1000 resultados para laadullinen tutkimus
Resumo:
The number of immigrant students in vocational education and training is steadily increasing in Finland. This poses challenges for teachers and schools. This research focuses on emerging questions of intercultural learning in the context of immigrant training, and on a method the Culture Laboratory that was developed in an attempt to respond to the challenges. The main methodological and theoretical framework lies in cultural-historical activity theory, developmental work research, and in the concepts of the intercultural and hybridity. The empirical material consists of videotaped recordings of discussions in the Culture Laboratory. The five main research questions focused on the strengths and limitations of the Culture Laboratory as a tool for intercultural learning, the significance of disturbances in it, the potential of suggestions for intercultural learning, paper as a mediating artifact , and the concept of intercultural space. The findings showed that the Culture Laboratory offered a solid background for developing intercultural learning. The disturbances manifested revealed a multitude of scripts and activities. It was also suggested that the structure of expansive learning could start from externalization instead of internalization. The suggestions the participants made opened up a hybrid learning space for intercultural development, and offered a good springboard for new ideas. Learning in Paperland posed both challenges and opportunities for immigrant students, and different paper trails emerged. Intercultural space in the Culture Laboratory was a developmental zone in which a hybrid process of observing, comparing, and creating took place. Key words: intercultural learning, immigrant training, cultural-historical activity theory, developmental work research,
Resumo:
Reciprocal development of the object and subject of learning. The renewal of the learning practices of front-line communities in a telecommunications company as part of the techno-economical paradigm change. Current changes in production have been seen as an indication of a shift from the techno-economical paradigm of a mass-production era to a new paradigm of the information and communication technological era. The rise of knowledge management in the late 1990s can be seen as one aspect of this paradigm shift, as knowledge creation and customer responsiveness were recognized as the prime factors in business competition. However, paradoxical conceptions concerning learning and agency have been presented in the discussion of knowledge management. One prevalent notion in the literature is that learning is based on individuals’ voluntary actions and this has now become incompatible with the growing interest in knowledge-management systems. Furthermore, commonly held view of learning as a general process that is independent of the object of learning contradicts the observation that the current need for new knowledge and new competences are caused by ongoing techno-economic changes. Even though the current view acknowledges that individuals and communities have key roles in knowledge creation, this conception defies the idea of the individuals’ and communities’ agency in developing the practices through which they learn. This research therefore presents a new theoretical interpretation of learning and agency based on Cultural-Historical Activity Theory. This approach overcomes the paradoxes in knowledge-management theory and offers means for understanding and analyzing changes in the ways of learning within work communities. This research is also an evaluation of the Competence-Laboratory method which was developed as part of the study as a special application of Developmental Work Research methodology. The research data comprises the videotaped competence-laboratory processes of four front-line work communities in a telecommunications company. The findings reported in the five articles included in this thesis are based on the analyses of this data. The new theoretical interpretation offered here is based on the assessment that the findings reported in the articles represent one of the front lines of the ongoing historical transformation of work-related learning since the research site represents one of the key industries of the new “knowledge society”. The research can be characterized as elaboration of a hypothesis concerning the development of work related learning. According to the new theoretical interpretation, the object of activity is also the object of distributed learning in work communities. The historical socialization of production has increased the number of actors involved in an activity, which has also increased the number of mutual interdependencies as well as the need for communication. Learning practices and organizational systems of learning are historically developed forms of distributed learning mediated by specific forms of division of labor, specific tools, and specific rules. However, the learning practices of the mass production era become increasingly inadequate to accommodate the conditions in the new economy. This was manifested in the front-line work communities in the research site as an aggravating contradiction between the new objects of learning and the prevailing learning practices. The constituent element of this new theoretical interpretation is the idea of a work community’s learning as part of its collaborative mastery of the developing business activity. The development of the business activity is at the same time a practical and an epistemic object for the community. This kind of changing object cannot be mastered by using learning practices designed for the stable conditions of mass production, because learning has to change along the changes in business. According to the model introduced in this thesis, the transformation of learning proceeds through specific stages: predefined learning tasks are first transformed into learning through re-conceptualizing the object of the activity and of the joint learning and then, as the new object becomes stabilized, into the creation of new kinds of learning practices to master the re-defined object of the activity. This transformation of the form of learning is realized through a stepwise expansion of the work community’s agency. To summarize, the conceptual model developed in this study sets the tool-mediated co-development of the subject and the object of learning as the theoretical starting point for developing new, second-generation knowledge management methods. Key words: knowledge management, learning practice, organizational system of learning, agency
