Miksi kehollisuuden ymmärtäminen on tärkeää sosiaalityössä?

Tutkielmani tarkoitus oli tavoitella vastausta kysymykseen: Miksi kehollisuuden ymmärtäminen on tärkeää sosiaalityössä? Tutkielmassani tuon esiin Merleau-Pontyn kehofilosofiasta tehdyt tulkinnat vuorovaikutuksen ja kehollisuuden osalta sekä Merleau-Pontyn taustalla vaikuttavien filosofien Martin Heideggerin ja Martin Buberin näkemykset ihmisen kohtaamisesta. Keskeisin käsite Merleau-Pontyn kehofilosofiassa on kontemplatiivinen keho. Muita ydinkäsitteitä ovat objektikeho, koettu keho, kehon kaava, kehon kuva ja kehotietoisuus. Ydin Merleau-Pontyn kehofilosofiassa on mielen ja kehon yhteenkietoutumisen käsitys, "minä olen yhtä kuin kehoni". Objektikeho ymmärretään ulkoapäin tarkasteltavana kehona, kun koettu keho on läsnä sisäisessä kokemuksessa. Martin Heideggerin käsitteistä keskeisiä ovat maailmaan heitettyys, silleen jättämisen asenne, laskeva ajattelu ja epävarsinainen ja varsinainen oleminen. Martin Buberin käsitteet kietoutuvat aktuaalisen Minä-Sinä ja Minä-Se maailman ympärille. Tutkimukseni on laadullinen, filosofinen, fenomenologis-hermeneuttinen tutkimus. Laadullisessa tutkimuksessa tarkoituksena on tilastollisen yleistyksen sijasta kuvata ja ymmärtää tiettyä toimintaa tai ilmiötä. Fenomenologisessa filosofiassa tavoitellaan ilmiöön liittyviä syvempiä merkityksiä ja ajatellaan, että yksittäistapaus on esimerkki yleisestä. Tarkastelen tutkielmassani kehon kokemusta ja havainnointia kohtaamisessa. Fenomenologis-hermeneuttisen tutkimuksen erityispiirre on, että tutkimuksen kohteena on ihminen. Tutkimuksen perustana olevat filosofiset ongelmat ovat ihmiskäsitys ja tiedon käsitys. Tietokysymyksistä keskeisiä ovat ymmärtäminen ja tulkinta ja ydinkäsitteitä kokemus, merkitys ja yhteisöllisyys. Tiedon hankinta koostui kirjallisista lähteistä. Pääasiallisen aineiston muodostivat Merleau-Pontyn kehofilosofinen kirjallisuus ja Merleau-Pontyn kehofilosofiasta tehtyjen tutkimusten tulkinnat ja Martin Heideggerin tutkimuskirjallisuudesta tehdyt tulkinnat sekä Martin Buberin kirjallisuus ja niistä tehdyt tulkinnat. Aineiston analyysi koostui ongelman ideasta, näkökulman ja esiymmärryksen määrittelystä, käsitteiden määrittelyistä ja aiemman tutkimuksen esittelystä ja tulkinnoista. Käytän tutkimuksessani fenomenologista päättelyä kuvaamaan kehollisuutta ilmiönä ja näkökulmana. Etiikka nousee keskeiseksi perusteluksi kehollisuuden ymmärtämisessä. Keskeistä on, että ymmärtääkseen etiikan perustan työskentelyssä sosiaalityöntekijän tulisi kääntyä itseensä löytääkseen kehollisuutensa ja tunnistaakseen oman toimintansa, ajatuksensa ja käsityksensä ihmisestä. Menetelmällisyys ei ole näkemyksessäni olennaista sosiaalityön asiakastyössä, vaikka se helpottaa työskentelyä. Keskeistä on eettinen, kehollinen asennoituminen kohtaamiseen

Longitudinal analysis of the quality of orthodontic treatment outcome and stability of occlusal traits

