NEPAL AND SIRAHA DISTRICT 59 APPENDIX 3 INVENTORY FORM FOR HEALTH POST FACILITIES 60 APPENDIX 4. BACKGROUND VARIABLES 70 APPENDIX 5.A STRUCTURED QUESTIONNAIRE FOR USER EXIT INTERVIEW 71 APPENDIX 5.B MAITHALI TRANSLATION OF THE QUESTIONNAIRE 75 APPENDIX 6 EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 79 APPENDIX 7. FINDINGS FROM HEALTH PERSONNEL IN-DEPTH INTERVIEWS 84 APPENDIX 8. USERS' EXPRESSIONS OF THE QUALITY OF CARE. QUOTATIONS. 85

The volume is a comprehensive handbook of oral history and memory studies in Finland. The Finnish research field has originally emerged at the collaborative intersection of history, folklore studies, and ethnology. Since then, this field has developed into vibrant multi- and cross-disciplinary arena characterized by a strong focus on methodological issues related to memory in culture and theoretical engagement with studies on narration and processes of remembering. The chapters of the book explore the perspectives on the production of memory-based knowledge in oral history interviews and collection campaigns of written reminiscences. Moreover, the book introduces versatile methodological approaches to the study of memory and memories, ranging from narrative to corpus analysis, and investigates the multiple media of remembrance from documentary film to museum exhibition. The chapters of the book also engage the field's disciplinary position and interrogate the potentials and challenges related to the application of the methods of oral history research and the use of memory-based knowledge beyond academia in political, societal, and community-based projects.

The great change in European relations with Russia took place in 1478 when Muscovy replaced the trading Republic of Novgorod as a neighbor of Sweden, Livonia and Lithuania. Western Europe was since that year bordering to a bellicose great power with large resources causing dread. The feelings of dread caused by Russia with Czars like Ivan the Terrible became a standing theme in printed matter as well as politics and the image of Russia became very much similar to the image of Turkey, which threatened Europe from South-East. Various, usually rather negative, stereotype expressions characterized the vocabulary of the 16th century.
The Peace of Stolbova in 1617 started a period of successive change. The era of Sweden as a Great Power led to growing knowledge about Russia in almost every respect, but it was still based on the already accepted stereotypes. They started, however, typically to seem more diluted and thin with time. The image of Russia as a threat was to a growing extent replaced by an image of a possibility. The perhaps most remarkable but rather unoriginal printed Swedish description of Russia of the era was Regni Muschovotici Sciographia, published by Petrus Petrejus.
At the final stage of Sweden's era as a great power there was a substantial widening but also polarization of the information on Russia. The Russian reform process during Tsar Peter I also began to influence the minds after the turn of the century in 1700. One of the principal describers of this process was Lars Johan Malm (Ehrenmalm), whose large manuscript about the power of the Russian Empire of that time, Några Anmärkningar Angående det Ryska Rijkets Nuvarande Macht from 1714, never reached the printers due to intervention from censors.

The ten articles in this edited volume examine the city of Varkaus as a small city struggling with structural change using historical documents as well as survey and interview data. The city of Varkaus, which has a long industrial history, has lost a large part of its industrial jobs in the first decades of this millennium and its population has fallen sharply in recent years. However, a survey of the adult population shows that the inhabitants of Varkaus are typically satisfied with their work, with their social relationships and their lives in general. Varkaus is seen as a safe and good living environment. A central element of well-being is couple relationship, as well as other social relationships. The lack of well-being often stems from unemployment, low income and feelings of not belonging to the place of residence. Young adults value their place of residence as well as their family relationships, but there are tensions in their life regarding work and income. The tranquility and proximity to nature of Varkaus are appreciated, but there are also many who long for more urban heartbeat in their hometown. - Tässä kymmenestä artikkelista koostuvassa kokoomateoksessa tarkastellaan Varkautta rakennemuutoksen kanssa kamppailevana pienenä kaupunkina historiallisia dokumentteja sekä vuosina 2016–2017 kerättyjä kysely- ja haastatteluaineistoa hyödyntäen. Pitkän teollisuushistorian omaava Varkauden kaupunki on tämän vuosituhannen ensimmäisinä vuosikymmeninä menettänyt suuren osan teollisista työpaikoistaan ja sen väestö on supistunut voimakkaasti. Kuitenkin koko aikuisväestöä edustava kysely kertoo, että varkautelaiset ovat tyypillisesti tyytyväisiä työhönsä, sosiaalisiin suhteisiinsa ja elämäänsä muutenkin. Varkaus nähdään turvallisena ja hyvän elämän puitteet tarjoavana asuinpaikkana. Hyvinvoinnin tärkeitä osatekijöitä ovat parisuhde ja muut sosiaaliset suhteet. Hyvinvoinnin puutteet liittyvät työttömyyteen, pienituloisuuteen sekä ulkopuolisuuden tunteisiin suhteessa asuinpaikkaan. Nuoret aikuiset arvostavat omaa asuinpaikkakuntaansa sekä perhe- ja sukulaisuussuhteitaan, mutta arkielämään liittyy jännitteitä työn ja toimeentulon osalta. Varkauden rauhallisuutta ja luonnonläheisyyttä arvostetaan, mutta monet toivoivat siltä myös enemmän kaupunkimaista sykettä.

