Late effects of cancer at a young age: Registry-based studies of the health of cancer patients and their off-spring

Modern cancer therapy has resulted in increased survival among patients diagnosed with cancer at a young age. These improvements have led to the investigation of late morbidity and mortality associated with cancer and its treatments. The aim of this study was to evaluate late effects of cancer treated at a young age on the health of patients and their offspring. Utilising the nationwide population-based registries in Finland, we evaluated the risk of hypothyroidism and the probability of parenthood in cancer survivors as well as preterm birth, neonatal outcomes, and the risk of cancer among offspring of patients. The survivor cohort, identified from the Finnish Cancer Registry, consisted of 25,784 cancer patients diag-nosed between ages 0 and 34 in 1953–2004. By linkage to the population register, siblings of these patients were identified for comparison. The prevalence of hypothyroidism was higher among former childhood cancer (aged 0–16) patients than in the general population. The probability of parenthood following early onset cancer was overall significantly reduced compared to siblings. Offspring of female cancer survivors were at an increased risk of preterm birth, this risk being highest among patients diagnosed in childhood and early adulthood (aged 20–34 years). The offspring were not, however, at a significantly increased risk of neonatal death or stillbirth, though they were more likely to need monitoring or intensive care in the neonatal period. The risk of sporadic cancer among offspring of male and female cancer survivors was not elevated in comparison to the general population. The study showed that former cancer patients are at risk of certain adverse endocrine and reproductive health outcomes and should be followed for timely intervention. The offspring of cancer survivors do not appear to be at risk for adverse health outcomes.

Outcomes of cervical human papillomavirus (HPV) infections among mothers in the Finnish Family HPV Study

To understand the natural history of cervical human papillomavirus (HPV)-infections, more information is needed on their genotype-specific prevalence, acquisition, clearance, persistence and progression. This thesis is part of the prospective Finnish Family HPV study. 329 pregnant women (mean age 25.5 years) were recruited during the third trimester of pregnancy and were followed up for 6 years. The outcomes of cervical HPV infections were evaluated among all the mothers participating in the study. Generalized estimating equation (GEE)-models and Poisson regression were used to estimate the risk factors of type-specific acquisition, clearance, persistence and progression of Species 7 and 9 HPV-genotypes. Independent protective factors against incident infections were higher number of life-time sexual partners, initiation of oral contraceptive use after age 20 years and becoming pregnant during FU. Older age and negative oral HR-HPV DNA status at baseline were associated with increased clearance, whereas higher number of current sexual partners decreased the probability of clearance. Early onset of smoking, practicing oral sex and older age increased the risk of type-specific persistence, while key predictors of CIN/SIL were persistent HR-HPV, abnormal Pap smear and new sexual partners. HPV16, together with multiple-type infections were the most frequent incident genotypes, most likely to remain persistent and least likely to clear. Collectively, LR-HPV types showed shorter incidence and clearance times than HR-HPV types. In multivariate models, different predictors were associated with these main viral outcomes, and there is some tentative evidence to suggest that oral mucosa might play a role in controlling some of these outcomes.

Cognitive Development of Very Low Birth Weight Children from Infancy to Pre-school Age

