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Purpose: The involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in day-to-day work settings, the shift toward client involvement is still in progress. We examined how health and social care professionals, together with clients and managers, co-develop their conceptions of client involvement and search for practical ways in which to implement these in organizational service processes. Design/methodology/approach: The empirical case of this study was a developmental intervention, the client involvement workshop, conducted in a Finnish municipal social and welfare center. The cultural-historical activity theory (CHAT) framework was used to analyze the development of client involvement ideas and the modes of interaction during the intervention. Findings: Analysis of the collective discussion revealed that the conceptions of client involvement developed through two interconnected object-orientations: Enabling client involvement in service encounters and promoting client involvement in the service system. The predominant mode of interaction in the collective discussion was that of "coordination." The clients' perspective and contributions were central aspects in the turning points from coordination to cooperation; professionals crossed organizational boundaries, and together with clients, constructed a new client involvement-based object. This suggests that client participation plays an important role in the development of services. Originality/value: The CHAT-based examination of the modes of interaction clarifies the potential of co-developing client-involvement-based services and highlights the importance of clients' participation in co-development. [ABSTRACT FROM AUTHOR]

Finnish higher education institutions offer continuous learning opportunities, including professional specialisation education programmes for the health and social sector. This article focuses on the conceptualisation of the impact of these programmes, which was the topic of discussion by education and working-life actors in research-based workshops. Drawing on the cultural–historical activity theory (CHAT) approach, the study seeks to answer the following research questions: What are the main themes through which the participants conceptualise the impact of education? How do the themes expand the conceptualisation of the impact of education? A qualitative study analysed data from the multi-professional discussions facilitated by researcherdevelopers in online workshops during the COVID-19 pandemic. The findings describe the impact-related discussion themes and analyse their expansive potential. Participants’ discursive actions in research-based online workshops manifest expansive conceptualisation on multiple dimensions, but also reveal dilemmatic impact-related questions that reflect the underlying contradictions of continuous learning programmes in the health and social sector. [ABSTRACT FROM AUTHOR]

Peer-based interventions are increasingly used for delivering mental health services to help people with an illness re-examine their situation and accept their illness as part of their life story. The role of the peer supporter in these interventions, known as experts-by-experience (EbE), is situated between mutual peer support and semi-professional service delivery, and they face the challenge of balancing an asymmetric, professional relationship with a reciprocal, mutuality-based, equal relationship. This article investigates how EbEs tackle this challenge when responding to clients' stories about their personal, distressing experiences in peer-based groups in psychiatric services. The results show how the EbEs responded to their clients' experience-sharing with two types of turns of talk. In the first response type, the EbEs highlighted reciprocal experience-sharing, nudging the clients toward accepting their illness. This invoked mutual affiliation and more problem-talk from the clients. In the second response type, the EbEs compromised reciprocal experience-sharing and advised clients on how to accept their illness in their everyday lives. This was considered less affiliative in relation to the client's problem description, and the sequence was brought to a close. Both response types involved epistemic asymmetries that needed to be managed in the interaction. Based on our analysis, semi-professional, experience-based expertise involves constant epistemic tensions, as the participants struggle to retain the mutual orientation toward peer-based experience-sharing and affiliation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Professional & Vocational Education (JPVE) / Ammattikasvatuksen Aikakauskirja is the property of Finnish Vocational Education Research Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cidadania em Ação is the property of Universidade do Estado de Santa Catarina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Technological innovation and the flexibilisation of labour markets have expanded the pool of workers engaged in globally distributed work. This paper aims to propose an analytical framework to understand and support the productive professional learning of those engaged in global work. Drawing on the theory of expansive learning in the cultural-historical activity theory tradition the study aims to stimulate and enrich the conceptual notion of work as a learning space in the discussion of workplace learning particularly in global work. Design/methodology/approach: Iteration between theory and data is applied to identify the dimensions of expansion for the configuration of learning spaces in global work. Data are drawn from the experiences of 10 professionals selected by purposive sampling in Austria, Italy, the Netherlands and Singapore. Findings: Six dimensions of expansion are identified as challenging and potentially empowering for professionals' configuration of learning spaces in global work: social-spatial, material-instrumental, moral-ethical, political-economic, personal-professional and temporal-developmental. Originality/value: The conceptual framework for the dimensions of expansion of learning spaces provides the broad strokes for reflexive curricula that democratise the learning and development of professionals in global work, who are currently underserved given the national orientation of vocational education and training and professional development ecosystems. [ABSTRACT FROM AUTHOR]

