Käyttäytymistieteellinen tiedekunta


Recent Submissions

  • Pesonen, Henri (Helsingin yliopisto, 2016)
    Sense of belonging has been defined as the degree to which an individual feels included, accepted, and supported by others in a variety of social settings, for example, a school context. Previous research on sense of belonging has mainly focused on students with special needs in inclusive schools. There appears to be a shortage of research on sense of belonging in different school placements (general and special) and in post-school life for individuals with intensive special education needs. The purpose of this thesis, which consists of three related, internationally published peer-reviewed articles (Studies I-III), was to examine to what extent sense of belonging can be supported in school and in post-school life for students with intensive special education needs in Finland. Particular focus was placed on the voices of those students in order to understand how best to create a positive school climate that supports sense of belonging for all. Teacher perceptions of the implemented three-tiered support model (Finland' s Basic Education Act 642/2010) and school visit data were utilized to contextualize the students conceptions and experiences. Study I examined conceptions associated with sense of belonging in general and special school placements for middle-school students with intensive special education needs (N = 5). Phenomenographic methods of analysis were utilized in Study I. In Study II, which was based on the narratives of two females (ages 26 and 29) with Autism Spectrum Disorder (ASD), the focus was on sense of belonging and various life transition issues that may appear in childhood, adolescence, and adulthood in the absence of appropriate social supports. Qualitative narrative approaches were used in Study II to analyze interview and document data in order to create life transition stories. Study III examined the implementation of new, special education legislation in Finland (Basic Education Act 642/2010) among students with intensive special education needs. The material for Study III consisted of (1) survey data on teacher perceptions (N = 526) of the implementation of the education legislation and the current organization of special education services, and (2) observations of the implementation of the legislation in schools (N = 12) across Finland. The analysis of the survey data in Study III was based on sequential mixed-methods design. The school observation data were analyzed qualitatively. In Study I, the qualitative phenomenographic analyses of interview transcripts revealed various conceptions regarding the students sense of belonging in different school placements (general and special). The students had undergone numerous placements in which their sense of belonging had been jeopardized, as disturbing relationships with teachers and peers seemed to have affected the students mental and physical well-being, resulting in disturbing behaviors in their earlier educational settings. Despite the various placements, the students felt better in their current, special, school, which had a positive climate. The results of Study II demonstrated that lack of social support increases the number of school placements and transitions and causes biases in forming a sense of belonging. The findings further suggested that providing social assistance and positive life experiences during emerging adulthood (ages 18-25) seems to matter most in forming a strong sense of belonging in life. Furthermore, the findings of both Studies I and II suggested that, for individuals with intensive special education needs, adapting one s behavior in order to feel a sense of belonging (Juvonen, 2006) might be associated with hiding the unique characteristics of a person s special needs. Study III found that teachers values and beliefs seem to influence the organization of special education (e.g., affecting the overall school climate). Furthermore, some schools and teachers implemented the law s integration requirement by placing all students with intensive special needs in separate units or school buildings, whereas other schools placed students in general education. The findings suggest that students with intensive special education needs can feel a sense of belonging primarily in schools in which adults work in multidisciplinary collaboration, which helps to create an accepting and supportive school climate. In the post-school phase, it appeared that positive experiences during emerging adulthood (between the ages of 18 and 25) seem to matter most in generating a strong sense of belonging to a community. Hence, individuals with intensive special needs would benefit from ongoing support from the time they first enter school with continuation through the post-school transition phase and into adulthood. Also, the results hypothetically imply that the school principal plays a significant role in creating a school climate that supports a sense of belonging for all students. The results of this thesis also shed light on several limitations that prevent generalizations from being made. Therefore, further study is unquestionably needed. This thesis has provided an initial exploration into the under-researched area of sense of belonging in different school placements and in post-school life for students with intensive special education needs. Keywords: sense of belonging, intensive special education needs, school placement, transition, teachers values and beliefs, school climate
  • Kangas, Jonna (Helsingin yliopisto, 2016)
    Children's participation in early childhood education has raised concern and discussion in the international researches lately. Young children have been considered to have lack of participation experiences in early education settings because of institutional policies, social understanding about childhood and perspectives of educators (Bae, 2009; Emilson and Folkesson, 2006; Smith, 2002). Focus of children as active agents of their own development through sociocultural learning paradigm the approach of participatory learning has been considered important in early childhood education and research (Berthelsen, Brownlee and Johansson, 2009). This approach of children's learning views participation as a developing and dynamic cultural phenomenon. This research is focusing on the educators' perspectives and the conceptions of children's participation in everyday pedagogic practices and is based on a survey conducted in early childhood education in Metropolitan area of Helsinki in 2010. The survey was realized in the VKK-Metro development and research project funded by the Ministry of Social and Health affairs. The participants represented 1114 working teams from 350 kindergartens. The working teams included 3721 educators taking care of 19 907 children. The analytical framework of research is based on an abductive approach conducted with mixed methods. The findings indicate that children's voice was considered important by educators. Also opportunities to make independent initiatives and choices were considered as a right and an item of learning and of developing of skills of participation. However children's chances to participate in decision making process and pedagogical processes were weak because of challenges of children's participation experienced by educators. These challenges were connected to both institutional issues, such as routines and adult-child-ratios, and professional skills and beliefs about children's competence. According to findings of this research children's participation is understood to include such aspects as having opportunities to have an influence in their learning and the culture of kindergartens, becoming respected and listened to by educators and having chances to practice responsibility and self-regulation. The role of educators as facilitators of children's participation is found essential and the research builds knowledge of children's participation through framework of participatory pedagogy in early education context. Through this framework the challenges of children's participation could be reflected and a culture of developing participation built in co-operation between educators, children and political and social environment of early childhood education.
