Laaja 4-vuotistarkastus : Vanhempien kokemuksia laajasta 4-vuotistarkastuksesta

Opinnäytetyön kuvaus: Opinnäytetyömme on osa Lapsen hyvä arki – hanketta. Hankkeen tavoitteena on luoda toimivia lasten ja perheiden hyvinvointia ja varhaista tukea palvelevia yhteistyö- ja kumppanuusmalleja eri toimijoiden välille. Olemme selvittäneet vanhempien kokemuksia laajasta 4-vuotistarkastuksesta sekä miten vanhemmat kokevat kasvatuskumppanuuden toteutumisen eri yhteistyötahojen kanssa. Teoreettinen ja käsitteellinen esittely: Opinnäytetyön teoreettisena taustana toimivat laaja 4-vuotistarkastus ja sen säännökset sekä kasvatuskumppanuus ja vanhemmuuden tukeminen. Metodologinen esittely: Opinnäytetyö toteutettiin kvalitatiivisella eli laadullisella tutkimusotteella. Tiedot on kerätty teemahaastattelulla. Tulokset litteroitiin ja analyysimenetelmänä käytimme sisällönanalyysiä. Keskeiset tutkimustulokset ja johtopäätökset: Haastatteluiden kautta saimme selville vanhempien kokemuksia laajan 4-vuotistarkastuksen ja kasvatuskumppanuuden toteutumisesta Kuusamossa. Johtopäätöksenä voimme todeta, että lapsen tasapainoisen kasvun ja kehityksen sekä koko perheen hyvinvoinnin tukemisessa laaja 4-vuotistarkastus on kokonaisvaltainen ja toimiva. Kasvatuskumppanuudella on suuri merkitys laajassa 4-vuotistarkastuksessa, koska se sitouttaa vanhemmat ja henkilöstön yhdessä turvaamaan lapsen hyvinvoinnin. Lisäksi vanhemmat kokivat tuen ja tiedon määrän riittäväksi sekä hyödylliseksi.Thesis description: Our thesis is a part of the Lapsen hyvä arki (Good life for Children) – project. The goal of the project is to create well functioning cooperation and partnership models between various actors to serve the wellbeing and early support for children and families. We have researched parental experience of the extensive periodical examination of the four year olds and how the parents experience the nurturing partnership between various cooperation partners. Theoretical summary: The extensive periodical examination of the four year olds and the regulations regarding it, as well as the nurturing partnership and parental support are the theo-retical background of this thesis. Methodological summary: Thesis was implemented by using qualitative research method. Information was gathered by themed interviews. The results were transcribed and the method of analysis was content analysis. Main results and Conclusions: Through the interviews we found out the parental experience of the realization of the extensive periodical examination of the four year olds and the nurtur-ing partnership in Kuusamo. As a conclusion we can state that for supporting the balanced growth and development of the child, and the wellbeing of the whole family, the extensive periodical examination of the four year olds is comprehensive and functional. The nurturing partnership has a great significance in the extensive periodical examination of the four year olds, because it commits both the parents and the personnel to secure the wellbeing of the child. In addition the parents experienced the amount of the support and information to be suf-ficient and useful

“Playing makes it fun” in out-of-school activities – children’s organised leisure

The aim of this article is to focus on how children perceive their time spent in organised out-of-school activities in Finland and establish whether these activities provide an arena for children's leisure. The article is based on two empirical studies, one on after-school activities and another on school sports clubs at the elementary school level. The most meaningful features for children were found to be time to play freely with friends and taking part in designing activities. Out-of-school activities are supervised and controlled because of various societal and educational requirements. The tension between children's views and institutional requirements is discussed.Peer reviewe

Talking about the institutional complexity of the integrated rehabilitation system—the importance of coordination

Rehabilitation in Finland is a good example of functions divided among several welfare sectors, such as health services and social services. The rehabilitation system in Finland is a complex one and there have been many efforts to create a coordinated entity. The purpose of this study is to open up a complex welfare system at the upper policy level and to understand the meaning of coordination at the level of service delivery. We shed light in particular on the national rehabilitation policy in Finland and how the policy has tried to overcome the negative effects of institutional complexity. In this study we used qualitative content analysis and frame analysis. As a result we identified four different welfare state frames with distinct features of policy problems, policy alternatives and institutional failure. The rehabilitation policy in Finland seems to be divided into different components which may cause problems at the level of service delivery and thus in the integration of services. Bringing these components together could at policy level enable a shared view of the rights of different population groups, effective management of integration at the level of service delivery and also an opportunity for change throughout the rehabilitation system

Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study

Globally, cancer is the second leading cause of death. Loneliness has been suggested as a risk factor for cancer mortality. However, connections between loneliness, social isolation, and cancer are poorly understood. In our longitudinal study (mean follow-up: 20.44 years) of 2570 middle-aged men, loneliness, social isolation, and health-related factors were measured at baseline. Cox proportional hazards analysis was used to examine the association between cancer incidence, loneliness, and social isolation. The effect of relationship status on cancer mortality among cancer patients was tested with the Kaplan-Meier method. Loneliness was associated with total cancer incidence after adjustments for tested lifestyle and health-related covariates. Social Isolation was associated with total cancer incidence, except when adjusted for lifestyle, diet, or Human Population Laboratory (HPL) Depression Scale scores. Loneliness was associated with lung cancer incidence, except when adjusted for HPL Depression Scale scores. There was no significant association between social isolation and lung cancer. Neither loneliness nor social isolation were connected with prostate or colorectal cancer. Being single at baseline was associated with worse survival outcomes for cancer patients. Our findings suggest that regardless of the social network size, loneliness among middle-aged men is associated with an increased likelihood of cancer.Peer reviewe

Sustainability analysis of Finnish pre-schoolers' diet based on targets of the EAT-Lancet reference diet

Purpose The EAT-Lancet reference diet is a healthy plant-based diet produced within planetary boundaries. To inform the food system transformation, we compared Finnish pre-schoolers' food consumption with the reference diet's food group targets. Methods Food record data for 3- to 6-year-old pre-schoolers were collected in the cross-sectional DAGIS survey. Ingredients of composite dishes were available in the data. In addition, we manually decomposed industrial products such as sausages and biscuits by estimating the shares of ingredients. We also estimated the consumption of added sugars and converted the consumption of dairy products into milk equivalents. We used usual intake modelling to estimate the mean consumption and the proportion of children who met the reference diet's targets. We set the target amounts separately for 3- to 4-year-olds and 5- to 6-year-olds in grams by proportioning the published target amounts (assuming a 2500 kcal diet) to the children's mean reported energy intake. Results For both age groups (3- to 4-year-olds, n = 460; 5- to 6-year-olds, n = 402), the daily mean consumption of whole grains, vegetables, legumes, nuts, and unsaturated oils was below targets, whereas the consumption of red meat, dairy foods, tubers, and added sugars was above targets. The consumption of fruit and fish was in line with targets. Conclusion To comply with the reference diet's targets, major changes in the diets of Finnish children are needed. The key food groups targeted for higher consumption are whole grains and legumes and targeted for lower consumption red meat and dairy products.Peer reviewe

Depression and loneliness may have a direct connection without mediating factors

Purpose of the article There is growing interest in loneliness and its various adverse effects on mental and physical health. While depression is one of the adverse health effects associated with loneliness, there have been some limitations in previous studies: 1) Research has mostly been carried out either in depressed patient samples or in general population samples with depressive symptoms as an outcome, 2) the follow-up times have been rather short, and 3) the mechanisms through which loneliness associates with depression are still unclear. Materials and methods We examined the association between loneliness and incident depression and possible mechanisms underlying this association in a population-based sample of middle-aged men (N = 2339; mean age 53; mean follow-up time 23.5 years). The association between loneliness and depression was explored with Cox proportional hazard analysis, and mediation analyses were performed with the PROCESS macro for SPSS. We used 13 health and lifestyle-related variables as covariates for adjustments in multivariate models and as mediators in simple mediation models. Results Those with depression as an outcome (n = 99) had significantly higher loneliness scale scores at baseline, and baseline loneliness was associated with depression, despite adjustments for potential confounding factors. No mediating factors were observed. Conclusions There was a strong direct association between loneliness and the incidence of depression. Based on our results, we encourage future researchers to look for possible mediators in wider range of variables.Peer reviewe

Early maladaptive schemas in chronically depressed patients : A preliminary investigation

Background Schema therapy has been proposed as a potentially effective treatment for chronic depression. However, little is known about early maladaptive schemas (EMSs), a key concept in schema therapy, in relation to chronic depression or chronic depression with comorbid personality pathology. The aim of the present study was to compare EMSs between currently chronically depressed patients with comorbid cluster C personality disorder (CDCPD), currently chronically depressed patients (CD), and patients remitted from chronic depression (CDR). Methods Based on data from a naturalistic follow-up study on psychiatric outpatients with major depressive disorder, three groups were formed according to Diagnostic and Statistical Manual of Mental Disorders-IV: CDCPD (n = 15), CD (n = 23), and CDR (n = 13). Groups were compared in terms of background information and measurements for depression (Beck Depression Inventory) and EMSs (Young Schema Questionnaire). Results Patients with CDCPD and CD did not differ in terms of background variables or the severity of depressive symptoms, but patients with CDCPD were more maladaptive with respect to the majority of EMSs. Patients with CDR were less depressed than CDCPD or CD patients, but did not differ in terms of EMSs compared with CD patients. Conclusions Comorbid cluster C personality disorder appears to be associated with more severe EMS endorsement in chronically depressed patients. Remitted patients show similar cognitive vulnerability factors in terms of EMSs compared to those currently chronically depressed. The findings suggest that EMSs may contribute to vulnerability to chronic depression. Focusing on EMSs may be beneficial in the treatment of chronic depression.Peer reviewe

