Mentorship for medical students : space for something else

Mentorship has been used in undergraduate medical education to support students ́ learning and development. The medical education literature describes various goals for mentoring, various designs of mentoring programs, and various roles and functions of the mentor. The aim of the thesis was to deepen the understanding of the meaning of mentoring for medical students ́ professional and personal development and to contribute new knowledge that will be useful when designing mentoring programs for medical students in the future. Students ́ experiences of two forms of mentoring were explored in four consecutive studies in Europe. Theories of professional competence, learning, and transition were used for the interpretation, understanding, and explanation of the findings. Studies I and II explored experiences of one-to-one mentoring during the first clinical courses, semesters 5–8. In Study I, a questionnaire showed that the students felt that the mentorship had facilitated their professional (78%) and personal (63%) development. They felt respected by their mentors, and the role of the mentor was experienced as being supportive and providing guidance and perspectives. In Study II, their experiences were further explored by means of interviews. Three themes were found: Space, Belief in the future, and Transition. Having a mentor gave a sense of security and constituted a “free zone” alongside the educational program. It gave hope about the future and increased motivation. The students were introduced to a new community and began to identify themselves as physicians. The mentorship created conditions to start to develop the more “elusive” professional competences, such as reflective capacity, emotional competence, and the feeling of belonging to a community. Studies III and IV further explored experiences of mentorship using interviews concerning combined group and one-to-one mentoring during semesters 1–11. In Study III, five themes were found about what the mentorship created opportunities for; Psychosocial support by the mentor, A relationship with a physician beneath the professional surface, Space for something else, Awareness of one ́s own development, and Reflection and learning with peers. The mentorship created space for reflection on the humanistic aspects of the professional role. A mentoring relationship can be on a personal level without frequent meetings and knowing one another well. Continuity helped the students to recognize their own development. Study IV focused on the transitional process of becoming a physician. The analyses resulted in three themes: Integrate oneself with the future role as a physician, Exciting clinical experiences with the mentor give incentives to learn, and Toward understanding the professional competence of a physician. The mentorship enabled the students to get a view of their future lives and start to integrate the professional role with themselves as persons. Early access to the clinical environment with the mentor was an incentive and gave meaning to the theoretical knowledge. Their understanding of professional competence and behavior evolved and they advanced toward understanding the wholeness of the profession. In conclusion: mentorship can facilitate medical students ́ professional and personal development by creating space for reflection and development of the more “elusive” competences of a physician, by giving incentives to learn, and by facilitating the students ́ process of becoming a physician

Turun ammattikorkeakoulun täydennyskoulutus ja palvelutoiminta : markkinoinnin haasteet