  • Siirilä, Jani (Helsingin yliopisto, 2016)
    In 2004, the United Nations announced the Decade of Education for Sustainable Development 2005-2014. One of the objectives was to include sustainable development at all national education levels via the curricula. In Finland goals of the decade implement RCE (Regional Centre of Expertise) network. The study explored how the concept of sustainable development was constructed in the national education system through the curricula. Altogether 26 representatives were selected from the RCE Espoo network. The study explored how the representatives understood the integrated concept of sustainable development, including its ecological, economic and social dimensions. The representatives were interviewed, and the data were analyzed using concept maps. The construction of the concept of sustainable development was broad and multidimensional in nature. It focused on several dimensions of sustainable development: the ecological dimension of the sustainable use of natural resources, the economic dimension of a sustainable economy based on limited planetary resources, and the social dimension of a welfare society. Constructing the concept of sustainable development was compared to society s commitment to sustainable development as expressed by the Finnish National Commission on Sustainable Development. The construction of the concept of sustainable development by the representatives was mainly alike to commitment to sustainable development but the emphasis of the goals A carbon-neutral society and Sustainable local communities were low. The latter goal included the aspect of climate change and adapting to it. The reform in the Finnish curricula predicts social change, one in which the meaning of developmental sustainability and a sustainable way of life will become stronger. The national education system should take society s commitment to sustainable development into account. The shared goals at all educational levels are 1) to have accomplished citizens who understand the meaning of sustainable development in their lives, and 2) to achieve a sustainable society and future.
  • Janhonen, Kristiina (Helsingin yliopisto, 2016)
    This dissertation examines food education from the perspectives of adolescents participation and agency. The study builds on a social constructivist understanding of learning and draws methodological inspiration from child-hood sociology. The empirical part of the study is based on two data-sets: Nordic survey data (N=1539) collected in 2006−2007 and data from a qualitative case study (2012−2013), which focused on 9th grade students in one Finnish school (14−17 years). The dissertation is compiled from four original publications. Articles I and II examine Nordic adolescents school lunch patterns and their considerations of meal choices in the family context. Articles III and IV examine adolescents school lunch practices as an educational resource and the challenges of school-based participatory research with young people. The results drawn from the comparative Nordic data-set function as a broader background, against which the results from the qualitative case study are discussed in this summary. The study is based on an interdisciplinary and multimethod research design, and has combined qualitative and quantitative data in an interpretive integration (i.e., a combination of qualitative and quantitative results at the stage of theoretical interpretation). The overall aim of the dissertation is to explore how adolescents views on their food practices could be more thoroughly used as an educational resource and how their participation and agency could be better supported in food education. This dissertation concludes that future work on adolescents participation and agency in food education would benefit from enhancing intergenerational dialogue and from approaching food-related learning as dynamic processes that reach beyond formal schooling.
