Asiakastietojärjestelmän muutos lakisääteisessä lastensuojelun sosiaalityössä - jännitteistä toimijuutta

Tämän pro gradu -tutkielman tarkoituksena on ollut tavoittaa niitä vaikutuksia, joita tietojärjestelmien käytöllä on sosiaali- ja terveysalalla. Tarkastelu sijoittuu lastensuojelun sosiaalityöhön. Yhden toimintayksikön tapahtumien kuvaus ja analyysi on puheenvuoro, jolla olen pyrkinyt tavoittamaan yhteyksiä tietojärjestelmien käyttöön liittyviin yleisiin ilmiöihin. Tutkielma on tiheä kuvaus lastensuojelun sosiaalityöstä asiakastietojärjestelmän muutosvaiheessa. Tapahtumia on jäsennetty toimijuuden käsitteen kautta (Archer 2003, Heiskala, 2000). Sosiaalityöntekijän toimijuus on ollut keskiössä tutkimussuunnitelman mukaisesti. Asiakastietojärjestelmä työntyi muutosvaiheessa toimijan rooliin vaikuttaen muun muassa lastensuojelun sosiaalityön työprosesseihin. Tietojärjestelmän toimijuus vaikuttaa sosiaalityöntekijään toimijana ja työntekijän toimijan asemaan. Aineistosta nousi teoretisoinnin (Layder, 1998) kautta esille jännitteisyys näiden keskeisten toimijoiden välillä. Jännite jäsentyi kolmelle kentälle. Lainsäädännön kenttä sulkee sisäänsä organisaatiota ja sosiaalityöntekijän perustehtävää kuvaavat kentät. Kenttien sisällöissä havaitsin yhtäläisyyttä Heiskalan (2000) yhteiskunnallisia pakkoja koskevaan jaotteluun. Pakot välittyvät semioottisesti tarkastellen merkkien eli lakimerkkien, rahamerkkien ja rituaalisesti vahvistettujen symbolien välityksellä. Tutkielman aineiston pohjalta on analysoitavaksi noussut kysymys uuden julkisjohtamisen (NPM) (Harvey, 2006, Julkunen, 2006) vaikutuksista lastensuojelun sosiaalityössä. Uuden julkisjohtamisen elementit tuottavat toimintaan jännitteitä edellä kuvatuilla kolmella kentällä. Yhtä toimintayksikköä koskeva aineisto antaa viitteitä siitä, että NPM toimii lastensuojelun sosiaalityössä toimintaa ohjaavana käyttöteoriana. Käyttöteorian (Argyris ja Schön, 1996) käsitteellä ymmärretään yksilön tai organisaation todellista toimintaa ohjaavaa teoriaa, mikä voi olla ristiriidassa julkilausuttujen toiminnan teorioiden kanssa. Yksilö tai organisaatio ei välttämättä ole tietoinen käyttöteorian ja julkilausutun teorian välisestä kuilusta, minkä esiin saaminen edellyttäisi reflektiota. Tutkimuskohteena on ollut Helsingin kaupungin sosiaaliviraston ruotsinkielisiä lastensuojelun palveluja tuottava yksikkö. Tutkimuksen aineisto on kerätty uuden asiakastietojärjestelmän käyttöönottovaiheessa 1.11.2008 28.2.2009. Menetelmällisesti tutkimus sijoittuu toimintatutkimukselliseen kehykseen (Carr ja Kemmis, 1986). Kenttävaiheen aikana yhdistin tutkijan ja toimijan roolit työskennellen sosiaalityöntekijänä tutkimukseni kohteena olleessa yksikössä. Kirjallinen aineisto koostuu järjestelmämuutosta koskevista päätöksistä, tiedotteista ja ohjeista. Järjestelmän muutosvaiheessa kokosin aineistoa osallistuvan havainnoinnin menetelmällä. Aineistossa on mukana myös yksikön työntekijöiden kanssa tuotettua materiaalia muutosvaiheen aikaisten sisältöjen haltuun ottamiseksi, esimerkiksi työn prosessikuvauksia. Aineisto on analysoitu sisällönanalyysillä. Analyysin edetessä kävin jäsennyksistäni keskustelua toimintayksikön työntekijöiden kanssa. Tapaamisten jälkeen jatkoin analyysiä ja teoretisointia käyttäen semioottista sosiologiaa metateoriana ja aktanttimallia muutosvaihetta kuvaavien kertomusten koostamisessa. Kertomusten pohjalta jatkoin toimijuuden analyysiä subjektiaseman (Törrönen, 2000) ja toimijan aseman (Alasuutari 2007) käsitteitä käyttäen.

