Life events and social support among patients with major depressive disorder

The study is part of a research project of 269 psychiatric patients with major depression, Vantaa Depression Study, in the Department of Mental Health and Alcohol Research of the National Public Health Institute and the Department of Psychiatry of the Peijas Medical Care District. The aim was to study at the onset of MDE psychosocial differences in subgroups of patients and clustering of events into time before depression and its prodromal phase, to study whether more severe life events and less social support predict poorer outcome in all patients, but most among those currently in partial remission, whether social support declines as a consequence of time spent in MDE, is sensitive to improvement, and whether social support is influenced by neuroticism and extraversion. After screening, a semistructured interview (SCAN, version 2.0) was used for the presence of DSM-IV MDE, and other psychiatric diagnoses. Life events and social support were studied with semistructured methods (IRLE, Paykel 1983; IMSR, Brugha et al. 1987), perceived social support and neuroticism/extraversion with questionnaires (PSSS-R, Blumenthal et al. 1987; EPI, Eysenck and Eysenck 1964) at baseline, 6 and 18 months. At the onset of depression life events were common. No major differences between subgroups of patients were found; the younger had more events, whereas those with comorbid alcoholism and personality disorders perceived less support. Although events were distributed evenly between the time before depression, the prodromal phase and the index MDE, two thirds of the patients attributed their depression to some life event. Adversities and poor perceived support influenced the outcome of all psychiatric patients, most in the subgroup of full remission. In the partial remission group, the impact of severe events and in the MDE, perceived support was important. Low objective and subjective support were predicted by longer time spent in MDE. Along with improvement subjective support improved. Neuroticism and extraversion were associated with the size of social network and perceived support and predicted change of perceived support. In conclusion, adversities were common in all phases of depression. They may thus have many roles; before depression they may precipitate it, in the prodromal phase worsen symptoms, and during the MDE, the outcome of depression. Patients often attributed their depression to a life event. Psychosocial subgroup differences were quite small. Perceived support predicted the outcome of depression, and time spent in MDE objective and subjective support. Neuroticism and extraversion may modify the level and change particularly in perceived support, thereby indirectly effecting vulnerability to depression.

Cancer survivors at work : Work-related problems and factors associated with their employment, work ability and social support from the work community

Due to the improved prognosis of many forms of cancer, an increasing number of cancer survivors are willing to return to work after their treatment. It is generally believed, however, that people with cancer are either unemployed, stay at home, or retire more often than people without cancer. This study investigated the problems that cancer survivors experience on the labour market, as well as the disease-related, sociodemographic and psychosocial factors at work that are associated with the employment and work ability of cancer survivors. The impact of cancer on employment was studied combining the data of Finnish Cancer Registry and census data of the years 1985, 1990, 1995 or 1997 of Statistics Finland. There were two data sets containing 46 312 and 12 542 people with cancer. The results showed that cancer survivors were slightly less often employed than their referents. Two to three years after the diagnosis the employment rate of the cancer survivors was 9% lower than that of their referents (64% vs. 73%), whereas the employment rate was the same before the diagnosis (78%). The employment rate varied greatly according to the cancer type and education. The probability of being employed was greater in the lower than in the higher educational groups. People with cancer were less often employed than people without cancer mainly because of their higher retirement rate (34% vs. 27%). As well as employment, retirement varied by cancer type. The risk of retirement was twofold for people having cancer of the nervous system or people with leukaemia compared to their referents, whereas people with skin cancer, for example, did not have an increased risk of retirement. The aim of the questionnaire study was to investigate whether the work ability of cancer survivors differs from that of people without cancer and whether cancer had impaired their work ability. There were 591 cancer survivors and 757 referents in the data. Even though current work ability of cancer survivors did not differ between the survivors and their referents, 26% of cancer survivors reported that their physical work ability, and 19% that their mental work ability had deteriorated due to cancer. The survivors who had other diseases or had had chemotherapy, most often reported impaired work ability, whereas survivors with a strong commitment to their work organization, or a good social climate at work, reported impairment less frequently. The aim of the other questionnaire study containing 640 people with the history of cancer was to examine extent of social support that cancer survivors needed, and had received from their work community. The cancer survivors had received most support from their co-workers, and they hoped for more support especially from the occupational health care personnel (39% of women and 29% of men). More support was especially needed by men who had lymphoma, had received chemotherapy or had a low education level. The results of this study show that the majority of the survivors are able to return to work. There is, however, a group of cancer survivors who leave work life early, have impaired work ability due to their illness, and suffer from lack of support from their work place and the occupational health services. Treatment-related, as well as sociodemographic factors play an important role in survivors' work-related problems, and presumably their possibilities to continue working.

Owner-driven decision support in holding-specific forest planning

Socio-economic and demographic changes among family forest owners and demands for versatile forestry decision aid motivated this study, which sought grounds for owner-driven forest planning. Finnish family forest owners’ forest-related decision making was analyzed in two interview-based qualitative studies, the main findings of which were surveyed quantitatively. Thereafter, a scheme for adaptively mixing methods in individually tailored decision support processes was constructed. The first study assessed owners’ decision-making strategies by examining varying levels of the sharing of decision-making power and the desire to learn. Five decision-making modes – trusting, learning, managing, pondering, and decisive – were discerned and discussed against conformable decision-aid approaches. The second study conceptualized smooth communication and assessed emotional, practical, and institutional boosters of and barriers to such smoothness in communicative decision support. The results emphasize the roles of trust, comprehension, and contextual services in owners’ communicative decision making. In the third study, a questionnaire tool to measure owners’ attitudes towards communicative planning was constructed by using trusting, learning, and decisive dimensions. Through a multivariate analysis of survey data, three owner groups were identified as fusions of the original decision-making modes: trusting learners (53%), decisive learners (27%), and decisive managers (20%). Differently weighted communicative services are recommended for these compound wishes. The findings of the studies above were synthesized in a form of adaptive decision analysis (ADA), which allows and encourages the decision-maker (owner) to make deliberate choices concerning the phases of a decision aid (planning) process. The ADA model relies on adaptability and feedback management, which foster smooth communication with the owner and (inter-)organizational learning of the planning institution(s). The summarized results indicate that recognizing the communication-related amenity values of family forest owners may be crucial in developing planning and extension services. It is therefore recommended that owners, root-level planners, consultation professionals, and pragmatic researchers collaboratively continue to seek stable change.