  • Leiviskä, Anniina (Helsingin yliopisto, 2016)
    The confrontation between modern and postmodern philosophical approaches is one of the most prominent and protracted academic debates of recent decades. In the philosophy of education, this debate has been ongoing since the 1980s and it continues to reverberate in contemporary discussions. One of the major themes of the debate is the endeavour of the modern philosophy of education to establish a universally valid rational foundation for educational theory and practice. This attempt has become a central target of criticism of the postmodern philosophies of education, which emphasize the contextual and situated nature of rationality and knowledge. As for the postmodern educational approaches, they have often been accused of giving rise to problematic forms of relativism. Rather than yielding fruitful solutions, the debate has largely resulted in an undesirable polarization between the modern and postmodern standpoints. This thesis seeks to take part in the discussion concerning the modernism-postmodernism debate from the viewpoint of Hans-Georg Gadamer's (1900-2002) philosophical hermeneutics. The thesis consists of three interrelated studies that examine the relation of Gadamer,s hermeneutics to some of the prominent representatives of modernism (Jürgen Habermas) and postmodernism (John Caputo and Richard Rorty) from different perspectives. The common aim of these studies is to demonstrate that Gadamer's philosophy is able to avoid some of the central philosophical problems and limitations associated with the aforementioned approaches and therefore it might also contribute to the movement beyond the unproductive modernism-postmodernism dichotomy in the philosophy of education. The studies particularly focus on the Gadamerian concepts of dialogical rationality and the truth of the subject matter (die Sache selbst), which represent an attempt to redefine the modernist notions of rationality and truth from a historically situated and postfoundationalist perspective. It is suggested in the thesis that through these concepts, Gadamer's hermeneutics can provide education with orienting ideals and principles for the philosophical critique of educational practices without jeopardizing the hermeneutical awareness of the historicity and contextuality of knowledge. Accordingly, on the basis of these concepts, Gadamer's philosophy circumvents both the foundationalist tendencies of the modern philosophies of education and the problems associated with such postmodern educational approaches that refrain from providing a justification for educational practices. Consequently, the study argues that Gadamer's hermeneutics offers a more defensible warrant for educational theory and practice than that provided by the modern and postmodern philosophies of education discussed in the thesis. Keywords: Gadamer, philosophical hermeneutics, the philosophy of education, modernism, postmodernism
  • Kosunen, Sonja (Helsingin yliopisto, 2016)
    This dissertation is positioned in the fields of sociology of education, urban sociology and family studies. The focus of the study is on schools and families lower-secondary school choices in 2010s urban Finland. The study consists of four academic articles and an introductory part, in which the results of the four original articles are presented and discussed in relation to each other. The first sub-study (I) is a literature review, in which the application and transmission of concepts in school choice research in five European countries is examined. The three empirical sub-studies (II−IV) concentrate on how the reputations and prestige of schools and their general and selective classes in the case city of Espoo are constructed in the parental discourse, what sorts of lower-secondary school choices the families conduct in relation to those hierarchies of symbolic prestige, and which factors seem to be interrelated to the success in the competition over certain study positions. The analysis concentrates on the differences in reputation between general and selective classes across and within schools, the constructed urban spaces of school choice, and families choices. The ways in which the educational trajectories of the pupils diversify and differentiate in basic education were analysed. The data consists of 96 semi-structured thematic interviews with parents of 6th graders. The interviews were conducted during the spring of 2011 in the research project Parents and School Choice. Family Strategies, Segregation and School Policies in Chilean and Finnish Basic Schooling (PASC). The data includes parents from all school catchment areas. The interviews were analysed by applying theory-informed qualitative content analysis. The theoretical framework leans strongly on Pierre Bourdieu s theory and conceptualisations of distinction. The analysis focuses on how the conducted school choices relate to families possession of different forms and combinations of cultural, social and economic capital and how these processes relate to the symbolically differentiated space of school choice. The study deals with who chooses, what is chosen, and especially with how and why. The parental discourse on school choice has been contrasted with the noted worry concerning the increase in urban segregation in the metropolitan area, the social and academic school differentiation, and the general condition of the Finnish comprehensive school. The space of school choice in the city of Espoo was divided into two separate spaces of school choice in the parental discourse: the local space of school choice and the selective space of school choice. The central divide was the pupil selection conducted by some of the schools to their selective classes. The local space of school choice consisted of general classes in schools within the catchment area. In some of the local spaces the symbolic hierarchy of the general classes was non-existent, but in some local areas the general classes across schools had a strict hierarchy. The general class in the bottom of the hierarchy was considered to be a study environment to avoid. The most common way of aiming to avoid the school allocation to those aversive classes was to apply for classes with a special emphasis. These classes comprised the selective space of school choice, which covered the whole city area and did not follow any catchment area borders. The transition from the local space to the selective space of school choice required different forms and amounts of cultural, social and economic capital from the family, and was not thereby equally accessible as an option to all families. In addition, the most desirable choices for the parents in their discourse were not the classes with elite reputations with high selectivity and presumably demanding teaching. The most desirable classes were often considered to be good enough in terms of teaching and learning, and somewhat selective, as long as desirable amounts of social and ethnic diversity existed. Contentment with school was emphasised in the discourse around the most desirable classes. The elite classes were avoided due to their expectedly high levels of unnecessary competition between pupils. The analysis on the school choices of upper-class families showed how the mobilisable amounts of different forms and combinations of capital strongly impacted the process of school choice. Optimising the school choice of the child in the competition over study positions was interconnected with social capital, as well as with the mechanisms of transforming and transmitting cultural and economic capital from one form to another and from one field to the next. The most successful with the highest numbers of realistic choices were those possessing the most amounts of capital. The role of social capital was emphasised. The success of the upper-class child in the competition seemed to derive from the habitus, and via their shared lifestyles success in the school choice seemed natural among them. The social differentiation produced by the practices of selection of pupils were noticed in the parental discourse, and the choice was legitimised by referring to meritocratic selection procedures and talented and motivated children. The cultural capital derived from the field of culture, such as skills in music or sports, turned out to be relevant trump cards in the competition over study-positions in selective classes within publicly funded compulsory education in Finland. The central features in the optimizing of the choice were the families capacities to evaluate their own position in the social space in relation to other families in the field as well as to the symbolic hierarchy of the schools. This combination is named as the social space of school choice. The limitations to parental action are urban limitations, caused by the urban structure of the city, as well as the borders of educational governance (e.g. catchment areas). The central notion is that the differentiation of school choices across families (how the families are able and willing to conduct school choices) are related to their possessed amounts of capital also in Finland. Interestingly, these processes of pupil selection seem to guide pupils from different social backgrounds seemingly naturally to different educational trajectories already within comprehensive education.
