"Pitää olla niinku sellaasta innovatiivista henkeä" : Vaasan kaupungin keskijohdon työntekijöiden kokemuksia työhyvinvoinnista

Työhyvinvointi on ollut paljon esillä julkisuudessa. Keskijohdon työhyvinvoinnin kokemusta kartoittavia tutkimuksia on tehty vähän Suomessa suhteessa ylemmän johdon, esimies- ja työntekijätason vastaaviin tutkimuksiin. Julkisella sektorilla toimii paljon keskijohdon henkilöstöä. Tämän tutkimuksen tavoitteena oli selvittää Vaasan kaupungin keskijohdon kokemuksia työhyvinvoinnista kolmella eri toimialalla. Tutkimuksen avulla nostetaan esille julkisella sektorilla keskijohdossa työskentelevien henkilöiden kokemuksia työhyvinvointia edistävistä ja estävistä tekijöistä. Tutkimus pyrki keräämään kokemuksellista tietoa työhyvinvoinnista keskijohdon työntekijöiden kokemana. Siksi oli perusteltua valita tutkimusmenetelmäksi laadullinen tutkimus. Tiedonhankinnassa sovellettiin Grounded Theory -menetelmää. Tutkimusaineistoa tarkasteltiin aineistopohjaisesti. Tutkimuksen aineistona oli keskijohdon työntekijöille tehdyt haastattelut. Aineiston pohjalta keskeisiksi käsitteiksi nostettiin keskijohto, työhyvinvointi ja julkinen sektori. Tutkimuksesta saatuja tuloksia peilattiin Rauramon (2008) työhyvinvoinnin portaisiin. Saadun aineiston pohjalta työhyvinvointi luokitella viiteen alaluokkaan: sosiaaliset tarpeet, arvostuksen tarve, turvallisuus, tilat ja välineet sekä itsensä toteuttaminen. Saadut tulokset tukevat pääsääntöisesti aikaisempien tutkimuksien tuloksia. Tutkimustuloksissa korostui työhyvinvoinnin kokemuksen tasapainoilu sitä edistävien ja estävien asioiden valossa. Toisaalta tämä epävakaa asetelma kuvastaa hyvin sitä organisatorista välitilaa ja muutosta, johon keskijohdon henkilöstö työssään asettuu.Wellbeing at work has been discussed a lot in the public. Only few studies have been carried out about wellbeing at work among middle management employees when compared to the amount of studies carried out related to other employee groups like the senior management, superiors and average employees. There are many employees working in the middle management in the public sector. The purpose of this study was to look at the experiences of middle management of wellbeing at work in three different sectors in the City of Vaasa. The study aims at revealing the factors either promoting or preventing wellbeing at work. The purpose of the study was to collect empirical knowledge about the wellbeing at work as experienced by the middle management employees. The study is qualitative. Grounded Theory – method was applied in data acquisition. A material based approach was used with the material. The material included the interviews with the middle management employees. The key concepts, based on the material, are middle management, wellbeing at work and public sector. The results of the study were reflected on by comparing them to Rauramos (2008) concept – the stairs of wellbeing at work. Based on the material, wellbeing at work can be categorized into five different sub-categories: social needs, the need to be appreciated, security, premises, equipment and self-actualization. The results of this study support the results of previous studies. The need to balance between promoting and preventing factors related to wellbeing at work was emphasized in the study. This unstable situation describes well the situation where the middle management is in the organization

Sininen biotalous

Luken kirjat, raportit, oppaat ja esitteet. Esiselvitys 16.4.2015201

Intergenerational Negotiations on (Hetero)sexuality and Romantic Relationships : Views of Young People and Parents in Multiethnic Contexts

Peer reviewe

Extended family history of type 1 diabetes inHLA-predisposed children with and without islet autoantibodies

Objective The aim of this study was to explore the extended family history of type 1 diabetes in children at genetic risk and define the impact of a positive family history on the development of islet autoimmunity and type 1 diabetes. Methods The subjects were participants in The Finnish Type 1 Diabetes Prediction and Prevention (DIPP) study and carried increased HLA-conferred risk for type 1 diabetes. The case children (N = 343) were positive for at least one islet autoantibody, and the control children (N = 343) matched by age, gender and class II HLA genotype were negative for islet autoantibodies at the time of data collection. Extended family history of type 1 diabetes was obtained by using a structured questionnaire. Results Among children who were autoantibody positive and progressed to type 1 diabetes 62.2% (28/45) had at least one relative with type 1 diabetes. Interestingly, 57.8% of these children (26/45) had such a relative outside the nuclear family compared to 30.7% of children with no autoantibodies (P= .001), 35.2% of those with only classical islet cell antibodies (P= .006), and 35.2% of non-progressors with biochemical autoantibodies (P= 0.011). A positive history of type 1 diabetes in the paternal extended family was more common in children with multiple biochemical autoantibodies compared to those with only one biochemical autoantibody (P= .010). No association between the specificity of the first appearing autoantibody and family history of the disease was found. Conclusions Type 1 diabetes in relatives outside the nuclear family is a significant risk factor for islet autoimmunity and progression to clinical disease in HLA susceptible children.Peer reviewe

Sociodemographic factors affecting glycaemic control in Finnish paediatric patients with type 1 diabetes

