Does Poor Health Mobilize People into Action? : Health, Political Trust and Participation.

Recently, awareness of the importance of health in explaining political participation has grown considerably. Studies have focused on individual participation forms but not on broader participation modes. Furthermore, analyses of the mechanisms explaining the health effects have been lacking. Here, structural equation models are employed to study the relationship between health, political trust, and institutional and non-institutional participation using data from Finland. Poor health is related to increased non-institutional participation, while good health boosts traditional institutional participation, although the latter relationship is very weak. These observations are explained by differences in political trust. Those in good health have stronger trust in the political system, while poor health is connected with reduced trust. These differences manifest themselves in varying behaviour. Poor health decreases trust which leads to increased non-institutional participation, while good health leads to a high trust and institutional activities.Peer reviewe

Health and Disability Gaps in Political Engagement: A Short Review

Peer reviewe

Surgical treatment and outcomes of scoliosis and cervical spine instability in Children

Structural changes in the spine are the most common children's musculoskeletal abnormalities, as they cover 70% of all musculoskeletal disorders in children and adolescent. Idiopathic scoliosis is the most common of these structural changes. The congenital structural problems of the spine form an entity of their own. Changes in the development of the spine during fetal period range from changes in individual vertebral to being part of a wider developmental disorder. Careful follow-up and research are the basis of care. Genetically induced syndromes form a wide heterogeneous group that have vertebral problems often seen in cervical development and growth. There are a number of rare diseases in this group. One of the primary aims of this thesis was to assess whether en bloc vertebral column derotation provides an efficient control or correction of thoracic rib hump as compared with no derotation in adolescents with an idiopathic scoliosis. The outcomes of hybrid and total pedicle screw instrumentation were compared in children undergoing surgery for neuromuscular scoliosis or severe scoliosis. Within the rare bone dysplastia group, we studied the outcomes of upper cervical spine fusion in this heterogeneous group.We showed that en bloc derotation provides an effective initial correction of the rib hump,but the effect diminishes during two year follow-up. Comparing hybrid technique with total pedicle screw method we proved that surgery with pedicle screw technique is more effective in correcting neuromuscular and severe scoliosis. Blood loss was significantly smaller (2000 ml) and patients had better major curve correction (two year follow-up 75% vs 59%) with less need for anteroposterior surgery when comparing these techniques in the neuromuscular group. Pedicle screw instrumentation provided shorter operative time (1 hour 39minutes), diminished blood loss(1600ml), enabled better major curve correction (73% vs 59%) with less need for anteroposterior surgery as compared with hybrid constructs in patients with severe over 90degrees scoliosis. Feasibility of different techniques were investigated in the rare disease group. Cervical spine instability in the patients with rare bone dysplasia surgery was found effective.Although results are encouraging , risks and complications are common.Surgery has become an important part of treatment in many types of spinal disorders.Better techniques evolve from old methods and procedures only if these are studied meticulously. Keywords: scoliosis, pedicle, rib hump, total pedicle screw technique, coronalbalance, sagittal balance, rare bone dysplasia, cervical spin

Health and Disability Gaps in Political Engagement: A Short Review

Peer reviewe

Yritysvastuu pk-yrityksissä

Opinnäytetyön tarkoituksena oli selvittää pääkaupunkiseudulla toimivien pienten ja keskisuurten yritysten suhtautumista yritysvastuuseen ja sen raportointiin. Tavoitteena oli nostaa esille yritysvastuuta tukevia järjestöjä ja ohjeistoja, jotka tukevat erityisesti pk-yritysten vastuullisuutta. Tutkimuksen avulla oli tarkoitus selvittää, mitä hyötyjä yritysvastuulla voidaan saavuttaa pk-yrityksissä. Tietoperustassa käsitellään yritysvastuuta Suomessa, pääkaupunkiseudulla ja pk-yrityksissä. Työssä luodaan myös katsaus isompien yritysten vastuuraportointiin. Opinnäytetyön tutkimus toteutettiin kvalitatiivisina teemahaastatteluina. Tutkimuksen tarkoituksena oli saada tietoa pk-yritysten suhtautumisesta yritysvastuuseen ja sen raportointiin. Haastattelujen tukena käytettiin havainnointia Ratkaisun paikka -yritysvastuutapahtumassa. Haastatteluiden pohjalta saatiin tietoa yritysten asenteista ja toimintatavoista vastuullisuuteen sekä yritysvastuun raportointiin liittyen. Haastatteluista ilmeni, että yritykset ovat kiinnostuneita yritysvastuusta, mutta suhtautuvat epäilevästi yritysvastuuraportoinnin hyötyihin. Kaikki haastateltavat näkivät yritysvastuun osa-alueet tärkeänä toiminnassaan, mutta eivät tiedostaneet toimintansa olevan vastuullista. Yritykset eivät tunnistaneet vastuullisten toimintatapojen olevan osa yritysvastuuta, sillä vastuullisuus ajateltiin kuuluvan yrittäjyyteen itsessään. Yritysvastuutapahtumassa havainnoitiin seminaariluentojen kautta millä tavalla pk-yrityksiä motivoidaan yritysvastuun toteuttamiseen. Seminaariluennot keskittyivät avaamaan yritysvastuun käsitettä tuoden käytännön esimerkkejä pk-yritysten toimintaan.The purpose of this thesis project was to determine the attitudes of small- and medium-sized enterprises (SMEs) operating in the metropolitan area to corporate responsibility and reporting. The aim was to raise awareness about organizations and guidelines that can support in particular the corporate responsibility of SMEs. The theoretical section of the thesis report deals with corporate responsibility in Finland, the metropolitan area and in SMEs. The thesis also reviews the reporting of corporate responsibility by larger companies. The research was conducted as a qualitative case study. The aim was to obtain information on the attitudes of SMEs towards corporate responsibility and its associated reporting. Observations at a corporate responsibility event “Ratkaisun paikka” were used to support the interviews. The interviews yielded information on the companies’ attitudes and practices towards corporate responsibility and corporate responsibility reporting. The interviews revealed that companies are interested in corporate responsibility but are skeptical about the benefits of corporate responsibility reporting. All of the interviewees felt that the areas of corporate responsibility were important in their operations, but were not aware of any current activities to be responsible. The companies did not identify the responsible practices as being a part of corporate responsibility, and responsibility was thought to be part of entrepreneurship itself. At the corporate responsibility event the seminar lectures were observed in terms of how the lecturers motivated SMEs towards greater corporate responsibility. The event gave information about corporate responsibility in general and showed some examples in practical ways