  • Niemi, Anna-Maija (Helsingin yliopisto, 2015)
    The study focuses on special needs education after basic education, particularly in the context of pre-vocational and vocational education and training. It analyses the positions of young people and the formation of their educational paths and choice-making. The starting point of the study is to consider the definitions given to the concepts of special and special educational needs . I ask, 1) how are special educational needs and students positions defined in pre-vocational and vocational education and training; 2) how are young people s educational paths, choices and subjectivities constructed in the practices of special needs education; and 3) how do different pedagogical practices restrict or enable participation in learning and studies of students regarded as having special educational needs? The study is positioned in the fields of sociology of education, disability studies, youth studies and gender studies. It includes five articles and a summary chapter. Methodologically, the study is multi-sited ethnographic research, contextualised in current education policy. The research data derives from two institutes of vocational education and training, while observing Metalwork and Machinery classes and Preparatory Training classes for disabled students over a six-month period. The data consist of interviews, field notes and education policy documents. In addition, the data also include life-historical interviews with 27 young adults as part of the Equality is Priority research project. My analytical approach is ethnographic and discursive. The practices of vocational education were found to be balanced between an inclusive education discourse and an individual, medical orientation that focuses on the identification of (special) needs. Visible both in the everyday life of vocational education and in education policy documents were, on the one hand, support for inclusive education, and on the other, a tendency to seek assurance from special needs statements and diagnoses. Many of the young people and professionals interviewed in the study interpreted the segregated arrangements of special needs education and the definition of special needs itself as stigmatizing. Combining the support needed by each student with general teaching was suggested as a pedagogic practice to combat stigmatization. Structural factors associated with the education system such as study field-specific entrance requirements, educational content, pedagogical practices and available support in each field influence how students regarded as having special educational needs are admitted and become attached to vocational education. For many young people applying and being accepted into upper secondary education seems to be complex and challenging. When addressing their own educational hopes and negotiating the options offered in study counselling, many did so in various roundabout ways. I propose that educational choices be seen as processes where young people shape their subjectivities and create spaces for their agency while negotiating the guidance offered by professional adults. The study suggests that in order to develop education in line with the objectives of an inclusive education policy, stereotypical definitions and meanings of special needs and disability should be constantly re-considered and questioned.
