“THE PATIENT SURVIVED DESPITE THE TREATMENT”. A study of Finnish health policy and New Public Management. Case: The Government Resolution on the Health 2015 public health programme.

Internationally, Finland has been among the most respected countries during several decades in terms of public health. WHO has had the most significant influence on Finnish health policy and the relationship has traditionally been warm. However, the situation has slightly changed in the last 10-20 years. The objectives of Finnish national health policy have been to secure the best possible health for the population and to minimize disparities in health between different population groups. Nevertheless, although the state of public health and welfare has steadily improved, the socioeconomic disparities in health have increased. This qualitative case study will demonstrate why health is political and why health matters. It will also present some recommendations for research topics and administrative reforms. It will be argued that lack of political interest in health policy leads to absence of health policy visions and political commitment, which can be disastrous for public health. This study will investigate how Finnish health policy is defined and organised, and it will also shed light on Finnish health policy formation processes and actors. Health policy is understood as a broader societal construct covering the domains of different ministries, not just Ministry of Social Affairs and Health (MSAH). The influences of economic recession of the 1990s, state subsidy reform in 1993, globalisation and the European Union will be addressed, as well. There is not much earlier Finnish research done on health policy from political science viewpoint. Therefore, this study is interdisciplinary and combines political science with administrative science, contemporary history and health policy research with a hint of epidemiology. As a method, literature review, semi-structured interviews and policy analysi will be utilised. Institutionalism, policy transfer, and corporatism are understood as the theoretical framework. According to the study, there are two health policies in Finland: the official health policy and health policy generated by industry, media and various interest organisations. The complex relationships between the Government and municipalities, and on the other hand, the MSAH and National Institute for Health and Welfare (THL) seemed significant in terms of Finnish health policy coordination. The study also showed that the Investigated case, Health 2015, does not fulfil all necessary criteria for a successful public health programme. There were also several features both in Health 2015 and Finnish health policy, which can be interpreted in NPM framework and seen having NPM influences.

Adult education policy in the European Union during the Lisbon decade : the shift to vocational adult learning and work skills matching

This doctoral dissertation investigates the adult education policy of the European Union (EU) in the framework of the Lisbon agenda 2000–2010, with a particular focus on the changes of policy orientation that occurred during this reference decade. The year 2006 can be considered, in fact, a turning point for the EU policy-making in the adult learning sector: a radical shift from a wide--ranging and comprehensive conception of educating adults towards a vocationally oriented understanding of this field and policy area has been observed, in particular in the second half of the so--called ‘Lisbon decade’. In this light, one of the principal objectives of the mainstream policy set by the Lisbon Strategy, that of fostering all forms of participation of adults in lifelong learning paths, appears to have muted its political background and vision in a very short period of time, reflecting an underlying polarisation and progressive transformation of European policy orientations. Hence, by means of content analysis and process tracing, it is shown that the new target of the EU adult education policy, in this framework, has shifted from citizens to workers, and the competence development model, borrowed from the corporate sector, has been established as the reference for the new policy road maps. This study draws on the theory of governance architectures and applies a post-ontological perspective to discuss whether the above trends are intrinsically due to the nature of the Lisbon Strategy, which encompasses education policies, and to what extent supranational actors and phenomena such as globalisation influence the European governance and decision--making. Moreover, it is shown that the way in which the EU is shaping the upgrading of skills and competences of adult learners is modeled around the needs of the ‘knowledge economy’, thus according a great deal of importance to the ‘new skills for new jobs’ and perhaps not enough to life skills in its broader sense which include, for example, social and civic competences: these are actually often promoted but rarely implemented in depth in the EU policy documents. In this framework, it is conveyed how different EU policy areas are intertwined and interrelated with global phenomena, and it is emphasised how far the building of the EU education systems should play a crucial role in the formation of critical thinking, civic competences and skills for a sustainable democratic citizenship, from which a truly cohesive and inclusive society fundamentally depend, and a model of environmental and cosmopolitan adult education is proposed in order to address the challenges of the new millennium. In conclusion, an appraisal of the EU’s public policy, along with some personal thoughts on how progress might be pursued and actualised, is outlined.

