87 research outputs found

    Perustoimeentulotuen siirto Kelalle : fenomenografinen tutkimus sosiaalityöntekijöiden kÀsityksistÀ aikuissosiaalityössÀ

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    Perustoimeentulotuen siirrosta Kelalle on keskusteltu useita kertoja vuodesta 1986 lÀhtien. Hallitus pÀÀtti kehysriihessÀ 25.3.2014, ettÀ perustoimeentulotuki siirtyy sosiaalitoimesta Kelassa kÀsiteltÀvÀksi etuudeksi 1.1.2017. TÀydentÀvÀn- ja ennaltaehkÀisevÀn toimeentulotuen myöntÀminen sÀilyy edelleen sosiaalitoimen tehtÀvÀnÀ. Tutkimme pro gradu-tutkielmassamme perustoimeentulotuen siirtymisen vaikutuksia Kelalle aikuissosiaalityön sosiaalityöntekijöiden nÀkökulmasta. Tutkimuksemme on fenomenografinen tutkimus, jonka tehtÀvÀnÀ on selvittÀÀ sosiaalityöntekijöiden kÀsityksiÀ muutoksen vaikutuksista. Teoreettisena viitekehyksenÀ kÀytÀmme kokonaisvaltaista sosiaalityötÀ. Tutkimuksen aineisto on kerÀtty teemahaastattelemalla kuutta aikuissosiaalityöntekijÀÀ Oulun kaupungista. Aineiston analyysimenetelmÀnÀ olemme kÀyttÀneet SWOT-nelikenttÀanalyysia, jonka avulla tarkastelemme sosiaalityöntekijöiden kÀsityksiÀ nykytilanteen vahvuuksista ja heikkouksista sekÀ tulevaisuuden uhkista ja mahdollisuuksista, joita tarkastelemme suhteessa kokonaisvaltaiseen sosiaalityöhön. Sosiaalityöntekijöiden kÀsitykset perustoimeentulotuen siirron vaikutuksista lisÀÀvÀt asiakkaiden tasa-arvoista kohtelua ja tasapuolisuutta kuntakohtaisten erojen poistuessa. Muutoksen nÀhtiin lisÀÀvÀn myös joustavuutta ja poistavan toimeentulotuen alikÀyttöÀ. Uhkana työntekijÀt nÀkivÀt kaikkein heikoimmassa asemassa olevien ihmisten ohjautumisen jatkossa Kelasta sosiaalitoimeen sekÀ kuntien myöntÀmÀn tÀydentÀvÀn- ja ennaltaehkÀisevÀn toimeentulotuen menojen kasvun. Kokonaisvaltaisen sosiaalityön toteutumisen nÀkökulmasta sosiaalityöntekijÀt nÀkivÀt tÀrkeÀnÀ yhteisen kriteeristön luomisen, jonka perusteella asiakkaat ohjautuisivat Kelalta sosiaalitoimeen. Yhteistyö Kelan ja sosiaalitoimen vÀlillÀ nÀhtiin erittÀin tÀrkeÀnÀ. YhtenÀ ratkaisuna esitettiin mahdollisia yhteispalvelupisteitÀ, jossa olisi saatavilla kaikki asiakkaiden tarvitsemat palvelut.acceptedVersio

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

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    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

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    Ruokapalvelut voivat pienentÀÀ ilmastovaikutuksiaan lisÀÀmĂ€llĂ€ kasvisruokien osuutta tarjotuista aterioista. Joukkoruokailun muuttuminen kasvisvoittoisemmaksi edellyttÀÀ ruokien kulttuuristen merkitysten muuttumista ja kasvisruoan erityisruokavalio- ja kevytlounasmerkityksen purkautumista. Hankkeessamme kehitettiin 30 vegaanista, pienen ilmastovaikutuksen pÀÀruokareseptiĂ€ ruokapalveluiden kĂ€yttöön. Osana reseptien testausta toteutimme asiakaskyselyn yhdeksĂ€ssĂ€ lounasravintolassa, joihin sisĂ€ltyivĂ€t viisi peruskoulun ja toisen asteen oppilaitoksen ravintolaa, kaksi opiskelijaravintolaa, henkilöstöravintola ja sairaalan ravintola. TĂ€ssĂ€ artikkelissa tarkastelemme, millaisia merkityksiĂ€ ruokapalveluiden asiakkaat liittĂ€vĂ€t kasvis- ja liharuokiin sekĂ€ millaisia tunnesitoumuksia ja normatiivisia kĂ€sityksiĂ€ niihin kytkeytyy. Argumentoimme Sara Ahmedin (2014) affektiivista normeihin investointia analysoivan lĂ€hestymistavan avulla, ettĂ€ on oleellista nĂ€hdĂ€ ruokakysymys yksilöllisten valintojen tai kognitiivisten prosessien sijaan kysymyksenĂ€ yhteiskunnallisista ja kulttuurisista normeista, joihin investoidutaan affektiivisesti ja toiston avulla. Artikkelimme avaa sekĂ€ moniaistillista, muistojen ja tottumusten vahvistamaa affektiivista liharuokiin kiinnittymistĂ€ ja siten syitĂ€ ruokavaliomuutoksen haastavuuteen, ettĂ€ kasvisruoan uusien merkitysten muotoutumispotentiaalia lounasruokailussa. Affektiivisiin investointeihin liittyvĂ€n sukupuolittuneisuuden lisĂ€ksi nostamme ilmastokestĂ€vyydestĂ€ kĂ€ytĂ€vÀÀn keskusteluun ruokaan liittyvĂ€n nationalismin, kulttuurisen omimisen ja eksotisoinnin. Tarjotessaan aterian noin kolmasosalle vĂ€estöstĂ€ pĂ€ivittĂ€in ruokapalveluilla on merkittĂ€vĂ€ potentiaali ruokaan liittyvien normien uudelleenmuotoutumisessa sekĂ€ ilmastokestĂ€vĂ€n ruokakulttuurin edistĂ€misessĂ€. Ruokapalvelujen mahdollisuuksiin tarjota tĂ€yttĂ€viĂ€, proteiinipitoisia ja maukkaita kasvispohjaisia ruokia tulisikin keskittÀÀ 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

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

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    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

    Genome-Wide Association Study and Functional Characterization Identifies Candidate Genes for Insulin-Stimulated Glucose Uptake

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    Distinct tissue-specific mechanisms mediate insulin action in fasting and postprandial states. Previous genetic studies have largely focused on insulin resistance in the fasting state, where hepatic insulin action dominates. Here we studied genetic variants influencing insulin levels measured 2 h after a glucose challenge in \u3e55,000 participants from three ancestry groups. We identified ten new loci (P \u3c 5 × 10-8) not previously associated with postchallenge insulin resistance, eight of which were shown to share their genetic architecture with type 2 diabetes in colocalization analyses. We investigated candidate genes at a subset of associated loci in cultured cells and identified nine candidate genes newly implicated in the expression or trafficking of GLUT4, the key glucose transporter in postprandial glucose uptake in muscle and fat. By focusing on postprandial insulin resistance, we highlighted the mechanisms of action at type 2 diabetes loci that are not adequately captured by studies of fasting glycemic traits

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

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    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.

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    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
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