Aims: Socioeconomic problems may present significant challenges when trying to reach optimal glycaemic control in paediatric patients with type 1 diabetes. We examined sociodemographic factors affecting metabolic control in patients in one of the biggest paediatric diabetes clinics in Finland. Methods: One hundred ninety-one children (age 2–15 years; median 11 years; 47% female) with type 1 diabetes and their families were recruited during outpatient visits in the paediatric diabetes clinic of Tampere University Hospital, Finland. The participants completed a questionnaire on the family's sociodemographic background. The child's glycaemic control was assessed by both glycosylated haemoglobin (HbA1c) and time in range (TIR). Risk factors for poor (HbA1c ≥75 mmol/mol; TIR <40%) and optimal (HbA1c <53 mmol/mol; TIR ≥70%) metabolic control were searched using logistic regression analyses. Results: Living in a nuclear family, male gender, younger age and a school assistant for diabetes management were associated with the simultaneous presence of both indicators of optimal metabolic control. Poor glycaemic control, as estimated by HbA1c, was associated with lower parental education and the child's older age. Parental smoking and the child's older age were associated with poor TIR. Conclusion: This study confirms the importance of sociodemographic factors in care of Finnish paediatric patients with type 1 diabetes. Sociodemographic status markers of the family could be used as triggers to alert paediatric diabetes teams to offer more tailored care to families with new-onset type 1 diabetes mellitus.Peer reviewe

In search of measures to improve the detection of increased cardiometabolic risk in children using second-generation antipsychotic medications

Purpose: Second-generation antipsychotic medications (SGAs) are widely used in child psychiatry. SGA-induced metabolic disturbances are common in children, but monitoring practices need systematisation. The study’s aims were to test an SGA-monitoring protocol, examine the distributions of metabolic measurements compared to reference values in child psychiatry patients, and determine whether using a homeostasis model for the assessment of insulin resistance (HOMA-IR) and triglyceride/high-density lipoprotein (TG/HDL) ratio could improve the detection of increased cardiometabolic risk. Materials and methods: A systematic monitoring protocol was implemented. Weight and height, blood pressure, fasting glucose, insulin, HDL, and TG were measured at baseline and four times during follow-up. HOMA-IR, TG/HDL ratio and zBMI were calculated. Age-, gender- and BMI-specific percentile curves for HOMA-IR were used to define elevated cardiometabolic risk. Results: The study patients (n = 55, mean age 9.9 years) were followed for a median of 9 months. A disadvantageous, statistically significant shift, often appearing within the reference range, was seen in zBMI, TG, HDL, glucose, insulin, HOMA-IR, and TG/HDL ratio. The increase in HOMA-IR appeared earlier than individual laboratory values and was more evident than the TG/HDL ratio increase. An HOMA-IR cut point of 1.98 resulted in a sensitivity and specificity of 83%. Compared to a previous study performed in the same location, the monitoring rates of metabolic parameters improved. Conclusion: The monitoring protocol implementation improved the monitoring of metabolic parameters in child psychiatric patients using SGAs. Using HOMA-IR as part of systematic SGA monitoring could help detect metabolic adverse effects.publishedVersionPeer reviewe

Lifestyle counselling during pregnancy and offspring weight development until four years of age: follow-up study of a controlled trial

Background Fetal conditions are known to be partly responsible for the child’s risk for obesity. Our pilot study aimed to determine the effect of gestational lifestyle counseling on the offspring weight gain until 4 years of age and to estimate power for future studies. Design and methods First-time pregnant mothers participated in a controlled trial conducted in maternity health clinics during 2004 – 2006. The intervention included individual counseling on physical activity and diet, and an option to attend supervised group exercise sessions. The participant mothers (N = 109) received a follow-up questionnaire concerning 13 repeated growth measurements of their offspring. Response rate to the follow-up questionnaire was 66.1% (N = 72/109). Results The increase of BMI z-score between 24–48 months was not significantly slower among the intervention group offspring (95% CI −0.025 to 0.009, p = 0.34) compared to control group. Z-scores for weight-for-length/height did not differ between groups when the period 0–48 months was analyzed (95% CI −0.010 to 0.014, p = 0.75). Conclusions In this pilot study gestational lifestyle counseling did not significantly slow the weight gain of the offspring. Gestational intervention studies with at least 300 mothers per group are needed to confirm the possible effect on offspring’s risk for obesity.BioMed Central open acces

Pragmatic controlled trial to prevent childhood obesity in maternity and child health care clinics: pregnancy and infant weight outcomes (The VACOPP Study)

Background According to current evidence, the prevention of obesity should start early in life. Even the prenatal environment may expose a child to unhealthy weight gain; maternal gestational diabetes is known to be among the prenatal risk factors conducive to obesity. Here we report the effects of antenatal dietary and physical activity counselling on pregnancy and infant weight gain outcomes. Methods The study was a non-randomised controlled pragmatic trial aiming to prevent childhood obesity, the setting being municipal maternity health care clinics. The participants (n = 185) were mothers at risk of developing gestational diabetes mellitus and their offspring. The children of the intervention group mothers were born between 2009 and 2010, and children of the control group in 2008. The intervention started between 10–17 gestational weeks and consisted of individual counselling on diet and physical activity by a public health nurse, and two group counselling sessions by a dietician and a physiotherapist. The expectant mothers also received a written information leaflet to motivate them to breastfeed their offspring for at least 6 months. We report the proportion of mothers with pathological glucose tolerance at 26–28 weeks’ gestation, the mother’s gestational weight gain (GWG) and newborn anthropometry. Infant weight gain from 0 to 12 months of age was assessed as weight-for-length standard deviation scores (SDS) and mixed effect linear regression models. Results Intervention group mothers had fewer pathological oral glucose tolerance test results (14.6% vs. 29.2%; 95% CI 8.9 to 23.0% vs. 20.8 to 39.4%; p-value 0.016) suggesting that the intervention improved gestational glucose tolerance. Mother’s GWG, newborn anthropometry or infant weight gain did not differ significantly between the groups. Conclusion Since the intervention reduced the prevalence of gestational diabetes mellitus, it may have the potential to diminish obesity risk in offspring. However, results from earlier studies suggest that the possible effect on the offspring’s weight gain may manifest only later in childhood.BioMed Central open acces