817 resultados para felt
Resumo:
Altering the normal association between touch and its visual correlate can result in the illusory perception of a fake limb as part of our own body. Thus, when touch is seen to be applied to a rubber hand while felt synchronously on the corresponding hidden real hand, an illusion of ownership of the rubber hand usually occurs. The illusion has also been demonstrated using visuomotor correlation between the movements of the hidden real hand and the seen fake hand. This type of paradigm has been used with respect to the whole body generating out-of-the-body and body substitution illusions. However, such studies have only ever manipulated a single factor and although they used a form of virtual reality have not exploited the power of immersive virtual reality (IVR) to produce radical transformations in body ownership.
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The movement for open access to science seeks to achieve unrestricted and free access to academic publications on the Internet. To this end, two mechanisms have been established: the gold road, in which scientific journals are openly accessible, and the green road, in which publications are self-archived in repositories. The publication of the Finch Report in 2012, advocating exclusively the adoption of the gold road, generated a debate as to whether either of the two options should be prioritized. The recommendations of the Finch Report stirred controversy among academicians specialized in open access issues, who felt that the role played by repositories was not adequately considered and because the green road places the burden of publishing costs basically on authors. The Finch Report"s conclusions are compatible with the characteristics of science communication in the UK and they could surely also be applied to the (few) countries with a powerful publishing industry and substantial research funding. In Spain, both the current national legislation and the existing rules at universities largely advocate the green road. This is directly related to the structure of scientific communication in Spain, where many journals have little commercial significance, the system of charging a fee to authors has not been adopted, and there is a good repository infrastructure. As for open access policies, the performance of the scientific communication system in each country should be carefully analyzed to determine the most suitable open access strategy. [Int Microbiol 2013; 16(3):199-203]
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Nursing discharge planning for elderly medical inpatients is an essential element of care to ensure optimal transition to home and to reduce post-discharge adverse events. The objectives of this cross-sectional study were to investigate the association between nursing discharge planning components in older medical inpatients, patients' readiness for hospital discharge and unplanned health care utilization during the following 30 days. Results indicated that no patients benefited from comprehensive discharge planning but most benefited from less than half of the discharge planning components. The most frequent intervention recorded was coordination, and the least common was patients' participation in decisions regarding discharge. Patients who received more nursing discharge components felt significantly less ready to go home and had significantly more readmissions during the 30-day follow-up period. This study highlights large gaps in the nursing discharge planning process in older medical inpatients and identifies specific areas where improvements are most needed.
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Fonament i objectiu: La Fibromiàlgia (FM) és una malaltia reumàtica caracteritzada per dolor generalitzat, que afecta a un tant per cent elevat de la població general , majoritàriament dones i d’etiologia desconeguda, i que pensem que no afecta tan sols als qui la pateixen, sinó que també als seus familiars. En aquest estudi s’han avaluat diferents variables com l’impacte emocional, la vida social, aspectes econòmics i laborals i altres activitats en familiars de primer grau de pacients amb FM. L’objectiu principal és determinar quin és el grau d’afectació negativa en la seva qualitat de vida. Material i mètodes: Es va fer un estudi observacional clínic a un grup de 27 familiars de 1er grau que convivien a la mateixa casa que els respectius afectats per FM. Se’ls va passar un qüestionari ad- hoc de 16 preguntes tancades, basades en estudis previs , i també una entrevista oberta amb l’objectiu de reforçar les dades estadístiques. Les entrevistes es varen fer a la Unitat de Fibromiàlgia de l’Hospital Santa Maria de Lleida. Resultats: Es va entrevistar a 27 familiars, 85’2 % homes, la majoria de entre 51 – 70 anys (63%). El 85’2 % eren casats, amb estudis primaris el 59’3% i el 88% tenien coneixements sobre la malaltia del familiar afectat. El percentatge de familiars que van opinar que hi havia una minva del grau de felicitats amb la malaltia era del 74’1%. El 85% no havia pensat mai en trencar la relació familiar. El 70% referien canvis en la vida social i relacional arrel del diagnòstic de FM , un 88’9% havien tingut que augmentar l’ajut en tasques domèstiques i el 70’4% patien efectes econòmics negatius arrel de la malaltia. La relació sexual es va veure afectada en un 85% dels casos, en canvi no es varen veure alteracions del son ni de la percepció de salut. Conclusions: El fet de conviure amb una persona afectada de FM suposa pèrdua del grau de felicitat i canvis en la vida social, relacional i sexual amb empitjorament del nivell econòmic.