Diakoniatyön paikka ihmisten arjessa

This study examines the diaconia work of the Finnish Evangelical Lutheran Church from the standpoint of clients. The role of diaconia work has grown since the early 1990s recession, and since it established itself as one of the actors along with other social organizations. Previous studies have described the changing role of diaconal work, especially from the standpoint of diaconia workers and co-operators. This research goes back to examine, beyond the activities of the diaconia work of everyday practices, its relations of ruling which are determining practices. The theoretical and methodological framework rises from the thinking of Dorothy E. Smith, the creator of institutional ethnography. Its origins are in feminism, Marxism, phenomenology, etnomethodology, and symbolic interactionism. However, it does not represent any school. Unlike the objectivity-based traditional sociology, institutional ethnography has its starting point in everyday life, and people s subjective experience of it. Everyday life is just a starting point, and is used to examine everyday life s experiences of hidden relations of ruling, linking people and organizations. The level of generalization is just on the relations of ruling. The research task is to examine those meanings of diaconia work which are embedded in its clients experiences. The research task is investigated with two questions: how diaconia work among its clients takes shape and what kinds of relations of ruling exist in diaconia work. The meanings of diaconia work come through an examination of the relations of ruling, which create new forms of diaconal work compared with previous studies. For the study, two kinds of data were collected: a questionnaire and ethnographic fieldwork. The first data set was collected from diaconal workers using the questionnaire. It gives background information of the diaconia work process from the standpoint of the clients. In the ethnographic study there were two phases. The first ethnographic material was collected from one local parish by observing, interviewing clients and diaconal workers and gathering documents. The number of observations was 36 customer appointments, and 29 interviews. The second ethnographic material was included as a part of the analysis, in which ruling relations in people s experiences were collected from the transcribed data. Close reading and narrative analysis are used as analysing methods. The analysis has three phases. First, the experiences are identified with close reading; the following step is to select some of the institutional processes that are shaping those experiences and are relevant for the research. At the third stage, those processes are investigated in order to describe analytically how they determine people s experience. The analysis produces another narrative about diaconia work, which provides tools for examining the diaconal work from a new perspective. Through the analysis it is possible to see diaconia as an exchange ratio, in which the exchange takes place between a client and a diaconia worker, but also more broadly with other actors, such as social workers, shop clerks, or with other parishioners. The exchange ratio is examined from the perspective of power which is embedded in the client s experiences. The analysis reveals that the most important relations of ruling are humiliation and randomness in the exchange ratio of diaconia work; valuating spirituality above the bodily being; and replacing official social work. The results give a map about the relations of ruling of diaconia work which gives tools to look at diaconia work s meanings to the clients. The hidden element of humiliation in the exchange ratio breaks the current picture of diaconia work. The ethos of the holistic encounters and empathic practices are shown to be of another kind when spirituality is preferred to the bodily being. Nevertheless, diaconia appears to be a place for a respectful encounter, especially in situations where the public sector s actors are retreating on liability or clients are in a life crisis. The collapse of the welfare state structures imposes on diaconia work tasks that have not previously belonged to it. At the local level, clients receive partners from diaconia workers in order to advocate them in the welfare system. Actions to influence the wider societal structures are not reached because of lacking resources. An awareness of the oppressive practices of diaconia work and their critical reviewing are the keys to the development of diaconia work, since there are such practices even in holistic and respectful diaconia work. While the research raises new information for the development of diaconia work, it also opens up new aspects for developing other kinds of social work by emphasizing the importance of taking people s experiences seriously. Keywords: diaconia work, institutional ethnography, Dorothy E. Smith, experience, customer, relations of ruling.

