Oireista puhuminen lääkärin vastaanotolla : Keskustelunanalyyttinen tutkimus lääkärin kysymyksistä

Talking about symptoms during medical consultation. A conversation analytical study of doctors questions This linguistically oriented conversation analytic study investigates doctors questions and patients answers during medical consultation. The focus is on 1) the syntactic constructions of the doctors questions concerning the patients symptoms, 2) the function of different types of syntactic constructions, and 3) the sequential placement of the questions. The data used in the study consist of 57 videotaped doctor patient encounters in Finnish primary health care. The study shows that the traditional division between open and closed questions is vague and needs to be examined further. Open wh-questions and closed yes/no questions form heterogeneous classes: some of the closed questions can be treated as open and vice versa. Wh-questions which occur during the physical examination are often constructed to elicit short answers. These questions can consist of one word (e.g. milloin when ) which does not move to a new topic but supports the unfinished activity of palpation. During the verbal examination, wh-questions are formulated to elicit long descriptions as answers. For example, by asking mites + X ( what about + X), the doctor can open up a new topic and simultaneously give the patient the opportunity to discuss the topic from his/her perspective. Almost half of the yes/no questions project longer than just a minimal answer (e.g. a short confirmation or rejection). In these questions, the doctors use verbal elements which show that more than just a minimal answer is required. They can, for example, add an indefinite element (joku some or mitään any ) to a yes/no question, add a conjunctive vai ( or ) to the end of the question and thus open a space for various types of answers, or add a suggested answer to the question. In addition, the results show that declarative questions not only check understanding, but display the doctor s diagnosing process, check whether the doctor can move on to the next topic or action, and display implicitly the doctor s idea of what is connected and what is relevant. One aim of the study is to describe how different syntactic structures work together. A typical question chain consists of two or three questions. The first question is an open wh-question that elicits a new topic and creates different types of presuppositions. Contingent questions are constructed as yes/no questions that seek an affirmative answer or as declarative sentences that seek confirmation. Contingent questions can function as repair initiators and thus support achieving mutual understanding. Therefore, they are tools for the doctor to construct a description of the medical problem collaboratively with the patient. The results add to the results of previous studies on questions in medical consultation, but also suggest some corrections. They provide additional evidence for the idea that different types of syntactic constructions are useful in different types of settings. However, they also show that the variety of questions that doctors use is more manifold and diverse than the variety introduced in earlier studies and textbooks.

Toiminta ja tarkoite : Tutkimus suomen pronominista

The study describes the use and meaning of the Finnish demonstrative pronouns, focus being on the pronoun "tämä" (roughly 'this'). The Finnish demonstrative system is a three way one, the other two demonstratives are "tuo" ('that') and "se" ('it'). The data consisted of 12 half hours of video- and tape-recorded face-to-face and telephone conversations. The method for the study was ethnomethodological conversation analysis (CA); in addition to CA, the theoretical framework consisted of functional linguistics and linguistic anthropology. First, the study dealt with the syntactic distribution of the three demonstratives. The pronouns were analysed according to whether they are before or after the verb, and whether they compose an NP on their own or are determinants of a lexical NP. The study suggested that the form and the placement of the NP presents the referent as continuous/discontinuous or given/new. Givenness of a referent was defined as "identified adequately for the purposes of the on-going action". The so-called dislocated utterances were considered separately. It was found that left-dislocations are used for inserting referents in a particular relation to the on-going activity. Right-dislocations offer a solution for the sometimes competing motivations of newness and continuity: they are used for securing the identifiability of a referent that is implied to be continuous. Second, the study focussed on analysing the meaning of the pronouns according to three dimensions of reference: referential, indexical and relational. It was found that the demonstratives can organize interactional or spatial context. When organizing interactional context, the demonstrative pronouns express the role of identifying the referent in relation to the on-going activity. The pronoun "tämä" expresses that the referent is referentially open and the characterization of the referent is given in the on-going turn. Furthermore, it expresses asymmetry of the indexical ground: it expresses that the participants of a conversation do not share a mutual understanding of the activity at that particular time. In addition, the referent of the pronoun "tämä" is central for understanding the on-going action. Centrality could be understood as the relational feature of the pronoun. However, it is a consequence of the referential and indexical features of "tämä". The pronoun "tuo" also expresses referential openness, but it implies indexical symmetry. The pronoun "se" implies that the referent is known enough, and implies indexical symmetry. When used spatially, the pronouns may refer to a physical space or to a situation. They express or imply that the speaker is inside or outside the referent. The pronoun "tämä" implies inclusion, and the pronoun "tuo" expresses exclusion.

