Ainahan lapsi on joko tyttö tai poika:eteläpohjalaisten suhtautuminen sukupuolineutraaleihin nimiin

Tiivistelmä. Kandidaatintutkielmassani tutkin yli 50-vuotiaiden eteläpohjalaisten suhtautumista sukupuolineutraaleihin nimiin. Selvitän, miten eteläpohjalaiset luokittelevat neutraaleja nimiä, millaisia mielikuvia tutkielmassa esiintyvät etunimet heissä herättävät ja miten he yleisesti suhtautuvat sukupuolineutraaleihin nimiin. Tutkimusaineistoni koostuu 50 vastauksesta, jotka on kerätty syksyllä 2018 sähköisellä kyselylomakkeella. Käytän tutkielmassani vastaajilta saatuja aineistoesimerkkejä, ja tutkin, miten sukupuolineutraaleihin nimiin suhtaudutaan. Lisäksi esittelen saatuja tuloksia kuvioiden avulla. Tutkimukseni on siis sekä kvalitatiivista että kvantitatiivista tutkimusta. Tutkielmani tuloksista selviää, että eteläpohjalaiset suhtautuvat pääasiassa negatiivisesti sukupuolineutraaleihin nimiin. Tutkimuksessa esille nousevat näkemys vain kahden sukupuolen olemassaolosta sekä tarve erottaa ihmiset toisistaan nimen avulla. Lisäksi tutkimuksessa korostuu se, että useita neutraaleja nimiä ei pidetä lainkaan ihmisille sopivina. Vastaajat myös ajattelevat sukupuolineutraaleista nimistä samalla tavalla, koska nimistä syntyneet mielikuvat ovat keskenään hyvin samanlaisia. Vastaajat myös jaottelevat tutkimuksen kohteena olevia etunimiä sekä tietylle sukupuolelle kuuluviksi että sukupuolineutraaleiksi

”Jos nimi sopii naamaan, niin ei sillä ole väliä onko Päiviö vai Päivi.”:eteläpohjalaisten suhtautuminen sukupuolineutraaleihin etunimiin

