Boundaries in Action : An Activity-theoretical Study of Development, Learning, and Change in Health Care Organization for Patients with Multiple and Chronic Illnesses

This study examines boundaries in health care organizations. Boundaries are sometimes considered things to be avoided in everyday living. This study suggests that boundaries can be important temporally and spatially emerging locations of development, learning, and change in inter-organizational activity. Boundaries can act as mediators of cultural and social formations and practices. The data of the study was gathered in an intervention project during the years 2000-2002 in Helsinki in which the care of 26 patients with multiple and chronic illnesses was improved. The project used the Change Laboratory method that represents a research assisted method for developing work. The research questions of the study are: (1) What are the boundary dynamics of development, learning, and change in health care for patients with multiple and chronic illnesses? (2) How do individual patients experience boundaries in their health care? (3) How are the boundaries of health care constructed and reconstructed in social interaction? (4) What are the dynamics of boundary crossing in the experimentation with the new tools and new practice? The methodology of the study, the ethnography of the multi-organizational field of activity, draws on cultural-historical activity theory and anthropological methods. The ethnographic fieldwork involves multiple research techniques and a collaborative strategy for raising research data. The data of this study consists of observations, interviews, transcribed intervention sessions, and patients' health documents. According to the findings, the care of patients with multiple and chronic illnesses emerges as fragmented by divisions of a patient and professionals, specialties of medicine and levels of health care organization. These boundaries have a historical origin in the Finnish health care system. As an implication of these boundaries, patients frequently experience uncertainty and neglect in their care. However, the boundaries of a single patient were transformed in the Change Laboratory discussions among patients, professionals and researchers. In these discussions, the questioning of the prevailing boundaries was triggered by the observation of gaps in inter-organizational care. Transformation of the prevailing boundaries was achieved in implementation of the collaborative care agreement tool and the practice of negotiated care. However, the new tool and practice did not expand into general use during the project. The study identifies two complementary models for the development of health care organization in Finland. The 'care package model', which is based on productivity and process models adopted from engineering and the 'model of negotiated care', which is based on co-configuration and the public good.

Yksilöllisyys ja yhteisöllisyys K. E. Nipkowin uskonnonpedagogisen teorian kehityksessä 1960-1990

Individuality and the Community in the Development of K. E. Nipkow's Theory of Religious Education from 1960 to 1990 The purpose of this study was to describe and analyze the development occurred between 1960 and 1990 of the theory of religious education as proposed by K. E. Nipkow, the German Religious Education specialist, from the point of view of individuality and the community. Nipkow's methodological approach of dialectic convergence theory resulted in a dialogue between theological and educational factors, which supported the thirty-year development of Nipkow's models, theoretical foundations, and theory of religious education. Nipkow's doctoral dissertation, published in 1960, deals with individuality in the thinking of Pestalozzi, Humboldt and Schleiermacher. Nipkow regarded individuality as one of the basic concepts of education, which were to be interpreted anew as social and historical situations changed. In the late 1960s Nipkow developed the so-called experiential hermeneutically oriented context model for the needs of religious education. In this model, individuality is expressed in the attention paid to pupils' life situations and the educational reality. The multi-dimensional theoretical framework of religious education in 1975 emphasized supporting identity as a fundamental task of religious education. The concept of individuality was thus given a new form, in accordance with contemporary theories of developmental psychology. Other fundamental tasks, such as the socio-ethical task, the task of critical religious thinking, and that of ecumenical learning, meant a more specific emphasis on the community. It was an outline of a liberating education, which faced the individualistic-existential and social-ecclesiastical challenges of the time with a critical attitude. The further development of the theoretical outline in 1982 continued to uphold the perspectives of both individuality and the community, as Nipkow combined a historical-social dimension with theories of developmental psychology, especially that of life-span research. According to him, the development of the individual and communal life-reality belonged together. The fundamental task of religious education came to be learning to live and believe together. Nipkow transferred the idea of dialogue into inter-generational learning and developed elementarization as a methodology of Religious Education, which takes into account the point of departure of each age group. His theory of educational responsibility in the church (1990) contained the tasks of walking alongside the individual and the renewal of church communities as prerequisites of communicating the Christian faith in an era characterized by multifaceted Christianity. The "geisteswissenschaftliche" school and its concepts (Ger. Individualität; Bildung) were found to be the explanatory factor of the concepts of individuality and the community in the development of Nipkow's theory of religious education. The concept of education employed by Nipkow (Ger. Bildung) implies, on one hand, the individuality, autonomy, freedom and personal responsibility of people of different ages, and on the other hand, the dialogical nature of education in the community facilitated by this concept. Theologically, Nipkow associates himself in his views on individuality and the community with Schleiermacher's understanding of faith, of which openness towards the world was characteristic. The significance of individuality and the community in Nipkow's thinking was, furthermore, deepened by his participation, as a member of working parties, in the educational discussions of the World Council of Churches.