  • Kivikangas, J Matias (Helsingin yliopisto, 2015)
    Arguably, the emotions elicited by playing are the reason why people play digital games. Social interaction is an important source of emotion during game play, but research on it is rather sparse. In this dissertation I briefly review the emotion-theoretic literature in order to better understand what emotion means in the context of games, and how this should be taken into account when measuring emotions related to a game experience. Study I presents a review of the use of psychophysiological methods in game research. I show that the theoretical background behind these methods generally tends to be neglected. This could be remedied by a theoretical framework that integrates the understanding of emotions and explicitly describes the links between different emotion measures and the theoretical concepts they are professed to reflect. I present my proposition for the first step towards such a framework in Study II. I employ the sociality characteristics framework by de Kort and IJsselsteijn (2008) and my interpretation of the social factors in order to study the effect of the central social context factors on the emotional game experience. Study III presents evidence that in addition to tonic physiological levels, the relationship between the participants also affects the momentary, phasic responses to the key game events victory and defeat. In particular, although physiological signals can, to a certain extent, be used to assess emotional experiences (such as positive responses to a victory), in some cases the typical psychophysiological mappings may even be completely opposite. Interpreting these signals requires a broader theoretical understanding than what is typically acknowledged. Study IV supports the earlier findings that competition is experienced more positively than cooperation but that the effect is dependent on gender, as this was found only in males. For females, there was no difference between the two modes, and no difference in negative activation. In addition, self-reports concerning social presence suggested that this concept is not always associated with higher positive emotions, while a form of friendly rivalry (associated with lower social presence) might be experienced positively a finding apparently new in existing literature. Finally, Study V provides insight into the practical significance of the measurements with a predictive validity study, showing practical effects how the certain kinds of game experiences may lead to greater game use and preference, but that these links are not as simple as previously suggested. In sum, this work offers new knowledge on how social context factors are generally related to the game experience, on how emotions can be studied in game research and what theoretical considerations should be taken into account, and on the emotional effects of particular social context factors during play. The results are mainly useful for further basic game research, but they have also potential implications for general emotion research, the game industry, and in the long run, society at large.
  • Käyhkö, Leena (Helsingin yliopisto, 2015)
    New learning environments have opened the boundaries of schools by connecting them with different societal agencies outside schools. In European and national education policies and systematic curriculum contents, entrepreneurship education has been given increasingly significant attention, and entrepreneurship has become a social context or environment of learning. In entrepreneurship education research, only few studies have been conducted in the educational sciences. Researchers have pointed out the need for holistic educational science to act as a complement for business and a non-axiological ´neutral´ emphasis in approaching entrepreneurship and its theory. The present study focuses on entrepreneurship education as a boundary zone between school and society where traditional pedagogical practice is reconsidered as a question of learning theory. The study draws from cultural-historical activity theory and its theories about learning. As they have largely been focused on the classroom teaching and teaching methods, analyses of pedagogical practice have lacked the societal bond and historicity of the relationship between education and societal practice. To investigate the theoretical foundations of the relationship between school and society, the study addresses two theoretical orientations: John Dewey s philosophy of school and Engeström s theory of expansive learning. Based on their critiques of the theory of education the study contains a case study on entrepreneurship education. The case study was used as a window for context exploration, and it underlines the challenge of educational and learning theory. The case study material has been collected from the entrepreneurship education course of a high school specializing in entrepreneurship. The material contains both the ethnographic course implementation and interviews, documentary material and an intervention. The data analysis aimed to determine the internal dynamics, mechanisms and contradictions in the relationship between school and society in learning. A learning environment is conceptualized as an activity system. The implementation of its methodological solutions in the research was to investigate the socially mediated pedagogical practice, to explore the boundary object of people who are members of different communities and have a variety of interests, and to explore the school activity by tracing its local origin and by designing its future. The results of the study are summarized into four theses which direct attention to: (1) the dualist conceptualization of entrepreneurship, (2) the ontology of knowledge in entrepreneurship education, (3) diversity and multivoicedness as contexts of learning in the boundary between school and society, and (4) teachers as agency of pedagogical development. From the epistemological point of view school faces a new paradox in entrepreneurship education: the opening of the school to society carries a risk that society is understood as detached from the practices of societal life and treated as abstract, value-free and ahistorical reality. Keywords: activity system, entrepreneurship education, boundary-object, expansive learning, dialogical knowledge, co-configuration, partnership and learning environment
  • Rämä, Irene (Helsingin yliopisto, 2015)
    This three-part thesis explores the interaction of a teacher and pupils in a Finnish comprehensive school. The studied class is a special education class with six pupils with autism spectrum disorder (ASD). Individuals with ASD have challenges in interaction, communication and social behaviour. The interactional acts of the study participants are examined from varying perspectives. The theoretic framework of this study focuses on the structural elements of the interaction in educational situations. These elements are the mutual co-regulation of the participants (the interaction theory of Alan Fogel), the teacher s tacit knowledge and the pupils communicative spontaneity with the supporting prompts. Moreover, the pupils educational goals linked to interaction, communication and social behaviour are analysed. Through this analysis, the reciprocal relationships between the goals and the relationship with the educational goals presented in the general curriculum of the school are explored. The data is aggregated from a larger data set of the ISE Research Group in the University of Helsinki. The data mainly consists of video recordings from authentic educational situations and individual IEP documents of the pupils. The time span of the data covers the years from 2006 to 2014. The video clips were analysed through applied conversation analysis, and the educational goals were analysed by systematically comparing the goals to the categorization classes found in the International Classification of Functioning, Disability and Health (ICF). The results of the study are seamlessly intertwined with the activity of the teacher and stress the significance of quality and a pupil-sensitive teaching style in the special education context. The pedagogically sensitive activity of the teacher is described with the construct of dynamic sensitivity, which consists of the teacher s personal and professional attributes, teaching experience and tacit knowledge. The shared interaction environment, which is formed by mutual co-regulation with the pupils, is an integral part of generating this dynamic sensitivity.
