Patients' Needs for Care in Public Mental Health: Unity and Diversity of Self-Assessed Needs for Care.

PURPOSE: Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients' needs are organized. This study investigates both general and specific dimensions of patients' needs for care. METHODS: Patients' needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients' perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients' personal motivations, needs, and wants. Four seventy-one patients' profiles were analyzed through exploratory factor analysis. RESULTS: A four-factor bifactor model, including one general factor and three specific factors of needs, was most adequate. Specific factors were (a) "finances" and "administrative tasks"; (b) "transports," "public places," "self-care," "housework," and "food"; and (c) "family," "children," "intimate relationships," and "friendship." CONCLUSION: As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management, functional disabilities, and familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.

Geologic maps published by university de Girona's unity of geodynamics

In 1978 University de Girona's Unity of Geodynamics started publishing geological maps, in several themes and scales, of various areas of the Province of Girona (fig. 1). So far, up to 38 maps, gathered in several collections, have been published

John Dewey i l’educació democràtica = John Dewey and democratic education

In Dewey, philosophy and education are inseparable. It is often forgotten that Dewey’s conception of school and education has only been possible because he conceived thought in terms of lived experience, of constantly tested experience, of incessant research; in other words, of 'continuous search' of 'effective means of action'. In addition, according to Dewey, true education is an education in democracy, and that means investing in an education that deals with thought. The service to democratic progress is done precisely through an education in reasonability and taking into account the experience

Exiles and Constituents: Baltic Refugees and American Cold War Politics, 1948- 1960

This dissertation explores the complicated relations between Estonian, Latvian, and Lithuanian postwar refugees and American foreign policymakers between 1948 and 1960. There were seemingly shared interests between the parties during the first decade of the Cold War. Generally, Eastern European refugees refused to recognize Soviet hegemony in their homelands, and American policy towards the Soviet bloc during the Truman and Eisenhower administrations sought to undermine the Kremlin’s standing in the region. More specifically, Baltic refugees and State Department officials sought to preserve the 1940 non-recognition policy towards the Soviet annexation of the Baltic States. I propose that despite the seemingly natural convergence of interests, the American experiment of constructing a State-Private network revolving around fostering relations with exile groups was fraught with difficulties. These difficulties ultimately undermined any ability that the United States might have had to liberate the Baltic States from the Soviet Union. As this dissertation demonstrates, Baltic exiles were primarily concerned with preserving a high level of political continuity to the interwar republics under the assumption that they would be able to regain their positions in liberated, democratic societies. American policymakers, however, were primarily concerned with maintaining the non-recognition policy, the framework in which all policy considerations were analyzed. I argue that these two motivating factors created unnecessary tensions in American policy towards the Baltic republics in the spheres of psychological warfare as well as exile unity in the United States and Europe. Despite these shortcomings, I argue that out of the exiles’ failings was born a generation of Baltic constituents that blurred the political legitimacy line between exiles who sought to return home and ethnic Americans who were loyal to the United States. These Baltic constituents played an important role in garnering the support of the United States Congress, starting in the 1950s, but became increasingly influential after the 1956 Hungarian Revolution, despite the seemingly less important role Eastern Europe played in the Cold War. The actions of the Baltic constituents not only prevented the Baltic question from being forever lost in the memory hole of history, but actually created enough political pressure on the State Department that it was impossible to alter the long-standing policy of not recognizing the Soviet annexation of the Baltic States.

Democracy begins at home : parenting, empathy, and adolescents' support for democratic values