Resumo:
Work stress is after musculoskeletal disorders the second most common work-related health problem in the European Union, affecting 28% of EU employees. Furthermore, a 50% excessive cardiovascular disease risk among employees with work stress is reported. High job demands combined with low job control according to the Job Demands-Job Control model, or high effort combined with low rewards according to Effort-Reward Imbalance model, are likely to produce work stress in the majority of employees. Atherosclerotic wall thickening is a validated marker of an increased risk of cardiovascular disease. This study examined the role of childhood and adolescent factors as antecedents of work stress and early atherosclerosis, and in the relationship between them. The Cardiovascular Risk in Young Finns Study, (the CRYF project) started in 1980 when the participants were at the age of three to 18 years. Follow-ups have been conducted every three years until 1992, after that in 1997 and 2001, and the latest is ongoing in 2008. The participants parents reported their socioeconomic position in 1980 and 1983, and their life satisfaction in 1983. Biological risk factors were measured in 1980 and 2001. Type A behaviour was reported in 1986, 1989 and 2001. In the 2001 follow-up when the participants were aged 24 to 39, work stress was assessed from responses to questionnaires on job demands-job control and effort-reward imbalance, and education. Ultrasound measurement of the carotid intima-media thickness (CIMT) was used to assess atherosclerosis. There were 755, 746, 1014 and 494 participants in studies I-IV, respectively. The results showed that low parental socioeconomic position and parental life dissatisfaction during childhood and adolescence predicted higher levels of job strain 18 years later, and that education mediated the relationship between parental socioeconomic position and job strain. Childhood and adolescent family factors were not related to the effort-reward imbalance. Parental life satisfaction was associated with high rewards at work among the men, and high parental socioeconomic position was associated with high reward among the women. Among the men, the eagerness-energy component of Type A behaviour across different developmental periods predicted increased CIMT. Among the women, hard-driving component of Type A behaviour predicted decreased CIMT. Low leadership characteristic in adolescence and early adulthood was associated with both high job strain and increased CIMT, and attenuated the relationship between job strain and CIMT to non-significance in men. The current findings add to the literature on the relationship between job strain and health literature in adopting a developmental perspective. The results imply that work stress does not completely originate from work. There are childhood and adolescent environmental and dispositional effects on work stress and CIMT several years later, and these partly seem to operate through educational attainment.
Resumo:
In a musical context, the pitch of sounds is encoded according to domain-general principles not confined to music or even to audition overall but common to other perceptual and cognitive processes (such as multiple pattern encoding and feature integration), and to domain-specific and culture-specific properties related to a particular musical system only (such as the pitch steps of the Western tonal system). The studies included in this thesis shed light on the processing stages during which pitch encoding occurs on the basis of both domain-general and music-specific properties, and elucidate the putative brain mechanisms underlying pitch-related music perception. Study I showed, in subjects without formal musical education, that the pitch and timbre of multiple sounds are integrated as unified object representations in sensory memory before attentional intervention. Similarly, multiple pattern pitches are simultaneously maintained in non-musicians' sensory memory (Study II). These findings demonstrate the degree of sophistication of pitch processing at the sensory memory stage, requiring neither attention nor any special expertise of the subjects. Furthermore, music- and culture-specific properties, such as the pitch steps of the equal-tempered musical scale, are automatically discriminated in sensory memory even by subjects without formal musical education (Studies III and IV). The cognitive processing of pitch according to culture-specific musical-scale schemata hence occurs as early as at the sensory-memory stage of pitch analysis. Exposure and cortical plasticity seem to be involved in musical pitch encoding. For instance, after only one hour of laboratory training, the neural representations of pitch in the auditory cortex are altered (Study V). However, faulty brain mechanisms for attentive processing of fine-grained pitch steps lead to inborn deficits in music perception and recognition such as those encountered in congenital amusia (Study VI). These findings suggest that predispositions for exact pitch-step discrimination together with long-term exposure to music govern the acquisition of the automatized schematic knowledge of the music of a particular culture that even non-musicians possess.
