The Influence of Education and Depression on Autonomy of Women with Chronic Pelvic Pain: A Cross-sectional Study

Objective Patient autonomy has great importance for a valid informed consent in clinical practice. Our objectives were to quantify thedomains of patient autonomy and to evaluate the variables that can affect patient autonomy in women with chronic pelvic pain. Methods This study is a cross sectional survey performed in a tertiary care University Hospital. Fifty-two consecutive women scheduled for laparoscopic management of chronic pelvic were included. Three major components of autonomy (competence, information or freedom) were evaluated using a Likert scale with 24 validated affirmatives. Results Competence scores (0.85 vs 0.92; p = 0.006) and information scores (0.90 vs 0.93; p = 0.02) were low for women with less than eight years of school attendance. Information scores were low in the presence of anxiety (0.91 vs 0.93; p = 0.05) or depression (0.90 vs 0.93; p = 0.01). Conclusions Our data show that systematic evaluation of patient autonomy can provide clinical relevant information in gynecology. Low educational level, anxiety and depression might reduce the patient autonomy in women with chronic pelvic pain.

Research framework for the connection between environmental collaboration and firm performance

This thesis focuses on collaborative activities with regard to environmental issues both within the firm and outside the firm with the key suppliers and customers, i.e. internal and external environmental collaboration. Integrating environmental thinking into supply chain management has received increasing interest in recent years. The relational view and the natural resource-based-view together suggest that environmental capabilities can be built jointly with supply chain partners and used to gain sustained competitive advantage. Several studies have been undertaken to analyse the connection between environmental activities and firm performance but most studies have taken only economic performance into account. This study pays attention also to two other dimensions of firm performance, intra-firm supply chain performance and environmental performance, and aims at presenting the linkages between them and environmental collaboration. This thesis creates a research framework for the connections between environmental collaboration and firm performance and suggests approaches to analyse these. In order to find out the key concepts and their relationship, an extensive literature review is conducted. The research framework proposes a positive connection between internal and external environmental collaboration and all three dimensions of firm performance. In addition, environmental performance and intra-firm supply chain performance are expected to contribute positively to economic performance. Hence, firms are suggested to benefit from environmental collaboration both within the firm and outside the firm. Empirical testing of the developed research framework is out of the scope of this study. However, this thesis proposes using a mixed methods research approach, including survey research and multiple case studies. Finland State of Logistics 2012 survey commissioned by the Finnish Ministry of Transport and Communications and conducted by Turku School of Economics is used as an example of data for the quantitative phase. The applicability of these two methods is discussed at a general level and with regard to analysing the research framework developed in the thesis. Future research will aim at the development of the research framework and the methods in order to confirm the connection between environmental collaboration and firm performance.

Harmonization of Environmental Costs and Investments Reporting

The objective of this Master’s Thesis is to examine the current state of environmental costs and investments reporting at Stora Enso in the Business Area of Printing and Reading. Differences and the factors causing the differences in environmental costs and investments reporting are examined in order to further harmonize the reporting between the mills. Research method is a case study, which comprises 11 paper mills. Environmental costs are studied from year 2012 and environmental investments from year 2011 or from 2012 depending on the mill. The results show that there are two types of differences such as actual and harmonisable affecting to environmental costs reporting. Actual differences result from factors such as location and technical features of the mill. Harmonisable differences represent differences, which distort the actual differences. Factors that cause harmonisable differences are identification and traceability of environmental costs as well as interpretation of the instructions. Estimation of the environmental share of indirect environmental investments causes differences between the mills in environmental investments reporting, as it has to be done case-by-case judgments. A further research could consider a detailed examination of the data registering process in order to further improve traceability of environmental costs. Furthermore, identification and reporting of potential savings could be studied from environmental point of view as resource efficiency is an increasing interest.

Balance between education- and research-oriented publications from a Brazilian University Hospital

We analyzed the trends of scientific output of the University Hospital, Federal University of Rio de Janeiro. A total of 1420 publications were classified according to pattern and visibility. Most were non-research publications with domestic visibility. With time, there was a tendency to shift from non-research (or education-oriented) publications with domestic visibility to research publications with international visibility. This change may reflect new academic attitudes within the institution concerning the objectives of the hospital and the establishment of scientific research activities. The emphasis of this University Hospital had been on the training of new physicians. However, more recently, the production of new knowledge has been incorporated as a new objective. The analysis of the scientific production of the most productive sectors of the hospital also showed that most are developing non-research studies devoted to the local public while a few of the sectors are carrying out research studies published in journals with international status. The dilemma of quality versus quantity and of education versus research-oriented publication seems, however, to continue to exist within the specialized sectors. The methodology described here to analyze the scientific production of a university hospital can be used as a tool to better understand the evolution of medical research in Brazil and also to help formulate public policies and new strategies to include research among the major objectives of University Hospitals.