Opettajan ja vanhemman vuorovaikutus ja keskustelun kehykset koululaisen kehityskeskusteluissa

The aim of the study is to describe the consultation discussions between the teacher, parents and the student. The structure and the interaction of the conversation is in the focus of the study. The study explicates the organization of the interaction and orientation of the participants in the conversation. The study approaches conversation as a dynamic activity and studies it from the point of view of the participants. Assessment is one of the themes involved in the teacher-parent-student consultation discussions. Assessment as a duty of the school brings an institutional aspect in the conversation, but the ways it is implemented and expressed varies in the conversational situations. Participants communication and interaction in the situation influences the ways the consultation discussions are carried out. The framework of the study is based on the ethno methodological approach where a social situation and its meaning is seen negotiated by the participants. The interest of the study is to find out how the participants implement mutual understanding and how it can be observed in their interaction. Quantitatively, the interaction of the participants is described in the framework of the interaction analysis and linked to the socio-emotional and rational aspects of the interaction. The empirical part of the study consists of data collected with questionnaires and videotaped conversations. The main research problems of the study are, how the teachers and parents described the consultation discussions and how the interaction of the teacher, the parent and the student is organized during the conversation. The background of the study is linked to the previous studies concerning co-operation between the teacher and the parent and home-school relationship. This part of the study aims to enlighten how the consultation discussions are part of the co-operation in the school context. The questionnaires link the consultation discussions to the every day co-operation between the teacher and the family. Expectations and results described by the parents and teachers are analysed. Videotaped data is both analysed quantitatively based on interaction analysis and approached with the ethno methodological interpretation. The interest of my study is, how people participate in the situation of consultation discussion, how they orientate in it and influence the conversation. The analyses of the consultation discussions are based on the both quantitative interaction analysis and ethno methodological frame analysis. With the theoretical approach of my study I want to describe and enlighten the organization of the interaction and ways of orientation of the participants in consultation discussions. Keywords: consultation discussion, interaction, evaluation, orientation in the conversation, home-school cooperation, quantitative interaction analysis, frame analysis

"Pintaa syvemmälle" : Eettinen pohdinta opettajan voimavarana luokanopettajan ja erityisopettajan silmin

The purpose of this study is to determine what class teachers and special teachers emphasise in ethical consideration, in which situations they find that ethical difficulties arise and how they would overcome them. In additions, the study aims to describe the effects of ethical con-sideration on the teachers` work. The theoretical backround is based on theories concerning the ethics of the teacher and the literature associated with education and teaching. The empirical study was based on data obtained through questionnaires and interviews. The questionnaires were posted to 470 randomly-selected class teachers and special teachers; 298 of them (63%) completed and returned the questionnaire, and 19 teachers were inter-viewed. The results of the questionnaires and the interviews were examined crosswise with a mixed-methods procedure. The questionnaires were analysed by factor analysis. Those items which rose above the av-erage served as the foundation for the analysis. The questionnaires also included open ques-tions. These questions and the interviews were analysed with a content analysis method. Some principles of this method were combined with the results of the questionnaires to in-crease mutual understanding. In this study, the ethical consideration of the teachers was divided in to four notable parts: 1) moral obligations, 2) respect for the teaching stuff, 3) the demand for responsibility, and 4) dependence on the situation. These items were also notable both in situations that were ethi-cally difficult for teachers and in their solutions to these situations. It became evident that these situations were very common in everyday work and resulted from the character of the teachers´ work. This study showed that the teacher meets the pupils as a group and that the teacher must examine according to the circumstances the truth, individuality, special ar-rangements and co-operation between the school and the parents. The teachers` continuous lack of time limited the ethical consideration. It emerged that the teachers consider their work very multi-faceted and that the sense of obligation, power and responsibility was inevitably received emphasis. The consciousness of authority and the responsibilities associated with it seemed, however, to strengthen this ac-tion. The study showed that the teachers, especially the young female ones, long for more solidarity. Significantly, such experience does not eliminate the importance of ethical consid-eration; on the contrary, it deepens it. According to the results, creating conditions and cir-cumstances for the teachers that open co-operation is inevitable, and easy interaction will in-evitably be possible in the future. There was not observed any differences in ethical consideration between class teachers and special teachers. Therefore, the integration of the pupils to general teaching cannot be consid-ered questionable. Teachers´ answers suggested that ethical consideration improved the tolerance of stress, increased self-confidence and courage as well as belief in the future. The teachers considered ethical consideration important and encouraging for it increased justice and empathy in the teachers´ work.