Resumo:
Studying the continuity and underlying mechanisms of temperament change from early childhood through adulthood is clinically and theoretically relevant. Knowledge of the continuity and change of temperament from infancy onwards, especially as perceived by both parents is, however, still scanty. Only in recent years have researchers become aware that personality, long considered as stable in adulthood, may also change. Further, studies that focus on the transactional change of child temperament and parental personality also seem to be lacking, as are studies focusing on transactions between child temperament and more transient parental characteristics, like parental stress. Therefore, this longitudinal study examined the degree of continuity of temperament over five years from the infant s age of six months to the child s age of five and a half years, as perceived by both biological parents, and also investigated the bidirectional effects between child temperament and parents personality traits and overall stress experienced during that time. First, moderate to high levels of continuity of temperament from infancy to middle childhood were shown, depicting the developmental links between affectively positive and well-adjusted temperament characteristics, and between characteristics of early and later negative affectivity. The continuity of temperament was quantitatively and qualitatively similar in both parents ratings. The findings also demonstrate that infant and childhood temperament characteristics cluster to form stable temperament types that resemble personality types shown in child and adult personality studies. Second, the parental personality traits of extraversion and neuroticism were shown to be highly stable over five years, but evidence of change in relation to parents views of their child s temperament was also shown: an infant s higher positive affectivity predicted an increase in parental extraversion, while the infant s higher activity level predicted a decrease in parental neuroticism over five years. Furthermore, initially higher parental extraversion predicted higher ratings of the child s effortful control, while initially higher parental neuroticism predicted the child s higher negative affectivity. In terms of changes in parental stress, the infant s higher activity level predicted a decrease in maternal overall stress, while initially higher maternal stress predicted a higher level of child negative affectivity in middle childhood. Together, the results demonstrate that the mother- and father-rated temperament of the child shows continuity during the early years of life, but also support the view that the development of these characteristics is sensitive to important contextual factors such as parental personality and overall stress. While parental personality and experienced stress were shown to have an effect on the child s developing temperament, the reverse was also true: the parents own personality traits and perceived stress seemed to be highly stable, but also susceptible to their experiences of their child s temperament.
Resumo:
In the 1990 s the companies utilizing and producing new information technology, especially so-called new media, were also expected to be forerunners in new forms of work and organization. Researchers anticipated that new, more creative forms of work and the changing content of working life were about to replace old industrial and standardized ways of working. However, research on actual companies in the IT sector revealed a situation where only minor changes to existing organizational forms were seen .Many of the independent companies faced great difficulties trying to survive the rapid changes in the products and production forms in the emerging field. Most of the research on the new media field has been conducted as surveys, and an understanding of the actual everyday work process has remained thin. My research is a longitudinal study of the early phases of one new media company in Finland. The study is an analysis of the challenges the company faced in a rapidly changing business field and the attempts to overcome these challenges. The two main analyses in the study focus on the developmental phases of the company and the disturbances in the production process. Based on these analyses, I study changes and learning at work using the methodological framework of developmental work research. Developmental work research is a Finnish variant of the cultural-historical activity theory applied to the study of learning and transformations at work. The data was gathered over a three-year period of ethnographic fieldwork. I documented the production processes and everyday life in the company as a participant observer. I interviewed key persons, video and audio-taped meetings, followed e-mail correspondence and collected various documents, such as agreements and memos. I developed a systematic method for analyzing the disturbances in the production process by combining the various data sources. The systematic analysis of the disturbances depicted a very complex and only partly managed production process. The production process had a long duration, and no single actor had an understanding of it as a whole. Most of the disturbances had to do with the customer relationships. The nature of the disturbances was latent; they were recognized but not addressed. In the particular production processes that I analyzed, the ending life span of a particular product, a CD-ROM, became obvious. This finding can be interpreted in relation to the developmental phase of the production and the transformation of the field as a whole. Based on the analysis of the developmental phases and the disturbances, I formulate a hypothesis of the contradictions and developmental potentials of the activity studied. The conclusions of the study challenge the existing understanding of how to conceptualize and study organizational learning in production work. Most theories of organizational learning do not address qualitative changes in production nor historical challenges of organizational learning itself. My study opens up a new horizon in understanding organizational learning in a rapidly changing field where a learning culture based on craft or mass production work is insufficient. There is a need for anticipatory and proactive organizational learning. Proactive learning is needed to anticipate the changes in production type, and the life cycles of products.