Cautious Voters - Supportive Parties: Opinion Concruence between Voters and Parties on the EU Dimension

This article analyses party-voter congruence on European integration matters in the EU member states. Drawing on existing research, we put forward eight hypotheses which are tested with data from the EES2004 survey. We show that parties are closer to their voters on the left/right dimension than on the EU dimension. Parties are also more supportive of European integration than are their voters. Party system characteristics (number of parties, ideological range) did not affect opinion congruence. The responsiveness analysis at the party level shows that government parties were less responsive than opposition parties; party size was related to responsiveness, with opinion congruence higher in smaller parties; and responsiveness was lower among centrist parties. Voters are also better represented on the EU dimension by their parties in the new than in the older EU member states. This difference may result from the EU occupying a more central place on the political agendas of the new member states

Disability, Perceived Discrimination and Political Participation

Disability affects the lives of hundreds of millions across the world. People with disabilities often experience discrimination and unequal treatment. Sometimes the mere categorization of people into groups, that is, ‘healthy’ vs. ‘disabled’, is enough to trigger discriminatory behaviour against people with disabilities. Previous studies show that in general disabilities depress political participation. However, the effect of disability-based discrimination on participation has received little scholarly attention. We study how perceptions of discrimination affect three forms of political participation: voting; contacting politicians; and participating in demonstrations. Results show that disability decreases voting, especially when associated with perceptions of discrimination. The analysis points in the opposite direction when the other two forms of political participation are analysed. People with disabilities are more likely to partake in demonstrations and contact politicians than non-disabled. Thus, disability-based discrimination is not always a hindrance to participation. It sometimes further motivates people with disabilities to participate.Peer reviewe

Vaikean omega-skolioosin hoito, potilastapaus

English abstrac

Bibliography of the Publications of Simo Parpola

no abstrac

Policy Making in Finnish Social and Health Care - A Network Approach

Only abstract. Paper copies of master’s theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of master’s theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmä. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnäytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet på nätet eller endast tillgängliga i bibliotekets avhandlingsterminaler.The overall aim of this study was to analyse the structure of decision making in the domain of Finnish social and health care services legislation from the policy network perspective. This perspective connects both public and private organisational actors into the policy-making process. These actors have varying interests and policy preferences which they try to bring into to the process so that the final decisions that are made are as close as possible to their own goals. Actors also vary in their resources which affects their ability to realise their aims. According to the policy network perspective, advantageous positions in the policy networks are instrumental in the actors’ pursuit of political influence. It is the combination of network positions and other resources that define the overall extent of the actors’ political influence. The data for the analysis was collected from 45 organisational actors involved in the decision-making process. The interviews were primarily based on questionnaires with close-ended multiple-choice questions. The questionnaire included (among others) questions about inter-organisational network relations among actors, their interest in chosen law proposals, their support for these proposals and their assessment of which actors are most influential in the domain. The results show that the bargaining environment in the domain from the mid 1980s to the turn of the decade was very friendly for reforms in the social and health care services. The "policy space" was multidimensional i.e. there were several cross-cutting cleavages that divided the domain actors into overlapping groups. In the early 1990's the same policy space suddenly polarised, which was manifested in the dramatically falling overall level of support for the government proposals. Now there were only two groups of actors that rarely agreed on anything. Because there was only one dimension that divided these groups, finding consensus on anything became difficult. It was also shown that a central position in the policy network is related to the overall satisfaction in the new legislation. Interestingly, this relationship was stronger in the time of expansion than in the time of cut-backs. One probable reason for the decline of the importance of the policy network was the government's increased decision-making power that was due to the change in the constitution in 1992. However, this change did not result in major changes in the overall power structure of the domain. It is possible that the policy network works as a buffer, which to a certain extent suppresses the effects of changes in the distribution of other resources in the policy domain