Public and private sector cooperative opportunities in the Finnish healthcare internationalization : views from the public sector’s perspective

Traditionally mostly publicly provided Finnish healthcare services are confronted today by the evident challenge of rising healthcare costs as the expenditure on health and social case has exceeded Finland’s national GDP growth significantly since the new millennium. While the opening of the traditional barriers through the EU’s new patient directive resulting in increasing international competition and the free flow of patients within the EU present opportunities for the Finnish healthcare services industry there are also several challenges for the existing healthcare system as proposed by the Ministry of Employment and the Economy in 2011. Due to the structure and nature of the current Finnish healthcare service system the greatest potential for internationalization is seen from a joint cooperation of the public and private sectors in an internationalization network for Finnish healthcare services. As its formation has recently also taken as a strategic initiative to be completed by the Ministry of Employment and the Economy and no earlier research exists on how this is seen in practice by the network actors, the purpose of this study is to examine the proposed solution of forming an internationalization network between the public and private sector actors in Finland in practice from the viewpoint of public sector actors. The research relied heavily on the reports by the Finnish Ministries in understanding the current situation of the Finnish healthcare services internationalization and its potential. Suitable theories were also used to build a more comprehensive view of the matter. The study applied a qualitative research approach on the explorative research problem. The data collection was achieved through expert interviews in two of the largest Finnish public healthcare service providers; the Turku and Helsinki Central University Hospitals. Expert interviews were considered as the most suitable method for data collection in order to create an in-depth understanding of the topic within the limitations of this thesis. In turn, two different public healthcare service providers were chosen to give a broader view of the field instead of focusing on a specific unit and also to allow a possible comparison between the two different organizations. The latter however was shown not to be suitable for the purposes of this study as the opinions of the respondents varied largely also within their own organizations. The conclusion is that while the actors agree on the evident internationalization of Finnish healthcare services, there are several large-scale structural challenges effectively preventing such activities while at the same time the opportunities within Finland vary, as there are several niches but no real large-scale advantages in the highly competitive industry. Interest towards cooperation between the sectors are seen especially in exploiting the advantages offered by the private sector in commercialization and marketization, yet however no clear views exist on how these activities should be governed or structured in the short-term as a larger reform of the entire Finnish healthcare service sector is needed in the long-term.

Opportunities, constraints and constrained opportunities – A study on mothers’ working time patterns in 22 European countries

The aim of this study was to analyse mothers’ working time patterns across 22 European countries. The focus was on three questions: how much mothers prefer to work, how much they actually work, and to what degree their preferred and actual working times are (in)consistent with each other. The focus was on cross-national differences in mothers’ working time patterns, comparison of mothers’ working times to that of childless women and fathers, as well as on individual- and country-level factors that explain the variation between them. In the theoretical background, the departure point was an integrative theoretical approach where the assumption is that there are various kinds of explanations for the differences in mothers’ working time patterns – namely structural, cultural and institutional – , and that these factors are laid in two levels: individual- and country-levels. Data were extracted from the European Social Survey (ESS) 2010 / 2011. The results showed that mothers’ working time patterns, both preferred and actual working times, varied across European countries. Four clusters were formed to illustrate the differences. In the full-time pattern, full-time work was the most important form of work, leaving all other working time forms marginal. The full-time pattern was perceived in terms of preferred working times in Bulgaria and Portugal. In polarised pattern countries, fulltime work was also important, but it was accompanied by a large share of mothers not working at all. In the case of preferred working times, many Eastern and Southern European countries followed it whereas in terms of actual working times it included all Eastern and Southern European countries as well as Finland. The combination pattern was characterised by the importance of long part-time hours and full-time work. It was the preferred working time pattern in the Nordic countries, France, Slovenia, and Spain, but Belgium, Denmark, France, Norway, and Sweden followed it in terms of actual working times. The fourth cluster that described mothers’ working times was called the part-time pattern, and it was illustrated by the prevalence of short and long part-time work. In the case of preferred working times, it was followed in Belgium, Germany, Ireland, the Netherlands and Switzerland. Besides Belgium, the part-time pattern was followed in the same countries in terms of actual working times. The consistency between preferred and actual working times was rather strong in a majority of countries. However, six countries fell under different working time patterns when preferred and actual working times were compared. Comparison of working mothers’, childless women’s, and fathers’ working times showed that differences between these groups were surprisingly small. It was only in part-time pattern countries that working mothers worked significantly shorter hours than working childless women and fathers. Results therefore revealed that when mothers’ working times are under study, an important question regarding the population examined is whether it consists of all mothers or only working mothers. Results moreover supported the use of the integrative theoretical approach when studying mothers’ working time patterns. Results indicate that mothers’ working time patterns in all countries are shaped by various opportunities and constraints, which are comprised of structural, cultural, institutional, and individual-level factors.