Preliminary Material /Asbjørn Eide , Jakob Th. Möller and Ineta Ziemele -- The Right to Peace Milestones in the Development of International Humanitarian Law /Daniel Thürer -- Post-War American International Law Scepticism: The International Criminal Court, Stockholm 1924 /Mark Weston Janis -- Peace as a Human Right: The Jus Cogens Prohibition of Aggression /Alfred de Zayas -- The Human Right to Peace /William A. Schabas -- Security and Human Rights in the Regulation of Private Military Companies: The Role of the Home State /Francesco Francioni -- The United Nations and Human Rights What Makes Democracy Good? /Lyal S. Sunga -- Is the United Nations Human Rights Council Living Up to the International Community's Expectations? /Markus G. Schmidt -- The UN Human Rights Council: The Perennial Struggle between Realism and Idealism /Bertrand G. Ramcharan -- Eight UN Petitions Procedures: A Comparative Analysis /Jakob Th. Möller -- The Legal Status of Views Adopted by the Human Rights Committee – From Genesis to Adoption of General Comment No. 33 /Geir Ulfstein -- Winter Break 2010: A Week in the Life of a Special Rapporteur /Martin Scheinin -- Legal and Judicial Shortcomings of the Surrogate State of "UNMIKISTAN" /Margrét Heinreksdóttir -- The Right to Inclusive Education for Children with Disabilities – Innovations in the CRPD /Arnardóttir Arnardóttir -- Human Rights at the Regional Level The Council of Europe: A Champion in Monitoring Implementation of Human Rights Standards? /Petter F. Wille -- Flexibilising the Modes of Amending the European Convention on Human Rights: An Idea for a 'Statute' for the European Court /Krzysztof Drzewicki -- Strengthening of the Principle of Subsidiarity of the European Convention on Human Rights /Björg Thorarensen -- Presumption of Convention Compliance /Davíð Þór Björgvinsson -- The Right to Adequate Judicial Reasoning /Ragnar Aðalsteinsson -- Dialogue Between States and International Human Rights Monitoring Organs – Especially the European Commission Against Racism and Intolerance /Lauri Hannikainen -- How Old Are You? Age Discrimination and EU Law /Allan Rosas -- NHRIs in the European Union: Status Quo Vadis? /Morten Kjærum and Jonas Grimheden -- Selected Examples of the Contemporary Practice of the Inter-American System in Confronting Grave Violations of Human Rights: United States and Colombia /Diego Rodríguez-Pinzón -- Indigenous Peoples and Minorities Prevention of Discrimination, Protection of Minorities, and the Rights of Indigenous Peoples: Challenges and Choices /Asbjørn Eide -- Minority Protection in the African System of Human Rights /Michelo Hansungule -- Indigenous Peoples on the International Scene: A Personal Reminiscence /Lee Swepston -- Indigenous Peoples and the Right to Development /Rainer Hofmann and Juri Alistair Gauthier -- Principal Problems Regarding Indigenous Land Rights and Recent Endeavours to Resolve Them /Erica-Irene A. Daes -- Traditional Knowledge of Indigenous Peoples: Preserve or Protect? – That's the Question! /Mpazi Sinjela -- Redefining Sovereignty and Self-Determination through a Declaration of Sovereignty: The Inuit Way of Defining the Parameters for Future Arctic Governance /Timo Koivurova.

"The dependency on social security: Social bums in disengaged society? In Finland, most discussion on the welfare state's condition has focused on stabilizing the public-sector's finances. However, more essential for the future of the welfare state is its' social foundation, meaning people's experiences of fairness, equality and reliability of the society as well as the welfare state's capability of taking care of the most vulnerable groups of people.

A functional welfare state combines economic stability with the social foundation. However in the mid 2010s there are cracks in the social foundation of the welfare state .

In this book the cracks of welfare state's social foundation are analysed from the perspective of dependency on social security. Especially the Finns' attitudes and political divisions, policies, the length of customership of last-resort social security, the functionality of service and income transfer systems, social segmentation created by breadlines and coping on the last-resort social security are observed.

The book is meant for all interested in the condition and future of the welfare state. It is suitable as a textbook in universities and universities of applied sciences.

