Perustoimeentulotuen siirto Kelalle : fenomenografinen tutkimus sosiaalityöntekijöiden käsityksistä aikuissosiaalityössä

Perustoimeentulotuen siirrosta Kelalle on keskusteltu useita kertoja vuodesta 1986 lähtien. Hallitus päätti kehysriihessä 25.3.2014, että perustoimeentulotuki siirtyy sosiaalitoimesta Kelassa käsiteltäväksi etuudeksi 1.1.2017. Täydentävän- ja ennaltaehkäisevän toimeentulotuen myöntäminen säilyy edelleen sosiaalitoimen tehtävänä. Tutkimme pro gradu-tutkielmassamme perustoimeentulotuen siirtymisen vaikutuksia Kelalle aikuissosiaalityön sosiaalityöntekijöiden näkökulmasta. Tutkimuksemme on fenomenografinen tutkimus, jonka tehtävänä on selvittää sosiaalityöntekijöiden käsityksiä muutoksen vaikutuksista. Teoreettisena viitekehyksenä käytämme kokonaisvaltaista sosiaalityötä. Tutkimuksen aineisto on kerätty teemahaastattelemalla kuutta aikuissosiaalityöntekijää Oulun kaupungista. Aineiston analyysimenetelmänä olemme käyttäneet SWOT-nelikenttäanalyysia, jonka avulla tarkastelemme sosiaalityöntekijöiden käsityksiä nykytilanteen vahvuuksista ja heikkouksista sekä tulevaisuuden uhkista ja mahdollisuuksista, joita tarkastelemme suhteessa kokonaisvaltaiseen sosiaalityöhön. Sosiaalityöntekijöiden käsitykset perustoimeentulotuen siirron vaikutuksista lisäävät asiakkaiden tasa-arvoista kohtelua ja tasapuolisuutta kuntakohtaisten erojen poistuessa. Muutoksen nähtiin lisäävän myös joustavuutta ja poistavan toimeentulotuen alikäyttöä. Uhkana työntekijät näkivät kaikkein heikoimmassa asemassa olevien ihmisten ohjautumisen jatkossa Kelasta sosiaalitoimeen sekä kuntien myöntämän täydentävän- ja ennaltaehkäisevän toimeentulotuen menojen kasvun. Kokonaisvaltaisen sosiaalityön toteutumisen näkökulmasta sosiaalityöntekijät näkivät tärkeänä yhteisen kriteeristön luomisen, jonka perusteella asiakkaat ohjautuisivat Kelalta sosiaalitoimeen. Yhteistyö Kelan ja sosiaalitoimen välillä nähtiin erittäin tärkeänä. Yhtenä ratkaisuna esitettiin mahdollisia yhteispalvelupisteitä, jossa olisi saatavilla kaikki asiakkaiden tarvitsemat palvelut.acceptedVersio

eHealth challenges in rehabilitation processes - rehabilitation professionals’ experiences in the North Savo region

Aging people are forced to steadily extend their working-lives since the old-age dependency ratio will rise considerably in the near future. Meanwhile, social and healthcare resources will become increasingly scarce, although the need for healthcare and rehabilitation services is bound to increase. The aim of this study was to examine rehabilitation professionals’ experiences related to eHealth and technology in the rehabilitation process in the North Savo region. The research was carried out as a part of the European Social Fund (ESF) funded project ”Expertise and Business Network for  Rehabilitation Services in Northern Savo”. 30 rehabilitation workers were interviewed (67% women) in 2020. The participants were aged 24-60 years and their job titles were e.g. doctors, physiotherapists, practical nurses and community sector representatives. The interviews were carried out using a semi-structured format. The interviews were recorded, transcribed, and analysed using the inductive content analysis method. The technology and digitalisation experiences of the rehabilitation workers in North Savo region can be divided into five categories. Technical problems causing challenges in rehabilitation included inadequate information and patient data management, and poor or lacking data-applications, ICT-tools and systems. The cost of technology was perceived as a factor influencing rehabilitation from both an individual and organisational perspective. The emergence of COVID-19 has had a positive impact on the use of technology and digital services. Suitable technology and digital services for rehabilitation need to be developed towards a more individual, client-centric direction. To promote the adoption of technology in the field of rehabilitation and to support positive change in attitudes towards technology, more education is needed. The ever-evolving field of rehabilitation demands effective eHealth applications and processes alongside highly competent rehabilitation professionals to meet the needs of the aging population base in North Savo region. There is a need for more client-centric eHealth and rehabilitation processes, wherein the rehabilitation workers’ needs are met – physically and psychosocially. By bringing together rehabilitation and ICT expertise in North Savo region, it is possible to provide training and education to raise the level of both the rehabilitation processes and level of expertise of rehabilitation workers in the region

Climate sustainable institutional catering and the transformation of food culture in Finland : An investigation of meanings, affects and norms related to plant-based food and meat