Imbalance of naive and memory T lymphocytes with sustained high cellular activation during the first year of life from uninfected children born to HIV-1-infected mothers on HAART

The immune consequences of in utero HIV exposure to uninfected children whose mothers were submitted to highly active antiretroviral therapy (HAART) during gestation are not well defined. We evaluated 45 HIV-exposed uninfected (ENI) neonates and 45 healthy unexposed control (CT) neonates. All HIV-infected mothers received HAART during pregnancy, and the viral load at delivery was <50 copies/mL for 56.8%. Twenty-three ENI neonates were further evaluated after 12 months and compared to 23 unexposed healthy age-matched infants. Immunophenotyping was performed by flow cytometry in cord and peripheral blood. Cord blood lymphocyte numbers did not differ between groups. However, ENI neonates had a lower percentage of naive T cells than CT neonates (CD4+, 76.6 vs 83.1%, P < 0.001; CD8+, 70.9 vs 79.6%, P = 0.003) and higher percentages of central memory T cells than CT neonates (CD4+, 13.9 vs 8.7%, P < 0.001; CD8+, 8.6 vs 4.8%, P = 0.001). CD38 mean fluorescence intensity of T cells was higher in ENI neonates (CD4+, 62.2 vs 52.1, P = 0.007; CD8+, 47.7 vs 35.3, P < 0.001). At 12 months, ENI infants still had higher mean fluorescence intensity of CD38 on T cells (CD4+, 34.2 vs 23.3, P < 0.001; CD8+, 26.8 vs 19.4, P = 0.035). Despite effective maternal virologic control at delivery, HIV-exposed uninfected children were born with lower levels of naive T cells. Immune activation was present at birth and remained until at least 12 months of age, suggesting that in utero exposure to HIV causes subtle immune abnormalities.

Protective effect of maternal prenatal melatonin administration on rat pups born to mothers submitted to constant light during gestation

We studied the effects of adverse conditions such as constant light (LL) on the circadian rhythm of malate (MDH, EC 1.1.1.37) and lactate (LDH, EC 1.1.1.27) dehydrogenase activities of the testes of male Wistar rats on postnatal day 28 (PN28), anxiety-like behavior (elevated plus-maze test) at PN60 and sexual behavior at PN120. The rats were assigned to mother groups on day 10 of pregnancy: control (12-h light/dark), LL (light from day 10 to 21 of pregnancy), and LL+Mel (LL and sc injection to the mothers of a daily dose of melatonin, 1 mg/kg body weight at circadian time 12, from day 17 to 21 of pregnancy). LL offspring did not show circadian rhythms of MDH (N = 62) and LDH (N = 63) activities (cosinor and ANOVA-LSD Fisher). They presented a 44.7% decrease in open-arm entries and a 67.9% decrease in time (plus-maze test, N = 15, P < 0.001, Mann-Whitney U-test and Kruskal-Wallis test), an increase in mounting (94.4%), intromission (94.5%) and ejaculation (56.6%) latencies (N = 12, P < 0.01, Mann-Whitney U-test and Kruskal-Wallis test) and lower numbers of these events (61, 59 and 73%, respectively; P < 0.01, N = 12) compared to controls. The offspring of the LL+Mel group presented MDH and LDH circadian rhythms (P < 0.05, N = 50, cosinor and ANOVA-LSD Fisher), anxiety-like and sexual behaviors similar to control. These findings supported the importance of the melatonin signal and provide evidence for the protective effects of hormones on maternal programming during gestation. This protective action of melatonin is probably related to its entrainment capacity, favoring internal coupling of the fetal multioscillatory system.