  • Häikiö, Kaarina (Helsingin yliopisto, 2015)
    The purpose of this study is to shed light on the status of the patient in health policies implemented in order to secure patients access to care and to improve the quality of the care. The study focuses on patients and the treatment guarantee from the viewpoints of government and nongovernmental organisations in 2004-2010. The treatment guarantee is the only segment of legislation that gives patients concrete assurance of access to treatment and quality care. The experiences of patients and organisations in combination with inconsistencies in official follow-up data reinforce the need for this study. The three-level theoretical framework of the study based on the discourse-historical approach in Ruth Wodak s linguistic model. It builds on the impressive background of period pieces and modern-day diagnostics (zeitdiagnose), special phenomena such as the notion of patients as actors in the health policy debate, and language management. The task of the study is to describe the status of patients in the context of the treatment guarantee, as well as to outlines the relationship of public health organisations and government authorities to the reform in national health policy over the period 2004-2010. The study addresses questions about the status of patients and questions about the viewpoints of government and public health organisations concerning the treatment guarantee. The research material comprises documents from government and organisations, data from interviews with experts, and articles from the Helsingin Sanomat daily newspaper. Content analysis occasionally shifts to discourse analysis in the course of the study. The government authorities expected the treatment guarantee as a major health care reform, but according to the experts' interviews it did no turn out that way partly due to the weak implementation. National government authorities and public health organisations differ in use of the concept of a treatment guarantee. The public health organisations were not concerned about a usage threshold for use the concept of a treatment guarantee. Government authorities had different practices in use the concept. At the beginning of the research period, the Ministry of Social Affairs and Health , unlike other government authorities, shunned the concept. When the matter was dealt with in Parliament, however, the opposition referred to the concept of a treatment guarantee. Perceptions about the content of the treatment guarantee varied among the actors, and its application changed during the research period. Narrowly speaking it meant that access to treatment was only provided within a certain time frame. The treatment guarantee was usually written without mentioning the patient. If the patient was mentioned in the documents from the government and public health organisations he or she was usually referred to as an object. There were signs of imminent change in the preparatory documents of the Health Care Act in 2010. The documents still described the patient as an object, but they were also described as an actor. In documents from public health organisations, the patient was perceived as an active player in a generally positive way. In documents from the government, the patient was positively perceived as an object. In parliament, when the legislative process for the treatment guarantee drew to a close, members of parliament began speaking more about the economy and less about the patients, nor were the patient viewed as a potential voter. Public health organisations discussed the empowerment of patients just before the reform, but the trend quickly diminished after the legal reforms were initiated in March 2005.These organisations wrote about the treatment guarantee as a patient right as late as 2006. According to the data from experts interviews the treatment guarantee did not give protection to patient.
  • Losoi, Heidi (Helsingin yliopisto, 2015)
    Despite extensive research, there is considerable diversity and debate concerning the expected recovery course and the etiology of persistent symptoms after mild traumatic brain injury (MTBI). In recent years, resilience, which is defined as an ability to recover from adversity, has emerged as one potential psychological construct associated with outcome from MTBI. The aim of this study was to investigate the psychometric properties of the Finnish version of the Resilience Scale (RS) and its short version (RS-14), their use in MTBI research, and to examine the association between resilience and outcome from MTBI. In addition, this study aimed to thoroughly and prospectively report the recovery from MTBI in previously healthy adults. The psychometric properties of the Finnish version of the RS were examined with a convenience sample of 243 participants. Working aged participants with MTBI (n=74) without pre-injury neurological or mental health problems and orthopedically injured trauma controls (n=40) were recruited from the Emergency Department of Tampere University Hospital. Participants filled out self-report questionnaires about demographic variables, resilience, post-concussion symptoms, fatigue, insomnia, pain, post-traumatic stress, depressive symptoms, and quality of life at 1, 6, and 12 months following injury. Neuropsychological examination was conducted for the patients with MTBI and for the controls at 1 month after injury and for the MTBI group at 6 months. Data regarding return to work of the MTBI group was also gathered. The Finnish version of the Resilience Scale (RS) and its short version (RS-14) have good psychometric properties and can be reliably used in MTBI research. Greater resilience was associated with fewer post-concussive symptoms and better quality of life, whereas lower resilience was associated with more symptoms and lower quality of life. Resilience was also a significant predictor of self-reported fatigue following MTBI even when controlling for factors known to be associated with fatigue (depression, sleep disorders, and pain). In this sample of previously healthy adults, MTBI had a good prognosis. By six months following injury, patients with MTBI did not differ as a group from non-head injury trauma controls on cognition, fatigue, or mental health, and by 12 months their level of post-concussion symptoms and quality of life was similar to that of controls. Almost all (96%) patients with MTBI returned to work/normal activities (RTW) within the follow-up of one year. Patients reporting ongoing mild post-concussion syndrome (PCS) at the 12-month follow-up did not have more severe brain or bodily injuries than those without PCS. A large percentage (62.5%) of those with persistent PCS had a modifiable psychological risk factor (i.e., depression, possible post-traumatic stress disorder, and/or low resilience) at the beginning of recovery.