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Background: Studies have found higher levels of insecure attachment in individuals with schizophrenia. Attachment theory provides a framework necessary for conceptualizing the development of interpersonal functioning. Some aspects of the attachment of the believer to his/her spiritual figure are similar to those between the child and his/her parents. The correspondence hypothesis suggests that early child-parent interactions correspond to a person's relation to a spiritual figure. The compensation hypothesis suggests that an insecure attachment history would lead to a strong religiousness/spirituality as a compensation for the lack of felt security. The aim of this study is to explore attachment models in psychosis vs. healthy controls, the relationships between attachment and psychopathology and the attachment processes related to spiritual figures. Methods: Attachment models were measured in 30 patients with psychosis and 18 controls with the AAI (Adult Attachment interview) in relationship with psychopathology. Beliefs and practices related to a spiritual figure were investigated by qualitative and quantitative analyses. Results: Patients with psychosis showed a high prevalence of insecure avoidant attachment. Spiritual entities functioned like attachment figures in two thirds of cases. Interviews revealed the transformation of internal working models within relation to a spiritual figure: a compensation process was found in 7 of the 32 subjects who showed a significant attachment to a spiritual figure. Conclusions: Attachment theory allows us to highlight one of the underlying dimensions of spiritual coping in patients with psychosis.
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In the rubber hand illusion tactile stimulation seen on a rubber hand, that is synchronous with tactile stimulation felt on the hidden real hand, can lead to an illusion of ownership over the rubber hand. This illusion has been shown to produce a temperature decrease in the hidden hand, suggesting that such illusory ownership produces disownership of the real hand. Here we apply immersive virtual reality (VR) to experimentally investigate this with respect to sensitivity to temperature change. Forty participants experienced immersion in a VR with a virtual body (VB) seen from a first person perspective. For half the participants the VB was consistent in posture and movement with their own body, and in the other half there was inconsistency. Temperature sensitivity on the palm of the hand was measured before and during the virtual experience. The results show that temperature sensitivity decreased in the consistent compared to the inconsistent condition. Moreover, the change in sensitivity was significantly correlated with the subjective illusion of virtual arm ownership but modulated by the illusion of ownership over the full virtual body. This suggests that a full body ownership illusion results in a unification of the virtual and real bodies into one overall entity - with proprioception and tactile sensations on the real body integrated with the visual presence of the virtual body. The results are interpreted in the framework of a"body matrix" recently introduced into the literature.
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The purpose of this study was to clarify the concept of advocacy in context of procedural pain care and to investigate the implementation of advocacy in that context. First, the concept of advocacy was described on the basis of a literature review (n = 89 empirical studies from 1990 to 2003). Then, the concept was described in the context of procedural pain care on the basis of interview data (n = 22 patients, 21 nurses) in a medical and surgical context. In the second phase, an instrument exploring the content of advocacy and the implementation of advocacy in context of procedural pain care was developed and validated. Then, the content of advocacy and implementation of it was explored in a sample of otolaryngeal patients (n = 405) and nurses (n = 118) in 12 hospitals. In the third phase, an update literature review (n = 35 empirical studies from 2003 to 2007) was conducted, and all data from phases one and two were reviewed in order to refine the elements the concept of advocacy, and the relationships between these elements. As a result of this study, advocacy in context of procedural pain care was defined as consisting of the dual aspects of patient advocacy and professional advocacy, and called nursing advocacy. It was divided into dimensions and subdimensions in which patient and nurse empowerment seems to play a vital role. All the data obtained lend support to this definition of nursing advocacy. Patients and nurses felt that nearly all of the activities that they considered as advocacy were implemented.
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At the dawn of the eighteenth century chemistry was establishing itself as a physical science on its own right, after a long ancillary relationship with medicine and pharmacy, which had began two centuries before. This association, and the many changes that came along the scientific revolution spread into many walks of life. The Luso-Brazilian world, apparently so removed from the new developments, could not help to be touched by them, as this study shows, in which two contemporary medical authors are analysed. Both were Portuguese who had long lived in Brazil; both practised and wrote extensively on Medicine; both felt the influence of the new times, albeit in quite different ways.