Bakgrund Demokratiska samhällen är sårbara och historiskt sett sällsynta. Förutsättningarna för en fungerande demokrati innefattar mer än formella institutioner eller enbart frånvaron av diktatorer och extremgrupper. För att en regim skall fungera enligt demokratiska principer behövs medborgare som stöder demokratiska värden. Därför är det av vikt att förstå de processer som får individer att känna tilltro till demokratiska värden. Trots att man kan anta att stöd för sådana värderingar utvecklas som ett resultat av social inlärning är de konkreta omständigheterna som leder till ett dylikt lärande mindre uppenbara. Den klassiska litteraturen beträffande politisk socialisation lyfte fram föräldrarna som avgörande för de ungas medborgerliga fostran, men i moderna samhällen har föräldrarna sällan som en uttalad målsättning att försöka påverka sina barns nuvarande eller framtida politiska preferenser. Den föreliggande studiens mål var att fördjupa diskursen kring politisk socialisation gen om att analysera föräldraskapets betydelse för demokratiska värderingar hos ungdomar. Metod Den föreliggande studien utgick från två slumpmässiga urval. Det ena omfattade 1341 studerande, 17 år gamla, inom andra stadiets utbildning i tre regioner i Finland (södra, syd-västra och västra) och det andra 678 studerande, 16 år gamla vid studiens inledande, från den flamländska delen av Belgien. Studien innefattade frågeformulär som besvarades under skoltid. Resultat De centrala resultaten från studien kan sammanfattas i fyra punkter. För det första kunde empatiskt tänkande konstateras vara en god förklarande variabel för ungdomars demokratiska värderingar (Artikel 1). För det andra gav studien stöd för antagandet att stödjande föräldraskap är av betydelse för utvecklingen av empati under ungdomsåren (Artikel 2). För det tredje utvärderades empati, i relation till andra betydelsefulla variabler, som förklarande variabel för demokratiska värderingar (Artikel 3). För det fjärde gav den föreliggande studien bevis för att demokratiskt föräldraskap, både direkt och indirekt, är relaterat till demokratiska värderingar hos ungdomar. Sammanfattning Sammanfattningsvis visade den föreliggande studien hur föräldraskap både direkt och indirekt kan påverka demokratiska värderingar hos ungdomar och hur dessa resultat kunde användas för demokratisk samhällsfostran.

The Finnish Paper Workers' Union at a crossroads: Labor union representativeness in a changing environment, 1980-2008

This thesis consists of four articles and an introductory section. The main research questions in all the articles refer to the changes in the representativeness of the Finnish Paper Workers' Union. Representativeness stands for the entire entity of external, internal, legal and reputational factors that enable the labor union to represent its members and achieve its goals. This concept is based on an extensive reading of quantitative and qualitative industrial relations literature, which includes works based on Marxist labor-capital relations (such as Hyman's industrial relations studies), and more recent union density studies as well as gender- and ethnic diversity-based 'union revitalization' studies. Müller-Jentsch's German studies of industrial relations have been of particular importance as well as Streeck's industrial unionism and technology studies. The concept of representativeness is an attempt to combine the insights of these diverse strands of literature and bring the scientific discussion of labor unions back to the core of a union's function: representing its members. As such, it can be seen as a theoretical innovation. The concept helps to acknowledge both the heterogeneity of the membership and the totality of a labor union organization. The concept of representativeness aims to move beyond notions of 'power'. External representativeness can be expressed through the position of the labor union in the industrial relations system and the economy. Internal representativeness focuses on the aspects of labor unions that relate to the function of the union as an association with members, such as internal democracy. Legal representativeness lies in the formal legal position of the union – its rights and instruments. This includes collective bargaining legislation, co-decision rules and industrial conflict legislation. Reputational representativeness is related to how the union is seen by other actors and the general public, and can be approximated using data on strike activity. All these aspects of representativeness are path-dependent, and show the results of previous struggles over issues. The concept of representativeness goes beyond notions of labor union power and symbolizes an attempt to bring back the focus of industrial relations studies to the union's basic function of representing its members. The first article shows in detail the industrial conflict of the Finnish paper industry in 2005. The intended focus was the issue of gender in the negotiations over a new collective agreement, but the focal point of the industrial conflict was the issue of outsourcing and how this should be organized. Also, the issue of continuous shifts as an issue of working time