Resumo:
The aim of this dissertation is to explore the academic thinking and personal epistemology of university students. More specifically, the aim is to understand and promote students’ research and academic skills as a central goal of academic studies in the research-intensive university of Helsinki. Two of the four studies examine the personal epistemology of psychology students in different study phases, and the variation in personal epistemology among final-year psychology, theology and pharmacy students. Furthermore, personal epistemology was explored as a phenomenon among the student groups. In the fourth study the individual answers of the students interviewed are investigated in more detail. The main focus is on examining students’ beliefs about the nature of knowledge and knowledge acquisition as a representation of their personal epistemology. Study I presents a model which describes the main elements and aspects of teaching and learning in pharmacy education. Firstly, the meaning of quality of teaching and learning is explored. On the basis of this information, the study concentrates on the pedagogical implications of changing pharmacy teaching to improve the quality of learning. Study II describes the results of a cross-sectional study of psychology students participating in undergraduate and master’s level psychology programmes. The students (N = 53) were interviewed concerning their beliefs about knowledge and knowing, the aim being to explore students’ responses about thinking and reasoning. The results are analysed using content analysis to create categories of personal epistemology and comparisons among the students according to the phase of their studies. Study III examines interdisciplinary differences in final-year psychology, pharmacy and theology students’ (N = 52) academic thinking and personal epistemology. The aims of study IV are to examine and compare the consistency of personal epistemology profiles among university students (N = 87) representing three academic disciplines. The individual answers are examined and rated on a scale from absolutist to evaluativist thinking. On the basis of this data, three personal epistemology profiles are identified: a) absolutist profiles; b) relativistic profiles; and c) evaluativist profiles consisting of the subgroups entitled “limited” and “sophisticated”. The results of the studies clearly demonstrate that personal epistemology varies between students in different age groups, study phases, and disciplines. Three categories, including several subcategories, emerge to describe the personal epistemology of students. Furthermore, three personal epistemology profiles can be identified from the data. The comparison between students reveals interesting differences and similarities among student groups, and developmental trends of personal epistemology.
Resumo:
The aim of this dissertation was to adapt a questionnaire for assessing students’ approaches to learning and their experiences of the teaching-learning environment. The aim was to explore the validity of the modified Experiences of Teaching and Learning Questionnaire (ETLQ) by examining how the instruments measure the underlying dimensions of student experiences and their learning. The focus was on the relation between students’ experiences of their teaching-learning environment and their approaches to learning. Moreover, the relation between students’ experiences and students’ and teachers’ conceptions of good teaching was examined. In Study I the focus was on the use of the ETLQ in two different contexts: Finnish and British. The study aimed to explore the similarities and differences between the factor structures that emerged from both data sets. The results showed that the factor structures concerning students’ experiences of their teaching-learning environment and their approaches to learning were highly similar in the two contexts. Study I also examined how students’ experiences of the teaching-learning environment are related to their approaches to learning in the two contexts. The results showed that students’ positive experiences of their teaching-learning environment were positively related to their deep approach to learning and negatively to the surface approach to learning in both the Finnish and British data sets. This result was replicated in Study II, which examined the relation between approaches to learning and experiences of the teaching-learning environment on a group level. Furthermore, Study II aimed to explore students’ approaches to learning and their experiences of the teaching-learning environment in different disciplines. The results showed that the deep approach to learning was more common in the soft sciences than in the hard sciences. In Study III, students’ conceptions of good teaching were explored by using qualitative methods, more precisely, by open-ended questions. The aim was to examine students’ conceptions, disciplinary differences and their relation to students’ approaches to learning. The focus was on three disciplines, which differed in terms of students’ experiences of their teaching-learning environment. The results showed that students’ conceptions of good teaching were in line with the theory of good teaching and there were disciplinary differences in their conceptions. Study IV examined university teachers’ conceptions of good teaching, which corresponded to the learning-focused approach to teaching. Furthermore, another aim in this doctoral dissertation was to compare the students’ and teachers’ conceptions of good teaching, the results of which showed that these conceptions appear to have similarities. The four studies indicated that the ETLQ appears to be a sufficiently robust measurement instrument in different contexts. Moreover, its strength is its ability to be at the same time a valid research instrument and a practical tool for enhancing the quality of students’ learning. In addition, the four studies emphasise that in order to enhance teaching and learning in higher education, various perspectives have to be taken into account. This study sheds light on the interaction between students’ approaches to learning, their conceptions of good teaching, their experiences of the teaching-learning environment, and finally, the disciplinary culture.
