Kouluun kiinnittymisen merkitys huostaanotetuilla ja sijaishuollossa olevilla lapsilla ja nuorilla

Tiivistelmä. Tässä kandidaatin tutkielmassa oli tarkoitus selvittää, millainen merkitys kouluun kiinnittymisellä on huostaanotetuilla ja sijaishuollossa olevilla lapsilla ja nuorilla. Tarkemmin haluttiin tietää, mitkä asiat lisäävät kouluun kiinnittymistä, mitä hyötyjä kiinnittymisestä on ja mikä tekee kouluun kiinnittymisestä haastavaa. Kirjallisuuskatsauksen lähdeaineisto koostui kansainvälisistä vertaisarvioiduista tutkimusartikkeleista. Tutkielma on toteutettu kuvailevana kirjallisuuskatsauksena. Huostaanotetut ja sijoitetut lapset kohtaavat paljon enemmän ja monimuotoisempia haasteita elämässään yleisen väestön lapsiin verrattuna. Epävakaat kotiolot luovat monia stressitekijöitä ja vaikuttavat myös lapsen koulunkäyntiin. Näihin moninaisiin ongelmiin pitäisi paremmin pystyä vastaamaan, jotta huostaanotetut ja sijoitetut lapset saisivat turvalliset kasvuolosuhteet ja heidän hyvinvointiinsa panostettaisiin. Monelle heistä lapsuuden ongelmat kulkeutuvat mukana aikuisuuteen ja voivat aiheuttaa koulun keskeyttämistä, syrjäytymistä, mielenterveysongelmia, päihteiden väärinkäyttöä, aikaisin vanhemmaksi tuloa tai rikollisuutta. Koulu ja koulutus nähdään vakaana ja turvallisena ympäristönä ja jatkumona, vaikka kotiolot olisivat epävakaat. Koulun tarkoitus ei ole ainoastaan opettaa lukemista ja laskemista, vaan myös luoda sellainen ympäristö, missä lapsi viihtyy ja tuntee olonsa turvalliseksi. Kouluun kiinnittyminen on tärkeä osa koulutusta. Lapsi voi tuntea olevansa osa luokkaa ja koulua sekä tuntea välittämistä, huolenpitoa ja sitä, että hän on yhtä arvokas kuin kuka tahansa muukin. Tämä vaatii lapsen opettajalta sitoutumista sekä yhteistyötaitoja työskennellä koulun henkilökunnan, sijaishoitajien sekä sosiaalityöntekijöiden kanssa. Tutkimukset osoittavat, että koulukiinnittyminen lisäsi akateemisia saavutuksia, vähensi akateemisesti uhkaavaa käytöstä, paransi sosiaalista taitoja ja paransi nuoren itsetuntoa. Sen lisäksi havaittiin, että ongelma käyttäytymisen väheneminen sekä tuen saaminen huoltajilta ja sosiaalityöntekijöiltä lisäsivät kouluun kiinnittymistäSchool engagement’s importance to children and young people in child protection or foster care. Abstract. In this bachelor’s thesis, the purpose was to find out what kind of significance school engagement has for children and young people who have been taken into care and are in foster care. In more detail, we wanted to know what things increase school engagement, what are the benefits of engagement, and what makes school engagement challenging. The source material of the literature review consisted of international peer-reviewed research articles. The thesis has been implemented as a descriptive literature review. Children in care and foster care face many more problems and more diverse challenges in their lives compared to children in the general population. Unstable home conditions create many stressors and also affect the child’s school attendance. It should be better to be able to respond to these various problems, so that the children taken into care and placements have safe growing conditions and their well-being is invested in. For many of them, childhood problems carry over into adulthood and can cause them to drop out of school, be marginalized, have mental health problems, abuse substances, become parents early, or become criminals. School and education are seen as a stable and safe environment and a continuum, even if home conditions are unstable. The purpose of the school is not only to teach reading and math, but also to create an environment where the child is comfortable and feels safe. Getting engaged to school is an important part of education. The child can feel that he is a part of the class and the school, and that he is cared for, and that he is just as valuable as anyone else. This requires commitment from the child’s teacher and cooperation skills to work with the school’s staff, foster carers and social workers. Research shows that school engagement increased academic achievement, reduced academically threatening behavior, improved social skills, and improved a young person’s self-esteem. In addition, it was found that a reduction in problem behavior and receiving support from guardians and social workers increased school engagement

The influence of psychosocial factors at work and life style on health and work ability among professional workers