This article investigates the learning of a digital printing network that was seeking sustainable collaboration in the textile, clothing, and interior printing industry. Digitalization is transforming work, giving rise to new types of networks and creating learning challenges for participants. The object of digital printing activity becomes heterogeneous, open-ended, and indefinite. The concept of the complex object of work, which is based on cultural-historical activity theory, is introduced to examine the dynamics between the digitalization of work and network learning. Data were collected at the starting phase of the network collaboration, when participants discussed the future object of the digital printing activity. The participants were involved in design, textile manufacturing, digital printing, vocational education, and research, and consumer-customers were also represented. The authors argue that revealing the complexity of the object of work on multiple levels of learning is crucial to enhancing innovation in the networks of the digital age. [ABSTRACT FROM AUTHOR]

In interprofessional service networks, employees cross professional boundaries to collaborate with colleagues and clients with expertise and values different from their own. It can be a struggle to adopt shared work practices and deal with “multivoicedness.” At the same time, networks allow members to engage in meaningful service provision, gain a broader understanding of the service provided, and obtain social support. Intertwined network struggles and resource gains have received limited attention in the interprofessional care literature to date. The aim of the study was to investigate the learning potential of the co-existing struggles and resource gains. This article reports findings from two interprofessional networks. Interviews were conducted with 19 employees and thematically analysed. Three types of struggles and six types of resource gains of networking were identified. The struggles relate, first, to the assumptions of networking following similar practices to those in a home organisation; second, to the challenges of dealing with the multivoicedness of networking; and, third, to the experienced gap between the networking ideals and the reality of cooperation. At the same time, the network members experience gains in emotional resources (e.g., stronger sense of meaningfulness at work), cognitive resources (e.g., understanding the customer needs from alternative perspectives), and social resources (e.g., being able to rely on other professionals’ competence). Learning potential emerged from the dynamics between coexisting struggles and resource gains. [ABSTRACT FROM PUBLISHER]

Purpose – This paper aims to analyze learning in organizational transformations by focusing on concept-level tensions faced in two young companies, which were searching for a reorientation of activity with a production network between innovative product development and efficient mass production. Design/methodology/approach – An intervention-based research project was carried out with two manufacturing companies. The data originate from workshops, whose aim was to identify learning needs based on the discussion of practices of networked production. Concept-level learning is analyzed by examining the dynamic relationships between production concepts and product concepts. Findings – The most influential concept-level tension stemmed from the co-existence of two production concepts, product development and mass production, which manifested as ambiguity about proper actions in the production network. Other focal tensions were identified between the production and product concepts and within the companies’ network relationships. The dominance of the mass production concept restricted the envisioning of new modes of collaboration and mutual learning in the production network. Research limitations/implications – The workshop participants did not include representatives from the case companies’ production network. Nevertheless, researchers brought the network partners’ conceptions into the workshop discussion through the presented mirror data. Practical implications – Companies striving to develop novel production concepts that call for continuous collaboration with customers and suppliers need forums for mutual learning to create solutions to concept-level tensions. Originality/value – Companies may develop two production concepts over lengthy periods. The tensions that manifest due to incoherent guiding logics may be overcome by engaging in incremental and expansive concept-level learning, directed at the identification of relationships between production and product concepts. [ABSTRACT FROM AUTHOR]

Purpose – This article aims to analyze emergent learning practices for globalizing work through two research questions: "What are the conceptualizations of work represented by the Virtual Factory and how do they mediate globalizing work?" and "What is the potential of expansive learning efforts to expand conceptualizations towards the emergent learning practices of globalizing work?". Design/methodology/approach – Cultural-historical activity theory is applied, specifically the historical tool-mediated activity, concept formation and the zone of proximal development. A dynamic hierarchy of conceptualizations forms the framework for expansive learning efforts. Data were gathered by ethnographic and development interventionist methods from a distributed engineering design project. Findings – The paper finds that, historically, multi-layered conceptualizations of work face developmental challenges in globalizing work. Expansive learning efforts enhance the emergent learning practices when orienting global participants to motivating "why" and "where-to" conceptualizations. In order to turn emergent practices into sustainable learning practices, material representations need to be created to mediate the bottom-up and top-down conceptualizations at the interfaces of distributed work. Research limitations/implications – Emergent learning practices are studied longitudinally through concrete work in transformation. The learning approach emphasizes developmental interventions at global workplaces. Practical implications – Expansive learning efforts at different levels of conceptualization, may be supported by tools that mediate and sustain emergent learning practices. Social implications – Global workplace learning should be a concern of those involved with corporate social responsibility. Originality/value – Emergent learning practices offers a new approach for studies of globalizing work through its multi-layered conceptualizations of work. [ABSTRACT FROM AUTHOR]