Kansalaisuus työyhteisön arjessa : Maahanmuuttajien kertomuksia työelämästä

Citizenship in the everyday of a work community. Immigrants narratives of working life. Through globalisation and the mobility of workforce, citizenship has gained new forms, and the mere legal definition of citizenship no longer gives a comprehensive view of the citizenship of an individual. Also the social, cultural and financial dimensions of it are related to the concept of citizenship. In Finland, full citizenship is promoted, according to the Integration Act and social security system, by the requirement that immigrants should mainly get their livelihood through work. In my study I approach citizenship on four levels: the global, national, work community and private levels. In the study, the global has constituted the largest possible context, which refers to the local affects of global processes. The local and the global come together in the research in that globalisation is realised on the local level, i.e. in small communities such as work communities. The objective of the study is to examine how the citizenship of immigrants who live and work in Finland is constructed in the everyday life of a work community. The most central concept of the study is cultural script, which is based on prevailing forms of knowing, and which are constructed in different ways in different times and cultures. Conflicts of scripts in the working life and difficulties in understanding and applying them are in the centre of the study. In the study, the working life experiences of immigrants are approached through narrative research. The research material consists of the working life narratives of nine immigrants who live and work in Finland permanently. Each interviewee has been interviewed 2 4 times so the research material consists of 26 interviews. The material has been analysed from the points of view of perception, feeling and action. Deborah Tannen s and William Labov s as well as Matti Hyvärinen s method of expectancy analysis to locate cultural scripts has been utilised to organise the research material. In addition, David Herman s concepts of participatory roles and event types formed in narratives have been used in the analysis of the material. The basis in the analysis is that the world, events and experiences do not define the available processes; they are always culturally and individually anchored choices of the speaker and narrator. The most important results of the study are related to the gap between globalisation and everyday life. The discussion about the future need for workforce due to the changing population structure as well as about the benefits for national economy brought by internationalisation has continued in Finland for years. However, the working life narratives of the immigrants interviewed for the study show that an average citizen and member of a work community does not immediately encounter the macro level benefits in, for example, the mobility of workforce. In most of the working life narratives there was a point in speaking and saying, in which the immigrant worker either dares to speak or falls silent. Sometimes the courage to speak was related to language skills but more to the courage to be seen and to be part of a Finnish work community. Other workers that either speak their colleague with an immigrant background into a part of their work community or marginalise the colleague with their silence have an important role in a Finnish work community. In several working life narratives, the script of the Finnish working life and work community, the way to work, was opened to the immigrant and the so-called script exchange did not take place. The study shows that working life experiences and inclusion and exclusion built on the working life have an important role in the construction of active citizenship. The detailed analysis of the working life experience narratives gives new, relevant research data about citizenship as inclusion.

Effects of gender, and SLCO1B1 and CYP7A1 polymorphisms on plasma bile acids in humans and the pharmacokinetics of therapeutic ursodeoxycholic acid