Resumo:
Multiple sclerosis (MS) is a chronic, inflammatory disease of the central nervous system, characterized especially by myelin and axon damage. Cognitive impairment in MS is common but difficult to detect without a neuropsychological examination. Valid and reliable methods are needed in clinical practice and research to detect deficits, follow their natural evolution, and verify treatment effects. The Paced Auditory Serial Addition Test (PASAT) is a measure of sustained and divided attention, working memory, and information processing speed, and it is widely used in MS patients neuropsychological evaluation. Additionally, the PASAT is the sole cognitive measure in an assessment tool primarly designed for MS clinical trials, the Multiple Sclerosis Functional Composite (MSFC). The aims of the present study were to determine a) the frequency, characteristics, and evolution of cognitive impairment among relapsing-remitting MS patients, and b) the validity and reliability of the PASAT in measuring cognitive performance in MS patients. The subjects were 45 relapsing-remitting MS patients from Seinäjoki Central Hospital, Department of Neurology and 48 healthy controls. Both groups underwent comprehensive neuropsychological assessments, including the PASAT, twice in a one-year follow-up, and additionally a sample of 10 patients and controls were evaluated with the PASAT in serial assessments five times in one month. The frequency of cognitive dysfunction among relapsing-remitting MS patients in the present study was 42%. Impairments were characterized especially by slowed information processing speed and memory deficits. During the one-year follow-up, the cognitive performance was relatively stable among MS patients on a group level. However, the practice effects in cognitive tests were less pronounced among MS patients than healthy controls. At an individual level the spectrum of MS patients cognitive deficits was wide in regards to their characteristics, severity, and evolution. The PASAT was moderately accurate in detecting MS-associated cognitive impairment, and 69% of patients were correctly classified as cognitively impaired or unimpaired when comprehensive neuropsychological assessment was used as a "gold standard". Self-reported nervousness and poor arithmetical skills seemed to explain misclassifications. MS-related fatigue was objectively demonstrated as fading performance towards the end of the test. Despite the observed practice effect, the reliability of the PASAT was excellent, and it was sensitive to the cognitive decline taking place during the follow-up in a subgroup of patients. The PASAT can be recommended for use in the neuropsychological assessment of MS patients. The test is fairly sensitive, but less specific; consequently, the reasons for low scores have to be carefully identified before interpreting them as clinically significant.
Resumo:
Selective attention refers to the process in which certain information is actively selected for conscious processing, while other information is ignored. The aim of the present studies was to investigate the human brain mechanisms of auditory and audiovisual selective attention with functional magnetic resonance imaging (fMRI), electroencephalography (EEG) and magnetoencephalography (MEG). The main focus was on attention-related processing in the auditory cortex. It was found that selective attention to sounds strongly enhances auditory cortex activity associated with processing the sounds. In addition, the amplitude of this attention-related modulation was shown to increase with the presentation rate of attended sounds. Attention to the pitch of sounds and to their location appeared to enhance activity in overlapping auditory-cortex regions. However, attention to location produced stronger activity than attention to pitch in the temporo-parietal junction and frontal cortical regions. In addition, a study on bimodal attentional selection found stronger audiovisual than auditory or visual attention-related modulations in the auditory cortex. These results were discussed in light of Näätänen s attentional-trace theory and other research concerning the brain mechanisms of selective attention.