was very important. The drawn-out conflict can be seen as a struggle over principles, and under pressure the labor union had to concede ground on the aforementioned issues. The article concludes that in this specific conflict, the union represented its' female members to a lesser extent, because the other issues took such priority. Furthermore, because of the substantive concessions. the union lost some of its internal representativeness, and the stubbornness of the union may have even harmed the reputation of the union. This article also includes an early version of the representativeness framework, through which this conflict is analyzed. The second article discusses wage developments, union density and collective bargaining within the context of representativeness. It is shown that the union has been able to secure substantial benefits for its members, regardless of declining employment. Collective agreements have often been based on centralized incomes policies, but the paper sector has not always joined these. Attention is furthermore paid to the changing competition of the General Assembly, with a surprisingly strong position of the Left Alliance still. In an attempt to replicate analysis of union density measures, an analysis of sectoral union density shows that similar factors as in aggregate data influence this measure, though – due to methodological issues – the results may not be robust. On this issue, it can be said that the method of analysis for aggregate union density is not suitable for sectoral union density analysis. The increasingly conflict-ridden industrial relations predicted have not actually materialized. The article concludes by asking whether the aim of ever-increasing wages is a sustainable one in the light of the pressures of globalization, though wage costs are a relatively small part of total costs. The third article discusses the history and use of outsourcing in the Finnish paper industry. It is shown using Hyman's framework of constituencies that over time, the perspective of the union changed from 'members of the Paper Workers' Union' to a more specific view of who is a core member of the union. Within the context of the industrial unionism that the union claims to practice, this is an important change. The article shows that the union more and more caters for a core group, while auxiliary personnel is less important to the union's identity and constituencies, which means that the union's internal representativeness has decreased. Maintenance workers are an exception; the union and employers have developed a rotating system that increases the efficient allocation of these employees. The core reason of the exceptional status of maintenance personnel is their high level of non-transferable skills. In the end it is debatable whether the compromise on outsourcing solves the challenges facing the industry. The fourth article shows diverging discourses within the union with regard to union-employer partnership for competitiveness improvements and instruments of local union representatives. In the collective agreement of 2008, the provision regulating wage effects of significant changes in the organization or content of work was thoroughly changed, though this mainly reflected decisions by the Labor Court on the pre-2008 version of the provision. This change laid bare the deep rift between the Social Democratic and Left Alliance (ex-Communist) factions of the union. The article argues that through the changed legal meaning of the provision, the union was able to transform concession bargaining into a basis for partnership. The internal discontent about this issue is nonetheless substantial and a threat to the unity of the union, both locally and at the union level. On the basis of the results of the articles, other factors influencing representativeness, such as technology and EU law and an overview of the main changes in the Finnish paper industry, it is concluded that, especially in recent years, the Finnish Paper Workers' Union has lost some of its representativeness. In particular, the loss of the efficiency of strikes is noted, the compromise on outsourcing which may have alienated a substantial part of the union's membership, and the change in the collective agreement of 2008 have caused this decline. In the latter case, the internal disunion on that issue shows the constraints of the union's internal democracy. Furthermore, the failure of the union to join the TEAM industrial union (by democratic means), the internal conflicts and a narrow focus on its own sector may also hurt the union in the future, as the paper industry in Finland is going through a structural change. None of these changes in representativeness would have been so drastic without the considerable pressure of globalization - in particular changing markets, changing technology and a loss of domestic investments to foreign investments, which in the end have benefited the corporations more than the Finnish employees of these corporations. Taken together, the union risks becoming socially irrelevant in time, though it will remain formally very strong on the basis of its institutional setting and financial situation.