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Today satellites propulsion is based on the use of monopropellant and/or bipropellant chemical systems. The maneuvering of satellite is based on the hydrazine decomposition micropropulsors catalyzed by metallic iridium supported on g-alumina. This reaction is a surface reaction and is strongly exothermic and implies that the operation of the micropropulsor is controlled by the mass and heat diffusions. For this reason and for the fact that the propulsor operation is frequently in pulsed regime, the catalyst should support high pressure and temperature variations within a short time period. The performance and the durability of the commercial catalyst are jeopardized by the low thermal conductivity of the alumina. The low thermal conductivity of the alumina support restricts the heat diffusion and leads to the formation of hot spots on the catalyst surface causing the metal sintering and/or fractures of the support, resulting in loss of the activity and catalyst destruction. This work presents the synthesis and characterization of new carbon composite support for the active element iridium, in substitution of the commercial catalysts alumina based support. These supports are constituted of carbon nanofibers (30 to 40 nm diameter) supported on a macroscopic carbon felt. These materials present high thermal conductivity and mechanical resistance, as well as the easiness to be shaped with different macroscopic shapes. The mechanical stability and the performance of the iridium supported on the carbon composite support, evaluated in a laboratory scale test in hydrazine decomposition reaction, are superior compared to the commercial catalyst.
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Tutkimuksella selvitettiin eri tekijöiden merkitystä hammaslääkärien tehdessä uraansa koskevia valintoja lähtien ammatinvalinnasta. Tutkimuksessa verrattiin erilaisissa työpaikoissa toimivien hammaslääkärien sekä hammaslääketieteen opiskelijoiden odotuksia ja kokemuksia. Tutkimus tehtiin kyselynä postitse lähetetyin lomakkein. Kyselyyn osallistui 350 hammaslääkäriä ja 115 opiskelijaa. Kiinnostus lääketieteeseen ja työn konkreettisuus olivat keskeisimmät syyt lähteä hammaslääketiedettä opiskelemaan. Suurin osa sekä hammaslääkäreistä että opiskelijoista valitsisi vähintään todennäköisesti saman ammatin uudelleen, hammaslääkäreistä yksityishammaslääkärit useimmin. 69 % hammaslääkäreistä oli aloittanut työuransa terveyskeskuksessa, opiskelijoista 46 % toivoi työpaikkaa yksityissektorilta ja 37 % terveyskeskuksesta. Hammaslääkärit kokivat työn mielekkyyden, positiivisen kaiun, työn ja elämän reunaehtojen sekä taloudellisen turvallisuuden vaikuttaneen ensimmäiseen työpaikkaan menoon vähemmän kuin opiskelijat arvioivat niiden vaikuttavan. Työssä tärkeänä sekä hammaslääkärit että opiskelijat pitivät hyviä työolosuhteita ja mielekästä työn sisältöä. Toimiva yhteistyö työparin kanssa oli myös erittäin tärkeää. Hammaslääkärit pitivät hyviä työoloja ja autonomiaa tärkeämpinä kuin opiskelijat, joille puolestaan uralla eteneminen ja työajan joustot olivat tärkeämpiä. Hammaslääkärit arvostivat työtä ja työssä suoriutumista sekä hyvää työpaikkaa enemmän kuin opiskelijat. Parhaiten työssään toteutuvana suhteessa asian merkitykseen hammaslääkärit kokivat autonomian ja huonoiten ilmapiirin. Naiset kokivat asioiden toteutumisessa enemmän puutteita kuin miehet. Työpaikkaansa heikosti sitoutuneita oli 8 %, joista valtaosa terveyskeskushammaslääkäreitä. Heikosti sitoutuneet kokivat sitoutuneita huonompina varsinkin työilmapiirin, työolosuhteet ja mahdollisuuden uralla etenemiseen. Hammaslääkärit olivat halukkaampia jatkokoulutukseen kuin kokivat siihen olevanmahdollisuuksia; 25 % oli harkinnut erikoistumista, mutta luopunut ajatuksesta, ja20 % halusi erikoistua, mutta koki siihen käytännön esteitä. Jatkossa tulisi tarkemmin analysoida ja toistettavin tutkimuksin seurata hammaslääkärien urakokemuksia ja valintoja sekä koetun työssä vallitsevan tilanteen ja asioiden merkityksen välistä suhdetta. Myös opiskelijoiden urasuunnitelmia ja arvostuksia tulisi tutkia säännöllisin väliajoin.