A year after Crimea: continuity and change of Finnish-Russian relations reflected in the views of the government officials of Finland and Russia

This thesis discusses the dynamism of bilateral relations between Finland and Russia and their interconnection with wider EU-Russia relations in the sight of the recent conflict in Ukraine. In particular, incorporation of Crimea in the territory of Russia in March 2014 is believed to have triggered a series of disputes between the European Union and Russia and thus, have impacted the course of the bilateral Finnish-Russian relations. The study leans on a premise that there are some historical traditions and regularities in the Finnish foreign policy course towards Russia which make the bilateral Finnish-Russian relations special. These traditions are distinguished and described in the book “Russia Forever? Towards Pragmatism in Finnish/Russian relations” (2008) edited by H. Rytövuori-Apunen. Assuming that the featured traditions take place in modern relations between Finland and Russia, the aim of the thesis is to find out how these traditions reappear during the year shaped by the events in Ukraine. In order to do that, author follows the timeline of happenings around the Ukraine crisis starting with Crimea’s referendum on independence, and exams the way these events were commented on and evaluated by the key government officials and political institutions of Finland and Russia. The main focus is given to the Finnish official discourse on Russia during the study period. The data collection, consisting of mostly primary sources (ministerial press releases and comments, statements, speeches and blog posts of individual policy makers) is processed using the thematic analysis supported by the content analysis. The study reveals that the consequences of the Ukraine crisis have brought, among others, complications to the economic cooperation between Finland and Russia, and have stimulated the increased attention of the Finnish decision makers to the country’s security questions. As a result, the character and importance of some historical regularities of the Finnish foreign policies on Russia, like the Continental Dilemma, have taken new shape.

Exploring multiracial/cultural identities through mothers' voices /

This study explored the experiences of mothers of multiracial/cultural children within the context of family, school, and community. Three categories of mothers of multiracial/cultural children were interviewed privately and then invited to meet as a group to explore some of their reflections and experiences. The categories consisted of 4 mothers with multiracial/cultural children presently attending elementary school, 2 mothers of multiracial/cultural children who are now adults and 3 mothers from my own multiracial/cultural family. The study explored the researcher's personal quest for a multiracial/cultural identity and combined interviews with her daughter, her sister, and her mother to reveal the multiracial/cultural experience from a personal perspective. Content analysis of the narratives revealed that multiracial/cultural children produce their own culture and establish new and personally relevant priorities as they develop their self-identities. Findings further indicated that present-day, mainstream mothers from the dominant majority group of Canadians, tell a different story than similar mothers of previous cohorts, and that although sociopolitical and economic changes have influenced the experiences ofthese women, their stories remain remarkably similar across racial and cultural lines. The findings from this study may promote the development of multicultural programs in Canada as they offer both prospects and challenges to multiracial/cultural children and multicultural educators. It is hoped that this study will provide a better understanding of multiculturalism and encourage educators to heighten their racial and cultural awareness as they strive to critically examine their own cultural stories and realign their praxis within the evolving Canadian mosaic.

