Taking a Proposal Seriously : Orientations to Agenda and Agency in Support Workers’ Responses to Client Proposals

While joint decision-making is regularly launched by a proposal, it is the recipients’ responses that crucially influence the proposal outcome. This chapter examines how support workers respond to the proposals made by clients during rehabilitation group meetings at the Clubhouse. Drawing on a collection of 180 client-initiated proposal sequences, the paper describes two dilemmas that the support workers face when seeking to take client proposals “seriously.” The first concerns the meeting’s agenda and consists of a tension between providing recognition for the individual client and encouraging collective participation. The second dilemma has to do with agency and consists of a tension between focusing on the client as the originator of the proposal and avoiding treating him or her alone accountable for it. The analysis of these dilemmas contributes to a deeper understanding of group decision-making, in general, while these findings have specific relevance in mental health rehabilitation.While joint decision-making is regularly launched by a proposal, it is the recipients’ responses that crucially influence the proposal outcome. This chapter examines how support workers respond to the proposals made by clients during rehabilitation group meetings at the Clubhouse. Drawing on a collection of 180 client-initiated proposal sequences, the paper describes two dilemmas that the support workers face when seeking to take client proposals “seriously.” The first concerns the meeting’s agenda and consists of a tension between providing recognition for the individual client and encouraging collective participation. The second dilemma has to do with agency and consists of a tension between focusing on the client as the originator of the proposal and avoiding treating him or her alone accountable for it. The analysis of these dilemmas contributes to a deeper understanding of group decision-making, in general, while these findings have specific relevance in mental health rehabilitation.Peer reviewe

Promoting Client Participation and Constructing Decisions in Mental Health Rehabilitation Meetings

The chapter analyzes practices by which support workers promote client participation in mental health rehabilitation meetings at the Clubhouse. While promoting client participation, the support workers also need to ascertain that at least some decisions get constructed during the meetings. This combination of goals—promoting participation and constructing decisions—leads to a series of dilemmatic practices, the dynamics of which the chapter focuses on analyzing. The support workers may treat clients’ turns retrospectively as proposals, even if the status of these turns as such is ambiguous. In the face of a lack of recipient uptake, the support workers may remind the clients about their epistemic access to the content of the proposal or pursue their agreement or commitment to the idea. These practices involve the support workers carrying primary responsibility over the unfolding of interaction, which is argued to compromise the jointness of the decision-making outcome.The chapter analyzes practices by which support workers promote client participation in mental health rehabilitation meetings at the Clubhouse. While promoting client participation, the support workers also need to ascertain that at least some decisions get constructed during the meetings. This combination of goals—promoting participation and constructing decisions—leads to a series of dilemmatic practices, the dynamics of which the chapter focuses on analyzing. The support workers may treat clients’ turns retrospectively as proposals, even if the status of these turns as such is ambiguous. In the face of a lack of recipient uptake, the support workers may remind the clients about their epistemic access to the content of the proposal or pursue their agreement or commitment to the idea. These practices involve the support workers carrying primary responsibility over the unfolding of interaction, which is argued to compromise the jointness of the decision-making outcome.Peer reviewe

Johdanto:tunturien lapsesta saamelaisten rengiksi

Tiivistelmä Nils-Aslak Valkeapää oli saamelaisen kulttuurin ofelaš, tiennäyttäjä ja tulenkantaja aikana jolloin saamelaisuus oli tuomittu katoavaksi kulttuuriksi ja saamen kieli kuolevaksikieleksi. Ylpeydellä ja taistelutahdolla hän alkoi muuttaa valtakulttuurien ja oman kansansa näkemystä. Yhdessä muiden nuorten saamelaisten kanssa hän sai aikaan käänteen, jota kutsutaan saamelaisten kulttuuriseksi ja kielelliseksi renessanssiksi. Näitä nuoria yhdisti samankaltainen, syvältä saamelaisista perinteistä ammentava tausta, jota he tunnustivat häpeämättä. Myös Nils-Aslak Valkeapäälle saamelaisuus oli luonnollisin olotila: se olemisen tapa, johon hän oli syntynyt ja jossa kasvanut. Tässä laajassa johdantoluvussa luomme katsauksen Áilun tuotantoon eri aikakausina. Kuvailemme aluksi sitä elämänmuotoa, jossa Áilu kasvoi, sillä se eroaa merkittävästi sekä valtakulttuurien että nykyisestä saamelaisesta elämänmuodosta. Tuotannon esittely etenee sekä alakohtaisesti että kronologisesti, ja sitä täydennetään henkilöhistorian pääpiirteillä, sikäli kun ne ovat merkityksellisiä hänen tekemiensä taiteellisten valintojen ymmärtämisessä. Tuotannon esittelyn lomassa kuvaillaan myös tämän kirjan artikkelit ja esitellään niiden kirjoittajat

The Knowledge Test Feedback Interventions (KTFI) increases knowledge level of spinal stenosis patients before surgery – A randomized controlled follow-up trial

ObjectiveTo assess the impact of a preoperative educational intervention on the knowledge level of patients with spinal stenosis.MethodsOne hundred spinal stenosis patients were randomized into a preoperative educational intervention group (IG, n = 50) or a control group (CG, n = 50). All the patients received routine preoperative education. In addition, the IG went through an empowering telephone discourse based on a knowledge test performed before admission to hospital. Data on patients’ knowledge level were collected at baseline (after the treatment decision), admission to hospital, discharge from hospital and at 3 and 6 months follow-up.ResultsAt baseline, there was no difference in the knowledge level of the study groups. At admission, the knowledge level was significantly higher in five of six dimension of empowering knowledge in the IG compared to the CG. During follow-up, the knowledge level within the study groups remained stable.ConclusionA preoperative KTFI significantly increased the patients’ knowledge level in most dimensions of empowering knowledge.</p

Profiling of smokers and snuffers among young Finnish men:cross-sectional epidemiological study

Abstract Objective: The purpose of this study was to get new information from several sources about the background factors of Finnish smokers, snuffers, and dual users. Profiles of young smokers and snuffers were investigated in association with restorative treatment need, oral hygiene, eating habits, physical activity, body mass index (BMI), psychological and socioeconomic factors. Material and methods: The study group comprised 3420 conscripts. The data were collected from four different sources: a health examination including an oral health screening, a computer-based questionnaire for investigating individual background factors, a psychological test assessing cognitive skills, and the Cooper test. Statistical analyses comprised cross tabulation and binary logistic regression modelling. Results: The odds for smoking were the greatest among those who had DT (Decayed teeth) > 0, used energy drinks or alcohol regularly, or whose parents were divorced. A score of ≥2900 m in the Cooper test, a higher physical exercise level, a higher own education level, and using sports drinks decreased the odds for smoking. The odds for snuffing were higher among those who ran >2500 m in the Cooper test, had a BMI of ≥25, used sports/energy drinks, or exercised regularly, and lower among those who achieved good results in the cognitive test. Using energy/sports drinks or alcohol was positively and a higher education level was negatively associated with dual use. Conclusions: Along with increasing prevalence of snuffing, heterogeneity is likely among snuffers. Good cognitive skills may prevent from smoking and snuffing