Bile acids are important steroid-derived molecules essential for fat absorption in the small intestine. They are produced in the liver and secreted into the bile. Bile acids are transported by bile flow to the small intestine, where they aid the digestion of lipids. Most bile acids are reabsorbed in the small intestine and return to the liver through the portal vein. The whole recycling process is referred to as the enterohepatic circulation, during which only a small amount of bile acids are removed from the body via faeces. The enterohepatic circulation of bile acids involves the delicate coordination of a number of bile acid transporters expressed in the liver and the small intestine. Organic anion transporting polypeptide 1B1 (OATP1B1), encoded by the solute carrier organic anion transporter family, member 1B1 (SLCO1B1) gene, mediates the sodium independent hepatocellular uptake of bile acids. Two common SNPs in the SLCO1B1 gene are well known to affect the transport activity of OATP1B1. Moreover, bile acid synthesis is an important elimination route for cholesterol. Cholesterol 7α-hydroxylase (CYP7A1) is the rate-limiting enzyme of bile acid production. The aim of this thesis was to investigate the effects of SLCO1B1 polymorphism on the fasting plasma levels of individual endogenous bile acids and a bile acid synthesis marker, and the pharmacokinetics of exogenously administered ursodeoxycholic acid (UDCA). Furthermore, the effects of CYP7A1 genetic polymorphism and gender on the fasting plasma concentrations of individual endogenous bile acids and the bile acid synthesis marker were evaluated. Firstly, a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method for the determination of bile acids was developed (Study I). A retrospective study examined the effects of SLCO1B1 genetic polymorphism on the fasting plasma concentrations of individual bile acids and a bile acid synthesis marker in 65 healthy subjects (Study II). In another retrospective study with 143 healthy individuals, the effects of CYP7A1 genetic polymorphism and gender as well as SLCO1B1 polymorphism on the fasting plasma levels of individual bile acids and the bile acid synthesis marker were investigated (Study III). The effects of SLCO1B1 polymorphism on the pharmacokinetics of exogenously administered UDCA were evaluated in a prospective genotype panel study including 27 healthy volunteers (Study IV). A robust, sensitive and simple HPLC-MS/MS method was developed for the simultaneous determination of 16 individual bile acids in human plasma. The method validation parameters for all the analytes met the requirements of the FDA (Food and Drug Administration) bioanalytical guidelines. This HPLC-MS/MS method was applied in Studies II-IV. In Study II, the fasting plasma concentrations of several bile acids and the bile acid synthesis marker seemed to be affected by SLCO1B1 genetic polymorphism, but these findings were not replicated in Study III with a larger sample size. Moreover, SLCO1B1 polymorphism had no effect on the pharmacokinetic parameters of exogenously administered UDCA. Furthermore, no consistent association was observed between CYP7A1 genetic polymorphism and the fasting plasma concentrations of individual bile acids or the bile acid synthesis marker. In contrast, gender had a major effect on the fasting plasma concentrations of several bile acids and also total bile acids. In conclusion, gender, but not SLCO1B1 or CYP7A1 polymorphisms, has a major effect on the fasting plasma concentrations of individual bile acids. Moreover, the common genetic polymorphism of CYP7A1 is unlikely to influence the activity of CYP7A1 under normal physiological conditions. OATP1B1 does not play an important role in the in vivo disposition of exogenously administered UDCA.

Tietokone ikäihmisen arjessa

The aged people in the target group of my study belong to generation, which has experienced the shift from agricultural society via industrial society up to the society which has been described as information society. They have grown up concurrently with the technological development, but during the recent years the technological development has accelerated. One can say that the older the target study group has come the more information technological skills they need to possess to be equal actors in our society. However, especially in case of aged people the learning and maintaining of skills in information technology has mainly been left dependent on their personal motivation. The purpose of this report is to study the use of computers in the life of the aged people. The report studies the will and ability of the aged people to learn the skill of using computers, and the new possibilities which this brings into their lives. The study questions are the following: 1) Why the aged people start to use computers? 2) How the aged people benefit information technology in their own life? 3) How computers have extended the environment of the aged people? 4) What kind of problems the aged people have experienced in use of computers? The research material consists of group interviews and individual interviews (total of 23 people). The interview material has been collected among the participants on information technology courses of the Senior University of Helsinki University during years 2004-2005. The research method used is theme interviewing. In addition, the material of opinions about information technology of people born in decades of 1920 and 1930, gathered as part of the Ikihyvä Päijät-Häme 2002 -research has been used. On basis of this research one can say that the aged people do have motivation to study the use of computers, although many interviewees commented that they also have met problems in use of computers. The motivation has grown also because the fear that without the skills to use computers they could drift into outsiders of the society, whereas instead as skilled computer users they felt to be equal citizens compared with the younger age groups, and that they can maintain their independence and autonomy. Especially, the independent use of banking routines over the Internet and use of emails seem to give them a position as modern actors. Many interview statements also underline that computers will bring both joy and benefit to the users. Studying the use of computers is a new and interesting hobby, which can fill the hole left in the life after leaving the working life. Using skills of text processing and processing of pictures one can, for example, record the traditional knowledge of the family and ancestry to the younger generations, and write articles or even books on the professional area of ones own. Single people emphasize that computers can even act as companionship substitutes. One can use Internet for virtual traveling, which provides a new dimension in use of computers. Internet can also be used to maintain family relationships, especially between grandparents and remote grandchildren. Typical problems in use of computers appeared to be that reaching the right professional helpdesk advisers of the service providers is difficult and requires lots of time and patience. However, the interviewees were not willing to give up their computers, because they had already used to these. Keywords: digital divide, aging, Internet, usability, motivation, information technology, information society.