The editor of the book, Juho Saari, is Professor in social and health policy at the University of Tampere and part-time Professor in welfare sociology at the University of Eastern Finland. He has also a docent at the University of Helsinki, at the University of Turku and at the University of Jyväskylä. " - "Suurin osa hyvinvointivaltion tilasta käydystä yhteiskuntapoliittisesta keskustelusta on kohdentunut julkisen talouden vakauttamiseen. Kuitenkin keskeisempää hyvinvointivaltion tulevaisuudelle on sen sosiaalinen perusta, eli ihmisten kokemukset yhteiskunnan reiluudesta, tasa-arvoisuudesta ja luotettavuudesta sekä hyvinvointivaltion kyky kantaa vastuu kaikkein haavoittuvimmassa asemassa olevista ryhmistä. Toimiva hyvinvointivaltio sovittaa yhteen taloudellisen kestävyyden ja sosiaalisen perustan. Kuitenkin 2010-luvun puolivälin hyvinvointivaltion sosiaalisessa perustassa on halkeamia.

Tässä teoksessa analysoidaan hyvinvointivaltion sosiaalisen perustan halkeamia ja murroksia sosiaaliturvariippuvuuden näkökulmasta. Erityisesti tarkastelemme siihen liittyviä suomalaisten asenteita ja poliittisia jakolinjoja, politiikkalinjauksia, viimesijaisen turvan asiakkuuksien kestoa, palvelu- ja tulonsiirtojärjestelmien toimivuutta, leipäjonojen luomia yhteiskunnallisia jakolinjoja ja ihmisten selviytymistä viimesijaisella turvalla.

Teos on tarkoitettu kaikille hyvinvointivaltion tilasta ja tulevaisuudesta kiinnostuneille. Se soveltuu oppikirjaksi yliopistoihin ja ammattikorkeakouluihin.