Mothers' experiences in the elementary school education of their children of mixed heritage /

This study explores the perceptions and experiences of middle-class women, mostly mothers, regarding the elementary school education of their children of mixed heritage. Because it endeavours to provide a forum in which the voices of women are considered a source of valuable information for educators, this study contributes to the fields of feminist and mothering research. Participants assign meanings to their lived experiences (Schon, 1983; van Manen 1997) and contemplate the various ways in which a mixed heritage mayor may not affect a child's schooling. Four main participants were interviewed who are mothers whose children of mixed heritage presently attend public elementary schools in Ontario, Canada. The study had an emergent design, thus allowing the researcher to make decisions as the study progressed. Three additional participants were included in the study to provide a wider perspective on the topic. These 3 additional women were the researcher herself as she explored her self-conceptual baggage (Kirby & McKenna. 1989); the researcher's mother in an attempt to consider the motherline (Lowinsky, 1992); and a volunteer non-mother of mixed ethnicity. The study involved a total of 12 individual interviews of approximately 2 hours in length. The 4 main participants and the researcher were each interviewed twice; the researcher's mother and the volunteer non-mother were each interviewed once. The researcher also attempted a focus group and kept a journal throughout the research process. Much of the analysis centers on women's interpretations of the mixed heritage experience and on their suggestions for elementary school educators. It concludes pondering on the invisibility (Chiong, 1998) of such children within the school system and calling for increased teacher education as a way to bring the mixed heritage experience out of the shadows.

"Welcome to my life" : the experiences of single mothers who are the recipients of multiple state provided benefits

Abstract This research takes the lens of social reproduction as a starting point for an examination of the effects of recent social welfare reforms on the lives o.fsingle mothers. As the cumulative effects o.f diminishing state provided benefits take hold, tensions are heightened as single mothers internalize the insecurity of earning an income in 11 capitalist labour market, while trying to carry out all that is involved in social reproduction with inadequate means of survival. Through interviewing single mothers who are the recipients of mUltiple state provided benefits (social assistance, student loans, subsidized housing and subsidized childcare), this thesis illuminates the cOl1linued regulation of women in an effort to assure that social reproduction is occurring at the lowest cost possible. State provided benefits are set lip in such a way that it is near impossible for single mothers to make ends meet without entering the labour force or entering into co-residential relationships. This push towards the labour force and/or marriage via punitive welfare policies illuminates the devaluation of the labour that is done at home. Through interviewing 5 single mothers, I will demonstrate the extensive labour that goes into maintaining their households. In addition .J case managers are interviewed. The employees of social assistance, subsidized hOllsing, subsidized childcare and student loans, have much agency in deeming who is worthy of receiving benefits. The employees of these agencies have the ability to make these women's lives easier or more complicated by how the workers interpret the policy regulations. Social policies are of paramount importance in the quest for women's equality and thus have consequences for how women's daily lives are organized. The rules and regulations that govern the individual policies are complex and bureaucratic and have implications for the ways in which women must organize their lives in order to survive. The shifts in social policy have been guided by neo-liberal assumptions with a focus on individual responsibility and a market-modeled welfare state. The caring work that is involved in raising children to be productive in a capitalist society is ignored or devalued in current policies. The emphasis in each polic.:v is on getting women who receive benefits into the paid work force, with little facilitation or investment into the caring work these women do on a daily basis that in turn supports capitalism. Policies, such as social assistance, subsidized housing, subsidized childcare and student loans, are set up in such a way that ignores the reality of women's day-to-day lives and devalues the necessary work done at home. It takes an abundance of labour and strategizing for women to seek out necessary means of survival, labour that is amplified when a woman is dealing with mUltiple slate provided benefits.

The Falls of Niagara : being a complete guide to all the points of interest around and in the immediate neighbourhood of the great cataract with views taken from sketches by Washington Friend, and from photographs. --

Includes index.

A Souvenir of the Niagara Falls, showing Summer and Winter views of Niagara Falls and their surroundings. --

Cover title: Niagara Falls illustrated, Summer and Winter.

Hackstaff's new guide book of Niagara Falls : illustrated with a new map and views of the falls.

Title vignette.