Macroseismology as a Component of Seismicity Assessments in an Intraplate Region: Studies of Northern Europe with Emphasis on Finland

This work focuses on the role of macroseismology in the assessment of seismicity and probabilistic seismic hazard in Northern Europe. The main type of data under consideration is a set of macroseismic observations available for a given earthquake. The macroseismic questionnaires used to collect earthquake observations from local residents since the late 1800s constitute a special part of the seismological heritage in the region. Information of the earthquakes felt on the coasts of the Gulf of Bothnia between 31 March and 2 April 1883 and on 28 July 1888 was retrieved from the contemporary Finnish and Swedish newspapers, while the earthquake of 4 November 1898 GMT is an example of an early systematic macroseismic survey in the region. A data set of more than 1200 macroseismic questionnaires is available for the earthquake in Central Finland on 16 November 1931. Basic macroseismic investigations including preparation of new intensity data point (IDP) maps were conducted for these earthquakes. Previously disregarded usable observations were found in the press. The improved collection of IDPs of the 1888 earthquake shows that this event was a rare occurrence in the area. In contrast to earlier notions it was felt on both sides of the Gulf of Bothnia. The data on the earthquake of 4 November 1898 GMT were augmented with historical background information discovered in various archives and libraries. This earthquake was of some concern to the authorities, because extra fire inspections were conducted in three towns at least, i.e. Tornio, Haparanda and Piteå, located in the centre of the area of perceptibility. This event posed the indirect hazard of fire, although its magnitude around 4.6 was minor on the global scale. The distribution of slightly damaging intensities was larger than previously outlined. This may have resulted from the amplification of the ground shaking in the soft soil of the coast and river valleys where most of the population was found. The large data set of the 1931 earthquake provided an opportunity to apply statistical methods and assess methodologies that can be used when dealing with macroseismic intensity. It was evaluated using correspondence analysis. Different approaches such as gridding were tested to estimate the macroseismic field from the intensity values distributed irregularly in space. In general, the characteristics of intensity warrant careful consideration. A more pervasive perception of intensity as an ordinal quantity affected by uncertainties is advocated. A parametric earthquake catalogue comprising entries from both the macroseismic and instrumental era was used for probabilistic seismic hazard assessment. The parametric-historic methodology was applied to estimate seismic hazard at a given site in Finland and to prepare a seismic hazard map for Northern Europe. The interpretation of these results is an important issue, because the recurrence times of damaging earthquakes may well exceed thousands of years in an intraplate setting such as Northern Europe. This application may therefore be seen as an example of short-term hazard assessment.

A Historical Approach to Children s Physics Education : Modelling of DC-circuit Phenomena in a Small Group