Ruokapalvelut voivat pienentää ilmastovaikutuksiaan lisäämällä kasvisruokien osuutta tarjotuista aterioista. Joukkoruokailun muuttuminen kasvisvoittoisemmaksi edellyttää ruokien kulttuuristen merkitysten muuttumista ja kasvisruoan erityisruokavalio- ja kevytlounasmerkityksen purkautumista. Hankkeessamme kehitettiin 30 vegaanista, pienen ilmastovaikutuksen pääruokareseptiä ruokapalveluiden käyttöön. Osana reseptien testausta toteutimme asiakaskyselyn yhdeksässä lounasravintolassa, joihin sisältyivät viisi peruskoulun ja toisen asteen oppilaitoksen ravintolaa, kaksi opiskelijaravintolaa, henkilöstöravintola ja sairaalan ravintola. Tässä artikkelissa tarkastelemme, millaisia merkityksiä ruokapalveluiden asiakkaat liittävät kasvis- ja liharuokiin sekä millaisia tunnesitoumuksia ja normatiivisia käsityksiä niihin kytkeytyy. Argumentoimme Sara Ahmedin (2014) affektiivista normeihin investointia analysoivan lähestymistavan avulla, että on oleellista nähdä ruokakysymys yksilöllisten valintojen tai kognitiivisten prosessien sijaan kysymyksenä yhteiskunnallisista ja kulttuurisista normeista, joihin investoidutaan affektiivisesti ja toiston avulla. Artikkelimme avaa sekä moniaistillista, muistojen ja tottumusten vahvistamaa affektiivista liharuokiin kiinnittymistä ja siten syitä ruokavaliomuutoksen haastavuuteen, että kasvisruoan uusien merkitysten muotoutumispotentiaalia lounasruokailussa. Affektiivisiin investointeihin liittyvän sukupuolittuneisuuden lisäksi nostamme ilmastokestävyydestä käytävään keskusteluun ruokaan liittyvän nationalismin, kulttuurisen omimisen ja eksotisoinnin. Tarjotessaan aterian noin kolmasosalle väestöstä päivittäin ruokapalveluilla on merkittävä potentiaali ruokaan liittyvien normien uudelleenmuotoutumisessa sekä ilmastokestävän ruokakulttuurin edistämisessä. Ruokapalvelujen mahdollisuuksiin tarjota täyttäviä, proteiinipitoisia ja maukkaita kasvispohjaisia ruokia tulisikin keskittää resursseja.Food services can reduce their climate impact by increasing the share of plant-based food in meals served. Transitioning to increased plant-based eating in large catering settings requires a change in the cultural meanings attached to food. Our project developed 30 vegan, low impact main course recipes for food services. As part of testing the recipes, we conducted a customer survey at nine lunch restaurants. In this article, we examine the meanings that food service customers assign to vegan and meat lunches. Using Sara Ahmed’s (2014) approach to affective investments, we argue that it is essential to see this food issue as a question of social and cultural norms invested affectively and through repetition. Our article suggests that individuals have an affective attachment to meat, which is defined by habit and multisensory processes, thereby resulting in normative, yet unsustainable, meat-centric eating practices. However, our article also demonstrates the formation of new meanings of vegan foods where, for instance, experimenting with plant-based eating creates potential for a dietary change. In addition to the gendered nature of affective investments, we touch upon food-related nationalism, cultural appropriation, and exoticization in the debate on climate-sustainable food cultures.Peer reviewe

Multi-ancestry study of blood lipid levels identifies four loci interacting with physical activity.

Many genetic loci affect circulating lipid levels, but it remains unknown whether lifestyle factors, such as physical activity, modify these genetic effects. To identify lipid loci interacting with physical activity, we performed genome-wide analyses of circulating HDL cholesterol, LDL cholesterol, and triglyceride levels in up to 120,979 individuals of European, African, Asian, Hispanic, and Brazilian ancestry, with follow-up of suggestive associations in an additional 131,012 individuals. We find four loci, in/near CLASP1, LHX1, SNTA1, and CNTNAP2, that are associated with circulating lipid levels through interaction with physical activity; higher levels of physical activity enhance the HDL cholesterol-increasing effects of the CLASP1, LHX1, and SNTA1 loci and attenuate the LDL cholesterol-increasing effect of the CNTNAP2 locus. The CLASP1, LHX1, and SNTA1 regions harbor genes linked to muscle function and lipid metabolism. Our results elucidate the role of physical activity interactions in the genetic contribution to blood lipid levels

Trans-Ethnic Fine-Mapping of Lipid Loci Identifies Population-Specific Signals and Allelic Heterogeneity That Increases the Trait Variance Explained