  • Jansson, Satu-Mari (Helsingin yliopisto, 2015)
    Theatre and drama as forms of learning in organisations This dissertation concerns theatre and drama as a form of learning in organisational contexts. When developing human resources and activities in organisations, people are usually seen as rational human beings, which means overlooking their emotional side. The object of development is seen to be a rational professional who is filled with information as a commodity, which can then be shifted as such from one person to another. This view does not take into account the fact that people create new knowledge as they bring together their own understandings, motivations and emotions when solving mutual problems. This study suggests that when facing the challenges of working life, organisations need more comprehensive viewpoints and methods. In addition, the emotions and cognition are interconnected, which is why in organisational development people s emotions should be considered. Hence in the process of organisational development, the arts, and especially theatre and drama, can offer a full spectrum of methods for activating learning. Through theatre and drama, meaning is created by doing, as meaning is given form through physical movement and visuality, as well as kinetically. To examine this phenomenon, I have brought together activity theory, developmental work research and the arts. I construe theatre both as an object of intervention and as an intervention method. The dissertation consists of five articles and a summary. The summary answers the following two research questions: 1) How can theatre and drama be construed as forms of learning in work? 2) How can activity theory and the methodology of developmental work research enrich the analysis of theatre and drama? My empirical interventions for the research involved the Rovaniemi Theatre Lapland s Regional Theatre and the executive board of one of the units of University of Applied Sciences. The Rovaniemi Theatre offers an example of the changes that are occurring in the theatre field, the learning challenges that theatres are facing, and theatre as a form of learning for professionals in organisational development. In the case of the Rovaniemi Theatre, the logic of intervention research is applied for the first time in a professional theatre context. In 2008-2009 I worked for 15 months in a development project where I engaged all of the theatre s employees in order to analyse and understand their ongoing development. Their work practices were broadening, as some performances were being rehearsed without scripts, using group improvisation or devising instead. I gathered research data throughout the project: observations, interviews and video material. The second intervention concerned the development of change management in the context of University of Applied Sciences (during 2013). In this project I brought together cultural-historical activity theory, developmental work research and Forum Theatre. Forum Theatre was initially created by Augusto Boal to promote political change through a theatrical method and format. As part of the intervention we rehearsed a theatrical performance based on Forum Theatre. We wrote a script and rehearsed a performance consisting of three scenes. The methodology of developmental work research intertwined with the scriptwriting process, although we devised the performance originally without a script. The research data were gathered at the beginning of the project by interviewing the executive board, and the three-hour intervention was videotaped. After six months I interviewed several managers who had participated in the intervention, and a photo workshop was held where they photographed their learning experiences and the effects of the project. What combines the two interventions is that I applied the theoretical concept of developmental contradiction, which is widely used amongst researchers in developmental work research. Contradictions emerge in the change and development of work, and are felt in the work as disturbances, interruptions and problems (Engeström, 1985; 2004a; 2004b). These contradictions are experienced as conflicts, dilemmas and work-related new meaning makings (Engeström and Sannino, 2011). In view of this, to prevent the separation of emotions and cognition in organisational development we need new theoretical concepts. The concept of personal sense of work (Leontjev, 1977, 120) is one such solution. In organisational change, employees build a new relationship with their work, one in which the emotions are involved. Unless new connections can be made, emotional conflict may result. The idea that theatre and drama can be used to activate learning in the workplace and in human resource development, however, has yet to truly emerge. This dissertation is the first attempt to describe how theatre and drama can be analysed as forms of learning in organisations with the help of developmental work research and how the emotions play a key role in work development. The present dissertation provides insight into work development in the context of theatrical intervention and the emotions during the development process, as employees deal with their personal sense of work (Leontjev, 1977, 120). The study also shows how theatrical interventions, can be carried out for organisations, and how the processing of emotions engendered by work development can be focused on.