This three-phase design research describes the modelling processes for DC-circuit phenomena. The first phase presents an analysis of the development of the DC-circuit historical models in the context of constructing Volta s pile at the turn of the 18th century. The second phase involves the designing of a teaching experiment for comprehensive school third graders. Among other considerations, the design work utilises the results of the first phase and research literature of pupils mental models for DC-circuit phenomena. The third phase of the research was concerned with the realisation of the planned teaching experiment. The aim of this phase was to study the development of the external representations of DC-circuit phenomena in a small group of third graders. The aim of the study has been to search for new ways to guide pupils to learn DC-circuit phenomena while emphasing understanding at the qualitative level. Thus, electricity, which has been perceived as a difficult and abstract subject, could be learnt more comprehensively. Especially, the research of younger pupils learning of electricity concepts has not been of great interest at the international level, although DC-circuit phenomena are also taught in the lower classes of comprehensive schools. The results of this study are important, because there has tended to be more teaching of natural sciences in the lower classes of comprehensive schools, and attempts are being made to develop this trend in Finland. In the theoretical part of the research an Experimental-centred representation approach, which emphasises the role of experimentalism in the development of pupil s representations, is created. According to this approach learning at the qualitative level consists of empirical operations like experimenting, observations, perception, and prequantification of nature phenomena, and modelling operations like explaining and reasoning. Besides planning teaching, the new approach can be used as an analysis tool in describing both historical modelling and the development of pupils representations. In the first phase of the study, the research question was: How did the historical models of DC-circuit phenomena develop in Volta s time? The analysis uncovered three qualitative historical models associated with the historical concept formation process. The models include conceptions of the electric circuit as a scene in the DC-circuit phenomena, the comparative electric-current phenomenon as a cause of different observable effect phenomena, and the strength of the battery as a cause of the electric-current phenomenon. These models describe the concept formation process and its phases in Volta s time. The models are portrayed in the analysis using fragments of the models, where observation-based fragments and theoretical fragements are distinguished from each other. The results emphasise the significance of the qualitative concept formation and the meaning of language in the historical modelling of DC-circuit phenomena. For this reason these viewpoints are stressed in planning the teaching experiment in the second phase of the research. In addition, the design process utilised the experimentation behind the historical models of DC-circuit phenomena In the third phase of the study the research question is as follows: How will the small group s external representations of DC-circuit phenomena develop during the teaching experiment? The main question is divided into the following two sub questions: What kind of talk exists in the small group s learning? What kinds of external representations for DC-circuit phenomena exist in the small group discourse during the teaching experiment? The analysis revealed that the teaching experiment of the small group succeeded in its aim to activate talk in the small group. The designed connection cards proved especially successful in activating talk. The connection cards are cards that represent the components of the electric circuit. In the teaching experiment the pupils constructed different connections with the connection cards and discussed, what kinds of DC-circuit phenomena would take place in the corresponding real connections. The talk of the small group was analysed by comparing two situations, firstly, when the small group discussed using connections made with the connection cards and secondly with the same connections using real components. According to the results the talk of the small group included more higher-order thinking when using the connection cards than with similar real components. In order to answer the second sub question concerning the small group s external representations that appeared in the talk during the teaching experiment; student talk was visualised by the fragment maps which incorporate the electric circuit, the electric current and the source voltage. The fragment maps represent the gradual development of the external representations of DC-circuit phenomena in the small group during the teaching experiment. The results of the study challenge the results of previous research into the abstractness and difficulty of electricity concepts. According to this research, the external representations of DC-circuit phenomena clearly developed in the small group of third graders. Furthermore, the fragment maps uncover that although the theoretical explanations of DC-circuit phenomena, which have been obtained as results of typical mental model studies, remain undeveloped, learning at the qualitative level of understanding does take place.

Verkkomedian käyttö ja tutkiminen : Iltalehti Online 1995-2001

Marja Heinonen s dissertation Verkkomedian käyttö ja tutkiminen. Iltalehti Online 1995-2001 describes the usage of new internet based news service Iltalehti Online during its first years of existence, 1995-2001. The study focuses on the content of the service and users attitudes towards the new media and its contents. Heinonen has also analyzed and described the research methods that can be used in the research of any new media phenomenon when there is no historical perspective to do the research. Heinonen has created a process model for the research of net medium, which is based on a multidimensional approach. She has chosen an iterative research method inspired by Sudweeks and Simoff s CEDA-methodology in which qualitative and quantitative methods take turns both creating results and new research questions. The dissertation discusses and describes the possibilities of combining several research methods in the study of online news media. On general level it discusses the methodological possibilities of researching a completely new media form when there is no historical perspective. The result of these discussions is in favour for the multidimensional methods. The empiric research was built around three cases of Iltalehti Online among its users: log analysis 1996-1999, interviews 1999 and clustering 2000-2001. Even though the results of different cases were somewhat conflicting here are the central results from the analysis of Iltalehti Online 1995-2001: - Reading was strongly determined by the gender. - The structure of Iltalehti Online guided the reading strongly. - People did not make a clear distinction in content between news and entertainment. - Users created new habits in their everyday life during the first years of using Iltalehti Online. These habits were categorized as follows: - break between everyday routines - established habit - new practice within the rhythm of the day - In the clustering of the users sports, culture and celebrities were the most distinguishing contents. Users did not move across these borders as much as within them. The dissertation gives contribution to the development of multidimensional research methods in the field of emerging phenomena in media field. It is also a unique description of a phase of development in media history through an unique research material. There is no such information (logs + demographics) available of any other Finnish online news media. Either from the first years or today.