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The purpose of the present study was to examine the clinical validation of a Virtual Reality Environment (VRE) designed to normalize eating patterns in Eating Disorders (ED). The efficacy of VR in eliciting emotions, sense of presence and reality of the VRE were explored in 22 ED patients and 37 healthy eating individuals. The VRE (non-immersive) consisted of a kitchen room where participants had to eat a virtual pizza. In order to assess the sense of presence and reality produced by the VRE, participants answered seven questions with a Likert scale (0-10) during the experience, and then filled out the Reality Judgment and Presence Questionnaire (RJPQ) and ITC-Sense of Presence Inventory (ITC-SOPI). The results showed that the VRE induced a sense of presence and was felt as real for both groups, without differences in the experience of 'ease' with the VRE, sense of physical space, or the ecological validity assigned to the virtual kitchen and eating virtually. However, the ED patients reported paying more attention and experiencing greater emotional involvement and dysphoria after virtual eating. The results suggest that the VRE was clinically meaningful to the ED patients and might be a relevant therapy tool for normalizing their eating patterns.
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La mort i el procés de morir són fets quotidians en les persones grans i, conseqüentment, en els centres sociosanitaris, on bona part de les persones usuàries són d’edat avançada. Tot i que es tracta d’un fenomen natural que s’inclou dins del cicle vital de les persones, en la nostra societat la mort encara provoca rebuig, por, ansietat, tristesa i inquietud. En aquest marc, les estudiants1 d’infermeria són un col·lectiu que poden patir especialment l’impacte de la mort. Primer, perquè com a membres de la societat tenen interioritzat el codi social preestablert envers aquest tema i, segon, perquè durant la seva formació estan en contacte amb persones que estan al final de la vida i poden presenciar vivències de mort. En el primer període de pràctiques dels estudis d’infermeria, les estudiants han de fer front a diverses situacions del dia a dia fins aleshores desconegudes. Els conflictes interpersonals amb l'equip de treball i la inseguretat sobre les habilitats i les competències professionals són alguns dels aspectes que acostumen a viure amb més tensió. Tot i això, el que més impacte els provoca és la cura de les persones al final de la vida. Davant d'una situació de tensió, la persona viu un component estressor, que suposa el punt d’inflexió. A partir d’aquí s’activen els components adaptatius, que és el que emocionalment fa que la persona pugui fer front a aquesta situació estressant. A més, hi ha un component de suport, que són les ajudes que té. Segons com es treballi el component adaptatiu farà que la persona reaccioni en un futur de forma més automàtica i inconscient o, al contrari, que la persona respongui de forma més conscient i intencionada. El present treball està concebut per comprendre quins elements psicosocials – components estressors i components de suport– poden afectar a les estudiants que presencien la vivència de la mort de malalts geriàtrics terminals en el primer període de pràctiques en un centre sociosanitari. S’ha dissenyat un estudi descriptiu transversal quantitatiu, de caràcter exploratori, per tal de descriure la freqüència i algunes característiques psicosocials al voltant de la mort en estudiants d'infermeria en el seu primer període de pràctiques, tant a nivell personal com a nivell professional. La mostra de l'estudi són 65 estudiants, la majoria són dones d'entre els 18 i els 29 anys –més d’un 90%–. Els resultats indiquen que un 80% dels futurs professionals estudiats han patit la mort d’alguna persona significativa al llarg de la seva vida; d'aquests, gairebé un de cada quatre presenta dol complicat. Quant a la vivència de mort en les pràctiques, el 83% l'ha experimentat. Tot i aquest elevat percentatge, no totes les experiències tenen una connotació negativa. En prop de la meitat dels casos, les morts són percebudes com una experiència enriquidora i natural. Els components estressors més impactants que les estudiants han viscut durant les pràctiques per la mort d’alguna persona malalta són: la reacció de la família del finat, el patiment que es genera al seu voltant, algun signe o símptoma físic experimentat pel malalt al final del procés, i la pròpia reacció emocional. Els components de suport expressats són: saber gestionar les pròpies emocions, tenir més formació sobre relació d’ ajuda i empatia, tenir més formació en control de símptomes i comunicació, per atendre usuaris –tant malalts com familiars- i que algú els informés i orientés en el procés. Altres resultats a tenir en compte són que la població estudiada té més preocupació o inquietud per la mort i el procés de morir de la persona estimada i menys per la pròpia mort. A més, tot i que la meitat no hagués escollit geriatria com opció a les primeres pràctiques clíniques, gairebé tot el grup estudiat ho recomanaria després d'haver viscut l'experiència. Les implicacions pràctiques d'aquest estudi porten a pensar que es pot reorientar la informació i preparació que es dóna a les estudiants d’infermeria abans del primer contacte amb la realitat dels centres sociosanitaris, així com també el paper de formació i suport que pot fer tant la persona tutora de pràctiques com les infermeres de referència dels diferents centres. En conclusió, caldria dissenyar estratègies formatives i de suport entorn a la preparació psicològica personal de l’estudiant; entorn a l’acompanyament, les cures pal·liatives i el dol; i valorar la seva eficiència en el futur.