Tiivistelmä. Tutkin pro gradu -tutkielmassani, miten eteläpohjalaiset suhtautuvat sukupuolineutraaleihin etunimiin. Selvitän, miten ja millä perusteella eteläpohjalaiset mieltävät etunimiä sukupuolineutraaleiksi, millaisia mielleyhtymiä he niihin liittävät ja miten eri ikäryhmien suhtautuminen eroaa toisistaan. Tutkielmani tavoitteena on siis saada laaja käsitys siitä, millaista eteläpohjalaisten suhtautuminen neutraaleja nimiä kohtaan on ja millaisia eroja alle 50-vuotiaiden ja yli 50-vuotiaiden näkemyksissä ilmenee. Tutkimukseni teoreettinen tausta koostuu nimistöntutkimuksesta ja vielä tarkemmin sanottuna sosiolingvistisestä nimistöntutkimuksesta. Lisäksi tutkimukseni edustaa myös kansanlingvististä nimistöntutkimusta, koska tutkin nimiin liittyviä asenteita sekä suhtautumista. Tutkimusmenetelmäni ovat kvalitatiiviset, sillä työni tarkoituksena on ymmärtää neutraaleihin nimiin suhtautumista ilmiönä. Analyysimenetelmänä minulla ovat sisällönanalyysi sekä sisällön erittely, joiden lisäksi hyödynnän tutkielmassani myös joitain kvantitatiivisen tutkimuksen menetelmiä. Olen kerännyt tutkimusaineistoni sähköisillä kyselylomakkeilla vuosina 2018 ja 2020. Minulla on kaksi eri aineistoa, yli 50-vuotiaat ja alle 50-vuotiaat Etelä-Pohjanmaan alueella asuvat informantit, joiden vastauksia tarkastelen. Vastauksia olenkin kyselyyni saanut yhteensä 382, joista olen suodattanut käsiteltäväksi 100 vastausta. Tutkimukseni osoittaa, että sekä yli 50-vuotiaat että alle 50-vuotiaat eteläpohjalaiset luokittelevat tutkimuksessani olevia etunimiä useimmin sukupuolineutraaleiksi. Vastaajat perustelevat näkemyksiään nimen tuttuuden, merkityksen ja syntyvän mielikuvan perusteella, mutta he myös vertaavat nimeä johonkin toiseen etunimeen. Lisäksi osa perustelee vastauksiaan nimen sopivuudella molemmille sukupuolille tai nimen sopimattomuudella ihmiselle. Tutkimuksessani myös ilmenee, että vanhempi ikäryhmä haluaa nimenkantajan sukupuolen selviävän suoraan nimen perusteella ja kokee etunimet useammin ihmiselle sopimattomina kuin nuorempi ikäryhmä. Lisäksi molemmissa ryhmissä yli puolet vastaajista kokee sukupuolineutraalit etunimet tarpeettomina. Yli 50-vuotiaat perustelevat nimien tarpeettomuutta useammin vain kahden sukupuolen olemassaololla ja alle 50-vuotiaat taas nimen vaihtamisen mahdollisuudella. Kuitenkin osa vastaajista kokee, että sukupuolineutraaleille nimille on tarvetta. Eteläpohjalaiset myös kertovat itse suhtautuvansa neutraaleihin nimiin positiivisesti, neutraalisti ja negatiivisesti. Analyysistani ilmenee, että nuorempi ikäryhmä suhtautuu toista ryhmää useammin neutraaleihin nimiin positiivisesti ja vanhempi ryhmä negatiivisesti. Ryhmien väliset erot eivät kuitenkaan ole huomattavia, mutta tulevat esiin parhaiten avoimien kysymysten vastausten kautta. Analyysistani nousee lisäksi esiin, että sukupuolineutraaleihin etunimiin informantit liittävät mielikuvia eniten nimenkantajan luonteesta ja ulkonäöstä, mutta myös jonkin verran tämän perheestä, kiinnostuksen kohteista, asuinpaikasta, taustasta ja iästä. Joskus tosin etunimi ei herätä vastaajissa minkäänlaisia mielikuvia. Nimiin liitetyt mielikuvat kuitenkin pohjautuvat useimmiten aina jollain tavalla nimen merkitykseen, mutta joitain poikkeuksiakin on. Pääasiassa ikäryhmille syntyy keskenään samankaltaisia mielikuvia nimenkantajista, mutta alle 50-vuotiaat yhdistävät nimenkantajaan mielikuvia tämän taustasta ja perheestä useammin kuin yli 50-vuotiaat. Vanhemmalla ikäryhmällä taas on ollut nuorempaa ikäryhmää useammin vaikeuksia muodostaa minkäänlaisia mielikuvia nimenkantajista

Study protocol for a cluster randomised controlled trial to assess the effectiveness of user-driven intervention to prevent aggressive events in psychiatric services

Background People admitted to psychiatric hospitals with a diagnosis of schizophrenia may display behavioural problems. These may require management approaches such as use of coercive practices, which impact the well-being of staff members, visiting families and friends, peers, as well as patients themselves. Studies have proposed that not only patients’ conditions, but also treatment environment and ward culture may affect patients’ behaviour. Seclusion and restraint could possibly be prevented with staff education about user-centred, more humane approaches. Staff education could also increase collaboration between patients, family members and staff, which may further positively affect treatment culture and lower the need for using coercive treatment methods. Methods This is a single-blind, two-arm cluster randomised controlled trial involving 28 psychiatric hospital wards across Finland. Units will be randomised to receive either a staff educational programme delivered by the team of researchers, or standard care. The primary outcome is the incidence of use of patient seclusion rooms, assessed from the local/national health registers. Secondary outcomes include use of other coercive methods (limb restraint, forced injection, and physical restraint), service use, treatment satisfaction, general functioning among patients, and team climate and employee turn-over (nursing staff). Discussion The study, designed in close collaboration with staff members, patients and their relatives, will provide evidence for a co-operative and user-centred educational intervention aiming to decrease the prevalence of coercive methods and service use in the units, increase the functional status of patients and improve team climate in the units. We have identified no similar trials

The Impact of a Web-Based Course Concerning Patient Education for Mental Health Care Professionals: Quasi-Experimental Study