Objective There is very little research on patient organizations (POs), even though their numbers and influence seem to be increasing. The purpose of this study was to describe the establishment, membership, size, organization, decision making and basic funding of national POs in Finland. Setting and participants National POs ( n = 130) were identified from their umbrella organizations and by Internet searches. Data were collected from POs’ web pages (87% of POs had one), Finland’s Slot Machine Association (RAY, an important public financier of POs), a relevant survey done by a local TV-company, and interviews and written materials of POs. Results and conclusions Some current national POs were established around the turn of the 19th century. The rate of establishment of new POs increased from the 1970s and particularly in the 1990s when POs were characterized by increasing specialization. POs focused on different patient groups and diseases and were founded by philanthropists, physicians, patients, parents and the drug industry. Members could be patients, patient relatives, health-care professionals and organizations. POs widely varied in memberships (20–145 000, in 2002) and in number of paid personnel (0–1395, in 2002), organizational structure and decision making. Interest groups and financiers were often represented in decision-making organs. Activities included mutual support and service production, and, increasingly, informing and lobbying. POs had wide domestic and international co-operation and networking. Drug industry marketing was visible on PO web pages. Budget sizes varied (4000–15 million euros, in 2001). The main public financier was RAY. The old national POs were large and part of national social and health care, but newer ones were often established for mutual support and lobbying. National POs are not uniform but characterized by great variation. The number of national POs is increasing suggesting tighter competition for financing and visibility in the future. [ABSTRACT FROM AUTHOR]

The number of technologies used in health care is growing, patients’ educational level has risen, health and drug information is increasingly available and patients today are actively looking for information from different sources. The aim of the study was to investigate physicians’ opinions on patients’ requests for specific treatments and examinations.The data were gathered as part of an annual physician's survey sent to all Finnish physicians (n = 16 698) by the Finnish Medical Association in March 2002. The response rate was 85% (n = 14 157). Physicians involved in clinical work were selected for this study (n = 12 255).Half (53%,n = 6521) of the clinicians reported either‘very often’, or‘often’ receiving requests from patients for specific treatments or examinations, and of them, 76% (n = 4972) reported an increase in such requests. The younger clinicians received more often patient requests. Women physicians, those working in health centres, and non-specialized clinicians reported more experience of, and an increase in patients making requests. Of those clinicians who received patient requests‘very often’ or‘often’, 24% (n = 1595) considered such requests as having a positive, and 43% (n = 2808) a negative, effect on patient care and interaction; clinicians who did not receive many patient requests had similar opinions. Older, men, those working in private practice and specialized clinicians had a more positive attitude towards such requests than other clinicians. The reasons given for the positive and negative opinions were varied.Active patients (consumer patients) are a reality in the Finnish health care system. Physicians have varying opinions on this phenomenon. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare physicians', midwives' and lay people's attitudes towards genetic screening and testing to find out whether medical education and experience influence attitudes of genetic screening and testing. The study was based on comparison of answers to joint questions in three different cross-sectional postal surveys between October 1996 and April 1998 in Finland. Target groups were physicians (study base n = 772, response rate 74%, including gynaecologists, paediatricians, general practitioners and clinical geneticists), midwives and public health nurses (collectively referred to as midwives in the following; n = 800, response rate 79%), and lay people (n 1/42000, response rate 62%). Midwives were more worried about the consequences of genetic testing and stressed the autonomy of the customer more strongly than lay people did. Furthermore, professionals considered that lay peoples' expectations as regards to genetic testing are too high. Having more medical education was related to having less 'cannot say' and missing responses. Our results do not suggest that major conflicts about the direction of genetic testing and screening would arise in near future. However, different positions and interests should be considered. Reporting in public about new prospects and developments in medical genetics should pay more attention also to concerns for balancing promises and drawbacks. [ABSTRACT FROM AUTHOR]

Examines the impact of prenatal screening on maternity services in Finland. Determination on the technical quality and health-gain benefits of the test; Assessment on the quality of fetus; Application of prenatal screening in serum screening for Down's syndrome.