Sopimusohjaus ohjausmenettelynä sairaanhoitopiirin ja terveyskeskusten yksiköissä ja niiden lääkärien työssä

This study concerns the implementation of steering by contracting in health care units and in the work of the doctors employed by them. The study analyses how contracting as a process is being implemented in hospital district units, health centres and in the work of their doctors, as well as how these units carry out their operations and patient care within the restrictions set by the contracts. Based on interviews with doctors, the study analyses the realisation of operations within the units from the doctors perspective and through their work. The key result of the study is that the steering impact of contracting was not felt at the level of practical work. The contracting was implemented by assigning the related tasks to management only. The management implemented the contract by managing their resources rather than by intervening in doctors activities or the content of their tasks. The steering did not extend to improving practical care processes. This allowed the unchanged continuation of core operations in an autonomous manner and in part, protected from the impacts of contracting. In health centres, the contract concluded was viewed as merely steering the operations of the hospital district and its implementation did not receive the support of the centres. The fact that primary health care and specialised health care constitute separate contracting parties had adverse effects on the contract s implementation and the integration of care. A theoretical review unveiled several reasons for the failure of steering by contracting to alter operations within units. These included the perception steering by contracting as a weak change incentive. The doctors shunned the introduction of an economic logic and ideology into health care and viewed steering by contracting as a hindrance to delivering care to patients and a disturbance to their work and patient relationships. Contracting caused tensions between representatives of the financial administration and health care professionals. It also caused internal tensions, while it had varying impacts on different specialities, including the introduction of varying potential to influence contracts. Most factors preventing the realisation of the steering objective could have been ameliorated through positive leadership. There is a need to bridge the gap between financial steering and patient work. Key measures include encouraging the commitment of middle management, supporting leadership expertise and identifying the right methods of contributing to a mutual understanding between the cultures of financing, administration and health care. Criticism of the purchasers expertise and the view that undersized orders are due to the purchaser s financial difficulties underlines the importance of the purchaser s size. Overly detailed, product-based contracts seemed to place the focus on the quantities and costs of services rather than health impacts and efficiency of operations. Bundling contracts into larger service packages would encourage the enhancement of operations. Steering by contracting represents unexploited potential: it could function as a forum for integrated regional planning of services, and the prioritisation and integration of care, and offer an opportunity and an incentive for developing core operations.

Educators’ perspectives about how older hospital patients can engage in a falls prevention education programme: A qualitative process evaluation

- Objectives Falls are the most frequent adverse event reported in hospitals. Patient and staff education delivered by trained educators significantly reduced falls and injurious falls in an older rehabilitation population. The purpose of the study was to explore the educators’ perspectives of delivering the education and to conceptualise how the programme worked to prevent falls among older patients who received the education. - Design A qualitative exploratory study. - Methods Data were gathered from three sources: conducting a focus group and an interview (n=10 educators), written educator notes and reflective researcher field notes based on interactions with the educators during the primary study. The educators delivered the programme on eight rehabilitation wards for periods of between 10 and 40 weeks. They provided older patients with individualised education to engage in falls prevention and provided staff with education to support patient actions. Data were thematically analysed and presented using a conceptual framework. - Results Falls prevention education led to mutual understanding between staff and patients which assisted patients to engage in falls prevention behaviours. Mutual understanding was derived from the following observations: the educators perceived that they could facilitate an effective three-way interaction between staff actions, patient actions and the ward environment which led to behaviour change on the wards. This included engaging with staff and patients, and assisting them to reconcile differing perspectives about falls prevention behaviours. - Conclusions Individualised falls prevention education effectively provides patients who receive it with the capability and motivation to develop and undertake behavioural strategies that reduce their falls, if supported by staff and the ward environment.