The survival of preterm born infants has increased but the prevalence of long-term morbidities has still remained high. Preterm born children are at an increased risk for various developmental impairments including both severe neurological deficits as well as deficits in cognitive development. According to the literature the developmental outcome perspective differs between countries, centers, and eras. Definitions of preterm infant vary between studies, and the follow-up has been carried out with diverse methods making the comparison less reliable. It is essential to offer parents upto-date information about the outcome of preterm infants born in the same area. A centralized follow-up of children at risk makes it possible to monitor the consequences of changes in the treatment practices of hospitals on developmental outcome. This thesis is part of a larger regional, prospective multidisciplinary follow-up project entitled “Development and Functioning of Very Low Birth Weight Infants from Infancy to School Age” (PIeniPAinoisten RIskilasten käyttäytyminen ja toimintakyky imeväisiästä kouluikään, PIPARI). The thesis consists of four original studies that present data of very low birth weight (VLBW) infants born between 2001 and 2006, who are followed up from the neonatal period until the age of five years. The main outcome measure was cognitive development and secondary outcomes were significant neurological deficits (cerebral palsy, CP, deafness, and blindness). In Study I, the early crying and fussing behavior of preterm infants was studied using parental diaries, and the relation of crying behavior and cognitive and motor development at the age of two years was assessed. In Study II, the developmental outcome (cognitive, CP, deafness, and blindness) at the age of two years was studied in relation to demographic, antenatal, neonatal, and brain imaging data. Development was studied in relationship to a full-term born control group born in the same hospital. In Study III, the stability of cognitive development was studied in VLBW and full-term groups by comparing the outcomes at the ages of two and five years. Finally, in Study IV the precursors of reading skills (phonological processing, rapid automatized naming, and letter knowledge) were assessed for VLBW and full-term children at the age of five years. Pre-reading skills were studied in relation to demographic, antenatal, neonatal, and brain imaging data. The main findings of the thesis were that VLBW infants who fussed or cried more in the infancy were not at greater risk for problems in their cognitive development. However, crying was associated with poorer motor development. The developmental outcome of the present population was better that has been reported earlier and this improvement covered also cognitive development. However, the difference to fullterm born peers was still significant. Major brain pathology and intestinal perforation were independent significant risk factors for adverse outcome, also when several individual risk factors were controlled for. Cognitive development at the age of two years was strongly related with development at the age of five years, stressing the importance of the early assessment, and the possibility for early interventions. Finally, VLBW children had poorer pre-reading skills compared with their full-term born peers, but the IQ was an important mediator even when children with mental retardation were excluded from the analysis. The findings suggest that counseling parents about the developmental perspectives of their preterm infant should be based on data covering the same birth hospital. Neonatal brain imaging data and neonatal morbidity are important predictors for developmental outcome. The findings of the present study stress the importance of both short-term (two years) and long-term (five years) follow-ups for the individual, and for improving the quality of care.

Professional development among educators pursuing a B.Ed. program in special education in Tanzania : a study of motives and perceived outcomes

Implementation of different policies and plans aiming at providing education for all is a challenge in Tanzania. The need for educators and professionals with relevant knowledge and qualifications in special education is substantial. Teacher education does not equip educators with sufficient knowledge and skills in special education and professional development programs in special education are few in number. Up to 2005 no degree programs in special education at university level were available in Tanzania. The B.Ed. Special Education program offered by the Open University of Tanzania in collaboration with Åbo Akademi University in Finland was one of the efforts aimed at addressing the big national need for teachers and other professionals with degree qualifications in special education. This pilot program offered unique possibilities to study professional development in Tanzania. The research group in this study consisted of the group of students who participated in the degree program 2005-2007. The study is guided by three theoretical perspectives: individual, social and societal. The individual perspective emphasizes psychological factors as motives, motivation, achievement, self-directed behavior and personal growth. Within social perspective, professional development is viewed as situated within the social and cultural context. The third perspective, the societal, focuses on change, reforms, innovations and transformation of school systems and societies. Accordingly, professional development is viewed as an individual, social and societal phenomenon. The overall aim of the study is to explore the participants’ motives for participating in a B.Ed. Special Education program and the perceived outcomes of the program in terms of professional development. In order to achieve the objectives of the study, a case study approach was adopted. Questionnaires and semi-structured interviews were administered in three waves between January 2007 and February 2009 to the 35 educators participating in the B.Ed. Special Education program. The findings of the study reveal that the participants expressed motives which were related to job performance, knowledge, skills, academic degree and career. Also altruistic motives were expressed by the participants in terms of helping and supporting students with special needs and their communities. The perceived outcomes of the program were in line with the expressed motives. However, the results indicate that the participants also learned new skills, as interaction skills and guidance and counseling skills. Increased self-confidence was also mentioned as an outcome. The participants also got deepened understanding of disability issues. In addition, they learned strategies for creating awareness of persons with disability in the communities. Thus the findings of the study indicate positive outcomes of the program in terms of professional development. The conclusion of the study is that individual, social and societal factors interact when it comes to explaining why Tanzanian educators in special education choose to pursue a degree program in special education. The individual motives, as increased knowledge and better prospects of career development interact with the social and societal motives to help and support vulnerable student groups. The study contributes to increased understanding of the complexity of professional development and of the realities educators meet when educational reforms are implemented in a developing country.