Microhabitat selection in an assemblage of crickets (Orthoptera: Ensifera) of a tropical evergreen forest in Southern India

1. Habitat selection is a universal aspect of animal ecology that has important fitness consequences and may drive patterns of spatial organisation in ecological communities. 2. Measurements of habitat selection have mostly been carried out on single species and at the landscape level. Quantitative studies examining microhabitat selection at the community level are scarce, especially in insects. 3. In this study, microhabitat selection in a natural assemblage of cricket species was examined for the first time using resource selection functions (RSF), an approach more commonly applied in studies of macrohabitat selection. 4. The availability and differential use of six microhabitats by 13 species of crickets inhabiting a tropical evergreen forest in southern India was examined. The six available microhabitats included leaf litter-covered ground, tree trunks, dead logs, brambles, understorey and canopy foliage. The area offered by the six microhabitats was estimated using standard methods of forest structure measurement. Of the six microhabitats, the understorey and canopy accounted for approximately 70% of the total available area. 5. The use of different microhabitats by the 13 species was investigated using acoustic sampling of crickets to locate calling individuals. Using RSF, it was found that of 13 cricket species examined, 10 showed 100% selection for a specific microhabitat. Of these, two species showed fairly high selection for brambles and dead logs, which were rare microhabitats, highlighting the importance of preserving all components of forest structure.

13C-1H HSQC Experiment of Probe Molecules Aligned in Thermotropic Liquid Crystals: Sensitivity and Resolution Enhancement in the Indirect Dimension

The spectra of molecules oriented in liquid crystalline media are dominated by partially averaged dipolar couplings. In the 13C–1H HSQC, due to the inefficient hetero-nuclear dipolar decoupling in the indirect dimension, normally carried out by using a π pulse, there is a considerable loss of resolution. Furthermore, in such strongly orienting media the 1H–1H and 13C–1H dipolar couplings leads to fast dephasing of transverse magnetization causing inefficient polarization transfer and hence the loss of sensitivity in the indirect dimension. In this study we have carried out 13C–1H HSQC experiment with efficient polarization transfer from 1H to 13C for molecules aligned in liquid crystalline media. The homonuclear dipolar decoupling using FFLG during the INEPT transfer delays and also during evolution period combined with the π pulse heteronuclear decoupling in the t1 period has been applied. The studies showed a significant reduction in partially averaged dipolar couplings and thereby enhancement in the resolution and sensitivity in the indirect dimension. This has been demonstrated on pyridazine and pyrimidine oriented in the liquid crystal. The two closely resonating carbons in pyrimidine are better resolved in the present study compared to the earlier work [H.S. Vinay Deepak, Anu Joy, N. Suryaprakash, Determination of natural abundance 15N–1H and 13C–1H dipolar couplings of molecules in a strongly orienting media using two-dimensional inverse experiments, Magn. Reson. Chem. 44 (2006) 553–565].