OBJECTIVES: The purpose of this article is to explore the associations of psychosocial factors at work, life style, and stressful life events on health and work ability among white-collar workers. METHODS: A cross-sectional survey was conducted among workers in commercial services (n = 1141). The main outcome variables were work ability, measured by the work ability index (WAI), and mental and physical health, measured by the Short-Form Health Survey (SF-12). Individual characteristics, psychosocial factors at work, stressful life events, and lifestyle factors were determined by a questionnaire. Maximum oxygen uptake, weight, height, and biceps strength were measured during a physical examination. RESULTS: Work ability of white-collar workers in commercial services industry was strongly associated with psychosocial factors at work such as teamwork, stress handling, and self-development and, to a lesser extent, with stressful life events, lack of physical activity, and obesity. Determinants of mental health were very similar to those of work ability, whereas physical health was influenced primarily by life style factors. With respect to work ability, the influence of unhealthy life style seems more important for older workers, than for their younger colleagues. CONCLUSION: Among white-collar workers mental and physical health were of equal importance to work ability, but only mental health and work ability shared the same determinants. The strong associations between psychosocial factors at work and mental health and work ability suggest that in this study population health promotion should address working conditions rather than individual life style factors

Prostate MRI added to CAPRA, MSKCC and Partin cancer nomograms significantly enhances the prediction of adverse findings and biochemical recurrence after radical prostatectomy

Background To determine the added value of preoperative prostate multiparametric MRI (mpMRI) supplementary to clinical variables and their role in predicting post prostatectomy adverse findings and biochemically recurrent cancer (BCR). Methods All consecutive patients treated at HUS Helsinki University Hospital with robot assisted radical prostatectomy (RALP) between 2014 and 2015 were included in the analysis. The mpMRI data, clinical variables, histopathological characteristics, and follow-up information were collected. Study end-points were adverse RALP findings: extraprostatic extension, seminal vesicle invasion, lymph node involvement, and BCR. The Memorial Sloan Kettering Cancer Center (MSKCC) nomogram, Cancer of the Prostate Risk Assessment (CAPRA) score and the Partin score were combined with any adverse findings at mpMRI. Predictive accuracy for adverse RALP findings by the regression models was estimated before and after the addition of MRI results. Logistic regression, area under curve (AUC), decision curve analyses, Kaplan-Meier survival curves and Cox proportional hazard models were used. Results Preoperative mpMRI data from 387 patients were available for analysis. Clinical variables alone, MSKCC nomogram or Partin tables were outperformed by models with mpMRI for the prediction of any adverse finding at RP. AUC for clinical parameters versus clinical parameters and mpMRI variables were 0.77 versus 0.82 for any adverse finding. For MSKCC nomogram versus MSKCC nomogram and mpMRI variables the AUCs were 0.71 and 0.78 for any adverse finding. For Partin tables versus Partin tables and mpMRI variables the AUCs were 0.62 and 0.73 for any adverse finding. In survival analysis, mpMRI-projected adverse RP findings stratify CAPRA and MSKCC high-risk patients into groups with distinct probability for BCR. Conclusions Preoperative mpMRI improves the predictive value of commonly used clinical variables for pathological stage at RP and time to BCR. mpMRI is available for risk stratification prebiopsy, and should be considered as additional source of information to the standard predictive nomograms.Peer reviewe

School environment as predictor of teacher sick leave: data-linked prospective cohort study

Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers

Associations of PTEN and ERG with Magnetic Resonance Imaging Visibility and Assessment of Non–organ-confined Pathology and Biochemical Recurrence After Radical Prostatectomy