Christian-Muslim Dialogue : Perspectives of Four Lebanese Thinkers

This study describes and analyses two Lebanese Muslims and two Lebanese Christians ideas about Christian-Muslim dialogue, its nature, aims, and methods and its different dimensions, which include doctrinal, ethical, and social dimensions. On the basis of the analysis, the four thinkers contributions for promoting constructive dialogue are evaluated. The persons studied are two religious authorities, the Shiite Great Ayatollah Muhammad Husayn Fadlallah (b. 1935) and the Eastern Orthodox Metropolitan of Mount Lebanon, Georges Khodr (b. 1923), and two academic scholars, Doctor Mahmoud Ayoub (b. 1935) and Doctor, Father Mouchir Aoun (b. 1964), from the Shiite and Greek Catholic communities, respectively. The method of the study is systematic analysis. The sources consist of the four thinkers writings on Christian-Muslim relations, the most of which have been published in Lebanon in the 1990s and 2000s in the Arabic language. In their general guidelines for Christian-Muslim dialogue, the four authors do not offer any novel or unusual insights. However, their dialogue visions are multi-faceted, motivating interreligious encounter both on religious and practical grounds and clarifying the theological grounds and socio-political conditions of this endeavour. The major challenge appears to be the tension between loyalty to one s own convictions and taking into account the particular self-understanding of the other. While this tension may be ultimately unsolvable, it is obvious that linking dialogue tightly to missionary motivations or certain theological agenda imposed on the others is not conducive for better mutual understanding. As for how diverse theologies of religions affect interreligious dialogue, narrow exclusivism hardly promotes mutual knowledge and appreciation, but also inclusive and pluralistic positions have their particular dilemmas. In the end, dialogue is possible from diverse positions on theology of religions. All the authors discuss the theological themes of divine revelation, concept of God, and human condition and ultimate destiny. The two religions particular views on these issues cannot be reconciled, but the authors offer diverse means to facilitate mutual understanding on them, such as increasing mutual knowledge, questioning certain traditional condemnations, showing theological parallels between the two religions, and transcending doctrinal disagreements by stressing common religious experience or ethical concerns. Among the theological themes, especially the concept of God seems to offer possibilities for better understanding than has traditionally been the case. Significantly, all the four authors maintain that Christians and Muslims share the faith in the one God, irrespective of their disagreements about the nature of his oneness. Basic ethical principles are not discussed as widely by the four authors as might be expected, which may reflect the shared cultural background and common ethical values of the Lebanese Muslims and Christians. On this level, Christians alienation from the Islamic law appears as the most significant challenge to mutual understanding, while neighbourly love and the golden rule of ethics offer a fruitful basis for further dialogue. As for the issue of political power-sharing in Lebanon, it is clear that the proposal of an Islamic state is problematic in a country with a sizable Christian minority and a heterogeneous Muslim population. Some form of democracy seems more viable for a multireligious country, but the question remains how to retain religion as a vital force in society, which is felt to be important by all the four Lebanese authors.