Global processes, local strategies : migration of educated Dominicans.

The aim of this thesis is to examine migration of educated Dominicans in light of global processes. Current global developments have resulted in increasingly global movements of people, yet people tend to come from certain places in large numbers rather than others. At the same time, international migration is increasingly selective, which shows in the disproportional number of educated migrants. This study discovers individual and societal motivations that explain why young educated Dominicans decide to migrate and return. The theoretical framework of this thesis underlines that migration is a dynamic process rooted in other global developments. Migratory movements should be seen as a result of interacting macro- and microstructures, which are linked by a number of intermediate mechanisms, meso-structures. The way individuals perceive opportunity structures concretises the way global developments mediate to the micro-level. The case of the Dominican Republic shows that there is a diversity of local responses to the world system, as Dominicans have produced their own unique historical responses to global changes. The thesis explains that Dominican migration is importantly conditioned by socioeconomic and educational background. Migration is more accessible for the educated middle class, because of the availability of better resources. Educated migrants also seem less likely to rely on networks to organize their migrations. The role of networks in migration differs by socioeconomic background on the one hand, and by the specific connections each individual has to current and previous migrants on the other hand. The personal and cultural values of the migrant are also pivotal. The central argument of this thesis is that a veritable culture of migration has evolved in the Dominican Republic. The actual economic, political and social circumstances have led many Dominicans to believe that there are better opportunities elsewhere. The globalisation of certain expectations on the one hand, and the development of the specifically Dominican feeling of ‘externalism’ on the other, have for their part given rise to the Dominican culture of migration. The study also suggests that the current Dominican development model encourages migration. Besides global structures, local structures are found to ve pivotal in determining how global processes are materialised in a specific place. The research for this thesis was conducted by using qualitative methodology. The focus of this thesis was on thematic interviews that reveal the subject’s point of view and give a fuller understanding of migration and mobility of the educated. The data was mainly collected during a field research phase in Santo Domingo, the Dominican Republic in December 2009 and January 2010. The principal material consists of ten thematic interviews held with educated Dominican current or former migrants. Four expert interviews, relevant empirical data, theoretical literature and newspaper articles were also comprehensively used.

Evaluating the Predictability of the Volatility Smile Using Return Distributions

In this paper, we examine the predictability of observed volatility smiles in three major European index options markets, utilising the historical return distributions of the respective underlying assets. The analysis involves an application of the Black (1976) pricing model adjusted in accordance with the Jarrow-Rudd methodology as proposed in 1982. Thereby we adjust the expected future returns for the third and fourth central moments as these represent deviations from normality in the distributions of observed returns. Thus, they are considered one possible explanation to the existence of the smile. The obtained results indicate that the inclusion of the higher moments in the pricing model to some extent reduces the volatility smile, compared with the unadjusted Black-76 model. However, as the smile is partly a function of supply, demand, and liquidity, and as such intricate to model, this modification does not appear sufficient to fully capture the characteristics of the smile.