EU Strategy for the Baltic Sea Region: its added value in environmental social and economic dimensions

The European Council has invited the European Commission to present the first macro-regional strategy – the EU Strategy for the Baltic Sea Region (EUSBSR) on the 14th of December 2007, primarily to address collective challenges and opportunities of the Region and also to engender cohesion in support of an European integration policy. However, macro-regional strategies conceived to aid European integration and territorial cohesion were viewed by academics with skepticism, obscuring the strategies’ potential impact. This thesis intends to investigate and measure the added value of the EUSBSR in order to analyze its impact on regional development and its feasibility as a guide for future programs intending to strengthen European cohesion and integration. To determine the added value of the EUSBSR the thesis is organized into three sections, so as to address environmental, social, and economic concerns, respectively. The first case examines EU-Russia cooperation in an environmental context to investigate how environmental cooperation with an external neighbor could forge increased cohesion in a macro-regional setting. To figure the added cooperation that academic cooperation among universities would contribute to social dimension, the work has chosen several study results. Lastly, to measure out the added value for the economic strategy objective, the study employs the project for Improved Global Competitiveness in an example of ‘A Baltic Sea Region Program for Innovation, Cluster and SME-Networks’ as an economic plan.

Education and development projects in Brazil (1932-2004): political economy perspective

This paper discusses the long-run history of education policies in Brazil. It is suggested that the main reason for the educational backwardness was the existence of strong political interests over education. It is also defended that these interests can be empirically observed in the allocation of public resources between the different levels of education, with political choices favouring specific groups in society. It was not a matter of lack of investment in education, but of inadequate allocation of resources. This pattern of political-based policies created a strong negative path dependence of misallocation of resources in education in Brazil, particularly with significant underinvestment in secondary education.

Home schooling in view of John Calvin : a study in education and communion of saints /

This study explores the tension that has emerged around the rise of home schooling in a faith-community strongly committed to establishing and maintaining day schools in the tradition of John Calvin. It aims to identify and understand factors that contributed to this tension and to find ways to bridge, diffuse, reduce, or eliminate it. In line with Calvin, personal convictions, and the nature of the community, the study takes a Christian epistemological and axiological stance. Its premise is that the integrity of the commvmity is more important than the manner in which its children are taught. The study reviews relevant literature and several interviews. It considers both secular and Christian literature to understand communities, community breakdown, and community restoration. It also examines literature about the significance of home, school, and community relationships; the attraction of Reformed day schools; and the appeal of home schooling. Interviews were conducted with 4 home schooling couples and 2 focus groups. One focus group included local school representatives, and the other home schoolers and school representatives from an area with reputedly less tension on the issue. Interviews were designed for participants to give their perspectives on reasons for home schooling, the existing tension, and ways to resolve the issues. The study identifies the rise of home schooling in this particular context as the initial issue and the community's deficiency to properly deal with it as the chief cause for the rising tensions. However, I argue that, within the norms the community firmly believes in, home schooling need not jeopardize its integrity. I call for personal, social, and spiritual renewal to restore the covenant community in gratitude to God.

The connection between career education and career maturity /

The value of career education is measured by the extent to which it enhances students' decision making skills regarding career planning. This is referred to as "career maturity". The purpose of this study was to examine what connections could be found between career education and career maturity within one career planning course. A senior level career planning class was studied in depth for one semester and five senior students participated in the study. The five students were interviewed three times during the semester to determine whether, and to what extent, students feel more prepared personally to make decisions as a result of a guided course of instruction. The current trend in education shows an increased emphasis on career education. The government mandates career education, students are in need of career planning courses, and parents want students to learn how to effectively make decisions concerning their future. With this increased emphasis comes the need to evaluate current career education programs which is why this study is significant and useful. The central findings were as follows: first, as a result of taking a career planning course students did increase their career maturity. Second, current career education planning curriculum was similar to the proposed course of study for career planning which comes into effect in September 1999. Current curriculum does help to prepare students to make informed educational and career decisions, a chief aim of the proposed curriculum. Knowing that this outcome is currently achieved will help when the course is being organized to fit the new curriculum.

Youth's experiences of motivation in school physical education and sport

This study's objective was to examine how thirteen year-old females perceive and describe their lived experiences of being physically active in school PE (physical education) and organized youth sport settings through a self-determination theory (Deci & Ryan, 1985) lens. Motivational factors and links between both settings were discussed with five participants using in-depth interviews. Participants discussed factors that facilitated and disrupted their motivation to be active in PE and sport settings. The selfdetermination theory was used as a framework in this qualitative study and results are based on participants' own words and perspectives. Results indicate that participants' positive experiences in school PE and organized sport have the potential to meet their needs of autonomy, competence and relatedness. The autonomy supportive behaviours of social agents, feeling challenged and successful at activities and the strong relationships formed in both settings are all things that motivated young people in this study to continue being physically active throughout high-school and into adulthood.