Globalisaatio sekä kilpailun lisääntyminen aiheuttavat epävarmuutta työmarkkinoilla. Teknologian kehittyminen sekä haastavat työtehtävät vaativat työntekijöiltä jatkuvaa tietojen ja oman osaamisen päivittämistä. Yritykset ostavat henkilöstönsä kouluttamiseen esimerkiksi täydennyskoulutusta, jota tarjoavat ammattikorkeakoulut sekä muut koulutusorganisaatiot. Ammattikorkeakoulut ovat myös lain mukaan velvollisia tarjoamaan aikuiskoulutusta ja näin edistämään elinikäistä oppimista. Turun ammattikorkeakoulu tarjoaa täydennyskoulutuksen ja palvelutoiminnan palveluja yrityksille, jotka haluavat kouluttaa työntekijöitään tai hyödyntää koulun opiskelijoiden, opettajien ja muiden asiantuntijoiden osaamista omassa toiminnassaan. Tutkimuksen tavoitteena oli selvittää Turun ammattikorkeakoulun täydennyskoulutuksen ja palvelutoiminnan markkinoinnin haasteita. Tarkoituksena oli myös tutkia markkinoinnin ja erityisesti myynnin ja markkinointiviestinnän kehittämistarpeita. Tutkimusta varten tein myös kvalitatiivisen haastattelututkimuksen Turun ammattikorkeakoulun täydennyskoulutus- ja palvelupäälliköille. Työ sisältää tutkimuksen lisäksi yleistä tietoa Turun ammattikorkeakoulun toiminnasta sekä täydennyskoulutuksesta ja muista koulutuksen tarjoajista Turun alueella. Asiantuntijapalvelujen markkinointia ja myyntiä käsittelevissä osioissa käsitellään palvelujen markkinointia, Turun ammattikorkeakoulun täydennyskoulutuksen ja palvelutoiminnan käyttämiä markkinointiviestintäkeinoja sekä asiantuntijan myyntitaitoa, myynnin apukeinoja sekä myyntivalmennusta koulutusten myynnin tueksi.Globalization and the increased competition cause uncertainty in labor market. Technologies development and challenging duties demand employees to continuously update their knowledge and know-how. Companies train their employees by buying for example supplementary education from technical colleges. Universities of applied sciences are also bound by law to supply adult education and so enhance their district’s lifelong learning. Turku University of Applied Sciences offers supplementary education and service activity’s services to companies who want to train their personnel or make good use of school’s students, teachers and other experts’ know-how in their own operations. The goal of this thesis was to study the challenges of marketing of supplementary education and service activity in Turku University of Applied sciences. The purpose was also to research what improvements could be made especially in sales and marketing communication. I also did a qualitative interview study where I interviewed the heads of supplementary education’s training division. This thesis includes general knowledge of operations in Turku University of Applied Sciences and its supplementary education and also other adult education providers in Turku area. In chapters that concerns consultancy services’ marketing and selling covers the marketing of services, marketing communication techniques in supplementary education and service activity. Other issues are experts’ salesmanship, means of selling and sales training

Regeneration failure of Scots pine changes the species composition of young forests

How seedling mortality and browsing affects species composition of regenerating forests has been mostly studied on a small scale. Yet, large-scale analyses based on extensive data are essential for robust prediction of species composition in young forests. In this study, we used a dataset from a national inventory of young forests (1-4 metres in height) to investigate the species composition of young forests across Sweden. We found that most of the regenerated forest area (almost 90%) was planted with Norway spruce (southern Sweden) and Scots pine (northern Sweden). Regeneration of Norway spruce was generally relatively successful but as a consequence of seedling mortality and browsing, almost 40% of the area regenerated with Scots pine will probably not develop into pine-dominated stands. Thus, low survival of Scots pine seedlings and trees can profoundly change the trajectory of species composition of the young forest from what was originally intended, and a large proportion of the young stands may develop into mixtures of conifers and broadleaves. While such mixtures may benefit certain biodiversity and ecosystem services, a loss of Scots pine dominated stands may also have adverse impacts on the economic returns as well as pine-dependent biodiversity and recreational values

Using citizen data in a population model to estimate population size of moose (Alces alces)

Long-term and wide-ranging citizen science programs provide a unique opportunity to monitor wildlife populations and trends through time while encouraging stakeholder participation, engagement, and trust. Hunter observations is such a program that in Sweden is used on a regular basis to monitor population trends of moose. However, hunter observations are not reliable to determine the actual population size. We developed a mechanistic moose population model that integrated citizen science data and used it at various geographical scales to estimate moose population size between 2012 and 2020. A sensitivity analysis, specifically performed for recruitment, adult sex ratio and calf sex ratio, showed that the simulated population size was most sensitive for variation in recruitment. According to the results, Sweden had a total moose population of -311 000 (+/- 4%) individuals pre-hunt and -228 000 (+/- 4%) post-hunt in 2020. The post-hunt moose abundance has decreased nationwide with 15%, from 0.72 to 0.61 moose per km2 during the 2012 - 2020 period. The present post-hunt moose density was estimated at 0.39, 0.78, 0.84 and 0.54 per km2 for the regions northernmost, northern, central and southern Sweden, respectively. The simulation model can be used for strategic and operative management at various geographical scales and is publicly available. By integrating citizen data with a mechanistic population model, a new low-cost method of estimating population size and relevant population dynamics was established