Common past, divided memories: historical memory of the Polish minority members in Lithuania

The Master’s thesis examines historical memory of the Polish minority members in Lithuania with regard to how their interpretation of the common Polish-Lithuanian history reiterates or differs from the official Polish and Lithuanian narratives conveyed by the school textbooks. History teaching in high schools carries a crucial state-supported role of “identity building policies” – it maintains a national narrative of memory, which might be exclusive to minorities and their peculiar understanding of history. Lithuanians Poles, in this regard, represent a national minority, which is exposed to two conflicting national narratives of the common past – Polish and Lithuanian. As members of the Polish nation, their understanding of the common Polish-Lithuanian history is conditioned by the Polish historical narrative, acquired as part of the collective memory of the family and/or different minority organizations. On the other hand, they encounter Lithuanian historical narrative of the Polish-Lithuanian past throughout the secondary school history education, where the curriculum, even if taught in Polish, largely represents the Lithuanian point of view. The concept of collective memory is utilized to refer to collective representations of national memory (i.e. publicly articulated narratives and images of collective past in history textbooks) as well as to socially framed individual memories (i.e. historical memory of minority members, where individual remembering is framed by the social context of their identity). The thesis compares the official national historical narratives in Lithuania and Poland, as conveyed by the Polish and Lithuanian history textbooks. The consequent analysis of qualitative interviews with the Polish minority members in Lithuania offers insights into historical memory of Lithuanian Poles and its relation to the official Polish and Lithuanian national narratives of the common past. Qualitative content analysis is applied in both parts of the analysis. The narratives which emerge from the interview data could be broadly grouped into two segments. First, a more pronounced view on the past combines the following elements: i) emphasis on the value of multicultural and diverse past of Lithuania, ii) contestation of “Lithuanocentricity” of the Lithuanian narrative and iii) rejection of the term “occupation”, based on the cultural presuppositions – the dominant position of Polish culture and language in the Vilnius region, symbolic belonging and “Lithuanianness” of the local Poles. While the opposition to the term of “occupation” is in accord with the official Polish narrative conveyed by the textbooks, the former two elements do not neatly adhere to either Polish or Lithuanian textbook narratives. They should rather be considered as an expression of claims for inclusion of plural pasts into Lithuanian collective memory and hence as claims for symbolic enfranchisement into the Lithuanian “imagined community”. The second strand of views, on the other hand, does not exclude assertions about the historically dominant position of Polish culture in Lithuania, but at the same time places more emphasis on the political and historical continuity of the Lithuanian state and highlights a long-standing symbolic connectedness of Vilnius and Lithuania, thus, striking a middle way between the Polish and Lithuanian interpretations of the past.

Global Processes, Local Strategies : migration of educated Dominicans.

The aim of this thesis is to examine migration of educated Dominicans in light of global processes. Current global developments have resulted in increasingly global movements of people, yet people tend to come from certain places in large numbers rather than others. At the same time, international migration is increasingly selective, which shows in the disproportional number of educated migrants. This study discovers individual and societal motivations that explain why young educated Dominicans decide to migrate and return. The theoretical framework of this thesis underlines that migration is a dynamic process rooted in other global developments. Migratory movements should be seen as a result of interacting macro- and microstructures, which are linked by a number of intermediate mechanisms, meso-structures. The way individuals perceive opportunity structures concretises the way global developments mediate to the micro-level. The case of the Dominican Republic shows that there is a diversity of local responses to the world system, as Dominicans have produced their own unique historical responses to global changes. The thesis explains that Dominican migration is importantly conditioned by socioeconomic and educational background. Migration is more accessible for the educated middle class, because of the availability of better resources. Educated migrants also seem less likely to rely on networks to organize their migrations. The role of networks in migration differs by socioeconomic background on the one hand, and by the specific connections each individual has to current and previous migrants on the other hand. The personal and cultural values of the migrant are also pivotal. The central argument of this thesis is that a veritable culture of migration has evolved in the Dominican Republic. The actual economic, political and social circumstances have led many Dominicans to believe that there are better opportunities elsewhere. The globalisation of certain expectations on the one hand, and the development of the specifically Dominican feeling of ‘externalism’ on the other, have for their part given rise to the Dominican culture of migration. The study also suggests that the current Dominican development model encourages migration. Besides global structures, local structures are found to ve pivotal in determining how global processes are materialised in a specific place. The research for this thesis was conducted by using qualitative methodology. The focus of this thesis was on thematic interviews that reveal the subject’s point of view and give a fuller understanding of migration and mobility of the educated. The data was mainly collected during a field research phase in Santo Domingo, the Dominican Republic in December 2009 and January 2010. The principal material consists of ten thematic interviews held with educated Dominican current or former migrants. Four expert interviews, relevant empirical data, theoretical literature and newspaper articles were also comprehensively used.