Kallet til livets embete : mødre i helse og lidelse

Mothers represent the natural caring. Natural caring is the object of caring science and of research interest because it establishes the central core of professional caring. In this study, we encounter patients who are mothers in need of care in a psychiatric context. Motherhood involves taking responsibility that extends beyond one's own life, because the child represents possibilities in a yet unknown future. Understanding and knowledge about the mothers' struggle in health and suffering are of crucial importance to enable clinical practice to make provisions for and adapt to the individual patient. The overall purpose of this dissertation is to illuminate how the innermost essence of caring emerges in health and suffering in patients who are mothers in psychiatric care. The purpose of the study in a clinical sense is to seek to understand and illuminate the patient's inner world in health and suffering in terms of contextual, existential, ontological and ethical dimensions. The dissertation is exploratory and descriptive in nature and encompasses induction, deduction and abduction as logics tools of reasoning. A theoretical model of natural caring and a universal theoretical model of the innermost essence of caring is developed as seen from the patient's world in a psychiatric context. The dissertation is anchored in human science's view of the human being and the world and in caring science's perspective. Caring science's view of the human being as a unity comprising body, soul and spirit is central in the study's concept of the patient. This multi-dimensional conception of the human being encompasses the dissertation's basic values and is decisive for choice of methodology. Hermeneutic epistemology guided the interpretation of the empirical data, the paradigmatic theses and assumptions. The dialectical movement in interpretation moves back and forth between empirical data, caring science theory and philosophical theory and reveals deeper insight into meaningful content in the clinical context. The interpretation process comprises four levels of abstraction: rational, contextual, existential and ontological. Hermeneutic philosophy guides the inductive and deductive approach to interpretation, as well as the movement between the clinical context and the caring science paradigm. In this encounter between the visible and invisible reality, the image of natural caring – motherliness emerged. The dissertation consists of four studies. The first study is a systematic review of nineteen research articles. The three other studies are hermeneutical interpretations based on text materials from open interviews. Fifteen participants were interviewed, all of whom are mothers of children between 0 and 18 years of age. All were outpatients in the psychiatric specialist health service. In the interpretation process, the mothers' struggle in health and suffering emerges as a struggle between the inner and outer world. Being a mother and patient in health and suffering in a psychiatric context means to struggle to be oneself, to create oneself, to live and realize one's good deeds as a mother and human being. To be oneself, to possess oneself as a mother is not only a question of tending, playing and learning in order to master a practical situation or to survive. It involves constituting a deep, inner desire to courageously create oneself so that the child is able to realize his or her potential in health and suffering. Motherliness manifests itself in caring as a call to ministering humanity and life. The voice of motherliness is understood as the voice of life—the eternal, inner call of love and freedom. The inner call craves fulfilment. Motherliness in natural caring does not retreat. Motherliness defines the Other as freedom and proceeds without regard for all other exterior requirements to realizing wellbeing. The inner essence of caring is attentive, aware and heeds the call of the heart. The innermost essence of caring is to be and to make oneself responsible for the Other. Responsibility cannot be relinquished; free choice consists in whether or not to follow the call. To renounce the inner call to responsibility is to deny oneself and one's dignity as a human being. The theoretical models provide clinical and systematic caring science with knowledge and understanding based on the natural caring spirit inherent in the human being. The study elucidates and strengthens the ontological basic assumptions about the human being as a unity of body, soul and spirit, the sanctity of the human being and the core of caring, ethos. The results of the dissertation will provide clinical practice with knowledge about the inner movements of the mothers' souls in relation to their responsibility as mothers and human beings. Being able to understand the basic conditions for responsibility is crucial for developing care that encompasses mother and child and the mutual relationship between them. This is basic knowledge for developing attitudes and actions that meet and provide for the needs of the patient as mother and as a whole, suffering human being.

