Occupational class and the changing patterns of hospitalization for affective and neurotic disorders : a nationwide register-based study of the Finnish working-age population, 1976–2010

This study aimed to examine the long-term changes and socioeconomic disparities in hospitalization for affective and neurotic disorders among the Finnish working-age population from 1976 to 2010. Register-based study, consisting of a 5-year follow-up of 3,223,624 Finnish working-age (18-64-year old) individuals in seven consecutive cohorts. We calculated the hazard ratios of psychiatric hospitalization for different occupational classes using Cox regression models. The risk of hospitalization for affective and neurotic disorders increased in all occupational classes after the economic recession in the 1990s, and then decreased in the 2000s. Before the 2000s, the risk was the highest among manual workers. In the 2000s the disparities between upper-level non-manual employees and other occupational classes increased. Hospitalization rates remained high among female manual workers and non-manual lower-level employees. This study revealed important similarities and differences between occupational classes in terms of long-term changes in hospitalization for affective and neurotic disorders. The results suggest that the labor market changes and healthcare reforms during the 1990s and 2000s in Finland have been more beneficial for higher than for lower occupational classes.Peer reviewe

Human service work and long-term sickness absence due to mental disorders : a prospective study of gender-specific patterns in 1,466,100 employees

Purpose: The aim of the study was to investigate sickness absence due to mental disorders in human service occupations. Methods: Participants (n = 1,466,100) were randomly selected from two consecutive national 9-year cohorts from the Statistics Finland population database; each cohort represented a 33% sample of the Finnish population aged 25-54 years. These data were linked to diagnosis-specific records on receipt of sickness allowance, drawn from a national register maintained by the Social Insurance Institution of Finland, using personal identification numbers. Results: Sociodemographic-adjusted hazard ratios (HRs) for sickness absence due to mental disorders in all human service occupations combined were 1.76 for men (95% confidence interval [CI], 1.70-1.84) and 1.36 for women (95% CI, 1.34-1.38) compared with men and women in all other occupations, respectively. Of the 15 specific human service occupations, compared with occupations from the same skill/education level without a significant human service component, medical doctors, psychologists, and service clerks were the only occupations with no increased hazard for either sex, and the HRs were highest for male social care workers (HR 3.02: 95% CI, 2.67-3.41). Conclusions: Most human service occupations had an increased risk of sickness absence due to mental disorders, and the increases in risks were especially high for men. (C) 2018 Elsevier Inc. All rights reserved.Peer reviewe

Human service work, gender and antidepressant use : a nationwide register-based 19-year follow-up of 752 683 women and men

Objectives To examine antidepressant use among male and female human service professionals. Methods A random sample of individuals between 25 years and 54 years of age (n=752 683; 49.2% women; mean age 39.5 years). Information about each individual’s filled antidepressant prescriptions from 1995 to 2014 was provided by the Social Insurance Institution. First, antidepressant use in five broad human service categories was compared with that in all other occupations grouped together, separately for men and women. Then, each of the 15 human service professions were compared with all other occupations from the same skill/education level (excluding other human services professions). Cox models were applied and the results are presented as HRs for antidepressant use with 95% CIs. Results The hazard of antidepressant use was higher among men working in human service versus all other occupations with the same skill/occupational level (1.22, 95% CI 1.18 to 1.27), but this was not the case for women (0.99, 95% CI 0.98 to 1.01). The risks differed between professions: male health and social care professionals (including medical doctors, nurses, practical nurses and home care assistants), social workers, childcare workers, teachers and psychologists had a higher risk of antidepressant use than men in non-human service occupations, whereas customer clerks had a lower risk. Conclusions Male human service professionals had a higher risk of antidepressant use than men working in non-human service occupations. Gendered sociocultural norms and values related to specific occupations as well as occupational selection may be the cause of the elevated risk.Peer reviewe

Distinctive role of income in the all-cause mortality among working age migrants and the settled population in Finland : A follow-up study from 2001 to 2014