Resumo:
The aim of the present study was to advance the methodology and use of time series analysis to quantify dynamic structures in psychophysiological processes and thereby to produce information on spontaneously coupled physiological responses and their behavioral and experiential correlates. Series of analyses using both simulated and empirical cardiac (IBI), electrodermal (EDA), and facial electromyographic (EMG) data indicated that, despite potential autocorrelated structures, smoothing increased the reliability of detecting response coupling from an interindividual distribution of intraindividual measures and that especially the measures of covariance produced accurate information on the extent of coupled responses. This methodology was applied to analyze spontaneously coupled IBI, EDA, and facial EMG responses and vagal activity in their relation to emotional experience and personality characteristics in a group of middle-aged men (n = 37) during the administration of the Rorschach testing protocol. The results revealed new characteristics in the relationship between phasic end-organ synchronization and vagal activity, on the one hand, and individual differences in emotional adjustment to novel situations on the other. Specifically, it appeared that the vagal system is intimately related to emotional and social responsivity. It was also found that the lack of spontaneously synchronized responses is related to decreased energetic arousal (e.g., depression, mood). These findings indicate that the present process analysis approach has many advantages for use in both experimental and applied research, and that it is a useful new paradigm in psychophysiological research. Keywords: Autonomic Nervous System; Emotion; Facial Electromyography; Individual Differences; Spontaneous Responses; Time Series Analysis; Vagal System
Resumo:
In clinical settings impulsivity refers to a symptom of psychiatric disorder, but nonclinically oriented research treats impulsivity as a personality and temperament dimension. This prospective study examined whether impulsivity predicts adverse health-related behaviour and increased risk of health problems in a large, nonclinical sample of 5433 subjects working in 12 Finnish hospitals. The data were collected using two questionnaire surveys at a 2-year interval. After controlling for alcohol use at baseline, higher impulsivity predicted increased alcohol consumption at follow-up in both genders (p < .01) and was associated with increased likelihood of becoming a heavy drinker or taking up smoking (p < .05). Impulsivity also predicted an increased number of cigarettes smoked per day in the follow-up among women (p < .001), but not among men, although adjustment for the number of cigarettes smoked at baseline attenuated these associations (p = .08 for women). In men, higher impulsivity was associated with shorter sleep duration and waking up several times per night independent of baseline characteristics (p < .01), whereas in women, higher impulsivity predicted difficulty in falling asleep and waking up feeling tired after the usual amount of sleep (p < .05). In women, these associations became nonsignificant after adjustment for pre-existing somatic and psychiatric diseases. Finally, higher impulsivity was associated with an increased 2-year incidence of physician-diagnosed peptic ulcer disease (adjusted odds ratio (OR) = 2.42, 95% confidence interval (CI) = 1.21 - 4.82) and onset of depression (OR = 1.95, 95% CI = 1.28 - 2.97) after adjustment for a variety of baseline covariates. In conclusion, this study shows that in a nonclinical population, impulsivity appears to be a risk factor for various unhealthy behaviour and health problems.
Resumo:
This thesis presents an experimental study of the speech prosody of identical and non-identical twins. Speech fluency, pauses, speech rate, utterance length and speech frequency were examined phonetically, auditorily, semantically and statistically. The methods included both reading tasks (reading the alphabet, numerical lists, sentences with foreign loan words, holiday theme questions as well as 1.5 pages of text with long sentences and complex words) and spontaneous speech tasks (picture description and answering holiday theme questions). The subjects were Finnish-speaking 22-28-year-old female twins: 8 identical (monozygotic) and 10 non-identical (dizygotic) pairs. One pair was male-female. Comparisons were made between twin groups and between sisters. The data was regathered from four twin pairs, to make it possible to investigate some subjects intra-individually. In addition phoneticians, phonetic students and people without knowledge of phonetic science were tested in two listening experiments. The results showed that the dizygotic twins differed more from each other than monozygotic twins and that monozygotic twin sisters shared more similarities than dizygotic twin sisters. For example, between monozygotic twin sisters smaller differences were found between word count, utterance length and speech rate in spontaneous speech tasks. Dizygotic twin sisters made more different kinds of reading mistakes with the same target words than monozygotic twin sisters, while monozygotic twin sisters made more of the same reading mistakes with the same target words than dizygotic twin sisters. The listening experiments showed that only professional phoneticians were able to recognize the twin sisters. Even though the twins had the possibility to freely choose their speech rate, pausing and speech frequency, they used their own speech patterns; these included the same average speech frequency, average speech rate, type of pausing routine or filled pauses, and other speech mannerisms throughout their speech.