Metformin in gestational diabetes mellitus

METFORMIININ KÄYTTÖ RASKAUSDIABETEKSESSA Raskausdiabeteksella tarkoitetaan sokeriaineenvaihdunnan häiriötä, joka todetaan ensimmäisen kerran raskauden aikana. Hoidolla voidaan vähentää raskausdiabetekseen liittyviä äidin ja vastasyntyneen haittoja. Lääkitystä tarvitaan, jos ruokavaliohoidolla ei saavuteta hyvää sokeritasapainoa. Perinteisesti lääkityksenä on käytetty insuliinia, mutta metformii¬nin käyttöä insuliinin vaihtoehtona on ehdotettu. Metformiini läpäisee istukan, mutta sen läpäisymekanismi ei ole selvillä. Tämän tutkimuskokonaisuuden pääasiallisin tarkoitus oli verrata metformiinin tehokkuutta ja turvallisuutta insuliiniin raskausdiabeteksen hoidossa selvittämällä lääkkeen vaiku¬tusta äitiin ja vastasyntyneeseen. Lisäksi haluttiin tutkia, mitkä tekijät ennustavat insulii¬nin tarvetta metformiinin lisänä, jotta saavutettaisiin hyvä sokeritasapaino. Metformiinin annoksen vaikutus äitiin ja vastasyntyneeseen arvioitiin mittaamalla metformiinin pitoisuus äidistä, ja sikiön puolelta napanuoran veressä. Tässä tutkimuksessa selvitettiin myös aktiivisen kuljetusproteiinin (OCT) merkitystä metformiinin kulkeutumiseen istukan läpi perfusiomalla istukkaa ex vivo . Ex vivo istukkaperfuusiotutkimuksen tulokset viittasivat siihen, että OCT-kuljetusproteiinilla ei ollut todennäköisesti merkittävää osuutta metformiinin kulkeutumisessa istukan läpi. Metformiinin pitoisuusmittaukset synnytyksen yhteydessä osoittivat metformiinin siirtyvän sikiöön istukan läpi suuressa määrin (96 %) kertymättä kuitenkaan sikiön verenkiertoon. Metformiinin pitoisuudella ei ollut vaikutusta vastasyntyneen hyvinvointiin. Maksi¬maalisella metformiinin annostuksella ja korkealla metformiinipitoisuudella todettiin olevan suotuisa vaikutus äidin painon nousuun raskauden aikana. Insuliiniin verrattuna metformiini ei lisännyt äidin, sikiön tai vastasyntyneen haittatapahtumia, eikä sillä ollut vaikutusta synnytystapaan. Sokeritasapaino insuliini- ja metformiinilääkityksen aikana oli yhtäläinen arvioitaessa sitä HbA1c- ja fruktosamiinimittauksilla, mutta 21 % metformiinin käyttäjistä tarvitsi lisäksi insuliinia hyvän sokeritasapainon saavuttamiseksi. Tutkimuksesssa todettiin, että mitä iäkkäämpi äiti oli, mitä varhaisemmassa raskauden vaiheessa sokerirasitus oli tehty ja lääkitys aloitettu, ja mitä korkeammat HbA1c ja fruktosamiinipitoisuudet olivat, sitä suuremmalla todennäköisyydellä metformiinin lisänä tarvittiin insuliinia.

The effects of maternal hyperglycemia on human umbilical vascular gene expression and neonatal rat lung development

Background: Maternal diabetes affects many fetal organ systems, including the vasculature and the lungs. The offspring of diabetic mothers have respiratory adaptation problems after birth. The mechanisms are multifactorial and the effects are prolonged during the postnatal period. An increasing incidence of diabetic pregnancies accentuates the importance of identifying the pathological mechanisms, which cause the metabolic and genetic changes that occur in offspring, born to diabetic mothers. Aims and methods: The aim of this thesis was to determine changes both in human umbilical cord exposed to maternal type 1 diabetes and in neonatal rat lungs after streptozotocin-induced maternal hyperglycemia, during pregnancy. Rat lungs were used as a model for the potential disease mechanisms. Gene expression alterations were determined in human umbilical cords at birth and in rat pup lungs at two week of age. During the first two postnatal weeks, rat lung development was studied morphologically and histologically. Further, the effect of postnatal hyperoxia on hyperglycemia-primed rat lungs was investigated at one week of age to mimic the clinical situation of supplemental oxygen treatment. Results: In the umbilical cord, maternal diabetes had a major negative effect on the expression of genes involved in blood vessel development. The genes regulating vascular tone were also affected. In neonatal rat lungs, intrauterine hyperglycemia had a prolonged effect on gene expression during late alveolarization. The most affected pathway was the upregulation of extracellular matrix proteins. Newborn rat lungs exposed to intrauterine hyperglycemia had thinner saccular walls without changes in airspace size, a smaller relative lung weight and lung total tissue area, and increased cellular apoptosis and proliferation compared to control lungs, possibly reflecting an aberrant maturational adaptation. At one and two weeks of age, cell proliferation and secondary crest formation were accelerated in hyperglycemia-exposed lungs. Postnatal hyperoxic exposure, alone caused arrested alveolarization with thin-walled and enlarged alveoli. In contrast, the dual exposure of intrauterine hyperglycemia and postnatal hyperoxia resulted in the phenotype of thick septa together with arrested alveolarization and decreased number of small pulmonary arteries. Conclusions: Maternal diabetic environment seems to alter the umbilical cord gene expression profile of the regulation of vascular development and function. Fetal hyperglycemia may additionally affect the genetic regulation of the postnatal lung development and may actually induce prolonged structural alterations in neonatal lungs together with a modifying effect on the deleterious pulmonary exposure of postnatal hyperoxia. This, combined with the novel human umbilical cord gene data could serve as stepping stones for future therapies to curb developmental aberrations.