Teoksen toimittaja Juho Saari on Tampereen yliopiston sosiaali- ja terveyspolitiikan professori ja Itä-Suomen yliopiston hyvinvointisosiologian osa-aikainen professori sekä Helsingin, Turun ja Jyväskylän yliopistojen dosentti.
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Tutkimuksessa tarkastellaan erästä Euroopan integraation vähemmän tutkittua ulottuvuutta: integraation vaikutuksia jälkikommunistisen yhteiskunnan kansalaisjärjestöihin. Liettualainen ympäristöjärjestösektori ja Ignalinan ydinvoimalan tapaus tarjoavat rajallisen, mutta samalla hyvin konkreettisen näkökulman kysymyksen tarkastelemiseksi. Tutkimus nojaa vuosina 2001-2003 kerätyn haastatteluaineiston laadulliseen analyysiin. Ignalinan ydinvoimalan tapauksen perusteella voidaan tulkita liettualaisten ympäristöjärjestöjen kohtaamia muutospaineita neuvostoajan lopulta aina Liettuan EU-jäsenyyteen saakka. Ignalinan ydinvoimalan ympärille keskittynyt liikehdintä oli yksi keskeisimmistä neuvostovallan vastaisen protestin välineistä 1980-luvun lopun Liettuassa. Ignalinan ydinvoimalasta muodostui tuolloin neuvostovallan poliittinen symboli; protestointi ydinvoimalaa vastaan oli samalla vastalause Moskovan sanelupolitiikalle ja vallitsevalle yhteiskunnalliselle järjestykselle. Ignalinan poliittinen symboliasema kuitenkin muuttui radikaalisti Liettuan itsenäisyysjulistuksen myötä: voimalasta muodostui niin taloudellisesti kuin poliittisestikin tärkeä kansallisen suvereniteetin osa. 1990-luvun lopulla ydinvoimalan poliittisen symboliaseman muutos sai yhä vahvemman ilmentymän EU:n esittäessä Ignalinan molempien reaktoreiden alasajoa ennen niiden lasketun käyttöiän umpeutumista. Eräät liettualaiset ympäristöjärjestöt toimivat aktiivisesti osana laajempia eurooppalaisia kansalaisjärjestöverkostoja vaatien itäisen Keski-Euroopan neuvostomallisten ydinvoimaloiden välitöntä sulkemista. Siten Ignalinan tapaus aiheuttaa monissa tapauksissa järjestöidentiteetin epävarmuutta: Yhtäältä ympäristöjärjestöidentiteetti vaatii kriittistä suhtautumista ydinvoimaan, erityisesti neuvostomallisiin RBMK-reaktoreihin. Toisaalta taas Ignalinan ydinvoimala koetaan Liettuan taloudellisen ja poliittisen omavaraisuuden takaajaksi. Ignalinan tapauksen ympärille rakentuva identiteettipoliittinen asetelma voidaan yksinkertaistaa tilanteeksi, jossa ympäristöjärjestöt hapuilevat kahden yhteensopimattoman toimintamallin välillä: järjestöt toivovat voivansa toteuttaa rooliaan ympäristöjärjestöinä, usein laajempien eurooppalaisten ympäristöjärjestöverkostojen mallin mukaisesti, mutta samalla kansallisen suvereniteettipolitiikan tuottamat mallit ovat vahvasti läsnä järjestöjen määrittäessä perusluonnettaan. Ignalinan tapauksen pohjalta tutkimuksessa tarkastellaan myös laajempia Euroopan integraatioon ja jälkikommunistiseen kansalaisjärjestötoimintaan liittyviä kehityskulkuja. Tutkimus tuo esiin, että Euroopan integraatio on luonut monitasoisen institutionaalisen järjestyksen, joka määrittää oman vaikutuspiirinsä säännöt. Euroopan integraatio on samalla ilmiö, joka toteutuu myös hyvin arkipäiväisissä asioissa ­ se on läsnä monissa mikrotason käytännöissä vaikuttaen siis myös ympäristöjärjestöjen toimintaan. Samalla voidaan havaita, että politiikan muodot ja tyylit eivät synny tyhjiössä tai pelkästään rationaalisten valintojen tuloksena; historia, sen tuottamat tulkinnat sekä rutiineihin perustuvat säännönmukaisuudet ovat läsnä poliittisessa elämässä, niin kansalaisjärjestötoiminnassa kuin muussakin yhteiskunnallisessa aktivismissa, samoin kuin hallinnollisissa käytännöissä. ; The colourful, sometimes even dramatic, history of Lithuanian environmental non-governmental organisations (NGOs) makes them an interesting subject of political science research. During the past fifteen years the role of the Lithuanian environmental movement has changed quite radically. The environmental movement had a central political role at the time of the Lithuanian independence activism in the late 1980s, but the movement later lost its mobilising potential and was marginalised by the beginning of the 1990s. Since then the environmental NGOs have been strongly affected by the process of European integration. Environmental NGOs have served both as agents and indicators of the institutional change taking place in Lithuania. The dynamics of this change can be analysed through the case of Ignalina ­ in the course of the past couple of decades the nuclear power plant of Ignalina in the north-east corner of Lithuania has been a reference point for a number of political discussions and processes. During the Lithuanian independence movement the nuclear power plant became a symbol of Soviet rule. As Ignalina was strongly associated with the hegemony of Moscow over Lithuania the plant occupied a central role in the fight towards national sovereignty. Independence activism took the form of environmental protests, especially in the early stages of the Lithuanian reform movement, and a large number of environmental organisations were established all over Lithuania. The political context provided an opportunity to address sensitive political questions through environmental activism. For instance, in September 1988 thousands of protesters formed a human chain ­ the ring of life ­ around the two units of Ignalina as a manifestation of Lithuanian national sovereignty and identity. The symbolic position of Ignalina changed radically after Lithuania s independence declaration in March 1990. As Moscow imposed an energy embargo on Lithuania it soon became clear that the country was