Lyhytjälkihoitoinen synnytys - äitien kokemuksia

Opinnäytetyön tarkoituksena oli kuvailla äitien kokemuksia lyhytjälkihoitoisen synnytyksen hoitoprosessista. Opinnäytetyö oli laadullinen tutkimus. Tutkimustehtävänä oli tutkia, millaisia kokemuksia äideillä oli lyhytjälkihoitoisesta synnytyksestä. Aineistonkeruumenetelmänä käytettiin teemahaastattelua. Tiedonantajina toimi kolme lyhytjälkihoitoisen synnytyksen läpikäynyttä äitiä. Tutkimusaineisto analysoitiin sisällön analyysillä. Opinnäytetyön tutkimustuloksina saatiin kolme pääluokkaa, jotka olivat ohjaus, tunnelma ja päätöksenteko. Äidit kokivat saaneensa hyvää ohjausta jokaisessa hoitopolun vaiheessa. Ohjausta äidit saivat tarvelähtöisesti. Äitien kokemuksien mukaan isä ei lapsivuodeosastolla saanut ohjausta. Tunnelma muodostui kiireettömyyden tunnusta, turvallisesta olosta osastolla sekä molemminpuolisesta luottamuksesta. Päätöksentekoon liittyi miten kotiutumista ehdotettiin, miten päätös tehtiin ja päätökseen vaikuttavat seikat. Äidit toivoivat, että henkilökunta olisi ehdottanut kotiutumista. Tärkeä oli myös havaita, että päätöksentekoon liittyi muita seikkoja kuten kotona odottavat muut lapset. Tutkimustyön tavoitteena oli tuottaa uutta kokemuksellista tietoa lyhytjälkihoisen synnytyksen kanssa työskenteleville. Tutkimuksella saatua tietoa voidaan käyttää apuna perheiden hoidon kehittämisessä sekä kätilötyön laadun parantamisessa.The purpose of this bachelor’s thesis was to describe mothers’ experiences of early perinatal hospital discharge. The objective was to discover what kind of experiences mothers had when they were treated in hospital and discharged. The aim of study was to produce new experiential knowledge for those who work with families and improve professional skills of midwives. The bachelor’s thesis was qualitative. The data collection method was a thematic interview of three mothers. The study material was analyzed with the method of content analysis. The results of this bachelor’s thesis showed that mothers experienced guidance, atmosphere and decision making to be the most important things in early perinatal nursing and discharge. Mothers felt that they received quality guidance during the whole course of treatment and guidance was given from their perspective. Mothers thought that no guidance was given to the father of the child. Atmosphere was composed of feeling of no hurry, emotions of safety and mutual trust. Decision making was composed of the elements of how early discharge was suggested, how the decision was made and other components that influenced the decision. Mothers wished that the suggestion of early perinatal discharge came from the nursing staff. It was also noteworthy that when making the decision, mothers also considered other factors like other children at home. The information received from this thesis can be used to help improve caring of these families and quality of midwifery

Children’s Fruit and Vegetable Preferences Are Associated with Their Mothers’ and Fathers’ Preferences

Children’s preference for fruit and vegetables must emerge during childhood. At children’s homes, mothers and fathers influence children’s developing food preferences with their own preferences and actions. The purpose of the study was to reveal the association parents have with their children’s fruit and vegetable preferences. The study was conducted in a sample of Finnish mothers and fathers of 3–5-year-old children. The participants were recruited, and questionnaires distributed through early childhood education and care centers in 2014 and 2015. The results showed considerable variance in the children’s preferences, and were more similar with their father’s, than their mother’s preference. There was an association between mother’s and children’s preference for “strong-tasting vegetables and berries“ (p = 0.005), “sweet-tasting fruit“ (p < 0.001) and “common vegetables“ (p = 0.037). Fathers preferences associated with children’s preferences for “strong-tasting vegetables and berries“ (p = 0.003). Food neophobia decreased children’s “strong-tasting vegetables and berries“ (p < 0.001) and “sweet-tasting fruit“ (p < 0.001) preferences. The father’s more relaxed attitude towards eating decreased children’s preferences for “strong-tasting vegetables and berries“ (p = 0.031) and “sweet-tasting fruit“ (p = 0.003). These findings indicate a need for more targeted strategies for increasing children’s preferences for fruit and vegetables and highlight the importance of taking both parents equally into account