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Tutkimuksen tavoitteena oli selvittää, millaiset ovat controllereiden työtehtävät ja controllereilta vaadittavat ominaisuudet tänä päivänä. Teoreettisena taustana tutkimuksessa oli johdon laskentatoimen kehitys 1980-luvulta tähän päivään. Tutkimus toteutettiin kvalitatiivisin menetelmin analysoimalla tänä vuonna julkaistuja suomalaisia ja ruotsalaisia controller-rekrytointi-ilmoituksia ja haastattelemalla henkilökohtaisesti controllerin työtehtävissä työskenteleviä henkilöitä useilta toimialoilta. Tutkimuksen keskeisimpänä tuloksena havaittiin, että yrityksen työpaikkailmoituksissa vaadittavissa ominaisuuksissa on eroavaisuuksia suhteessa haastattelussa painotettuihin ominaisuuksiin. Ilmoituksissa mainitut controllereiden työtehtävät olivat enemmän linjassa todellisten työtehtävien kanssa. Sekä työpaikkailmoituksissa että haastatteluissa kävi ilmi, että controllerin työtehtävä sisältää useasti edelleen ulkoiseen laskentaan liittyviä työtehtäviä. Tämä viittaa siihen, että controller-nimikkeen käyttö ei ole vielä vakiintunut vastaamaan johdon laskentatoimen tehtäviä. Controllereiden haastatteluissa nousi esiin useita controller-toiminnon kehityskohteita. Tutkimuksen johtopäätöksenä todettiin, että controllerin työtehtävien ja ominaisuuksien kehittämiseen ovat vaikuttaneet johdon laskentatoimen tietojärjestelmien kehitys, uudet laskentainnovaatiot ja controllerin roolinmuutos kohti strategista liiketoiminnan tukijaa. Yritysten controller-toimintoa ei ole haastatteluiden perusteella kuitenkaan vielä organisoitu vastaamaan tätä roolinmuutosta, joten controllerit kokivat, että heillä ei ole riittävästi aikaa analysointityöhön. Lisäksi controllereiden yhteistyötä kollegojen ja sidosryhmien kanssa pitäisi lisätä ja controller-toiminto tulisi tuoda lähemmäs liiketoimintaa.