dependent on its own sources of energy, of which the nuclear power plant of Ignalina was the most important one. Although Ignalina had only recently served as the symbol of Soviet oppression, the plant suddenly proved indispensable in the reconstruction of the nation and its material well-being. In 1995 the Lithuanian government tabled a EU membership application. Towards the end of the decade Ignalina was brought on the political agenda of the EU ­ it soon became evident to Lithuanians that the closure of the nuclear power plant would be considered a de facto prerequisite for EU membership. As a result, the question of Ignalina was highly politicised ­ the setting gave Ignalina a positions as the symbol of national sovereignty. There had been a radical shift in the political symbolism surrounding the plant. Meanwhile, the environmental NGOs faced a dilemma: Some of the environmental activists were closely linked to European anti-nuclear NGO networks and were strongly in favour of the decommissioning of Ignalina. However, many of the environmental NGOs also carried with them a long tradition of ethno-cultural thinking thus connecting the organisations closely to the notion of Lithuanian national sovereignty. Against this background it proved difficult for many organisations to define their role in view with the question of Ignalina ­ what would be appropriate political action? As a result, there remained a great deal of indecisiveness and confusion among the environmental NGOs as to the decommissioning plans of Ignalina, and more generally as to the role of the environmental organisations in the Lithuanian society. The case of Ignalina provides a framework within which it is possible to analyse certain dimensions of national sovereignty in an integrating, post-Cold War Europe. The integration of Central and Eastern Europe into the EU has produced a situation in which many of the expectations attached to national sovereignty are being challenged. The research also brings forward a topic that has received only limited attention in the past, namely the effects of European integration on non-governmental organisations in Central and Eastern Europe. By focusing on a specific sector of Lithuanian NGO activity it is possible to analyse the dynamics of europeanisation on a very concrete level. The case of Ignalina suggests that the activists of Lithuanian environmental NGOs are forced to ponder the raison d être of their organisations in the face of different, often conflicting institutional pressures. The expectations drawn from fresh national sovereignty are not always compatible with the models of action produced by the European integration process. The case evidences a conflict between post-Communist nation-building and the institutional limitations brought about by EU membership. Simply put, the idea of national sovereignty on the one hand and European integration on the other offer environmental NGOs distinctive, often conflicting, models of appropriate political action. The models of action created by the institutional framework of the EU are not easily compatible with the norms typical of a newly independent state. This identity political conflict is especially pronounced whenever national and European norms are placed in direct opposition with each other. However, it should be noted that the national and European levels of politics cannot be completely distinguished from each other. It is interesting to notice how models of action drawn from the EU system often form the very basis of national or local political action. Therefore it can be stated that the separation between European and national models of appropriate action is not always feasible. It is possible to approach most political questions, including the encounter of Lithuanian environmental NGOs and the EU, from an institutional perspective. The theoretical framework of the study is based on new institutionalism , and the notion of logic of appropriateness is central to the study ­ political institutions are analysed as collections of norms that define the rules of appropriate political action in different situations. In essence, politics is about appropriate action. The research seeks to explain the logic of appropriateness being followed by Lithuanian environmental NGOs. The research problem is approached through a set of questions: (1) How does the colourful history of the Lithuanian environmental movement affect the political characteristics of today s environmental NGOs? (2) What does the specific case of Ignalina tell us about the institutional contexts in which the Lithuanian environmental NGOs operate? (3) How to define the relationship between Lithuanian environmental NGOs and the politics of national sovereignty? (4) What is the relevance of the institutional framework of the EU to Lithuanian environmental NGOs? The study suggests that the rules of appropriateness change depending on the political context. At the same time, the conflicts produced by differing, overlapping institutional environments are reflected in the inner dynamics of political actors, resulting to indecisiveness and confusion. Since political action is first and foremost directed by the logic of appropriateness, the interpretations of political contexts are of central relevance. Therefore it is possible that a single object, such as a nuclear power plant, can be given a variety of interpretations in the realm of identity politics. The case of Ignalina evidences that symbolism and interpretation form the core of political life.