Information Visualization in a Business Decision Support System

Information visualization is a process of constructing a visual presentation of abstract quantitative data. The characteristics of visual perception enable humans to recognize patterns, trends and anomalies inherent in the data with little effort in a visual display. Such properties of the data are likely to be missed in a purely text-based presentation. Visualizations are therefore widely used in contemporary business decision support systems. Visual user interfaces called dashboards are tools for reporting the status of a company and its business environment to facilitate business intelligence (BI) and performance management activities. In this study, we examine the research on the principles of human visual perception and information visualization as well as the application of visualization in a business decision support system. A review of current BI software products reveals that the visualizations included in them are often quite ineffective in communicating important information. Based on the principles of visual perception and information visualization, we summarize a set of design guidelines for creating effective visual reporting interfaces.

Why Do Russians Support Censorship of the Media?

This article analyses support for censorship in Russia as part of the democratization process. Censorship has been an important part of Russian history and it was strengthened during the Soviet era. After the collapse of the Soviet system formal censorship was banned even though the reality has been different. Therefore it is not strange that many Russians would like to limit the freedom of the media and to censor certain topics. The views of Russians on censorship have been studied on the basis of a survey carried out in 2007. According to the results, three different dimensions of censorship were found. These dimensions include moral censorship, political censorship, and censorship of religious materials. Support for these dimensions varies on the basis of socio-demographic characteristics and media use. The article concludes that many Russians reject new phenomena, while support for the censorship of political criticism is not as high, but political censorship seems to enjoy more support among elites than among the common people.

Boost Customer Loyalty with Online Support. The Case of Mobile Telecoms Providers.

The paper explores the effect of customer satisfaction with online supporting services on loyalty to providers of an offline core service. Supporting services are provided to customers before, during, or after the purchase of a tangible or intangible core product, and have the purpose of enhancing or facilitating the use of this product. The internet has the potential to dominate all other marketing channels when it comes to the interactive and personalised communication that is considered quintessential for supporting services. Our study shows that the quality of online supporting services powerfully affects satisfaction with the provider and customer loyalty through its effect on online value and enjoyment. Managerial implications are provided.

”Waxaa i bartay hooyaday waawa u muhiim naaska caruurta.” Äitini opetti, että rintamaito on tärkeää lapselle. Osallistava tutkimus auktoritatiivisen tiedon omaksumisesta somalikulttuuritaustaisten naisten imetyskäytännöissä.

Suomessa asuvat somalitaustaiset maahanmuuttajaäidit luopuvat imetyksestä ja ruokkivat vauvojaan äidinmaidonkorvikkeella, vaikka somalikulttuurissa arvostetaan imetystä. Tuen ja tiedon puutetta on arveltu syyksi pulloruokinnan yleisyyteen. Tarkoituksenani on tutkia osallistavia menetelmiä käyttäen, minkälaisia imetykseen liittyviä tietojärjestelmiä somaliäidit pitävät auktoritatiivisina eli arvovaltaisina. Tarkastelen tiedon auktoritatiivisuutta etnografisten esimerkkien valossa hyödyntäen Brigitte Jordanin auktoritatiivisen tiedon käsitettä. Tutkin Jean Pierre Olivier de Sardanin teorian avulla, kuinka paikalliset populaarit tietojärjestelmät kohtaavat tieteellis-teknisen tiedon kehityksen kontekstissa. Tutkin myös, kuinka somaliäitien imetystietojärjestelmät kohtaavat suomalaisen terveydenhoitojärjestelmän edustaman imetystiedon. Osallistavien menetelmien tarkoituksena on saada heikkojen ja sorrettujen yhteisöjen ääni kuuluviin. Tutkimukseni tiedonantajina on seitsemäntoista somalimaahanmuuttajaäitiä ja yksi suomalainen äitiys- ja lastenneuvolan terveydenhoitaja. Käytän tiedonkeruumenetelminä puolistrukturoituja teemahaastatteluja, jonka lisäksi teen osallistuvaa havainnointia ja osallistavia menetelmiä kolmessa ryhmähaastattelutilanteessa. Käytän Rapi Rurad Appraisal (RRA) –menetelmiä, kuten Venn-diagrammia ja pisteytystä. Tutkimukseni tulos on, että somaliäitien imetykseen liittyvä tieto koostuu kolmesta tietojärjestelmästä, joita ovat sukuverkostoista tuleva perinteinen tietotaito, islaminuskon terveystieto sekä suomalaisen terveydenhoitojärjestelmän tieto. Näistä eri tietolähteistä tuleva imetystieto ei ole sisällöltään ristiriidassa. Imetykseen liittyvät vaikeudet ovat käytännön ongelmiin, kuten sukuverkoston hajoamiseen ja suomalaisen terveydenhoitojärjestelmän kanssa kommunikointiin liittyviä.