Health care climate, perceived self-care competence and glycemic control among patients with type 2 diabetes in primary care.

Peer reviewe

Search for Higgs Bosons in SUSY Cascades in CMS and Dark Matter with Non-universal Gaugino Masses

In grand unified theories (GUT), non-universal boundary conditions for the gaugino masses may arise at the unification scale, and affect the observability of the neutral MSSM Higgs bosons (h/H/A) at the LHC. The implications of such non-universal gaugino masses are investigated for the Higgs boson production in the SUSY cascade decay chain gluino --> squark quark, squark --> neutralino_2 quark, neutralino_2 --> neutralino_1 h/H/A, h/H/A --> b b-bar produced in pp interactions. In the singlet representation with universal gaugino masses only the light Higgs boson can be produced in this cascade with the parameter region of interest for us, while with non-universal gaugino masses heavy neutral MSSM Higgs boson production may dominate. The allowed parameter space in the light of the WMAP constraints on the cold dark matter relic density is investigated in the above scenarios for gaugino mass parameters. We also demonstrate that combination of representations can give the required amount of dark matter in any point of the parameter space. In the non-universal case we show that heavy Higgs bosons can be detected in the studied cascade in parameter regions with the WMAP preferred neutralino relic density.Comment: LaTeX (svjour,rotating,multirow,url,subfig,psfrag), 18 pages, 36 eps figure

Perusterveydenhuollon ja sosiaalitoimen henkilöstön työolot ja työuupumus neljässä kunnassa – Onko palvelutuotantotavalla väliä?

Tässä kyselytutkimuksessa verrattiin perusterveydenhuollon ja sosiaalitoimen henkilöstön psykososiaalisen työympäristön ja työuupumuksen muutoksia vuosina 2000 ja 2002 (N = 582/527) neljässä kunnassa, joista yhdessä perusterveyden- ja vanhustenhuollon palvelut tuotti kolmannen sektorin vapaaehtoisjärjestö ja muut sosiaalipalvelut kunta (Eteläkunta), kun taas kolmessa muussa kunnassa palvelut tuotettiin kunnallisesti (Itä-, Lounais- ja Länsikunta). Lisäksi tutkittiin työuupumukseen yhteydessä olevia tekijöitä. Eteläkunnassa oli ollut eniten muutoksia, mutta työn vaatimusten ja voimavarojen kehitys oli paras. Silti työuupumus oli lisääntynyt. Työuupumuksen keskiarvo oli kuitenkin alhaisin vuonna 2002. Johtajat olivat uupuneempia kuin muu henkilöstö. Palvelutuotantomallia paremmin työuupumusta selittivät työn vaatimukset, työn hallinta, työilmapiiri sekä henkilökunnan määrä ja riittävyys

Outsourcing primary health care services--How politicians explain the grounds for their decisions

Objective To explore outsourcing of primary health care (PHC) services in four municipalities in Finland with varying amounts and types of outsourcing: a Southern municipality (SM) which contracted all PHC services to a not-for-profit voluntary organization, and Eastern (EM), South-Western (SWM) and Western (WM) municipalities which had contracted out only a few services to profit or public organizations.Methods A mail survey to all municipality politicians (response rate 52%, N = 101) in 2004. Data were analyzed using cross-tabulations, Spearman correlation and linear regression analyses.Results Politicians were willing to outsource PHC services only partially, and many problems relating to outsourcing were reported. Politicians in all municipalities were least likely to outsource preventive services. A multiple linear regression model showed that reported preference to outsource in EM and in SWM was lower than in SM, and also lower among politicians from "leftist" political parties than "rightist" political parties. Perceived difficulties in local health policy issues were related to reduced preference to outsource. The model explained 27% of the variance of the inclination to outsource PHC services.Conclusions The findings highlight how important it is to take into account local health policy issues when assessing service-provision models.Outsourcing Primary health care services Local health policy issues Not-for-profit organization Public organization

Psychosocial work environment and emotional exhaustion--Does a service provision model play a role?

Objectives To investigate whether outsourcing of primary health care (PHC) services has affected the psychosocial work environment and emotional exhaustion.Methods Panel mail study 2000-2002 in Finland, 369 PHC employees. Comparison between Southern municipality (SM) after outsourcing PHC services to a not-for-profit organization and three municipalities with municipal service providers.Results Despite the positive development of the psychosocial work environment in SM, emotional exhaustion had increased there like in the comparison municipalities. However, in 2002 emotional exhaustion was at a lower level in SM than in one of the comparison municipalities. This difference could not be attributed to the production model itself but rather to baseline levels and changes in work demands and work resources.Conclusions Outsourcing of PHC services may improve employee health and thus effectiveness of health care if a new service provider emphasizes employee health more than a previous one and is more flexible to improve the quality of the psychosocial work environment. However, change itself may be stressful, and frequent changes of service providers should be avoided.Outsourcing Service provision model Primary health care Psychosocial work environment Emotional exhaustion