Pelon ja toivon välissä : Pätkätyöläisen urakerronta

This study analyzes the forming of the occupational identity of the well-educated fixed-term employees. Fixed-term employment contracts amongst the well-educated labour force are exceptionally common in Finland as compared to other European countries. Two groups of modern fixed-term employees are distinguished. The first comprises well-educated women employed in the public sector whose fixed-term employment often consists of successive periods as temporary substitutes. The other group comprises well-educated, upper white-collar men aged over 40, whose fixed-term employment careers often consist of jobs of project nature or posts that are filled for a fixed period only. Method of the study For the empirical data I interviewed 35 persons (26 women and 9 men) in 33 interviews, one of which was conducted by e-mail and one was a group interview. All the interviews were electronically recorded and coded. All the interviewees have two things in common: fixed-term employment and formal high education. Thirteen (13) of them are researchers, four nurses, four midwives, four journalists, and ten project experts. I used the snowball method to get in touch the interviewees. The first interviewees were those who were recommended by the trade unions and by my personal acquaintances. These interviewees, in turn, recommended other potential interviewees. In addition, announcements on the internet pages of the trade unions were used to reach other interviewees. In analysing process I read the research material several times to find the turning points in the narrative the interviewees told. I also searched for the most meaningful stories told and the meaning the interviewees gave to these stories and to the whole narrative. In addition to that I paid attention to co-production of the narrative with the interviewees and analyzed the narrative as performance to be able to search for the preferred identities the interviewees perform. (Riesman 2001, 698-701). I do not pay much attention to the question of truth of a narrative in the sense of its correspondence with facts; rather I think a working life narrative has two tasks: On the one hand one has to tell the facts and on the other hand, he/she has to describe the meaning of these facts to herself/himself. To emphasize the double nature of the narrative about one’s working life I analyzed the empirical data both by categorizing it according to the cultural models of storytelling (heroic story, comedy, irony and tragedy) and by studying the themes most of the interviewees talked about. Ethics of the study I chose to use narrative within qualitative interviews on the grounds that in my opinion is more ethical and more empowering than the more traditional structured interview methods. During the research process I carefully followed the ethical rules of a qualitative research. The purpose of the interviews and the research was told to the interviewees by giving them a written description of the study. Oral permission to use the interview in this research was obtained from the interviewees. The names and places, which are mentioned in the study, are changed to conceal the actual identity of the interviewees. I shared the analysis with the interviewees by sending each of them the first analysis of their personal interview. This way I asked them to make sure that the identity was hidden well enough and hoped to give interviewees a chance to look at their narratives, to instigate new actions and sustain the present one (Smith 2001, 721). Also I hoped to enjoy a new possibility of joint authorship. Main results As a result of the study I introduce six models of telling a story. The four typical western cultural models that guide the telling are: heroic story, comedy, tragedy and satirical story (Hänninen 1999). In addition to these models I found two ways of telling a career filled with fixed-term employments that differ significantly from traditional career story telling. However, the story models in which the interviewees pour their experience locates the fixed term employers work career in an imagined life trajectory and reveals the meaning they give to it. I analyze the many sided heroic story that Liisa tells as an example of the strength of the fear of failing or losing the job the fixed term employee feels. By this structure it is also possible to show that success is felt to be entirely a matter of chance. Tragedy, the failure in one’s trial to get something, is a model I introduce with the help of Vilppu’s story. This narrative gets its meaning both from the sorrow of the failure in the past and the rise of something new the teller has found. Aino tells her story as a comedy. By introducing her narrative, I suggest that the purpose of the comedy, a stronger social consensus, gets deeper and darker shade by fixed-term employment: one who works as a fixed term employee has to take his/her place in his/her work community by him/herself without the support the community gives to those in permanent position. By studying the satiric model Rauno uses, I argue that using irony both turns the power structures to a carnival and builds free space to the teller of the story and to the listener. Irony also helps in building a consensus, mutual understanding, between the teller and the listener and it shows the distance the teller tells to exist between him and others. Irony, however, demands some kind of success in one’s occupational career but also at least a minor disappointment in the progress of it. Helmi tells her story merely as a detective story. By introducing Helmi’s narrative, I argue that this story model strengthens the trust in fairness of the society the teller and the listener share. The analysis also emphasizes the central position of identity work, which is caused by fixed-term employment. Most of the interviewees talked about getting along in working life. I introduced Sari’s narrative as an example of this. In both of these latter narratives one’s personal character and habits are lifted as permanent parts of the actual professional expertise, which in turn varies according to different situations. By introducing these models, I reveal that the fixed-term employees have different strategies to cope with their job situations and these strategies vary according to their personal motives and situations and the actual purpose of the interview. However, I argue that they feel the space between their hopes and fears narrow and unsecure. In the research report I also introduce pieces of the stories – themes – that the interviewees use to build these survival strategies. They use their personal curriculum vitae or portfolio, their position in work community and their work morals to build their professional identity. Professional identity is flexible and varies in time and place, but even then it offers a tool to fix one’s identity work into something. It offers a viewpoint to society and a tool to measure one’s position in surrounding social nets. As one result of the study I analyze the position the fixed-term employees share on the edge of their job communities. I summarize the hopes and fears the interviewees have concerning employers, trade unions, educational institutions and the whole society. In their opinion, the solidarity between people has been weakened by the short-sighted power of the economy. The impact the fixed-term employment has on one’s professional identity and social capital is a many-sided and versatile process. Fixed-term employment both strengthens and weakens the professional identity, social capital and the building of trust. Fixed-term employment also affects one’s day-to-day life by excluding her/him from the norm and by one’s difficulty in making long-term plans (Jokinen 2005). Regardless of the nature of the job contract, the workers themselves are experts in making the best of their sometimes less than satisfying work life and they also build their professional identity by using creatively their education, work experiences and interpersonal relations. However, a long career of short fixed-term employments may seriously change the perception of employee about his/her role. He/she may start concentrating only in coping in his/her unsatisfactory situation and leaves the active improvement of the lousy working conditions to other people. Keywords: narrative, fixed-tem employment, occupational identity, work, story model, social capital, career  