"This research-based edited volume offers a clear, multifaceted and practical overview of the Finnish health and social care sector trends in the 2020s. The health and social care reform is again current as new ways of organising the sector are being developed on the foundation of the reform that fell through in spring 2019.

The book introduces the Finnish health and social care services reform from three perspectives. The first part of the book looks at the sector from a macro perspective, that is, from the perspective of the service system reform. The articles deal with a historical overview of previous reforms, integration, and research on effectiveness and cost-effectiveness. The second part focuses on the organisational level issues such as reform of management and know-how and the challenges digitalisation poses for the health and social services. The third part of the book centres on the perspective of the people who implement the changes. The themes of the articles include care workers' multi-actor collaboration, person-centred case management and client involvement.

The book is based on research done at the University of Eastern Finland as well as Finnish and international research literature. The authors represent various disciplines: health and social management, social work, social psychology and other social sciences and law. The book is aimed at managers and professionals, experts, decision makers, researchers and teachers in the field of health and social care. It is also suitable as a textbook for management studies at the university level." - "Tämä tutkimukseen perustuva kokoomateos tarjoaa selkeän, monipuolisen ja käytännönläheisen yleiskatsauksen siitä, mihin suuntaan suomalainen sosiaali- ja terveysala on kehittymässä 2020-luvulla. Sosiaali- ja terveydenhuollon uudistus on jälleen hyvin ajankohtainen, kun keväällä 2019 kariutuneen uudistuksen perustalle ollaan rakentamassa uudenlaisia hyvinvointialueita tai sote-maakuntia ja monialaisia sosiaali- ja terveyskeskuksia.

Kirjassa avataan monipuolisesti maamme sosiaali- ja terveyspalvelujen uudistumista kolmesta eri näkökulmasta. Teoksen ensimmäisessä osassa tarkastellaan sosiaali- ja terveysalaa makrotason eli palvelujärjestelmän uudistumisen näkökulmasta. Artikkelien aiheina ovat historiallinen katsaus aiempiin uudistuksiin, integraatio sekä vaikuttavuuden ja kustannusvaikuttavuuden tutkimus. Toinen osa kohdistuu organisaatiotason kysymyksiin, kuten johtamisen ja osaamisen uudistumiseen sekä sosiaali- ja terveysalan digitalisaation haasteisiin. Kirjan kolmas osa keskittyy sosiaali- ja terveysalan muutoksiin niitä toteuttavien ihmisten näkökulmasta. Artikkeleiden teemoina ovat sote-työntekijöiden monitoimijainen yhteistyö, asiakaslähtöinen palveluohjaus sekä asiakasosallisuus.

Kirja pohjautuu Itä-Suomen yliopistossa tehtyihin tutkimuksiin sekä kotimaiseen ja kansainväliseen tutkimuskirjallisuuteen. Kirjoittajat edustavat monia eri tieteenaloja: sosiaali- ja terveysjohtamista, sosiaalityötä, sosiaalipsykologiaa ja muita yhteiskuntatieteitä sekä oikeustieteitä. Kirja on suunnattu sosiaali- ja terveysalan johtajille ja ammattilaisille, asiantuntijoille, päätöksentekijöille, tutkijoille ja opettajille. Se soveltuu myös oppikirjaksi yliopistojen ja ammattikorkeakoulujen johtamisopintoihin."