Learning Challenges in Biogas Production for Sustainability : An activity theoretical study of a network from a swine industry chain

This study is about the challenges of learning in the creation and implementation of new sustainable technologies. The system of biogas production in the Programme of Sustainable Swine Production (3S Programme) conducted by the Sadia food processing company in Santa Catarina State, Brazil, is used as a case example for exploring the challenges, possibilities and obstacles of learning in the use of biogas production as a way to increase the environmental sustainability of swine production. The aim is to contribute to the discussion about the possibilities of developing systems of biogas production for sustainability (BPfS). In the study I develop hypotheses concerning the central challenges and possibilities for developing systems of BPfS in three phases. First, I construct a model of the network of activities involved in the BP for sustainability in the case study. Next, I construct a) an idealised model of the historically evolved concepts of BPfS through an analysis of the development of forms of BP and b) a hypothesis of the current central contradictions within and between the activity systems involved in BP for sustainability in the case study. This hypothesis is further developed through two actual empirical analyses: an analysis of the actors senses in taking part in the system, and an analysis of the disturbance processes in the implementation and operation of the BP system in the 3S Programme. The historical analysis shows that BP for sustainability in the 3S Programme emerged as a feasible solution for the contradiction between environmental protection and concentration, intensification and specialisation in swine production. This contradiction created a threat to the supply of swine to the food processing company. In the food production activity, the contradiction was expressed as a contradiction between the desire of the company to become a sustainable company and the situation in the outsourced farms. For the swine producers the contradiction was expressed between the contradictory rules in which the market exerted pressure which pushed for continual increases in scale, specialisation and concentration to keep the production economically viable, while the environmental rules imposed a limit to this expansion. Although the observed disturbances in the biogas system seemed to be merely technical and localised within the farms, the analysis proposed that these disturbances were formed in and between the activity systems involved in the network of BPfS during the implementation. The disturbances observed could be explained by four contradictions: a) contradictions between the new, more expanded activity of sustainable swine production and the old activity, b) a contradiction between the concept of BP for carbon credits and BP for local use in the BPfS that was implemented, c) contradictions between the new UNFCCC1 methodology for applying for carbon credits and the small size of the farms, and d) between the technologies of biogas use and burning available in the market and the small size of the farms. The main finding of this study relates to the zone of proximal development (ZPD) of the BPfS in Sadia food production chain. The model is first developed as a general model of concepts of BPfS and further developed here to the specific case of the BPfS in the 3S Programme. The model is composed of two developmental dimensions: societal and functional integration. The dimension of societal integration refers to the level of integration with other activities outside the farm. At one extreme, biogas production is self-sufficient and highly independent and the products of BP are consumed within the farm, while at the other extreme BP is highly integrated in markets and networks of collaboration, and BP products are exchanged within the markets. The dimension of functional integration refers to the level of integration between products and production processes so that economies of scope can be achieved by combining several functions using the same utility. At one extreme, BP is specialised in only one product, which allows achieving economies of scale, while at the other extreme there is an integrated production in which several biogas products are produced in order to maximise the outcomes from the BP system. The analysis suggests that BP is moving towards a societal integration, towards the market and towards a functional integration in which several biogas products are combined. The model is a hypothesis to be further tested through interventions by collectively constructing the new proposed concept of BPfS. Another important contribution of this study refers to the concept of the learning challenge. Three central learning challenges for developing a sustainable system of BP in the 3S Programme were identified: 1) the development of cheaper and more practical technologies of burning and measuring the gas, as well as the reduction of costs of the process of certification, 2) the development of new ways of using biogas within farms, and 3) the creation of new local markets and networks for selling BP products. One general learning challenge is to find more varied and synergic ways of using BP products than solely for the production of carbon credits. Both the model of the ZPD of BPfS and the identified learning challenges could be used as learning tools to facilitate the development of biogas production systems. The proposed model of the ZPD could be used to analyse different types of agricultural activities that face a similar contradiction. The findings could be used in interventions to help actors to find their own expansive actions and developmental projects for change. Rather than proposing a standardised best concept of BPfS, the idea of these learning tools is to facilitate the analysis of local situations and to help actors to make their activities more sustainable.