Yhteinen verkosto? : Tutkimus nuorten syrjäytymistä ehkäisevistä poikkihallinnollisista ryhmistä

Since the 1990s, European policy strategies have stressed the mutual responsibility and joint action of all societal branches in preventing social problems. Network policy is an integral part of the new governance that generates a new kind of dependency between the state and civil society in formulating and adhering to policy goals. Using empirical group interview data collected in Helsinki, the capital of Finland, this case study explores local multi-agency groups and their efforts to prevent the exclusion of children and young people. These groups consist mainly of professionals from the social office, youth clubs and schools. The study shows that these multi-agency groups serve as forums for professional negotiation where the intervention dilemma of liberal society can be addressed: the question of when it is justified and necessary for an authority or network to intervene in the life of children and their families, and how this is to be done. An element of tension in multi-agency prevention is introduced by the fact that its objectives and means are anchored both in the old tradition of the welfare state and in communitarian rhetoric. Thus multi-agency groups mend deficiencies in wellbeing and normalcy while at the same time try to co-ordinate the creation of the new community, which will hopefully reduce the burden on the public sector. Some of the professionals interviewed were keen to see new and even forceful interventions to guide the youth or to compel parents to assume their responsibilities. In group discussions, this approach often met resistance. The deeper the social problems that the professionals worked with, the more solidarity they showed for the families or the young people in need. Nothing seems to assure professionals and to legitimise their professional position better than advocating the under-privileged against the uncertainties of life and the structural inequalities of society. The groups that grappled with the clear, specific needs of certain children and families were the most capable of co-operation. This requires the approval of different powers and the expertise of distinct professions as well as a forum to negotiate case-specific actions in professional confidentiality. The ideals of primary prevention for everyone and value discussions alone fail to inspire sufficient multiagency co-operation. The ideal of a network seems to give word and shape to those societal goals that are difficult or even impossible to reach, but are nevertheless yearned for: mutual understanding of the good life, close social relationships, mutual trust and active agency for all citizens. Individualisation, the multiplicity of life styles and the possibility to choose have come true in such a way that the very idea of a mutual and binding network can be attained only momentarily and between restricted participants. In conclusion, uniting professional networks that negotiate intervention dilemmas with citizen networks based on changing compassions and feelings of moral superiority seems impossible. Rather, one should encourage openness to scrutiny among tangential or contradicting groups, networks and communities. Key words: network policy, prevention of exclusion, multi-agency groups, young people

Soviet-American Cooperative Research on Marine Mammals. Volume 1- Pinnipeds: Under Project V.6. Marine Mammals, of the US-USSR Agreement on Cooperation in the Field of Environmental Protection

Some 25 to 30 yr ago, when we as students were beginning our respective careers and were developing for the first time our awareness of marine mammals in the waters separating western North America from eastern Asia, we had visions of eventually bridging the communication gap which existed between our two countries at that time. Each of us was anxious to obtain information on the distribution, biology, and ecological relations of "our" seals and walruses on "the other side," beyond our respective political boundari~s where we were not permitted to go to study them. We were concerned that the resource management practices on the other side of the Bering and Chukchi Seas, implemented in isolation, on a purely unilateral basis, might endanger the species which we had come to know and were striving to conserve. At once apparent to both of us was the need for free exchange of biological information between our two countries and, ultimately, joint management of our shared resources. In a small way, we and others made some initial efforts to generate that exchange by personal correspondence and through vocal interchange at the annual meetings of the North Pacific Fur Seal Commission. By the enabling Agreement on Cooperation in the Field of Environmental Protection, reached between our two countries in 1972, our earlier visions at last came true. Since that time, within the framework of the Marine Mammal Project under Area V of that Agreement, we and our colleagues have forged a strong bond of professional accord and respect, in an atmosphere of free intercommunication and mutual understanding. The strength and utility of this arrangement from the beginning of our joint research are reflected in the reports contained in this, the first compendium of our work. The need for a series of such a compendia became apparent to us in 1976, and its implementation was agreed on by the regular meeting of the Project in La Jolla, Calif., in January 1977. Obviously, the preparation and publication of this first volume has been excessively delayed, in part by continuing political distrust between our governments but mainly by increasing demands placed on the time of the contributors. In this period of growing environmental concern in both countries, we and our colleagues have been totally immersed in other tasks and have experienced great difficulty in drawing together the works presented here. Much of the support for doing so was provided by the State of Alaska, through funding for Organized Research at the University of Alaska-Fairbanks. For its ultimate completion in publishable form we wish to thank Helen Stockholm, Director of Publications, Institute of Marine Science, University of Alaska, and her staff, especially Ruth Hand, and the numerous referees narned herein who gave willingly oftheir time to review each ofthe manuscripts critically and to provide a high measure of professionalism to the final product. (PDF file contains 110 pages.)