  • Torppa, Ritva (Helsingin yliopisto, 2015)
    The cochlear implant (CI) provides a sensation of hearing for deaf-born children. However, many CI children show poor language outcomes, which may be related to the deficiency of CIs in delivering pitch. This thesis studies the development of those neural processes and behavioural skills linked to the perception of pitch which may play a role in language acquisition. We measured with event-related brain potentials (ERPs) the neural discrimination of and attention shift to changes in music, the perception of word and sentence stress and related acoustic cues, and the auditory working memory (forward digit span) in 4̶ 13-year-old normally hearing (NH) and early-implanted children. We studied how the development of these aspects is related to musical activities known to advance brain development and perceptual skills in the NH population, and whether the perception of music is connected to word stress or visuospatial perception in NH adults. With regard to the development of neural responses, we found for the CI children usually well-formed ERP waveforms resembling those found for the NH children. However, some brain responses implied impoverished processing for the CI children, especially for timbre and pitch. The CI children who sang regularly at home were advantaged over the other CI children for the development of attention shift, which was linked to improved auditory working memory, implying better neural discrimination, an advantaged development of neural networks for attention and better updating of auditory working memory for the CI singers. For the CI children perception of word and sentence stress improved with improving discrimination of pitch (f0) and intensity and auditory working memory. Only the CI children participating in supervised musical activities performed and developed similarly to the NH children in these skills. The perception of musical rhythm improved with improving word stress and visuospatial perception for the NH adults. The results indicate that (i) perception of music and speech are connected not only via pitch and timbre, but also via rhythm, and (ii) the combination of singing at home and taking part in supervised musical activities, using also rhythmic exercises and visual cues, might be the best way to optimize pitch-related abilities, underlying cognitive functions, spoken language skills and quality of life for early-implanted children.
  • Waris, Petra (Helsingin yliopisto, 2015)
    The onset of schizophrenia before the age of 18 is commonly categorized as early onset schizophrenia. It accounts for less than 4% of all cases of schizophrenia, the prevalence of which is about 1% worldwide. Premorbid abnormalities seem to be very typical, and prognosis is often poor. Besides the negative and positive symptoms, severe neurocognitive deficits also occur. Schizophrenia and pervasive developmental disorders share a common history. From 1970 onwards these disorders have been regarded as separate conditions. These disorders have different ages of onset as well as developmental courses. Nevertheless, the clinical symptoms as well as the results of genetic and neuroimaging studies overlap. The participants in this thesis were adolescent schizophrenia patients (n = 18; 7 males, 11 females). The mean age of the participants at recruitment was 15.6 years (studies I-III) and at the time of psychological assessment 16.2 years (study IV). Study IV also included 15 adolescents with PDD without psychotic disorder (n = 15; 7 males, 8 females). Their mean age at recruitment was 16.1 years. All participants had a primary IQ over 70. Study I of this thesis assessed the possible comorbidity of early onset schizophrenia and pervasive developmental disorders. We found that a total of 44% of adolescents with schizophrenia had some pervasive developmental disorder already in childhood. However, most of the adolescents had a correct comorbid diagnosis until the onset of psychotic symptoms and the diagnosis of schizophrenia. Study II evaluated the number and nature of catatonic features among adolescents with schizophrenia. A further comparison was made of the nature and numbers of those features between adolescents suffering from schizophrenia alone and those schizophrenia patients with comorbid pervasive developmental disorder. All adolescents with schizophrenia presented many lifetime catatonic features. Adolescents with schizophrenia and comorbid pervasive developmental disorder had an earlier onset of catatonic features, more catatonic features and a greater variety of catatonic features compared to schizophrenia patients without comorbidity. Study III aimed to assess the developmental skills of adolescents with schizophrenia. All of the adolescents with schizophrenia exhibited some developmental delays. Adolescents with schizophrenia and comorbid pervasive developmental disorders exhibited more delays in developmental skills than did those schizophrenia adolescents without comorbidity. Study IV investigated neurocognition and social cognition between adolescents suffering from schizophrenia alone, those schizophrenia patients with comorbid pervasive developmental disorder and adolescents with pervasive developmental disorder only. The profiles of the neurocognitive abilities and disabilities between these three groups differed. The adolescents with schizophrenia and comorbid pervasive developmental disorder did not have more severe problems than the other two groups. The comorbid group displayed a combination of the visual strengths those are typical for PDDs and the deficits in processing speed associated with schizophrenia. These study findings showed that among adolescents with early onset schizophrenia is a subgroup of adolescents with comorbid pervasive developmental disorder. The symptoms of these adolescents seem to be more severe, and this subgroup should be taken into account in psychiatric services and rehabilitation.