Reinventing the third way : towards new forms of economic and democratic conduct

Avhandlingen studerar samspelet mellan det politiska och det ekonomiska systemet genom det föregående seklet, med speciellt fokus på den nyliberala omdaning som utspelats de senaste tre årtiondena. Med en liberaliserad ekonomi och en individualiserad människa måste också det politiska systemet utformas på ett annat sätt. Gradvisa förändringar har varit synliga, som den växande nätverksorganiseringen, dvs. att olika typer av utvecklingspolitik allt mer genomförs som ett samspel mellan samhällssektorerna, istället för att enbart utföras av den offentliga sektorn som tidigare. Genom fyra fallstudier i Österbotten demonstreras hur arenor för samverkan kan konstrueras i enlighet med vad den aktuella frågan kräver. Ett exempel är det innovationsnätverk som skapats i Karleby-Jakobstad-regionen, där offentliga och privata intressenter deltar, och som samtidigt bryter traditionella administrativa gränser. Ett annat mer negativt exempel är omstruktureringsprocessen i Kaskö-regionen eft er Metsä-Botnia-fabrikens nedläggning, där småkommunproblemet tillsammans med att den privata intressenten inte haft skyldighet att samverka lett till att en tillräckligt regionalt förankrad arena för en långsiktig utvecklingspolitik inte har kunnat skapas. Det här visar på trögheten i det finska systemet, där en stark enhetsstat och en splittrad kommunal nivå ur ett historiskt perspektiv hindrat flexibla anpassningar till samhällsförändringar. Avhandlingen visar att nätverksorganiseringen bör vara en integrerad del av de representativa strukturerna för att kunna påverka processernas utfall. Avhandlingen visar framförallt att deltagande och funktionellt definierade regionala och lokala arenor har stor potential, både ekonomiskt och demokratiskt. Det handlar om att skapa en kultur med aktiverade och engagerade medborgare, vilket står i kontrast till det allt mer passiverande representativa systemet. ---------------------------------------- Väitöskirja tutkii viime vuosisadan poliittisen ja taloudellisen järjestelmän vuorovaikutusta keskittyen erityisesti kolmen viimeisen vuosikymmenen uusliberaaliseen muutokseen. Talouden liberalisoituminen ja ihmisen individualisoituminen edellyttävät myös poliittisen järjestelmän mukautumista. Asteittaisia muutoksia on ollut havaittavissa, kuten kasvava verkosto-organisaatio, toisin sanoen eri alojen kehityspolitiikkaa toteutetaan yhä enemmän eri yhteiskuntasektoreiden vuorovaikutuksena, kun aikaisemmin ainoastaan julkinen sektori vastasi kehityspolitiikan toteuttamisesta. Pohjanmaan maakunnan neljän tapaustutkimuksen avulla osoitetaan, miten vuorovaikutusareena voidaan rakentaa kulloinkin ajankohtaisen asiakokonaisuuden ympärille. Tästä esimerkkinä on Kokkola-Pietarsaari –alueen innovaatioverkosto, johon osallistuvat sekä julkiset että yksityiset sidosryhmät ja joka samalla rikkoo perinteisiä hallinnollisia rajoja. Toinen, kielteisempi esimerkki on Kaskisten alueen rakennemu utosprosessi Metsä-Botnian tehtaan sulkemisen jälkeen. Siellä pienkuntaongelma yhdistettynä siihen, että yksityinen sidosryhmä ei ole ollut velvollinen tekemään yhteistyötä, on johtanut siihen, että ei ole kyetty luomaan alueen pitkäaikaiseen kehittämiseen sitoutunutta vuorovaikutusareenaa. Tämä osoittaa suomalaisen järjestelmän kankeuden, jossa historiallisesta näkökulmasta vahva yhtenäinen valtio ja hajanainen kuntataso estävät joustavan yhteiskuntamuutoksiin sopeutumisen. Väitöskirja osoittaa, että verkosto-organisaation on oltava yhteiskunnassa vaikuttaviin rakenteisiin integroitu osa, jotta se voi vaikuttaa prosessien tuloksiin. Väitöskirja osoittaa ennen kaikkea, että osallistuvilla ja toiminnallisesti määritellyillä alueellisilla ja paikallisilla areenoilla on suuri taloudellinen ja demokraattinen potentiaali. Passivoivan edustavan järjestelmän tilalle on luotava aktiivisten ja tavoitteisiin sitoutuneiden kansalaisten vuorovaikutusjärjestelmä.

Political Legitimacy and Ethnocultural Justice. Essays on Public Reason, Democratic Citizenship, and the Rights of Cultural Minorities

In this thesis, I argue that there are public cultural reasons that can underpin public justifications of minority rights of indigenous and national minorities in a constitutionaldemocracy. I do so by tackling diverse issues facing a liberal theory of multiculturalism. In the first essay, I criticize Will Kymlicka’s comprehensive liberal theory of minority rights and propose a political liberal alternative. The main problem of Will Kymlicka’s theory is that it builds on the contestable liberal value of individual autonomy and thus fails to take diversity seriously. In the second essay, I elaborate on the Rawlsian political liberalism assumed here by criticizing Chandran Kukathas’s version of political liberalism as overly accommodating to diversity. In the third essay, I discuss questions of method that arise for a political liberal approach to the moral-political foundations of multiculturalism, and propose a certain understanding of the political liberal enterprise and its crucial standard of reasonableness. In the fourth essay, I dwell on the political liberal ethic of citizenship and propose a strongly inclusionist interpretation of the duty of civility. In the fifth and last essay, I introduce a certain understanding of ethnocultural justice and propose a view on certain cultural reasons as public cultural reasons. Cultural reasons are public when they are based on necessarily established cultural marks of a democratic polity, as specified by the cultural establishment view; and when they are crucial for the societal cultural bases of self-respect of citizens. The arguments in this thesis support, and help to spell out, moral-political rights of indigenous and national minorities as formulated in international legal documents, such as the Declaration on the Rights of Indigenous Peoples (United Nations 2007) or the International Covenant on Economic, Social and Cultural Rights (United Nations 1966).

Autonomy of the state and development in the democratic capitalism

The paper argues that if the state, as an expression and part of a pact of domination, operates as a corporate actor with relative autonomy, vision and capacity to promote the development, it is a key institution to the economic transformation. Supported in the neo-Marxism, exposes the limits of institutionalist approach of autonomy of the state to explain its origin, but does not rule out this approach. Maintains that the class-balance theory of the state may explain its relative autonomy and at the same time aid in understanding the historical experiences of social-developmentalist state action, particularly in the social democratic regimes and in the current Latin America.