Gaps between assistive technologies and dementia care

A growing number of people are now entering the elderly age category in Japan; this raises the likelihood of more persons with dementia, as the probability of becoming cognitively impaired increases with age. There is an increasing need for caregivers who are well trained and experienced and who can pay special attention to the needs of people with dementia. Technology can play an important role in helping such people and their caregivers. A lack of mutual understanding between caregivers and researchers regarding the appropriate uses of assistive technologies is another problem. We have described the relationship between information and communication technology (ICT), especially assistive technologies, and social issues as a first step towards developing a technology roadmap. © 2012 IEEE.

A technology roadmap of assistive technologies for dementia care in Japan.

The number of elderly people in Japan is growing, which raises the issue of dementia, as the probability of becoming cognitively impaired increases with age. There is an increasing need for caregivers, who are well-trained, experienced and can pay special attention to the needs of people with dementia. Technology can play an important role in helping such people and their caregivers. A lack of mutual understanding between caregivers and researchers regarding the appropriate uses of assistive technologies is another problem. A vision of person-centred care based on the use of information and communication technology to maintain residents' autonomy and continuity in their lives is presented. Based on this vision, a roadmap and a list of challenges to realizing assistive technologies have been developed. The roadmap facilitates mutual understanding between caregivers and researchers, resulting in appropriate technologies to enhance the quality of life of people with dementia.

What price harmony? Teachers' methods of delivering an ethos of tolerance and respect for diversity in an integrated school in Northern Ireland

The aim of the paper is to explore teachers’ methods of delivering an ethos of tolerance, respect
and mutual understanding in one integrated secondary school in Northern Ireland. Drawing on
interviews with teachers in the school, it is argued that most teachers make ‘critical choices’
which both reflect and reinforce a ‘culture of avoidance’, whereby politically or religiously contentious
issues are avoided rather than explored. Although teachers are well-intentioned in making
these choices, it is shown that they have the potential to create the conditions that maintain or even
harden psychological boundaries between Catholics and Protestants rather than dilute them.

Fiddling for Outcomes: Traditional Music, Social Capital, and Arts Policy in Northern Ireland

Arts development policies increasingly tie funding to the potential of arts organisations to effectively deliver an array of extra-artistic social outcomes. This paper reports on the difficulties of this work in Northern Ireland, where the arts sector, and in particular the so-called 'traditional arts', have been drawn into a politically ambiguous discourse centered on the concepts of 'mutual understanding' and, more recently, 'social capital.' The paper traces the recent history of these policies and the difficulties in evaluating the social outcomes of arts programs. The use of the term 'social capital' in the work of Putnam and Bourdieu is considered. The paper argues, through a rereading of Bourdieu's articulation of the 'forms' of capital and Eagleton's 'ideology of the aesthetic,' the concept of social capital can be released from its current neoliberal trappings by imagining a reconnection of the concepts of 'capital' and 'the aesthetic.'

Funciones de la fotografía en las relaciones interculturales entre familias inmigrantes

En este artículo presentamos los resultados y el análisis de uno de los objetivos del proyecto I+D+i aprobado por el Ministerio de Economía y Competitividad de España titulado Mediaciones audiovisuales en las relaciones entre escuela y familias inmigrantes. Concretamente, el dirigido a conocer las funciones que tienen las imágenes fotográficas en las relaciones de un grupo de padres inmigrantes en el colegio al que asisten sus hijos e hijas. Los datos presentados corresponden a las narraciones biográfico-culturales y visuales iniciadas en las aulas por estas familias junto a la tutora del grupo, y continuadas en sus contextos personal y social. Concluimos que las fotografías en los relatos han tenido las funciones de: fuente de información, soporte de análisis, reflexión y debate y, finalmente, medio para comunicar el conocimiento experiencial generado. Dentro de esta última, se han utilizado tres procedimientos que hemos denominado: denotativo autorreferencial, connotativo texto-visual y secuencial.