In this book [titled Home, welfare work and vulnerability] the authors take the reader on welfare workers' home visits to clients in need of support in their living. Welfare workers refer to professionals in health and social care who in the book are represented among others by social workers, social care workers and nurses. The main concepts of the book are home, welfare work and vulnerability and these are contemplated from different angles. Welfare work entails encountering people who are in vulnerable situations in the midst of their everyday lives. They may need support in coping with their mental health, with physical illnesses, with the challenges of achieving sobriety and recovery or perhaps with the difficulties accompanying old age. On the one hand their ability to act is limited and weak but on the other they have many kinds of strengths and resources.

The book addresses a significant turning point in welfare services and work at which the objective is defined as the right of every individual to their own home and making living at home feasible for as long as possible. In the last fifty years or so many societal factors have made possible the dismantling of institutions, the reduction of places and the shortening of stays in institutions, the further development of care in the community, the construction of small residential and care facilities and most recently the further development of services to be taken into people's homes. The last stage of this dismantling of institutions is referred to in the book as the "home turn". As a societal change the home turn is complex – and that is how it is approached in the book. When one's own home is the main place in which welfare policy and work are implemented, it is important to scrutinize more closely what actually occurs there and what special issues are connected to this given context.

The book offers a timely point of view on the development of welfare services and the grass-root level welfare work done in the homes. It draws on interaction research based on ethnomethodology and human geography. Research data consist of recordings of home visits, researcher's field diaries and interviews with clients and workers. The work includes both chapters providing conceptual and theoretical overviews and empirical research on the encounters between client and worker(s) on home visits. Welfare work accomplished in people's homes entails many tensions and ethical issues which are analysed in the book and made visible through the means of research.

Abstract The research examines the U.S. approach to the independence of the Philippines and its stages at the end of the 1920's and in the early 1930's. The Philippines belonged to the United States from 1898 to 1946. The relationship between the two countries was quite controversial from the very beginning. Many of the different phases and factors resulted in the U.S. Congress passing a law in March 1934, which guaranteed full independence to the Philippines after a ten-year transition period. The birth of the law which led to Philippine independence was a complex political process, with a number of variables influencing the attitudes and the solution. These factors accounting for the formation of the solution changed as time progressed. One of the key variables in terms of the Act of Independence began when the Great Depression began in 1929, which affected especially agricultural producers. As the Philippines was administratively a part of the federal government, in these circles it was seen that only independence could be the solution to close the archipelago outside of the domestic market. In fact, the sugar and coconut imports from the Philippines were not a real competitor to the federal farmers. In addition to the domestic farmers the Cuban sugar producers, who were headed by U.S. investors, felt that Philippine duty-free import was challenging their share of the federal market. They were of the opinion that the independence of the Philippines could guarantee them better market positions in the federal sugar market, and strove to promote the Independence Act as soon as possible. As a result of the worsening unemployment situation Filipino migrant workers started competing for scarce jobs. As a part of the United States Filipinos had free immigration rights. In particular, on the west coast and in the employees' organizations, independence was seen as the easiest way to limit immigration. In addition to the economic cycle other significant factors were the changes in foreign policy, and in particular the rise of Japan as a powerful superpower in the Far East. The federal government and the majority of the Congress represented opposing views of the independence issue. The Congress was able to show strength in this confrontation. The main sources of the material consist of the U.S. government documents, the Congress document collections, foreign relations document collections, memoirs and other documents. ; Tiivistelmä Tutkimuksessa tarkastellaan Yhdysvaltain suhtautumista Filippiinien itsenäistymiseen ja siihen liittyneisiin vaiheisiin 1920 -luvun lopulla ja 1930-luvun alkupuoliskolla. Filippiinit kuuluivat Yhdysvalloille vuosina 1898–1946. Maiden välinen suhde oli hyvin kiistanalainen alusta alkaen. Monien eri vaiheiden ja tekijöiden seurauksena Yhdysvaltain kongressi hyväksyi maaliskuussa 1934 lain, joka takasi Filippiineille täyden itsenäisyyden kymmenen vuoden siirtymäajan jälkeen. Filippiinien itsenäistymiseen johtaneen lain synty oli monimutkainen poliittinen prosessi, jossa oli useita suhtautumiseen ja ratkaisuun vaikuttaneita muuttujia. Näiden tekijöiden osuus ratkaisun muodostumiseen muuttui ajan edetessä. Yksi keskeisimmistä muuttujista itsenäisyyslain suhteen oli vuonna 1929 Yhdysvalloissa alkanut suuri lamakausi, josta kärsivät erityisesti maataloustuottajat. Koska Filippiinit oli hallinnollisesti osa liittovaltiota, näissä piireissä nähtiin, että ainoastaan itsenäisyys voisi saattaa saariston sisämarkkinoiden ulkopuolelle. Filippiineiltä tuotava sokeri ja kookosöljy eivät olleet todelliset kilpailijat liittovaltion viljelijöille. Kotimaan viljelijäväestön lisäksi Kuuban sokerintuotantoon investoineet amerikkalaiset sijoittajapiirit kokivat Filippiinien tullivapaan tuonnin vievän heiltä markkinoita. He katsoivat, että Filippiinien itsenäisyys takaisi paremmat markkina-asemat liittovaltion sokerimarkkinoilla ja pyrkivät edistämään itsenäisyyslain mahdollisimman pikaista säätämistä. Alati pahenevan työttömyyden seurauksen filippiiniläiset siirtotyöläiset kilpailivat hupenevista työpaikoista. Filippiiniläisille oli taattu vapaa maahanmuutto-oikeus. Etenkin länsirannikolla ja työntekijäjärjestöissä saarten itsenäistyminen nähtiin olevan helpoin tie maahanmuuton rajoittamiseen. Taloudellisten suhdanteiden ohella muita merkittäviä tekijöitä olivat muutokset ulkopolitiikassa ja etenkin Japanin nousu voimakkaaksi suurvallaksi Kaukoidässä. Liittovaltion hallinto ja kongressin enemmistö edustivat vastakkaisia näkemyssuuntia itsenäisyyskysymyksessä. Kongressi pystyi osoittamaan voimansa tässä vastakkainasettelussa. Tutkimuksen keskeisin lähdeaineisto koostuu Yhdysvaltain hallinnon asiakirjoista, kongressin asiakirjakokoelmista, ulkoaisainhallinnon asiakirjakokoelmista, muistelmista sekä lähdeteoksista.