Predictors of browsing damage on commercial forests – A study linking nationwide management data

Population sizes and species distributions of wild ungulates in Europe have increased during the past decades, and continue to do so. As a result, browsing pressure in forests is increasing and concerns about the effects of increasingly common multi-species deer communities on forestry are rising. However, we currently lack an understanding of how the composition of deer communities affects browsing damage, particularly with respect to the role of species with different dietary requirements. Further, the relative importance of predictors of browsing damage in systems with multiple browsers remains elusive. Here, we used data from Swedish management, which is monitoring ungulates and their damage to forests, to test how deer densities, forage availability, and winter severity predict browsing damage on commercially important Scots pine (Pinus sylvestris) at national and regional scales. Moose (Alces alces) is the main browser of Scots pine, but competes with other deer over more preferred forage. During winter, a higher index of moose density was associated with higher browsing damage in northern Sweden, where there is low competition from other deer. In southern Sweden, competition from other deer is higher and a higher density index of roe deer (Capreolus capreolus) was associated with higher winter damage. However, there was no relationship between moose density and damage. We suggest that moose are forced to browse more pine due to interspecific competition over alternative forage resources in the south, yielding stronger relationships between densities of competing deer species and damage than between moose density and damage. Pine density, a proxy for forage availability, was an equally or more important determinant for browsing damage as deer density indices in most regions. Increasing pine density was associated with reduced browsing damage caused in winter in all regions and reduced damage caused in summer in central Sweden. Increased winter severity, as an index of snow depth, predicted increased winter damage in the northern region only. To reduce winter damage, our results suggest that management should consider deer densities and forage availability simultaneously, while adopting a multi-species approach. Results varied among regions, with densities of other deer being more relevant in the south and winter severity more relevant in the north. Management data did not predict summer damage well. Since national models did not capture regional variations, we conclude that management decisions and actions need to be tailored to the regional or local scale

Hemlös i Lund - En kvalitativ studie om institutioner som strukturerar vardagen vid avsaknaden av ett hem

Title: Homeless in Lund – a qualitative study of controlling institutions structuring everyday life in lack of a home Authors: Amanda Kalén and Desire Turesson Supervisor: Norma Montesino Assessor: Mats Hilte A home is far more than just a building. A home is where you can create your everyday-life and a place to relax. When you think of a daily routine, a house is almost always the place that comes first to mind. A home can also refer to an institution that will create an opportunity to have a normalized living. On the contrary, there are people in society who have a life that does not include a home. The purpose of this study was to explore the everyday-life of people who does not have a home, and what other controlling institutions there are to be found in the absence of a home. Through a qualitative study, both professionals working in the field and homeless people in Lund have been interviewed with a purpose to let their stories describe the structure of the everyday-life for homeless people in Lund. The interviews have resulted in an insight and a knowledge that implies the fact that stories from both professionals and homeless people are similar to one another. The descriptions show that homeless people have an everyday-life controlled by several institutions offering them support with daily needs. Examples of mentioned institutions are Diakonicentralen (voluntary organization in Lund), the shelter and Social Services. In the public sphere there is other authorities, such as police and security guards, who set the limits of the ability of homeless people to move around the city. Beside mentioned institutions there are also city residents who acts as a controlling institution due to their acting through either acceptance or rejection. The homeless people are described as spending a lot of time looking to raise money to meet their daily needs, which may involve the need to maintain an abuse

Evaluating the outcomes of collaborative wildlife governance: The role of social-ecological system context and collaboration dynamics