Resumo:
Cognitive impairments of attention, memory and executive functions are a fundamental feature of the pathophysiology of schizophrenia. The neurophysiological and neurochemical changes in the auditory cortex are shown to underlie cognitive impairmentsin schizophrenia patients. Functional state of the neural substrate of auditory information processing could be objectively and non-invasively probed with auditory event-related potentials (ERPs) and event- related fields (ERFs). In the current work, we explored the neurochemical effect on the neural origins of auditory information processing in relation to schizophrenia. By means of ERPs/ERFs we aimed to determine how neural substrates of auditory information processing are modulated by antipsychotic medication in schizophrenia spectrum patients (Studies I, II) and by neuropharmacological challenges in healthy human subjects (Studies III, IV). First, with auditory ERPs we investigated the effects of olanzapine (Study I) and risperidone (Study II) in a group of patients with schizophrenia spectrum disorders. After 2 and 4 weeks of treatment, olanzapine has no significant effects on mismatch negativity(MMN) and P300, which, as it has been suggested, respectively reflect preattentive and attention-dependent information processing. After 2 weeks of treatment, risperidone has no significant effect on P300, however risperidone reduces P200 amplitude. This latter effect of risperidone on neural resources responsible for P200 generation could be partly explained through the action of dopamine. Subsequently, we used simultaneous EEG/MEG to investigate the effects of memantine (Study III) and methylphenidate (Study IV) in healthy subjects. We found that memantine modulates MMN response without changing other ERP components. This could be interpreted as being due to the possible influence of memantine through the NMDA receptors on auditory change- detection mechanism, with processing of auditory stimuli remaining otherwise unchanged. Further, we found that methylphenidate does not modulate the MMN response. This finding could indicate no association between catecholaminergic activities and electrophysiological measures of preattentive auditory discrimination processes reflected in the MMN. However, methylphenidate decreases the P200 amplitudes. This could be interpreted as a modulation of auditory information processing reflected in P200 by dopaminergic and noradrenergic systems. Taken together, our set of studies indicates a complex pattern of neurochemical influences produced by the antipsychotic drugs in the neural substrate of auditory information processing in patients with schizophrenia spectrum disorders and by the pharmacological challenges in healthy subjects studied with ERPs and ERFs.
Resumo:
This study examines boundaries in health care organizations. Boundaries are sometimes considered things to be avoided in everyday living. This study suggests that boundaries can be important temporally and spatially emerging locations of development, learning, and change in inter-organizational activity. Boundaries can act as mediators of cultural and social formations and practices. The data of the study was gathered in an intervention project during the years 2000-2002 in Helsinki in which the care of 26 patients with multiple and chronic illnesses was improved. The project used the Change Laboratory method that represents a research assisted method for developing work. The research questions of the study are: (1) What are the boundary dynamics of development, learning, and change in health care for patients with multiple and chronic illnesses? (2) How do individual patients experience boundaries in their health care? (3) How are the boundaries of health care constructed and reconstructed in social interaction? (4) What are the dynamics of boundary crossing in the experimentation with the new tools and new practice? The methodology of the study, the ethnography of the multi-organizational field of activity, draws on cultural-historical activity theory and anthropological methods. The ethnographic fieldwork involves multiple research techniques and a collaborative strategy for raising research data. The data of this study consists of observations, interviews, transcribed intervention sessions, and patients' health documents. According to the findings, the care of patients with multiple and chronic illnesses emerges as fragmented by divisions of a patient and professionals, specialties of medicine and levels of health care organization. These boundaries have a historical origin in the Finnish health care system. As an implication of these boundaries, patients frequently experience uncertainty and neglect in their care. However, the boundaries of a single patient were transformed in the Change Laboratory discussions among patients, professionals and researchers. In these discussions, the questioning of the prevailing boundaries was triggered by the observation of gaps in inter-organizational care. Transformation of the prevailing boundaries was achieved in implementation of the collaborative care agreement tool and the practice of negotiated care. However, the new tool and practice did not expand into general use during the project. The study identifies two complementary models for the development of health care organization in Finland. The 'care package model', which is based on productivity and process models adopted from engineering and the 'model of negotiated care', which is based on co-configuration and the public good.