Children’s Fruit and Vegetable Preferences Are Associated with Their Mothers’ and Fathers’ Preferences

Children’s preference for fruit and vegetables must emerge during childhood. At children’s homes, mothers and fathers influence children’s developing food preferences with their own preferences and actions. The purpose of the study was to reveal the association parents have with their children’s fruit and vegetable preferences. The study was conducted in a sample of Finnish mothers and fathers of 3–5-year-old children. The participants were recruited, and questionnaires distributed through early childhood education and care centers in 2014 and 2015. The results showed considerable variance in the children’s preferences, and were more similar with their father’s, than their mother’s preference. There was an association between mother’s and children’s preference for “strong-tasting vegetables and berries“ (p = 0.005), “sweet-tasting fruit“ (p < 0.001) and “common vegetables“ (p = 0.037). Fathers preferences associated with children’s preferences for “strong-tasting vegetables and berries“ (p = 0.003). Food neophobia decreased children’s “strong-tasting vegetables and berries“ (p < 0.001) and “sweet-tasting fruit“ (p < 0.001) preferences. The father’s more relaxed attitude towards eating decreased children’s preferences for “strong-tasting vegetables and berries“ (p = 0.031) and “sweet-tasting fruit“ (p = 0.003). These findings indicate a need for more targeted strategies for increasing children’s preferences for fruit and vegetables and highlight the importance of taking both parents equally into account.Peer reviewe

A mobile diary method for studying children’s and adolescents’ emotions: a pilot study

Researching children’s and adolescents’ emotions from their own perspectives possesses special requirements for the data collection tools used. In this study, children’s and early adolescents’ emotions were investigated using a mobile diary method. The article describes and evaluates this data collection method and presents empirical results on fluctuation in the emotions of children and adolescents (n = 60, aged 7–14 years). The data, in the form of short text messages, were collected over one week. Every evening, children received seven questions on their emotions. Multilevel modeling was used to analyze the data. The results illustrate the potential of the mobile diary method with children and early adolescents. The data showed a two-factor structure, indicating that the mobile diary method was able to reveal the underlying dimensions of positive and negative emotions. The study also showed that daily variation in emotions along with systematic differences between participants in their emotional experiences (related to, e.g., the form of the family) can be captured using the method

Kumman vuoro? Kotityön ja vanhemmuuden jakamiselle annetut perustelut epätyypillisen työajan perheissä

Aiemman tutkimuksen mukaan epätyypillinen työaika haastaa sukupuolten työnjaolle annettuja perusteluja, koska näissä perheissä on usein tilanteita, jolloin toinen vanhemmista kantaa yksin vastuuta kodista ja lapsista toisen ollessa töissä. Tarkastelemme tässä tutkimuksessa, millaisia perusteluita suomalaiset, epätyypillistä työaikaa tekevät vanhemmat antavat kotityön ja vanhemmuuden jakamiselle perheessään. Hyödynsimme epätyypillistä työaikaa tekevien vanhempien haastatteluiden (n=34) analyysissa aiemmassa tutkimuksessa löydettyjä sukupuolten työn-jaon selitysmalleja sekä kategoria-analyysia. Löysimme viisi työnjaon perhetyyppiä: Naishoivaajien perheissä äidit perustelivat sukupuolittunutta työnjakoa perinteisiä sukupuoli-rooleja korostaen. Samoin mieselättäjien perheiden isät oikeuttivat vähäistä osallistumistaan perhevastuisiin ulkoisilla resursseilla ja elättäjyydellä kiinnittyen näin perinteisiin isän ja äidin kategorioihin. Vuorotteluvanhemmuuden perheissä vanhemmat kuvasivat työnjakoa tasapuoliseksi molempien puolisoiden ajan saatavuuteen ja tasa-arvoideologiaan perustuen. Urasuuntautuneen vanhemman perheissä työnjakoa perusteltiin toisen vanhemman työhön sitoutumisella. Lisäksi toisen vanhemman pidempi poissaolo kuormitti osaa perheistä, ja sillä oli merkitystä työnjaon perustelemisessa. Vaikka epätyypillinen työaika luo edellytyksiä työn ja perheen tasa-arvoiseen jakamiseen, perinteisiin sukupuolten kulttuurisiin kategorioihin kiinnittyminen luo ristiriitaisuutta kerrontaan ja estää tasa-arvon toteutumista

Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events

Background: Immune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear. Methods: In a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed. Results: Patients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT −/AE + group, 26.7% in the RT −/AE − group and 18.3% in the RT + /AE − group (p < 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT −/AE − and RT + /AE − groups (log rank p = 0.001 and p < 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT −/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582–0.935; p = 0.012, and HR 0.620; 95% CI 0.499–0.769; p < 0.001, respectively). Conclusions: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers.Peer reviewe

Disease Burden Attributed to Drug use in the Nordic Countries: a Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2019

The Nordic countries share similarities in many social and welfare domains, but drug policies have varied over time and between countries. We wanted to compare differences in mortality and disease burden attributed to drug use over time. Using results from the Global Burden of Disease (GBD) study, we extracted age-standardized estimates of deaths, DALYs, YLLs and YLDs per 100 000 population for Denmark, Finland, Iceland, Norway, and Sweden during the years 1990 to 2019. Among males, DALY rates in 2019 were highest in Finland and lowest in Iceland. Among females, DALY rates in 2019 were highest in Iceland and lowest in Sweden. Sweden have had the highest increase in burden since 1990, from 252 DALYs to 694 among males, and from 111 to 193 among females. Norway had a peak with highest level of all countries in 2001–2004 and thereafter a strong decline. Denmark have had the most constant burden over time, 566–600 DALYs among males from 1990 to 2010 and 210–240 DALYs among females. Strict drug policies in Nordic countries have not prevented an increase in some countries, so policies need to be reviewed.publishedVersio

The accumulation of problems of social functioning : outer, inner, and behavioral strands

This study examined the question of whether problems of social functioning in adulthood accumulate, and compared developmental processes involved in the accumulation of problems in men and women. Problems of social functioning in adulthood included, for example, poor financial standing, poor social relationships, and drinking problems. Risk factors in childhood and adolescence consisted of aggressiveness and anxiety, family problems, and negative schooling experiences. The study was based on the Jyvaskyla Longitudinal Study of Personality and Social Development, in which the lives of the participants have been followed from age 8 to age 36. The original sample consisted of 196 boys and 173 girls born in 1959. Data collected at ages 8, 14, 27, and 36 by using teacher ratings, questionnaires, interviews and criminal records were utilized. The results indicated that problems of social functioning tend to interact and co-occur. The accumulation of problems was more common among the men than among the women, and there were sex differences in the strands through which accumulated risk factors were transmuted into adult problems. The "outer strand", referring to lack of opportunities in life included career instability in both sexes; but early parenthood and a problematic partner only in women. "Behavioral strand", denoting the individual's tendency to exhibit problem behavior, and its negative consequences, was more prominent in the accumulation of problems in men than in women, whereas the "inner strand" in terms of sense of failure was more central in the case of women. Continuity in the accumulation of problems was weaker among women, and women's problems started to accumulate later in life than men's problems. As a conceptual conclusion, a distinction was drawn on the basis of the focus of interest (individual or population) and temporal perspective (state or process) between accumulation as a co-occurrence of problems, and accumulation as a chain of problems in individuals; and accumulation as a concentration of problems in a subgroup of people and accumulation as polarization of problems in a population. "Accumulation" in the present study refers to a long-term process on the individual level

Vuorotyöarki on pullantuoksuisia arkivapaita ja päänsärkyhattuja

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