Antecedents and Performance Outcomes of Entrepreneurial Orientation: a Comparative Cross-Country Study

Development of entrepreneurial orientation (EO) within a company is considered to be significant for firm performance in a contemporary market society with constantly changing environment. Considered as entrepreneurial, the firm is able to innovate, make risky investments and be proactive. The purpose of the thesis is to investigate factors which influence EO, the impact of EO on firm performance, and a mediating role of EO in developed and emerging market contexts. The empirical research is conducted quantitatively in a form of a survey in Russia and Finland. The results of the thesis have shown that the relationship between antecedents, EO and firm performance outcomes is different in developed and emerging contexts and can be explained by cultural differences and institutional development. The empirical research has both theoretical and practical novelty. It contributes to the existing literature on EO by the usage of comparative cross-country approach and a broader three-way interaction model between the variables. A general practical implication of the research is that managers may benefit from developing entrepreneurial strategic posture in particular contexts.

Gamification as a means for employee motivation, personal engagement and behavioral outcomes: a gamification system developers’ perspective

A major challenge faced by companies today is the engagement gap at the workplace and how to motivate employees to engage in less intrinsically motivating work activities that are valuable for the organization. The objective of this study is to investigate gamification as a means for employee motivation and personal engagement that result in behavioral outcomes from the gamification developers’ perspective. Theories of work motivation and engagement are viewed in relation to gamification. The empirical part conducts a qualitative multiple-case study. The data is analyzed with the CAQDAS NVivo. The empirical findings suggest that gamification can enhance employee motivation, but careful consideration of extrinsic motivators is necessary to avoid their detrimental effect on intrinsic motivation. Employee self-determination is built through internalization of gamified system’s goals reaching autonomous motivation to engage in the target behavior. Employee engagement is built by fulfilling the psychological conditions of meaningfulness, safety and availability. The results suggest that gamification can build employee motivation and engagement leading to behavior change if designed with the business objectives in mind. Moreover, the gamified system needs to be renewed to address the changes in the business environment and reflect them in the employee behavior.

Comparing adult-youth and adult-adult online sexual solicitation: Manipulative behaviors, situational factors, and outcomes