Background: Continuing education has an important role in supporting the competence of health care professionals. Although Web-based education is a growing business in various health sectors, few studies have been conducted in psychiatric settings to show its suitability in demanding work environments.Objective: We aimed to describe the impact of a Web-based educational course to increase self-efficacy, self-esteem, and team climate of health care professionals. Possible advantages and disadvantages of the Web-based course are also described.Methods: The study used nonrandomized, pre-post intervention design in 1 psychiatric hospital (3 wards). Health care professionals (n=33) were recruited. Self-efficacy, self-esteem, and team climate were measured at 3 assessment points (baseline, 8 weeks, and 6 months). Possible advantages and disadvantages were gathered with open-ended questions at the end of the course.Results: Our results of this nonrandomized, pre-post intervention study showed that health care professionals (n=33) had higher self-efficacy after the course, and the difference was statistically significant (mean 30.16, SD 3.31 vs mean 31.77, SD 3.35; P=.02). On the other hand, no differences were found in the self-esteem or team climate of the health care professionals before and after the course. Health care professionals found the Web-based course useful in supporting their work and relationships with patients. The tight schedule of the Web-based course and challenges in recruiting patients to use the patient education program with health care professionals were found to be the disadvantages.Conclusions: Web-based education might be a useful tool to improve the self-efficacy of health care professionals even in demanding work environments such as psychiatric hospitals. However, more studies with robust and sufficiently powered data are still needed

Symptoms of anxiety and depression predicting fall-related outcomes among older Americans: a longitudinal study

BackgroundAnxiety and depressive symptoms are associated with fear of falling and fear of falling-related activity restrictions. However, it remains unknown whether anxiety or depressive symptoms alone could predict fear of falling and activity restrictions in older adults. We sought to determine if anxiety and depressive symptoms alone could be an independent predictor of fear of falling and activity restrictions in community-dwelling older adults.MethodsThis longitudinal analysis used waves 5 (time 1, [T1]) and 6 (time 2, [T2], 1 year from T1) data (N = 6376) from the National Health and Aging Trends Study. The Generalized Anxiety Disorder Scale 2 and Patient Health Questionnaire 2 were used to assess anxiety and depressive symptoms, respectively. Interview questions included demographics, health-related data, and fall worry levels (no fear of falling, fear of falling but no activity restrictions, and activity restrictions). Using multinomial logistic regression models, we examined whether anxiety and depressive symptoms (T1) predicted fear of falling and activity restrictions (T2).ResultsIn wave 5 (T1, mean age: 78 years, 58.1% female), 10 and 13% of participants reported anxiety and depressive symptoms. About 19% of participants experienced fear of falling but not activity restrictions, and 10% of participants developed activity restrictions in wave 6 (T2), respectively. Participants with anxiety symptoms at T1 had a 1.33 times higher risk of fear of falling (95% CI = 1.02–1.72) and 1.41 times higher risk of activity restrictions (95% CI = 1.04–1.90) at T2. However, having depressive symptoms did not show any significance after adjusting for anxiety symptoms.ConclusionsAnxiety symptoms seemed to be an independent risk factor for future fear of falling and activity restrictions, while depressive symptoms were not. To prevent future fear of falling and activity restrictions, we should pay special attention to older individuals with anxiety symptoms.</p

Bone material properties and response to teriparatide in osteoporosis due to WNT1 and PLS3 mutations

Context: Patients with osteoporosis-associated WNT1 or PLS3 mutations have unique bone histomorphometric features and osteocyte-specific hormone expression patterns. Objective: To investigate the effects of WNT1 and PLS3 mutations on bone material properties. Design: Transiliac bone biopsies were evaluated by quantitative backscattered electron imaging, immunohistochemistry, and bone histomorphometry. Setting: Ambulatory patients. Patients: Three pediatric and eight adult patients with WNT1 or PLS3 mutations. Intervention: Bone mineralization density distribution and osteocyte protein expression was evaluated in 11 patients and repeated in six patients who underwent repeat biopsy after 24 months of teriparatide treatment. Main outcome measure: Bone mineralization density distribution and protein expression. Results: Children with WNT1 or PLS3 mutations had heterogeneous bone matrix mineralization, consistent with bone modeling during growth. Bone matrix mineralization was homogenous in adults and increased throughout the age spectrum. Teriparatide had very little effect on matrix mineralization or bone formation in patients with WNT1 or PLS3 mutations. However, teriparatide decreased trabecular osteocyte lacunae size and increased trabecular bone FGF23 expression. Conclusion: The contrast between preserved bone formation with heterogeneous mineralization in children and low bone turnover with homogenous bone mineral content in adults suggests that WNT1 and PLS3 have differential effects on bone modeling and remodeling. The lack of change in matrix mineralization in response to teriparatide, despite clear changes in osteocyte lacunae size and protein expression, suggests that altered WNT1 and PLS3 expression may interfere with coupling of osteocyte, osteoblast, and osteoclast function. Further studies are warranted to determine the mechanism of these changes.Peer reviewe