Objectives To assess the quality and stability of orthodontic treatment outcome relative to the initial malocclusion. Material and methods The study was performed in one public health care clinic in Finland. Study subjects comprised 51 orthodontic patients (age range 12.7-18.7 years). Pre-treatment medical records and lateral skull radiographs were analysed for malocclusion type. The main reasons for orthodontic treatment were mandibular retrognathia, Class II distal bite, deep bite and crowding. At the end of a retention phase (Examination 1), the quality of treatment outcome was assessed using the occlusal morphology and function index (OMFI) and patients were asked about treatment satisfaction. Stability of occlusal traits and patient satisfaction were re-evaluated after a two-year follow-up (Examination 2). Occlusal characteristics descriptive statistics were performed. Results At Examination 1, all six morphological criteria for acceptability were fulfilled by 76% and all functional criteria by 82% of the patients. All OMFI criteria were met by 67% of the patients. At Examination 2, 68% of the patients fulfilled all morphological and 82% all functional criteria of acceptability. At Examination 2, all the OMFI criteria were still met by 64% of the patients and 92% expressed satisfaction with own occlusion. The main reasons for unacceptability were deficiencies in canine relationship and overbite, in addition to functional protrusion interferences. Conclusions In the evaluated health care clinic, patient satisfaction and the quality of treatment outcome were high. However, deep bite showed a tendency for relapse.Peer reviewe

Are the Elderly With Maxillofacial Injuries at Increased Risk of Associated Injuries?

Peer reviewe

Oral health-related quality of life among home-dwelling older people with and without domiciliary care

Objectives The aim was to compare oral health-related quality of life (OHRQoL) between home-dwelling older people with and without domiciliary care when adjusted for gender, education, use of dental services and removable dental prostheses. Background OHRQoL of home-dwelling older people with and without domiciliary care is a neglected area of research, with few studies having been conducted. Materials and Methods A secondary analysis was conducted on the Finnish Health 2011 interview data. Home-dwelling participants (age >= 70) with or without domiciliary care were included (n = 758). OHRQoL was measured with the Oral Health Impact Profile questionnaire (OHIP-14) calculating three outcomes: prevalence of at least one impact reported: "occasionally," "fairly often" or "very often" (OFoVo), severity as mean sum score and mean of the seven OHIP-14 dimensions. These were evaluated by use of domiciliary care using logistic and negative binomial regression analyses. Results Domiciliary care clients tended to have poorer OHRQoL than non-clients (severity mean 4.33 vs 4.11, P = .057), especially men (6.71 vs 4.15, P = .027), and reported more psychological discomfort than non-clients (mean 1.10 vs 0.82, P = .039). The use of removable dental prostheses was the strongest predictor (OR 2.84, P < .001) of poor OHRQoL. Conclusion Domiciliary care clients tended to report poorer OHRQoL, especially with regard to psychological discomfort dimension than non-clients. Thus, support of oral hygiene and regular utilisation of oral health services should be part of domiciliary care among older people to enhance OHRQoL

Perceived oral health and oral health behaviours among home-dwelling older people with and without domiciliary care

Objectives The aim was to compare the perceived oral health and oral health behaviours of home-dwelling older people with and without domiciliary care.Background Oral health is poor in long-term care, but less is known about perceived oral health of home-dwelling older people receiving domiciliary care.Materials and methods Data from the Health 2000 and Health 2011 surveys (BRIF8901) were used. Interview participants were at least 70 years old and living at home with or without domiciliary care (n = 1298 in 2000 and n = 1027 in 2011). Differences in perceived oral health (subjective oral health, pain, eating difficulties) and oral health behaviours (hygiene, use of services) were compared based on the use of domiciliary care and stratified by gender. Differences between groups were compared with the chi-square test.Results In 2011, compared to non-clients, domiciliary care clients more often had poor subjective oral health (40.3% vs. 28.9%, P = .045). In both surveys, they also used oral health services less recently (2000, 76.4% vs. 60.9%; and 2011, 61.1% vs. 46.6%) and more often had difficulties chewing hard food (2000, 50.6% vs. 34%, P Conclusion Domiciliary care clients have poorer perceived oral health, and greater difficulties with eating and oral hygiene maintenance than non-clients.</div

Parental immigration and offspring post-traumatic stress disorder : A nationwide population-based register study