A enfermeira obstétrica frente às transformações de sua prática consequente ao movimento de humanização do campo obstétrico hospitalar

Este estudo de perspectiva histórico-social estuda as transformações das práticas das enfermeiras obstétricas consequente ao movimento de humanização do campo obstétrico hospitalar. Tem por objetivos: identificar o capital global das enfermeiras obstétricas; analisar as concepções das enfermeiras sobre a prática profissional no campo obstétrico hospitalar no contexto do movimento de humanização; discutir as transformações percebidas pelas enfermeiras obstétricas sobre sua prática. Utilizei como método a história oral. Os sujeitos foram 25 enfermeiras que vivenciaram no campo obstétrico hospitalar, antes e após a implementação do movimento de humanização. Os cenários foram seis maternidades municipais do Rio de Janeiro. A técnica de coleta de dados foi a entrevista semiestruturada. À luz da perspectiva histórica realizarei a análise dos dados, tendo como base os pressupostos de Pierre Bourdieu. A conjuntura obstétrica do nascimento das entrevistadas era a de transição do parto domiciliar para o ambiente hospitalar. O cenário do parto e nascimento de muitas delas foi uma instituição pública de saúde ou conveniada. As agentes são oriundas de famílias humildes, com pouco capital econômico e cultural. Ressalta-se que as condições de acumulação de capital destas enfermeiras, à época, foram proporcionais às oportunidades que tiveram no campo social em que se encontravam e do processo de socialização. Algumas, após o curso de graduação em enfermagem, buscaram a especialização para adquirir um certificado, que lhes aumentasse o volume de capital e as legitimasse para a realização da assistência ao parto normal. O contexto político onde muitas adquiriram o título de especialista era o de implementação do modelo humanizado no campo obstétrico do município do Rio de Janeiro, favorável para a redução de práticas intervencionistas à parturiente com o incentivo ao parto normal focado na autonomia e no empoderamento feminino. Desse modo, as enfermeiras perceberam que as lutas dos agentes no campo obstétrico para a implantação de um novo modo de agir na obstetrícia foram importantes no processo de mudança de suas práticas. Especificamente sobre as transformações de sua práticas elas evidenciaram que, com esse movimento social e político elas passaram a ver e a assistir a mulher, de forma mais próxima, mais humanizada através da aquisição de capital cultural eficiente, outra evidência destacada foi quanto à questão das lutas, houve o reconhecimento de que as lutas foram importantes no processo de mudança, pois com estas foi possível adquirir lucros simbólicos significativos que permitiram gerar mudanças de posição e de práticas obstétricas no campo hospitalar.

Desenvolvimento de um sistema de detecção fotoacústico utilizando dois microfones: aplicações em medidas de difusividade térmica

Neste trabalho, desenvolveu-se um sistema de detecção fotoacústico para medidas simultâneas e independentes dos sinais fotoacústicos dianteiro e traseiro, utilizando dois microfones e um único feixe de excitação. Utiliza-se a diferença de fase entre estes sinais para a determinação da difusividade térmica de materiais, com base na abordagem teórica da técnica da Diferença de Fase dos Dois Feixes (T2F). Na metodologia apresentada não há a necessidade de se alternar o feixe de excitação entre as faces da amostra. Esta característica torna mais rápido o procedimento de medida e simplifica o monitoramento automatizado de processos dinâmicos que afetam a difusividade térmica do material, como a cura de resinas poliméricas. É apresentado o procedimento utilizado para determinar a diferença entre as fases intrínsecas dos microfones e o método empregado para compensar tal diferença e, assim, obter a defasagem entre os sinais fotoacústicos dianteiro e traseiro. O sistema de detecção desenvolvido é avaliado em medidas de difusividade térmica de amostras metálicas (aço inoxidável AISI 304 e aço SAE 1020) e poliméricas (polipropileno e polietileno de baixa densidade). Os resultados obtidos concordam de forma satisfatória com dados disponíveis na literatura. Finalmente, a aplicação do sistema proposto ao monitoramento de cura de amostras de resina epóxi indicou sua potencialidade de acompanhar, em tempo real, este tipo de processo dinâmico.