Genome-wide association studies (GWAS) have identified ∼100 loci associated with blood lipid levels, but much of the trait heritability remains unexplained, and at most loci the identities of the trait-influencing variants remain unknown. We conducted a trans-ethnic fine-mapping study at 18, 22, and 18 GWAS loci on the Metabochip for their association with triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), respectively, in individuals of African American (n = 6,832), East Asian (n = 9,449), and European (n = 10,829) ancestry. We aimed to identify the variants with strongest association at each locus, identify additional and population-specific signals, refine association signals, and assess the relative significance of previously described functional variants. Among the 58 loci, 33 exhibited evidence of association at P<1×10−4 in at least one ancestry group. Sequential conditional analyses revealed that ten, nine, and four loci in African Americans, Europeans, and East Asians, respectively, exhibited two or more signals. At these loci, accounting for all signals led to a 1.3- to 1.8-fold increase in the explained phenotypic variance compared to the strongest signals. Distinct signals across ancestry groups were identified at PCSK9 and APOA5. Trans-ethnic analyses narrowed the signals to smaller sets of variants at GCKR, PPP1R3B, ABO, LCAT, and ABCA1. Of 27 variants reported previously to have functional effects, 74% exhibited the strongest association at the respective signal. In conclusion, trans-ethnic high-density genotyping and analysis confirm the presence of allelic heterogeneity, allow the identification of population-specific variants, and limit the number of candidate SNPs for functional studies

Multi-ancestry genome-wide association study accounting for gene-psychosocial factor interactions identifies novel loci for blood pressure traits

Psychological and social factors are known to influence blood pressure (BP) and risk of hypertension and associated cardiovascular diseases. To identify novel BP loci, we carried out genome-wide association meta-analyses of systolic, diastolic, pulse, and mean arterial BP, taking into account the interaction effects of genetic variants with three psychosocial factors: depressive symptoms, anxiety symptoms, and social support. Analyses were performed using a two-stage design in a sample of up to 128,894 adults from five ancestry groups. In the combined meta-analyses of stages 1 and 2, we identified 59 loci (p value &lt; 5e−8), including nine novel BP loci. The novel associations were observed mostly with pulse pressure, with fewer observed with mean arterial pressure. Five novel loci were identified in African ancestry, and all but one showed patterns of interaction with at least one psychosocial factor. Functional annotation of the novel&nbsp;loci supports a major role for genes implicated in the immune response (PLCL2), synaptic function and neurotransmission (LIN7A and PFIA2), as well as genes previously implicated in neuropsychiatric or stress-related disorders (FSTL5 and CHODL). These findings underscore the importance of considering psychological and social factors in gene discovery for BP, especially in non-European populations

Multi-ancestry sleep-by-SNP interaction analysis in 126,926 individuals reveals lipid loci stratified by sleep duration.

Both short and long sleep are associated with an adverse lipid profile, likely through different biological pathways. To elucidate the biology of sleep-associated adverse lipid profile, we conduct multi-ancestry genome-wide sleep-SNP interaction analyses on three lipid traits (HDL-c, LDL-c and triglycerides). In the total study sample (discovery + replication) of 126,926 individuals from 5 different ancestry groups, when considering either long or short total sleep time interactions in joint analyses, we identify 49 previously unreported lipid loci, and 10 additional previously unreported lipid loci in a restricted sample of European-ancestry cohorts. In addition, we identify new gene-sleep interactions for known lipid loci such as LPL and PCSK9. The previously unreported lipid loci have a modest explained variance in lipid levels: most notable, gene-short-sleep interactions explain 4.25% of the variance in triglyceride level. Collectively, these findings contribute to our understanding of the biological mechanisms involved in sleep-associated adverse lipid profiles

Gene-educational attainment interactions in a multi-population genome-wide meta-analysis identify novel lipid loci

Introduction: Educational attainment, widely used in epidemiologic studies as a surrogate for socioeconomic status, is a predictor of cardiovascular health outcomes. Methods: A two-stage genome-wide meta-analysis of low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglyceride (TG) levels was performed while accounting for gene-educational attainment interactions in up to 226,315 individuals from five population groups. We considered two educational attainment variables: “Some College” (yes/no, for any education beyond high school) and “Graduated College” (yes/no, for completing a 4-year college degree). Genome-wide significant (p &lt; 5 × 10−8) and suggestive (p &lt; 1 × 10−6) variants were identified in Stage 1 (in up to 108,784 individuals) through genome-wide analysis, and those variants were followed up in Stage 2 studies (in up to 117,531 individuals). Results: In combined analysis of Stages 1 and 2, we identified 18 novel lipid loci (nine for LDL, seven for HDL, and two for TG) by two degree-of-freedom (2 DF) joint tests of main and interaction effects. Four loci showed significant interaction with educational attainment. Two loci were significant only in cross-population analyses. Several loci include genes with known or suggested roles in adipose (FOXP1, MBOAT4, SKP2, STIM1, STX4), brain (BRI3, FILIP1, FOXP1, LINC00290, LMTK2, MBOAT4, MYO6, SENP6, SRGAP3, STIM1, TMEM167A, TMEM30A), and liver (BRI3, FOXP1) biology, highlighting the potential importance of brain-adipose-liver communication in the regulation of lipid metabolism. An investigation of the potential druggability of genes in identified loci resulted in five gene targets shown to interact with drugs approved by the Food and Drug Administration, including genes with roles in adipose and brain tissue. Discussion: Genome-wide interaction analysis of educational attainment identified novel lipid loci not previously detected by analyses limited to main genetic effects.</p