Circadian preferences and sleep in 15- to 20-year old Finnish students

Purpose Despite progress in research concerning adolescent and young adult sleep and circadian preferences, several aspects have remained unexamined. This study explored gender and diurnal rhythms in relation to several sleep-related factors: sleep duration, bedtime, wake-up time, tiredness, sleepiness, and optimal subjective sleep duration Methods Circadian preferences and sleep were investigated in 555 (Females N=247) Finnish students aged 15–20. The self-report measures included a shortened version of the Horne-Östberg Morningness-Eveningness Scale, the Epworth Sleepiness Scale as well as items probing feelings of tiredness, optimal subjective sleep durations, and bedtime and wake-up time on the most recent day and a typical weekend. Data were collected from Tuesday to Thursday during an ordinary school week. Results and conclusion The most frequent chronotype was the intermediate type (54%), and compared to previous studies, the prevalence of evening-oriented individuals was high (37%), whereas only 9% of the participants were classified as morning oriented. No gender-specific or chronotype-specific differences in sleep durations were observed, but girls/women and evening-orientated individuals reported suffering more from sleepiness, compared to boys/men and more morning-typed participants, respectively. About 20% of the total sample indicated that their subjective need for sleep was not satisfied during the weekdays nor the weekend, indicating chronic sleep deprivation. Among girls/women and evening-oriented individuals, the subjective sleep need was greater for weekday nights.Peer reviewe

Eriarvoisuuden kasvot liikunnassa

Vaikka sosioekonomisen aseman tiedetään olevan yhteydessä fyysisen aktiivisuuden ja paikallaanolon määrään, ei tiedetä, miten eri ammattiasemassa olevien työntekijöiden aktiivisuustaso eroaa työ- ja vapaapäivinä. Tämän tutkimuksen tarkoituksena oli tutkia istumisen ja seisomisen sekä kevyen ja reippaan aktiivisuuden määrää eri ammattiryhmien välillä työ- ja vapaapäivinä ikääntyneillä työntekijöillä.Tutkimus perustuu Finnish Retirement and Aging (FIREA) –seurantatutkimuksen kliiniseen osatutkimukseen, johon osallistui 276 varsinaissuomalaista kunta-alan työntekijää (keski-ikä 62,8 vuotta (keskihajonta 0,9), 83 % naisia), jotka jaettiin kolmeen ammattiryhmään: ylemmät toimihenkilöt, toimihenkilöt sekä työntekijät. Tutkittavat pitivät reiteen kiinnitettyä liikemittaria (Axivity AX3) neljä vuorokautta, joista kahden tuli olla työpäiviä ja kahden vapaapäiviä, ja täyttivät päiväkirjaa nukkumaanmeno- ja työajoistaan. Tilastollisiin analyyseihin valittiin mukaan vain sellaiset työ- ja vapaapäivät, joissa mittarin pitoaika hereillä ollessa oli vähintään 10 tuntia.Tulokset osoittivat, että työpäivinä toimihenkilöryhmiin kuuluvat istuivat enemmän ja pidempiä jaksoja ja liikkuivat vähemmän kuin työntekijät, mutta vapaapäivänä ammattiryhmien välillä ei havaittu aktiivisuuseroja. Ammattiryhmien väliset työpäivän aktiivisuuserot muodostuivat työajan aikana, eikä työpäivän vapaa-aikana aktiivisuuseroja ollut. Verrattaessa aktiivisuutta työpäivinä, työntekijöillä aktiivisuus oli matalampi vapaa-aikana kuin työaikana, kun taas toimihenkilöllä korkeampi vapaa-aikana kuin työaikana.Ikääntyneillä kunta-alan työntekijöillä havaitut ammattiryhmien väliset aktiivisuuserot muodostuivat pelkästään työajan aktiivisuuseroista, sillä vapaa-aikana tai vapaapäivinä ammattiryhmien välisiä aktiivisuuseroja ei havaittu. Työntekijöillä työaika oli aktiivisempaa kuin vapaa-aika, kun taas toimihenkilöillä työaika oli passiivisempaa kuin vapaa-aika. Näin ollen toimihenkilöt voisivat hyötyä esimerkiksi työaikaan kohdennetuista aktiivisuusinterventioista ja istumisen tauottamisesta, kun taas työntekijäammateissa olisi tärkeä kiinnittää huomioita aktiivisen työn tauottamiseen ja vapaa-ajan aktiivisuuden lisäämiseen mielekkäin keinoin.</p