Objectives: The aim of this study was to investigate the association between parental immigration status and a diagnosis of post-traumatic stress disorder (PTSD) in their offspring. Methods: This nested matched case-control study was based on a Finnish national birth cohort for 1987-2010 and cases were diagnosed with PTSD by 2012 from the Care Register for Health Care. We identified 3639 cases and 14,434 controls individually matched for gender, place and date of birth ( +/- 30 days). Conditional logistic regression analyses were conducted to examine the association between parental immigration status, parents' region of birth and time since paternal immigration, and PTSD after controlling for confounding factors. Results: The likelihood of being diagnosed with PTSD was significantly increased among children with an immigrant father (OR 1.8, 95% CI 1.3 - 2.4) than those with two Finnish parents and one immigrant mother. There was no significant association between having an immigrant mother or two immigrant parents and receiving a diagnosis of PTSD. The likelihood of being diagnosed with PTSD was increased if the children's fathers had migrated less than five years before their birth (OR 1.4, 95% CI 1.03 - 1.9) and if their immigrant fathers had been born in North Africa or the Middle East (OR 2.1, 95% CI 1.4 - 3.3). Limitations: The sample included a heterogeneous migrant group without information on the reason for migration. The cases were identified from hospital diagnosis that may have only included severe cases. Conclusion: The increased likelihood of a diagnosis of PTSD underlines the need for psychosocial services among second-generation immigrants.Peer reviewe

Obstetric and Neonatal Adversities, Parity, and Tourette Syndrome: A Nationwide Registry

Peer reviewe

Finnish-born children of immigrants are more likely to be diagnosed with developmental disorders related to speech and language, academic skills and coordination

Aim: We examined the association between having at least one parent born abroad and being diagnosed with a developmental disorder related to speech and language, academic skills or coordination. Methods: This nested case–control study was based on Finnish population records for 1996–2007. Cases from the Finnish Hospital Discharge Register were diagnosed with developmental disorders of speech and language, academic skills and coordination by the end of 2012. We identified 28 192 cases and 106 616 matched controls. Results: Children were more likely to be diagnosed with developmental disorders if they had an immigrant mother than children with two Finnish‐born parents, with an adjusted odds ratio (aOR) of 1.3 and 95% confidence interval (95% CI) of 1.2–1.4, an immigrant father (aOR 1.2, 95% CI 1.1–1.3) or two immigrant parents (aOR 1.5, 95% CI 1.3–1.6). The level of development of the parental country of origin was not associated with receiving a diagnosis. Conclusion: Children of immigrant parents were more likely to be diagnosed with developmental disorders and the association was strongest with regard to speech and language disorders. There were similar adjusted odds ratios for mothers, fathers and both parents. The development level of the country of origin was irrelevant.</p

Parent's self-reported tooth brushing and use of fluoridated toothpaste: Associations with their one-year-old child's preventive oral health behaviour

Objective The aim of the study was to examine if the tooth brushing frequency and use of fluoridated toothpaste of the mother and father were associated with the tooth brushing frequency and use of fluoridated toothpaste for their 1-year-old child. Methods This cross-sectional study is part of the FinnBrain Birth Cohort Study. Questionnaire data were obtained from 1672 mothers and 867 fathers on tooth brushing and use of fluoridated toothpaste, age, education, number of siblings and parity (when the child was 1-year-old). For 763 families (mother and father), data from both parents were available. Tooth brushing was dichotomized to at least twice daily (2× day) and less than 2× day, and use of fluoridated toothpaste for child to at least once daily and less than once daily. The association between brushing of child's teeth (both parents less than 2× day) and use of fluoridated toothpaste for the child (both parents less than once daily) with parent's own tooth brushing was modelled with logistic regression analyses adjusted for family-related variables (parents' age and education, number of older siblings) using odds ratios (OR) and 95% confidence intervals (CI). Results Families in which both parents brushed their own teeth less than 2× day were more likely to brush their child's teeth less than 2× day than families in which both parents brushed their own teeth 2× day (OR = 9.23; 95%CI = 5.42–15.69). The likelihood of not brushing the child's teeth 2× day was less strong when at least one of the parents brushed his/her own teeth 2× day (mother 2× day: OR = 1.97; 95%CI = 1.25–3.10; father 2× day: OR = 2.85; 95%CI = 1.51–5.40). Conclusions Less frequent tooth brushing of both mothers and fathers was strongly associated with less frequent tooth brushing of their child. When educating parents on child oral home care, parents' own home care and inclusion of fathers also need more attention.publishedVersio