Trilling race : the political economy of racialised visual-aural encounters

This thesis investigates the matter of race in the context of Finnish language acquisition among adult migrants in Finland. Here matter denotes both the materiality of race and how race comes to matter. Drawing primarily on an auto/ethno/graphic account of learning the Finnish language as a participant in the Finnish for foreigners classes, this thesis problematises the ontology and epistemology of race, i.e., what race is, how it is known, and what an engagement with race entails. Taking cues from the bodily practices of learning the Finnish trill or the rolling r, this study proposes a notion of “trilling race” and argues for an onto-epistemological dis/continuity that marks race’s arrival. The notion of dis/continuity reworks the distinction between continuity and discontinuity, and asks about the how of the arrival of any identity, the where, and the when. In so doing, an analysis of “trilling race” engages with one of the major problematics that has exercised much critical attention, namely: how to read race differently. That is, to rethink the conundrum of the need to counter “representational weight” (Puar 2007, 191) of race on the one hand, and to account for the racialised lived realities on the other. The link between a study of the phenomenon of host country language acquisition and an examination of the question of race is not as obvious as it might seem. For example, what does the argument that the process of language learning is racialised actually imply? Does it mean that race, as a process of racialisation or an ongoing configuration of sets of power relations, exerts force from an outside on the otherwise neutral process of learning the host country language? Or does it mean that race, as an identity category, presents as among the analytical perspectives, along with gender and class for instance, of the phenomenon of host country language acquisition? With these questions in mind, and to foreground the examination of the question of race in the context of Finnish language acquisition among adult migrants, this thesis opens with a discussion of the art installation Finnexia by Lisa Erdman. Finnexia is a fictitious drug said to facilitate Finnish language learning through accelerating the cognitive learning process and reducing the anxiety of speaking the Finnish language. Not only does the Finnexia installation make visible the ways in which the lack of skill in Finnish is fgured as the threshold – a border that separates the inside from the outside – to integration, but also, and importantly, it raises questions about the nature of difference, and the process of differentiation that separates the individual from the social, fact from fiction, nature from culture. These puzzles animate much of the analysis in this dissertation. These concerns continue to be addressed in the rest of part one. Whereas chapter two offers a reconsideration of the ambiguities of ethnisme/ethnicity and race, chapter three dilates on the methodological implications of a conception of the dis/continuity of race. Part two focuses on the matter of race and examines the political economy of visual-aural encounters, whereas part three shifts the focus and rethinks the possibilities and limitations of transforming racialised and normative constraints. Taking up these particular problematics, this thesis as a whole argues that race trills itself: its identity/difference is simultaneously made possible and impossible.

Show me your brain! Stories of interdisciplinary knowledge creation in practice. Experiences and observations from Aalto Design Factory, Finland.

This dissertation centres on the themes of knowledge creation, interdisciplinarity and knowledge work. My research approaches interdisciplinary knowledge creation (IKC) as practical situated activity. I argue that by approaching IKC from the practice-based perspective makes it possible to “deconstruct” how knowledge creation actually happens, and demystify its strong intellectual, mentalistic and expertise-based connotations. I have rendered the work of the observed knowledge workers into something ordinary, accessible and routinized. Consequently this has made it possible to grasp the pragmatic challenges as well the concrete drivers of such activity. Thus the effective way of organizing such activities becomes a question of organizing and leading effective everyday practices. To achieve that end, I have conducted ethnographic research of one explicitly interdisciplinary space within higher education, Aalto Design Factory in Helsinki, Finland, where I observed how students from different disciplines collaborated in new product development projects. I argue that IKC is a multi-dimensional construct that intertwines a particular way of doing; a way of experiencing; a way of embodied being; and a way of reflecting on the very doing itself. This places emphasis not only the practices themselves, but also on the way the individual experiences the practices, as this directly affects how the individual practices. My findings suggest that in order to effectively organize and execute knowledge creation activities organizations need to better accept and manage the emergent diversity and complexity inherent in such activities. In order to accomplish this, I highlight the importance of understanding and using a variety of (material) objects, the centrality of mundane everyday practices, the acceptance of contradictions and negotiations well as the role of management that is involved and engaged. To succeed in interdisciplinary knowledge creation is to lead not only by example, but also by being very much present in the very everyday practices that make it happen.