Background: Diagnosing clinically significant prostate cancer (PCa) is challenging, but may be facilitated by biomarkers and multiparametric magnetic resonance imaging (MRI). Objective: To determine the association between biomarkers phosphatase and tensin homolog (PTEN) and ETS-related gene (ERG) with visible and invisible PCa lesions in MRI, and to predict biochemical recurrence (BCR) and non-organ-confined (non-OC) PCa by integrating clinical, MRI, and biomarker-related data. Design, setting, and participants: A retrospective analysis of a population-based cohort of men with PCa, who underwent preoperative MRI followed by radical prostatectomy (RP) during 2014-2015 in Helsinki University Hospital (n = 346), was conducted. A tissue microarray corresponding to the MRI-visible and MRI-invisible lesions in RP specimens was constructed and stained for PTEN and ERG. Outcome measurements and statistical analysis: Associations of PTEN and ERG with MRI-visible and MRI-invisible lesions were examined (Pearson's chi 2 test), and predictions of non-OC disease together with clinical and MRI parameters were determined (area under the receiver operating characteristic curve and logistic regression analyses). BCR prediction was analyzed by Kaplan-Meier and Cox proportional hazard analyses. Results and limitations: Patients with MRI-invisible lesions (n = 35) had less PTEN loss and ERG-positive expression compared with patients (n = 90) with MRI-visible lesions (17.2% vs 43.3% [p = 0.006]; 8.6% vs 20.0% [p = 0.125]). Patients with invisible lesions had better, but not statistically significantly improved, BCR-free survival probability in Kaplan-Meier analyses (p = 0.055). Rates of BCR (5.7% vs 21.1%; p = 0.039), extraprostatic extension (11.4% vs 44.6%; p < 0.001), seminal vesicle invasion (0% vs 21.1%; p = 0.003), and lymph node metastasis (0% vs 12.2%; p = 0.033) differed between the groups in favor of patients with MRI-invisible lesions. Biomarkers had no independent role in predicting non-OC disease or BCR. The short follow-up period was a limitation. Conclusions: PTEN loss, BCR, and non-OC RP findings were more often encountered with MRI-visible lesions. Patient summary: Magnetic resonance imaging (MRI) of the prostate misses some cancer lesions. MRI-invisible lesions seem to be less aggressive than MRI-visible lesions. (C) 2020 European Association of Urology. Published by Elsevier B.V. All rights reserved.Peer reviewe

The State of the Art in Language Workbenches. Conclusions from the Language Workbench Challenge

Language workbenches are tools that provide high-level mechanisms for the implementation of (domain-specific) languages. Language workbenches are an active area of research that also receives many contributions from industry. To compare and discuss existing language workbenches, the annual Language Workbench Challenge was launched in 2011. Each year, participants are challenged to realize a given domain-specific language with their workbenches as a basis for discussion and comparison. In this paper, we describe the state of the art of language workbenches as observed in the previous editions of the Language Workbench Challenge. In particular, we capture the design space of language workbenches in a feature model and show where in this design space the participants of the 2013 Language Workbench Challenge reside. We compare these workbenches based on a DSL for questionnaires that was realized in all workbenches

A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial

Background: Need for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers. Methods/Design: A two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period. Discussion: This study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability

Diet, physical exercise and cognitive behavioral training as a combined workplace based intervention to reduce body weight and increase physical capacity in health care workers - a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Health care workers comprise a high-risk workgroup with respect to deterioration and early retirement. There is high prevalence of obesity and many of the workers are overweight. Together, these factors play a significant role in the health-related problems within this sector. The present study evaluates the effects of the first 3-months of a cluster randomized controlled lifestyle intervention among health care workers. The intervention addresses body weight, general health variables, physical capacity and musculoskeletal pain.</p> <p>Methods</p> <p>98 female, overweight health care workers were cluster-randomized to an intervention group or a reference group. The intervention consisted of an individually dietary plan with an energy deficit of 1200 kcal/day (15 min/hour), strengthening exercises (15 min/hour) and cognitive behavioral training (30 min/hour) during working hours 1 hour/week. Leisure time aerobic fitness was planned for 2 hour/week. The reference group was offered monthly oral presentations. Body weight, BMI, body fat percentage (bioimpedance), waist circumference, blood pressure, musculoskeletal pain, maximal oxygen uptake (maximal bicycle test), and isometric maximal muscle strength of 3 body regions were measured before and after the intervention period.</p> <p>Results</p> <p>In an intention-to-treat analysis from pre to post tests, the intervention group significantly reduced body weight with 3.6 kg (p < 0.001), BMI from 30.5 to 29.2 (p < 0.001), body fat percentage from 40.9 to 39.3 (p < 0.001), waist circumference from 99.7 to 95.5 cm (p < 0.001) and blood pressure from 134/85 to 127/80 mmHg (p < 0.001), with significant difference between the intervention and control group (p < 0.001) on all measures. No effect of intervention was found in musculoskeletal pain, maximal oxygen uptake and muscle strength, but on aerobic fitness.</p> <p>Conclusion</p> <p>The significantly reduced body weight, body fat, waist circumference and blood pressure as well as increased aerobic fitness in the intervention group show the great potential of workplace health promotion among this high-risk workgroup. Long-term effects of the intervention remain to be investigated.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01015716">NCT01015716</a></p