Factors associated with dropout during recruitment and follow-up periods of a mHealth-based randomized controlled trial for Mobile.Net to encourage treatment adherence for people with serious mental health problems

Background: Clinical trials are the gold standard of evidence-based practice. Still many papers inadequately report methodology in randomized controlled trials (RCTs), particularly for mHealth interventions for people with serious mental health problems. To ensure robust enough evidence, it is important to understand which study phases are the most vulnerable in the field of mental health care. Objective: We mapped the recruitment and the trial follow-up periods of participants to provide a picture of the dropout predictors from a mHealth-based trial. As an example, we used a mHealth-based multicenter RCT, titled “Mobile.Net,” targeted at people with serious mental health problems. Methods: Recruitment and follow-up processes of the Mobile.Net trial were monitored and analyzed. Recruitment outcomes were recorded as screened, eligible, consent not asked, refused, and enrolled. Patient engagement was recorded as follow-up outcomes: (1) attrition during short message service (SMS) text message intervention and (2) attrition during the 12-month follow-up period. Multiple regression analysis was used to identify which demographic factors were related to recruitment and retention. Results: We recruited 1139 patients during a 15-month period. Of 11,530 people screened, 36.31% (n=4186) were eligible. This eligible group tended to be significantly younger (mean 39.2, SD 13.2 years, P<.001) and more often women (2103/4181, 50.30%) than those who were not eligible (age: mean 43.7, SD 14.6 years; women: 3633/6514, 55.78%). At the point when potential participants were asked to give consent, a further 2278 refused. Those who refused were a little older (mean 40.2, SD 13.9 years) than those who agreed to participate (mean 38.3, SD 12.5 years; t1842=3.2, P<.001). We measured the outcomes after 12 months of the SMS text message intervention. Attrition from the SMS text message intervention was 4.8% (27/563). The patient dropout rate after 12 months was 0.36% (4/1123), as discovered from the register data. In all, 3.12% (35/1123) of the participants withdrew from the trial. However, dropout rates from the patient survey (either by paper or telephone interview) were 52.45% (589/1123) and 27.8% (155/558), respectively. Almost all participants (536/563, 95.2%) tolerated the intervention, but those who discontinued were more often women (21/27, 78%; P=.009). Finally, participants’ age (P<.001), gender (P<.001), vocational education (P=.04), and employment status (P<.001) seemed to predict their risk of dropping out from the postal survey. Conclusions: Patient recruitment and engagement in the 12-month follow-up conducted with a postal survey were the most vulnerable phases in the SMS text message-based trial. People with serious mental health problems may need extra support during the recruitment process and in engaging them in SMS text message-based trials to ensure robust enough evidence for mental health care

A digital waveguide-based approach for Clavinet modeling and synthesis

The Clavinet is an electromechanical musical instrument produced in the mid-twentieth century. As is the case for other vintage instruments, it is subject to aging and requires great effort to be maintained or restored. This paper reports analyses conducted on a Hohner Clavinet D6 and proposes a computational model to faithfully reproduce the Clavinet sound in real time, from tone generation to the emulation of the electronic components. The string excitation signal model is physically inspired and represents a cheap solution in terms of both computational resources and especially memory requirements (compared, e.g., to sample playback systems). Pickups and amplifier models have been implemented which enhance the natural character of the sound with respect to previous work. A model has been implemented on a real-time software platform, Pure Data, capable of a 10-voice polyphony with low latency on an embedded device. Finally, subjective listening tests conducted using the current model are compared to previous tests showing slightly improved results