Joblessness

The paper is divided into three parts, and a summary at the end. Part one explains how policies conditioned by historical circumstances moved away from the objective of high employment. Part two deals with the theoretical controversies in support or against particular policies. Part three sets out the basics in theory needed for a high employment policy. The paper concludes with a summary suggestion of some operational steps and observations.

Organizational creativity – Hegemonic and alternative discourses

SUMMARY Organizational creativity – hegemonic and alternative discourses Over the course of recent developments in the societal and business environment, the concept of creativity has been brought into new arenas. The rise of ‘creative industries’ and the idea of creativity as a form of capital have attracted the interests of business and management professionals – as well as academics. As the notion of creativity has been adopted in the organization studies literature, the concept of organizational creativity has been introduced to refer to creativity that takes place in an organizational context. This doctoral thesis focuses on organizational creativity, and its purpose is to explore and problematize the hegemonic organizational creativity discourse and to provide alternative viewpoints for theorizing about creativity in organizations. Taking a discourse theory approach, this thesis, first, provides an outline of the currently predominant, i.e. hegemonic, discourse on organizational creativity, which is explored regarding themes, perspectives, methods and paradigms. Second, this thesis consists of five studies that act as illustrations of certain alternative viewpoints. Through these exemplary studies, this thesis sheds light on the limitations and taken-for-granted aspects of the hegemonic discourse and discusses what these alternative viewpoints could offer for the understanding of and theorizing for organizational creativity. This study leans on an assumption that the development of organizational creativity knowledge and the related discourse is not inevitable or progressive but rather contingent. The organizational creativity discourse has developed in a certain direction, meaning that some themes, perspectives, and methods, as well as assumptions, values, and objectives, have gained a hegemonic position over others, and are therefore often taken for granted and considered valid and relevant. The hegemonization of certain aspects, however, contributes to the marginalization of others. The thesis concludes that the hegemonic discourse on organizational creativity is based on an extensive coverage of certain themes and perspectives, such as those focusing on individual cognitive processes, motivation, or organizational climate and their relation to creativity, to name a few. The limited focus on some themes and the confinement to certain prevalent perspectives, however, results in the marginalization of other themes and perspectives. The negative, often unintended, consequences, implications, and side effects of creativity, the factors that might hinder or prevent creativity, and a deeper inquiry into the ontology and epistemology of creativity have attracted relatively marginal interest. The material embeddedness of organizational creativity, in other words, the physical organizational environment as well as the human body and its non-cognitive resources, has largely been overlooked in the hegemonic discourse, although thereare studies in this area that give reason to believe that they might prove relevant for the understanding of creativity. The hegemonic discourse is based on an individual-centered understanding of creativity which overattributes creativity to an individual and his/her cognitive capabilities, while simultaneously neglecting how, for instance, the physical environment, artifacts, social dynamics and interactions condition organizational creativity. Due to historical reasons, quantitative as well as qualitative yet functionally- oriented studies have predominated the organizational creativity discourse, although studies falling into the interpretationist paradigm have gradually become more popular. The two radical paradigms, as well as methodological and analytical approaches typical of radical research, can be considered to hold a marginal position in the field of organizational creativity. The hegemonic organizational creativity discourse has provided extensive findings related to many aspects of organizational creativity, although the con- ceptualizations and understandings of organizational creativity in the hegemonic discourse are also in many respects limited and one-sided. The hegemonic discourse is based on an assumption that creativity is desirable, good, necessary, or even obligatory, and should be encouraged and nourished. The conceptualiza- tions of creativity favor the kind of creativity which is useful, valuable and can be harnessed for productivity. The current conceptualization is limited to the type of creativity that is acceptable and fits the managerial ideology, and washes out any risky, seemingly useless, or negative aspects of creativity. It also limits the possible meanings and representations that ‘creativity’ has in the respective discourse, excluding many meanings of creativity encountered in other discourses. The excessive focus on creativity that is good, positive, productive and fits the managerial agenda while ignoring other forms and aspects of creativity, however, contributes to the dilution of the notion. Practices aimed at encouraging the kind of creativity may actually entail a risk of fostering moderate alterations rather than more radical novelty, as well as management and organizational practices which limit creative endeavors, rather than increase their likelihood. The thesis concludes that although not often given the space and attention they deserve, there are alternative conceptualizations and understandings of organizational creativity which embrace a broader notion of creativity. The inability to accommodate the ‘other’ understandings and viewpoints within the organizational creativity discourse runs a risk of misrepresenting the complex and many-sided phenomenon of creativity in organizational context. Keywords: Organizational creativity, creativity, organization studies, discourse theory, hegemony