The acknowledgement of uncertainty and complexity in social-ecological systems has increased the implementation of collaborative governance regimes for environmental issues. The performance of these new regimes to deliver favourable social and ecological outcomes must therefore be evaluated. We focus on the case of Swedish wildlife governance, which has a tradition of using collaborative elements. In relation to moose (Alces alces), these collaborative aspects were recently formalized in an amended policy. We aim to assess some aspects of this new regime's performance with respect to intermediate ecological outcomes (i.e. quota fulfilment). We use path analysis to test the causal effects of system context and collaboration dynamics on governance outcomes. Collaboration dynamics were assessed using a web-based survey sent to all stakeholders in Moose Management Groups (response rate = 82 %). Our originally specified model yielded a good fit (SRMR of .030 and robust TLI of .996) and explained 20 % of the variation in outcomes. Context variables revealed significant direct effects on collaboration dynamics and outcomes. Larger Moose Management Areas and fluctuations in forage availability required more time investment from actors, while high land use diversity and density of other ungulate species negatively affected moose quota fulfilment. Moose Management Groups that invested more time and perceived to have a good knowledge base achieved better quota fulfilment. Collaboration dynamics thus had a positive direct effect on outcomes. From a policy perspective, our results raise questions regarding institutional fit because context factors had significant negative effects on collaboration dynamics and the outcomes of the collaborative process

Browsing Damage on Scots Pine: Direct and Indirect Effects of Landscape Characteristics, Moose and Deer Populations

Reducing browsing damages from cervids (Cervidae) on economically valuable tree species is a challenging task in many countries. Apart from cervid abundance, landscape characteristics, such as forest composition, land use, forage availability and climatic conditions, may affect the degree of browsing through both direct and indirect effects. A better understanding of basic mechanisms in this complex system is needed to design efficient and convincing management strategies. Focusing on Sweden as a case, which has been widely studied using regression analyses only, we applied path analysis to test the validity of a model on the indirect and direct links between landscape characteristics, cervid populations, and browsing damages on Scots pine (Pinus sylvestris). Our results validated the tested model in which moose (Alces alces) density and pine availability directly influence browsing damages. Increasing amounts of pine forests, preferred deciduous trees, and young forest had positive direct effects on moose densities and thereby indirectly contributed to increased browsing damages. The density of smaller deer species showed no direct effect on browsing damages on pine. Path analysis corroborated our attempt to disentangle direct and indirect potential causal drivers of browsing damages and shows that the choice of statistical method may alter the understanding of mechanistic driving forces

Gamma-Secretase Inhibitor Treatment Promotes VEGF-A-Driven Blood Vessel Growth and Vascular Leakage but Disrupts Neovascular Perfusion

The Notch signaling pathway is essential for normal development due to its role in control of cell differentiation, proliferation and survival. It is also critically involved in tumorigenesis and cancer progression. A key enzyme in the activation of Notch signaling is the gamma-secretase protein complex and therefore, gamma-secretase inhibitors (GSIs)—originally developed for Alzheimer's disease—are now being evaluated in clinical trials for human malignancies. It is also clear that Notch plays an important role in angiogenesis driven by Vascular Endothelial Growth Factor A (VEGF-A)—a process instrumental for tumor growth and metastasis. The effect of GSIs on tumor vasculature has not been conclusively determined. Here we report that Compound X (CX), a GSI previously reported to potently inhibit Notch signaling in vitro and in vivo, promotes angiogenic sprouting in vitro and during developmental angiogenesis in mice. Furthermore, CX treatment suppresses tumor growth in a mouse model of renal carcinoma, leads to the formation of abnormal vessels and an increased tumor vascular density. Using a rabbit model of VEGF-A-driven angiogenesis in skeletal muscle, we demonstrate that CX treatment promotes abnormal blood vessel growth characterized by vessel occlusion, disrupted blood flow, and increased vascular leakage. Based on these findings, we propose a model for how GSIs and other Notch inhibitors disrupt tumor blood vessel perfusion, which might be useful for understanding this new class of anti-cancer agents