Historical considerations and evolution of the forest policies for small woodlot owners of Quebec.

XVIII IUFRO World Congress, Ljubljana 1986.

Changing Paradigms in Biblical Criticism : 2 Kings 22:1 23:30 in the Flux of Discourses

The subject and methodology of biblical scholarship has expanded immense-ly during the last few decades. The traditional text-, literary-, source- and form-critical approaches, labeled historical-critical scholarship , have faced the challenge of social sciences. Various new literary, synchronic readings, sometimes characterized with the vague term postmodernism, have in turn challenged historicalcritical, and social-scientific approaches. Widened limits and diverging methodologies have caused a sense of crisis in biblical criticism. This metatheoretical thesis attempts to bridge the gap between philosophical discussion about the basis of biblical criticism and practical academic biblical scholarship. The study attempts to trace those epistemological changes that have produced the wealth of methods and results within biblical criticism. The account of the cult reform of King Josiah of Judah as reported in 2 Kings 22:1 23:30 serves as the case study because of its importance for critical study of the Hebrew Bible. Various scholarly approaches embracing 2 Kings 22:1 23:30 are experimentally arranged around four methodological positions: text, author, reader, and context. The heuristic model is a tentative application of Oliver Jahraus s model of four paradigms in literary theory. The study argues for six theses: 1) Our knowledge of the world is con-structed, fallible and theory-laden. 2) Methodological plurality is the neces-sary result of changes in epistemology and culture in general. 3) Oliver Jahraus s four methodological positions in regard to literature are also an applicable model within biblical criticism to comprehend the methodological plurality embracing the study of the Hebrew Bible. 4) Underlying the methodological discourse embracing biblical criticism is the epistemological ten-sion between the natural sciences and the humanities. 5) Biblical scholars should reconsider and analyze in detail concepts such as author and editor to overcome the dichotomy between the Göttingen and Cross schools. 6) To say something about the historicity of 2 Kings 22:1 23:30 one must bring together disparate elements from various disciplines and, finally, admit that though it may be possible to draw some permanent results, our conclusions often remain provisional.

Unraveling the helix of change : An activity-theoretical study of health care change efforts and their consequences

M.A. (Educ.) Anu Kajamaa from the University of Helsinki, Center for Research on Activity, Development and Learning (CRADLE), examines change efforts and their consequences in health care in the public sector. The aim of her academic dissertation is, by providing a new conceptual framework, to widen our understanding of organizational change efforts and their consequences and managerial challenges. Despite the multiple change efforts, the results of health care development projects have not been very promising, and many developmental needs and managerial challenges exist. The study challenges the predominant, well-framed health care change paradigm and calls for an expanded view to explore the underlying issues and multiplicities of change efforts and their consequences. The study asks what kind of expanded conceptual framework is needed to better understand organizational change as transcending currently dominant oppositions in management thinking, specifically in the field of health care. The study includes five explorative case studies of health care change efforts and their consequences in Finland. Theory and practice are tightly interconnected in the study. The methodology of the study integrates the ethnography of organizational change, a narrative approach and cultural-historical activity theory. From the stance of activity theory, historicity, contradictions, locality and employee participation play significant roles in developing health care. The empirical data of the study has mainly been collected in two projects, funded by the Finnish Work Environment Fund. The data was collected in public sector health care organizations during the years 2004-2010. By exploring the oppositions between distinct views on organizational change and the multi-site, multi-level and multi-logic of organizational change, the study develops an expanded, multidimensional activity-theoretical framework on organizational change and management thinking. The findings of the study contribute to activity theory and organization studies, and provide information for health care management and practitioners. The study illuminates that continuous development efforts bridged to one another and anchored to collectively created new activity models can lead to significant improvements and organizational learning in health care. The study presents such expansive learning processes. The ways of conducting change efforts in organizations play a critical role in the creation of collective new practices and tools and in establishing ownership over them. Some of the studied change efforts were discontinuous or encapsulated, not benefiting the larger whole. The study shows that the stagnation and unexpected consequences of change efforts relate to the unconnectedness of the different organizational sites, levels and logics. If not dealt with, the unintended consequences such as obstacles, breaks and conflicts may stem promising change and learning processes.