As convenções de desenvolvimento no governo Lula: um ensaio de economia política

Development conventions in Lula's mandates: an essay on political economy. This article analyses the different development proposals put forward during the two Lula Presidential mandates. It is argued that such proposals are structured as "development conventions", which involve different priorities and different solutions to the problem of structural transformation. Their analytical frame is also different as are the interest groups which uphold them. Therefore their epistemology must be placed in the political economy context. It is argued that, notwithstanding the weight gained by a "developmental" convention over the second mandate, a "stability" convention is still hegemonic and commands macroeconomic policies.

O neoliberalismo na America Latina

Neoliberalism in Latin America. Neoliberalism and globalization had decisive influence in shaping public policies both internal and foreign in Latin America. Less state, trade and market freedoms, social goals subordinated to economic criteria, are part and parcel of the neoliberal utopia. Price stability was erected as the main social objective; import substitution resulted replaced by exports as the main source of growth. The neoliberal net results as applied to Latin America are: less growth, deindustrialization, income concentration and precarious employments. Therefore, countries public policies should try to gain autonomy to use jointly markets and public intervention in a constructive and innovative fashion.

Karl Popper versus Theodor Adorno: lições de um confronto histórico

Karl Popper versus Theodor Adorno: Lessons from a historical confrontation. In 1961, during the Congress of the German Society of Sociology, two great theoretical references of the XX century faced in a historical debate about the logic of the social sciences. In addition to methodological issues strict sense, the confrontation became known as a debate between positivism and dialectic. The article first deals with the theoretical trajectories of Popper and Adorno and the relation of their theories with their political and ideological certainties. On one hand, the trajectory of the Popperian epistemology is examined, its contributions and vigorous attacks on Marx in what he called 'poverty of historicism" and false predictive Marxist world, and, on the other hand, the role of Adorno in the Frankfurt School, his criticism of totalitarianism and the defense of a critical emancipatory reason. The article also deals with the confrontation itself, the exposure of Popper's twenty-seven theses that culminate with the situation logic and the method of the economy as exemplary for the social sciences and Adorno's critical perspective of sociology and society as non-separable objects. In conclusion we show how the articulation of theory with the weltanschauung of each author helps to clarify the terms of the debate and how the confrontation contributed unequivocally to the dynamics of scientific progress and for the critical history of the ideas.