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The research assesses the skills of upper comprehensive school pupils in history. The focus is on locating personal motives, assessing wider reasons hidden in historical sources and evaluating source reliability. The research also questions how a wide use of multiple sources affects pupils’ holistic understanding of historical phenomena. The participants were a multicultural group of pupils. The origins of their cultures can be traced to the Balkan, the Middle East, Asia and Europe. The number of native Finnish speakers and pupils speaking Finnish as their second language was almost equal. The multicultural composition provides opportunities to assess how culturally responsive learning history from sources is. The intercultural approach to learning in a multicultural setting emphasizes equality as a precondition for learning. In order to set assignments at least to some extent match with all participants only those answers were taken into account which were produced by pupils who had studied history for a similar period of time in the Finnish comprehensive school system. Due to the small number of participants (41), the study avoids wide generalizations. Nevertheless, possible cultural blueprints in pupils’ way of thinking are noted. The first test examined the skills of pupils to find motives for emigration. The results showed that for 7th graders finding reasons is not a problematic task. However, the number of reasons noticed and justifications varied. In addition, the way the pupils explained their choices was a distinguishing factor. Some pupils interpreted source material making use of previous knowledge on the issue, while other pupils based their analysis solely on the text handed and did not try to add their own knowledge. Answers were divided into three categories: historical, explanatory and stating. Historical answers combined smoothly previously learned historical knowledge to one’s own source analysis; explanatory answers often ignored a wider frame, although they were effective when explaining e.g. historical concepts. The stating answers only noticed motives from the sources and made no attempts to explain them historically. Was the first test culturally responsive? All pupils representing different cultures tackled the first source exam successfully, but there were some signs of how historical concepts are understood in a slightly different way if the pupil’s personal history has no linkage to the concepts under scrutiny. The second test focused on the history of Native Americans. The test first required pupils to recognize whether short source extracts (5) were written by Indians or Caucasians. Based on what they had already learned from North American history, the pupils did not find it hard to distinguish between the sources. The analysis of multiphase causes and consequences of the disputes between Native Americans and white Americans caused dispersion among pupils. Using two historical sources and combining historical knowledge from both of them simultaneously was cumbersome for many. The explanations of consequences can be divided into two groups: the ones emphasizing short term consequences and those placing emphasis on long term consequences. The short term approach was mainly followed by boys in every group. The girls mainly paid attention to long term consequences. The result suggests that historical knowledge in sources is at least to some extent read through role and gender lenses. The third test required pupils to explain in their own words how the three sources given differed in their account of living conditions in Nazi Germany, which turned out to be demanding for many pupils. The pupils’ stronghold was rather the assessment of source reliability and accounts why the sources approached the same events differently. All participants wrote critical and justified comments on reliability and aspects that might have affected the content of the sources. The pupils felt that the main reasons that affected source reliability were the authors’ ethnic background, nationality and profession. The assessment showed that pupils were well aware that position in a historical situation has an impact on historical accounts, but in certain cases the victim’s account was seen as a historical truth. The account of events by a historian was chosen most often as the most reliable source, but it was often justified leniently with an indication to professionalism rather than with clear ideas of how historians conduct accounts based on sources. In brief, the last source test demonstrates that pupils have a strong idea that the ethnicity or nationalism determines how people explained events of the past. It is also an implication that pupils understand how historical knowledge is interpretative. The results also imply that history can be analyzed from a neutral perspective. One’s own membership in an ethnical or religious group does not automatically mean that a person’s cultural identity excludes historical explanations if something in them contradicts with his or her identity. The second method of extracting knowledge of pupils’ historical thinking was an essay analysis. The analysis shows that an analytical account of complicated political issues, which often include a great number of complicated political concepts, leads more likely to an inconsistent structure in the written work of pupils. The material also demonstrates that pupils have a strong tendency to take a critical stance when assessing history. Historical empathy in particular is shown if history somehow has a linkage to young people, children or minorities. Some topics can also awake strong feelings, especially among pupils with emigrant background, if there is a linkage between one’s own personal history and that of the school; and occasionally a student’s historical experience or thoughts replaced school history. Using sources during history lessons at school seems to have many advantages. It enhances the reasoning skills of pupils and their skills to assess the nature of historical knowledge. Thus one of the main aims and a great benefit of source work is to encourage pupils to express their own ideas and opinions. To conclude, when assessing the skills of adolescents in history - their work with sources, comments on history, historical knowledge and finally their historical thinking - one should be cautious and avoid cut off score evaluations. One purpose of pursuing history with sources is to encourage pupils to think independently, which is a useful tool for further identity construction. The idea that pupils have the right to conduct their own interpretations of history can be partially understood as part of a wider learning process, justification to study history comes from extrinsic reasons. The intrinsic reason is history itself; in order to understand history one should have a basic understanding of history as a specific domain of knowledge. Using sources does not mean that knowing history is of secondary importance. Only a balance between knowing the contextual history, understanding basic key concepts and working with sources is a solid base to improve pupils’ historical understanding.