Background: Although income level may play a significant part in mortality among migrants, previous research has not focused on the relationship between income, migration and mortality risk. The aim of this register study was to compare all-cause mortality by income level between different migrant groups and the majority settled population of Finland. Methods: A random sample was drawn of 1,058,391 working age people (age range 18–64 years; 50.4% men) living in Finland in 2000 and linked to mortality data from 2001 to 2014. The data were obtained from Statistics Finland. Cox proportional hazards models were used to investigate the association between region of origin and all-cause mortality in low- and high-income groups. Results: The risk for all-cause mortality was significantly lower among migrants than among the settled majority population (hazards ratio (HR) 0.57; 95% confidence interval (CI) 0.53–0.62). After adjustment for age, sex, marital status, employment status and personal income, the risk of mortality was significantly reduced for low-income migrants compared with the settled majority population with a low income level (HR 0.46; 95% CI 0.42–0.50) and for high-income migrants compared with the high-income settled majority (HR 0.81; 95% CI 0.69–0.95). Results comparing individual high-income migrant groups and the settled population were not significant. Low-income migrants from Africa, the Middle East and Asia had the lowest mortality risk of any migrant group studied (HR 0.32; 95% CI 0.27–0.39). Conclusions: Particularly low-income migrants seem to display a survival advantage compared with the corresponding income group in the settled majority population. Downward social mobility, differences in health-related lifestyles and the healthy migrant effect may explain this phenomenon.Peer reviewe

Koronavilkku-projektin loppuraportti

Koronavilkku oli koronaviruksen tartuntaketjujen katkaisun tehostamiseen tarkoitettu tietojärjestelmä. Se auttoi informoimaan käyttäjiä mahdollisesta altistumisesta koronavirukselle ja antoi heille toimintaohjeita. Mahdollisesti altistunut henkilö ohjattiin Koronavilkusta terveydenhuollon palveluihin. Tartunnan saanut puolestaan sai positiivisen laboratoriotestin jälkeen terveydenhuollosta Koronavilkun avauskoodin. Syöttämällä sen sovellukseen hän lähetti ilmoituksen tartunnastaan Koronavilkun taustajärjestelmään, josta lähti tieto mahdollisesti altistuneille. Koronavilkku toteutettiin korkeiden tietosuoja ja -turva vaatimuksien mukaisesti. Sovellus oli käytössä 31.8.2020 1.6.2022. Koronavilkku oli sovelluskäyttäjille vapaaehtoinen ja maksuton. Tässä loppuraportissa kerrotaan Koronavilkku-projektin vaiheista ja opeista. Lisäksi annetaan ideoita mahdolliseen vastaavaan tilanteeseen tulevaisuudessa

Welfare state retrenchment and increasing mental health inequality by educational credentials in Finland : a multicohort study

Objectives: Epidemiological studies have shown an association between educational credentials and mental disorders, but have not offered any explanation for the varying strength of this association in different historical contexts. In this study, we investigate the education-specific trends in hospitalisation due to psychiatric disorders in Finnish working-age men and women between 1976 and 2010, and offer a welfare state explanation for the secular trends found. Setting: Population-based setting with a 25% random sample of the population aged 30-65 years in 7 independent consecutive cohorts (1976-1980, 1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005, 2006-2010). Participants: Participants were randomly selected from the Statistics Finland population database (n=2 865 746). These data were linked to diagnosis-specific records on hospitalisations, drawn from the National Hospital Discharge Registry using personal identification numbers. Employment rates by educational credentials were drawn from the Statistics Finland employment database. Primary and secondary outcome measures: Hospitalisation and employment. Results: We found an increasing trend in psychiatric hospitalisation rates among the population with only an elementary school education, and a decreasing trend in those with higher educational credentials. The employment rate of the population with only an elementary school education decreased more than that of those with higher educational credentials. Conclusions: We propose that restricted employment opportunities are the main mechanism behind the increased educational inequality in hospitalisation for psychiatric disorders, while several secondary mechanisms (lack of outpatient healthcare services, welfare cuts, decreased alcohol duty) further accelerated the diverging long-term trends. All of these inequality-increasing mechanisms were activated by welfare state retrenchment, which included the liberalisation of financial markets and labour markets, severe austerity measures and narrowing down of public sector employment commitment.Peer reviewe