Catching up with competitiveness in emerging markets – An analysis of the role of the firm’s technology management strategies

Emerging markets have experienced rapid economic growth, and manufacturing firms have had to face the effects of globalisation. Some of the major emerging economies have been able to create a supportive business environment that fosters innovation, and China is a good example of a country that has been able to increase value-added investments. Conversely, when we look at Russia, another big emerging market, we witness a situation in which domestic firms struggle more with global competitiveness. Innovation has proven to be one of the most essential ingredients for firms aiming to grow and become more competitive. In emerging markets, the business environment sets many constraints for innovation. However, open strategic choices in new product development enable companies in emerging markets to expand their resource base and capability building. Networking and close inter-firm cooperation are essential in this regard. In this dissertation, I argue that technology transfer is one of the key tools for these companies to become internationally networked and to improve their competitiveness. It forces companies to reach outside the company and national borders, which in many cases, is a major challenge for firms in emerging markets. This dissertation focuses on how companies can catch up with competitiveness in emerging markets. The empirical studies included in the dissertation are based on analyses of survey data mainly of firms and their strategies in the Russian manufacturing industry. The dissertation contributes to the current strategic management literature by further investigating technology management strategies in manufacturing firms in emerging markets and the benefits of more open approaches to new product development and innovation.

Of empty thoughts and blind intuitions Kant's answer to McDowell

This paper examines the relation between intuition and concept in Kant in light of John McDowell's neo-Kantian position that intuitions are concept-laden.2 The focus is on Kant's twofold pronouncement that thoughts without content are empty and that intuitions without concepts are blind. I show that intuitions as singular representations are not instances of passive data intake but the result of synthetic unification of the given manifold of the senses by the power of the imagination under the guidance of the understanding. Against McDowell I argue that the amenability of intuitions to conceptual determination is not due some pre-existing, absolute conceptuality of the real but to the "work of the subject."3 On a more programmatic level, this paper seeks to demonstrate the limitations of a selective appropriation of Kant and the philosophical potential of a more comprehensive and thorough consideration of his work. Section 1 addresses the unique balance in Kant's philosophy between the work on particular problems and the orientation toward a systematic whole. Section 2 outlines McDowell's take on the Kantian distinction between intuition and concept in the context of the Kant readings by Sellars and Strawson. Section 3 exposes McDowell's relapse into the Myth of the Given. Section 4 proposes a reading of Kant's theoretical philosophy as an epistemology of metaphysical cognition. Section 5 details Kant's original account of sensible intuition in the Inaugural-Dissertation of 1770. Section 6 presents the transition from the manifold of the senses to the synthesis in the imagination and the unification through the categories in the Critique of pure reason (1781 and 1787). Section 7 addresses Kant's formalism in epistemology and metaphysics.

Putting the horse before the cart: a pragmatist analysis of knowledge

The definition of knowledge as justified true belief is the best we presently have. However, the canonical tripartite analysis of knowledge does not do justice to it due to a Platonic conception of a priori truth that puts the cart before the horse. Within a pragmatic approach, I argue that by doing away with a priori truth, namely by submitting truth to justification, and by accordingly altering the canonical analysis of knowledge, this is a fruitful definition. So fruitful indeed that it renders the Gettier counterexamples vacuous, allowing positive work in epistemology and related disciplines.

Hurry up and slow down : education to close the ingenuity gap /

To explore the idea of education to close the ingenuity gap I use Thomas Homer-Dixon's work to define ingenuity. The notion that the supply of ingenuity to solve our technical and social problems is not keeping pace with the ingenuity required to solve those problems is called the ingenuity gap. Man-made technological developments are increasing the density, intensity, and pace of globalisation. People must reorganise decision-making organisations and problem-solving methods to pragmatically combat the growing ingenuity gap. John Dewey's work illustrates the fundamental attitudes for the thinking and judgment associated with educating for ingenuity. Howard Gardner's idea that truth, beauty, and morality ought to form the core values and tenets of the philosophy of educating for ingenuity is integral to this thesis. The act of teaching facilitates the invitation to the communication necessary to foster ingenuity. John Novak-discusses the five relationships of educational leadership that enhance an environment of ingenuity. The International Baccalaureate (IB) is an existing model of global education, one that defines some of the school experiences and academic development of core values of educating for ingenuity. Expanding upon the structure of the IB and other research within this thesis, I speculate upon what my school, where educating for ingenuity so as to close the ingenuity gap is the goal, would be like.