Aikuiskoulutus Suomessa jaetaan ammatilliseen aikuiskoulutukseen ja vapaaseen sivistystyöhön. Tämä tutkimus kohdistuu vapaaseen sivistystyöhön ja vapaan sivistystyön oppilaitoksiin: liikunnan koulutuskeskuksiin, opintokeskuksiin, kesäyliopistoihin, kansanopistoihin ja kansalaisopistoihin. Tutkimuksessa tarkastellaan vapaan sivistystyön oppilaitosten tehtäväkuvan muutosta osana systeemistä järjestelmää. Oppilaitosten toimintaympäristön muutoksiin sopeutumista tarkastellaan erityisesti resurssiriippuvuuden ja alueellisuuden näkökulmista. Tutkimuksen tulokset kootaan yhteen muodostaen vapaan sivistystyön tulkintahorisontiksi toiminnan sisällöllistä muutosta kuvaava resurssiriippuvuusjana. Tutkimus on tekstintulkinnallishermeneuttinen. Tutkimuksen aineisto muodostuu alan tutkimuskirjallisuudesta, vapaan sivistystyön arviointi- ja kehittämisprosessien raporteista sekä vapaan sivistystyön oppilaitosten vuosina 2012 ja 2013 uudistettujen ylläpitämislupien hakemuksista. Viime vuosina laskenut valtionapu on vapaalle sivistystyölle kriittinen resurssi. Myös lainsäädäntöpohja, valtionapuperusteet ja valtionhallinnon ohjaus- ja toimintakäytännöt ovat muuttuneet ja vaikuttaneet vapaan sivistystyön oppilaitosten yleisiin toimintaedellytyksiin. Resursseja oppilaitokset ovat 1990-luvulta lähtien enenevässä määrin hankkineet myös monilta muilta koulutustoiminnan sektoreilta ja suoraan markkinoilta. Omaehtoisen persoonallisen kasvun tukeminen on ollut vapaan sivistystyön ydinsisältö. Ydinsisältö on muuntunut 1900-luvun aikana enemmän institutionalisoituneeksi koulutukseksi osana koulutusjärjestelmää, tai yleissivistävien harrasteopintojen tukemiseksi institutionalisoituneissa toimintapuitteissa. Vapaan sivistystyön oppilaitosten toiminnan sisältö on jatkuvasti sopeutunut sekä resursseiltaan että alueellisesti yhteiskunnan tarpeisiin. Toiminnan sisältömuutokset ovat olleet luonteeltaan inkrementaalisia ja tehtäväkuvaa koko ajan laventavia. Pitkällä kaarella ja isossa kuvassa tarkasteltuna vapaan sivistystyön oppilaitosten toiminta on aina ollut pääosin sisällöltään konservatiivista ja sopeutuvaa, eikä toiminnan kehysnormistoon koko kaaren aikana ole liittynyt leimallisesi yhteistä transformatiivista tehtävää. Oppilaitosten identiteetti nousee paikallisesta, maakunnallisesta tai valtakunnallisesta toimintatarpeesta. Toiminnan sisältöä perustellaan alueellisella koulutuksen saavutettavuuden tasa-arvolla ja tuotettujen koulutuspalveluiden tarvelähtöisyydellä. Paikallista identiteettiä korostetaan muutospaineessa, eikä aikaisempaa ylipaikallisempaa identiteettiä ole kovin laajasti omaksuttu. Uuden vuosituhannen puolella toimintaa ohjaavan opetus- ja kulttuuriministeriön toimesta on painotettu rakenteellista ja sisällöllistä muutostarvetta, hyötyä sekä erityisryhmien koulutusta. Jatkuva, 1990-luvulla alkanut, yhteiskunnallinen muutospaine on vaikuttanut ja vaikuttaa vapaan sivistystyön oppilaitosten toimintaympäristöön, mutta muutokseen reagointi on oppilaitosmuodoittaan ja oppilaitoskohtaisesti ollut hyvin erilaista. Oman roolin epäselvyys jatkuvassa toiminnan sisällön muutospaineessa niin resurssien, rakenteen kuin toimintaympäristönkin osalta aiheuttaa oppilaitoksille epävarmuutta oman ydintehtävän sisällöstä. Toisaalta pitkäaikainen systeeminen luottamuspääoma toimintaa ohjaavaan ministeriöön ja eduskuntaan on mahdollistanut hitaan, vaiheittaisen, ja paikallista muutosjoustavuutta hyödyntäneen muutoksen. Koulutussektorin valtiollinen toimintapolitiikkaohjaus (policy) on 2000-luvulla merkittävästi lisääntynyt erilaisten kehittämisohjelmien myötä. Myös kehittämishankkeista on tullut osalle oppilaitoksista resurssienhankinnan arkea. Vapaan sivistystyön oppilaitosten rooli osana oppivaa aluetta on käytettävissä olevan partnerin rooli ja ilmenee leimallisesti omaa koulutus- ja sivistystehtävää ja sen erityisyyttä korostamalla. Oppilaitokset ovat vahvasti identifioituneet tuottamaan alueellisia ja paikallisia koulutuspalveluja. Samalla kohderyhmäajattelu on noussut aikaisempaa keskeisemmäksi osaksi tehtäväkuvaa. Toiminnan suurin yhteinen nimittäjä näyttää olevan vahva tukeutuminen alueyhteisöihin ja niiden konkreettisiin tarpeisiin. ; In Finland there are two different forms of Adult education: vocational adult edu-cation and liberal adult education. In this adult educational research, the focus is in liberal adult education. There are five types of institutions of liberal adult educa- tion: adult education centres, folk high schools, summer universities, sports insti-tutes and study centres. The aim of the research was to increase the understanding of the changes in the missions of liberal adult education institutions. The institu-tions of liberal adult education can be viewed as a system. This study tries to un-derstand the change in the functional environment of liberal adult education insti-tutions observed particularily from the point of view of resource-dependence theory. The point of view is regional. This research is textual analyse utilizing the hermeneutical method. In conclusion, the main purpose is to explain the change of identity of the organizations of liberal adult education by the resoursedependense chain. There are three types of empirical materials in this study. Firstly, the research literature, secondly the reports of evaluation and developing processes of liberal adult education and thirdly the appointments of liberal adult education organizations permissions to support learning institution in years 2012 and 2013. The state covers approximately half of the expenses of liberal adult education institutions. State grants are a critical resource for liberal adult education institutions. The state of grants for liberal adult education organizations has been declining in last years. The ground for legislative regulation and state grants has changed. Also, the states control has changed to be more generalized. The marketorientation of organizations has increased. There has been bigger and bigger pressure to get more and more resources for the other sectors of education and markets. The support of self-motivated individual growth has been the core content of liberal adult education. During the 20th century liberal adult education has become more and more institutionalized. Also, the quantity of hobby-oriented courses in institutionalized frames has increased. The functions of liberal adult education establishments have continuously been adapting to fit both the needs of the local community, and the resources available. The changes in the content of the activities have been incremental and the goals of activities have spread. In the big picture, the actions of liberal adult education organizations have been adaptive and conservative. The action has never been labelled transformative. In the 21st century, the need for changes in structure and amount of organizations has increased. Also, there are needs to change the content of the activities. The state needs more explanations to the benefits of the activity, also the state requires focus to be put on special groups. The liberal adult education organizations can be seen as an actor of state granted service and education system. The 21st century is labelled by new thinking of the welfare state and the change in the role of the state. Governanlity is now a bigger part in the states' role in the activities. Government policing has increased significantly with the development of different advancement programs in the 21st century. Liberal adult education institutions are not a part of the regional development. They are only partners in "learning regions". Their orientation is mostly in educational practices. The identity of the organizations is that of a service provider. The identity is based on local, provincial or nationwide basic. All liberal adult education organizations are linked in many ways to their own environment. The benefit of the action is justified by the equal access for all and the need for educational services. The main common attribute is regionalism and the practical needs of the local community.