National Trends in Main Causes of Hospitalization : A Multi-Cohort Register Study of the Finnish Working-Age Population, 1976-2010

Peer reviewe

Virtuaalinen oppimisympäristö natiivikuvantamisen laboraatioharjoitteluun

Metropolia Ammattikorkeakoulu alkoi tammikuussa 2015 kouluttaa röntgenhoitajia ja bioanalyytikkoja ulkopaikkakunnilla lisääntyneen työvoimatarpeen vuoksi. Opinnäytetyön tavoitteena oli tuottaa virtuaalinen oppimisympäristö ja luoda sinne verkko-oppimateriaalia natiiviröntgentutkimuksiin liittyen. Natiiviröntgentutkimukset kuuluvat röntgenhoitajan ammatillisen osaamisen perustaan, sillä natiivikuvaus on yleisimmin suoritettava radiologinen tutkimus. Natiiviröntgentutkimukset ovat myös ensimmäinen kuvantamismuoto, johon uudet radiografian ja sädehoidon opiskelijat perehtyvät. Virtuaalinen oppimisympäristö suunniteltiin radiografian ja sädehoidon uusia opiskelijoita varten, erityisesti monimuoto-opiskelijoiden tarpeita ajatellen. Verkko-opetus lisääntyy koko ajan tekniikan kehittymisen myötä. Tämä mahdollistaa tiedon nopean siirtämisen, sen käsittelemisen ajasta ja paikasta riippumatta sekä sen, että opetusmateriaali on kaikkien saatavilla. Opinnäytetyö toteutettiin toiminnallisena ja materiaalia tuotettiin koulutusohjelman opettajien toiveiden mukaisesti kurssille asetettujen oppimistavoitteiden ohjaamina. Projektin lopputuotos on 360° panoraamakuvien avulla toteutettu virtuaalinen versio Metropolian natiiviröntgenkuvantamisen laboraatiotiloista. Kuviin on upotettu PowerPoint-esityksiä ja videoita, joiden avulla opiskelija voi tutustua natiiviröntgenkuvauslaitteisiin ja röntgentutkimusprosessiin ennen käytännön laboraatioharjoitteluja. Verkko-oppimateriaalien tarkoituksena on orientoida uudet opiskelijat natiiviröntgenissä tapahtuvaan työskentelyyn, sekä selittää keskeisimmät natiivikuvantamiseen liittyvät termitMetropolia University of Applied Sciences begins to educate X-ray nurses and biomedical laboratory scientists in co-operation with outlier universities of applied sciences in March 2015 due to the increased shortage of labor. The goal of the thesis was to produce a virtual learning environment and its educational content regarding plain X-ray examinations. These examinations belong to the essential foundation of X-ray nurses’ professional know-how, since plain X-rays are the most common radiological examinations. Plain X-ray exams are also the first imaging modality that new students of radiography and radiotherapy familiarize themselves with. The virtual learning environment was devised for new students of radiography and radiotherapy, especially those who study the course remotely. Online tuition is constantly increasing as technology develops. It enables fast data processing regardless of time and place, allowing for easy availability for everyone. The work was carried out as a functional thesis and the material was produced keeping within the set study objectives for the course in accordance with the desires of the degree programme teachers. The final product of the project is a 360° virtual version of Metropolia´s X-ray imaging classes, implemented by means of panorama pictures. The student can familiarize himself with the X-ray imaging equipment and process before taking part in practical exercise by utilising the PowerPoint shows and videos embedded into the pictures. The goal of the online material is to familiarize the new students with the plain X-ray working process and to clarify the most frequently used terms regarding plain X-ray imaging