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The Ageing in Working Life. Do Adolescence and Schooling Beat Adulthood and Experience? This study examines the changes in the work and the work organisations of employees in the fields of health care and retail trade who have turned 45 and their experience of change. In addition, the question of how ageing employees experience their status in post-modern working life is explored. Attention is also focused on the choices and decisions connected with staying at work and retiring. These views are examined in relation to professions and professional cultures. Thematic interviews (N=98) were used to gather the material. The effects of the market liberalistic turn in welfare policy are clearly seen in the everyday work of the health care professions. These changes were examined from the point of view of managing by outcomes and quality assurance, multi-professional cooperation, flexibility in the division of labour, and the spread of market-like procedures. The discourse of those in involved retail trade was dominated by extremely tight global market competition and control of outcomes, and by the structural changes taking place in the retail trade sector. This change discourse was to a large extent a reaction to those changes in the functional environment which were experienced as negative and to the conflict between their own professional identity and professional ethics on the one hand, and their functional environment on the other. There were also obstacles connected with professional culture: defending one's own station and power, guarding the 'frontier', showed up in attitudes towards new management and organisation models or towards structural and functional reforms. The deep structures of professional culture and the mindset of the actors change much more slowly than the functional practices of organisations. For those in a supervisory position, the loss of power due to becoming part of a chain or because of the introduction of a team organisation model was not an easy thing to accept. The nurses and others in related fields felt that they were forced to do work that was below their level of training and professional skill. For sales personnel and those who did assisting work in health care, power and the possibility of having an influence were not so important, as long as they were able to do their work in their own way and were trusted. This view is often completely forgotten, for example, in various organisation models in which power and the possibility of having an influence entwined with power are taken for granted as being clearly positive and desired aspects of job satisfaction. Up to date professional skills were experienced as being important from the point of view of professional identity and self-worth. Thus, training can be understood as a moral obligation, which in turn is intertwined with professional ideology. In the rhetoric of adult education, an adult is expected to be an active player who will seek training again and again if working life so requires. The dark side of this ideology, which leads to feelings of guilt, was apparent in the thoughts of the respondents. Am I never good enough at my job; why must I continually strive for better, additional qualifications? The majority of the respondents evaluated their expertise as being at quite a high level. This self-confidence did not extend to applying for a job. Job recruitment was seen as a situation in which age discrimination reached its peak. The interviewees were unanimous about the idea that society favours the young. Especially among those in the retail trade sector, there was a feeling that it would be difficult, if not impossible, to find a new job of the same level or a permanent post if they were made redundant. Age discrimination was also apparent in the retail trade field in the form of older employees being retired against their will or transferred to other tasks. It was felt that ruthless forced retirement of older workers was part of the personnel policy of some organisations. The importance of one's outward appearance was connected with the theme of discrimination. This phenomenon is described using the concept of the double standard of ageing in feminist research. An ageing woman is relegated to an inferior position due to both her age and her sex. A culture that would both make possible and allow various types of choices regardless of age, which is described as being characteristic of the post-modern era, does not seem to be very topical in the practice of working life. It is important for employees that the management and the personnel policy that is being implemented makes them feel like both their contribution and they as individuals are appreciated, that their opinions are listened to and that they are noticed as persons. The interviewees hoped for gratitude and a concern for the well-being of employees that shows in everyday life. They valued training and activities aimed at maintaining their work ability, but thought that better coping at work and a pleasant working environment cannot be achieved through such measures as along as the foundation is 'in a mess'. Development of the quality of working life is the only thing that can improve job satisfaction and get people to remain in the work force longer than at present. There should be a sufficient number of properly trained employees at the work place. It was important to the respondents that they be able to stay on their job to the end with honour, since compromising with their own quality standards or acting contrary to their ideal self-image in terms of professional ethics would strike a blow to their professional self-esteem. They called for the development of various types of workplace flexibility, and felt that they have the right to a lightened workload and to early retirement. Early retirement was even seen as an altruistic deed: it would free up a place for younger workers. Thoughts of retirements were explained by familiar factors such as health and finances, life situation, the enticement of free-time, as well as by various factors related to work. It is very important to ageing employees that their work has meaningful content. The values related to self-fulfilment are felt to be of great importance, and if they cannot be realised at work, the respondents wanted more free time, either through retirement or in the form of flexibility in working life.