Short text messages to encourage adherence to medication and follow-up for people with psychosis (Mobile.Net): randomized controlled trial in Finland

Background: A text messaging service (short message service [SMS]) has the potential to target large groups of people with long-term illnesses such as serious mental disorders, who may have difficulty with treatment adherence. Robust research on the impact of mobile technology interventions for these patients remains scarce. Objective: The main objective of our study was to investigate the impact of individually tailored short text messages on the rate of psychiatric hospital readmissions, health care service use, and clinical outcomes. In addition, we analyzed treatment costs. Methods: Between September 2011 and November 2012, we randomly assigned 1139 people to a tailored text message intervention (n=569) or usual care (n=570). Participants received semiautomated text messages for up to 12 months or usual care. The primary outcome, based on routinely collected health register data, was patient readmission into a psychiatric hospital during a 12-month follow-up period. Secondary outcomes were related to other service use, coercion, medication, adverse events, satisfaction, social functioning, quality of life, and economic factors (cost analysis). Results: There was 98.24% (1119/1139) follow-up at 12 months. Tailored mobile telephone text messages did not reduce the rate of hospital admissions (242/563, 43.0% of the SMS group vs 216/556, 38.8% of the control group; relative risk 1.11; 95% CI 0.92-1.33; P=.28), time between hospitalizations (mean difference 7.0 days 95% CI –8.0 to 24.0; P=.37), time spent in a psychiatric hospital during the year (mean difference 2.0 days 95% CI –2.0 to 7.0; P=.35), or other service outcomes. People who received text messages were less disabled, based on Global Assessment Scale scores at the time of their readmission, than those who did not receive text messages (odds ratio 0.68; 95% CI 0.47-0.97; P=.04). The costs of treatment were higher for people in the SMS group than in the control group (mean €10,103 vs €9210, respectively, P<.001). Conclusions: High-grade routinely collected data can provide clear outcomes for pragmatic randomized trials. SMS messaging tailored with the input of each individual patient did not decrease the rate of psychiatric hospital visits after the 12 months of follow-up. Although there may have been other, more subtle effects, the results of these were not evident in outcomes of agreed importance to clinicians, policymakers, and patients and their families

Internet use, eHealth literacy and attitudes toward computer/internet among people with schizophrenia spectrum disorders: a cross-sectional study in two distant European regions

Background: Individuals with schizophrenia spectrum disorders use the Internet for general and health-related purposes. Their ability to find, understand, and apply the health information they acquire online in order to make appropriate health decisions-known as eHealth literacy-has never been investigated. The European agenda strives to limit health inequalities and enhance mental health literacy. Nevertheless, each European member state varies in levels of Internet use and online health information-seeking. This study aimed to examine computer/Internet use for general and health-related purposes, eHealth literacy, and attitudes toward computer/Internet among adults with schizophrenia spectrum disorders from two distant European regions.Methods: Data were collected from mental health services of psychiatric clinics in Finland (FI) and Greece (GR). A total of 229 patients (FI = 128, GR = 101) participated in the questionnaire survey. The data analysis included evaluation of frequencies and group comparisons with multiple linear and logistic regression models.Results: The majority of Finnish participants were current Internet users (FI = 111, 87%, vs. GR = 33, 33%, P<.0001), while the majority of Greek participants had never used computers/Internet, mostly due to their perception that they do not need it. In both countries, more than half of Internet users used the Internet for health-related purposes (FI = 61, 55%, vs. GR = 20, 61%). The eHealth literacy of Internet users (previous and current Internet users) was found significantly higher in the Finnish group (FI: Mean = 27.05, SD 5.36; GR: Mean = 23.15, SD = 7.23, P<. 0001) upon comparison with their Greek counterparts. For current Internet users, Internet use patterns were significantly different between country groups. When adjusting for gender, age, education and disease duration, country was a significant predictor of frequency of Internet use, eHealth literacy and Interest. The Finnish group of Internet users scored higher in eHealth literacy, while the Greek group of never Internet users had a higher Interest in computer/Internet.Conclusions: eHealth literacy is either moderate (Finnish group) or low (Greek group). Thus, exposure to ICT and eHealth skills training are needed for this population. Recommendations to improve the eHealth literacy and access to health information among these individuals are provided