Online sexual solicitation (solicitation) of youth has received widespread media and research attention during the last decade. The prevalence rates of youth who have experienced solicitation or solicitation attempts vary between studies depending on the methodology used (e.g., whether youth or adults are the target study group). In studies focusing on youth victims, the prevalence of solicitation attempts made by adults during the past year is typically reported to be between 5 and 9%. Adults who solicit youth online have been found to use deception and other manipulative behaviors to gain access to sexual activities with youth. However, previous studies have lacked a control group of adults who solicit other adults online. Without this comparison, one could argue that deceiving others online about one’s identity, and engaging in manipulative behaviors, is an inherent part of most online sexual interactions with strangers. Additionally, little is known about the associations between manipulative behaviors and the solicitation outcomes. In research concerning offline sexual behaviors, it has been noted that situational factors, such as sexual arousal, may alter both sexual interest and behavior. The effects of situational factors on online sexual behaviors have been less extensively studied (especially so with a quantitative approach); no studies have to date focused on adults’ solicitation of youth. Investigating the role of a lowered sexual age preference and the role of situational factors in the soliciting adults could be an important step in order to receive deeper knowledge of the role of traits and states in the context of solicitation. Additionally, there is a lack of knowledge of the effect of the age of the youth. Although previous studies on solicitation has found that older youth, compared with younger youth and children, are more often solicited, the possible reasons for this have not been investigated. Are adults who solicit youth affected by legal deterrence (through the legal age of consent), is it because older youth are more available online, or are the adults’ age preferences merely a product of a normally distributed age preference in the population? The purpose of the present thesis was fivefold: 1) to obtain an estimate of the frequency of adults’ solicitation of youth as self-reported and observed in actual behavior; 2) to explore whether the legal age of consent (LAC) affects solicitation frequency, or whether a normally distributed sexual age preference more accurately describe the proportion of solicited youth of different ages; 3) to investigate the associations of both traits (e.g., lower sexual age preference) and states (immediate situational factors, such as alcohol intoxication), and the solicitation target; 4) to explore whether adults who solicit youth and adults who solicit adults are equally deceitful and manipulative online, and whether the different solicitation outcomes are as common in both groups; and 5) to investigate whether the deceitful and manipulative behaviors engaged in had different associations with the solicitation outcomes depending on the age of the solicited. In the survey study, a convenience sample of 1393 adult participants (aged 18 years or older) self-reported any online communication with strangers during the past year. Of these, 56% (776 respondents) reported that they had solicited or attempted to solicit at least one stranger. Of the respondents, 453 (58.4%) were men, and 323 (41.6%) were women. Participants with only adult contacts (18 years or older) constituted the majority (640 respondents). In contrast, 136 individuals reported a youth contact (a 13 year old or younger, or a 14 to 17-year old). Approximately half of the participants were men in the adult contact group, while 75% of the participants were men in the youth contact group. Approximately 60% of the participants with youth contacts were recruited from two websites associated with a pedophilic sexual interest. In an online quasi-experimental study, with researchers impersonating youth of different ages (10–18 year olds) in chat rooms, 251 online conversations with chat room visitors made up the entire sample. All chat room visitors alleged to be men. The self-reported frequency of having solicited youth (0–17-year olds) during the past year was approximately 10% in our sample of adults who reported communicating with any strangers online. When we observed this behavior in chat rooms, we found that approximately 30% of the chat room visitors who believed they interacted with a 10 to 14 year old attempted to solicit the youth. We found that solicitation attempts increased equally much when increasing the age of the impersonated youth from 14 to 16, as from 16 to 18. Thus, we concluded that a normally distributed age preference in the population was a more plausible explanation to the effect of the age of the solicited, rather than the LAC (here; 15 and 16). If the chat room visitors would have been deterred only by the LAC, we would have expected that the change in amount of solicitation attempts from an illegal age group to a legal age group would have been significantly stronger than changes between age groups within illegal-illegal and legal-legal groups. Our subsample of survey participants from the pedophilia-related websites expectedly reported that they had solicited youth more often in comparison to the sample gathered through general (i.e., not associated with any particular sexual preference) websites. We also found that participants with a youth contact reported higher levels of sexual arousal and shame before the sexual interaction with their online contact, compared with participants with an adult contact. Additionally, the participants with youth contacts who reported consumption of child- and adolescent pornography also reported being more sexually aroused before the interaction, compared to the participants with youth contacts who did not report consumption of these kinds of pornography. We also found clear indications that the online sexual interaction had an alleviatory effect on reported levels of sadness, boredom and stress, independent of the age of the contact. Generally, the participants with youth and adult contacts reported deceiving their contacts as often and suggesting keeping the communication a secret from someone as often. Participants with a youth contact, however, reported using more persuasion techniques for online sexual purposes or for the purpose of an offline meeting, compared to those with an adult contact. In the chat rooms, we found that more indirect ways of future sexual communication (e.g., continuing chatting) was suggested by the chat room visitors that were under the assumption of interacting with youth aged 10 to 14, compared with more direct means (e.g., meeting offline). Survey participants with youth contacts who had used deception, suggested keeping the interactions a secret, and/or persuaded their contact by appealing to the contacts feelings of love and attachment for the participant had also more often engaged in cybersex with the contact. No other manipulative behaviors were associated with the other investigated solicitation outcomes (receiving a sexual picture, meeting offline, and engaging in sexual contact offline) within this group of participants. However, using deception, suggesting secrecy and using persuasion was also positively associated with certain solicitation outcomes within participants with an adult contact. In summary, adults’ solicitation of youth is much more frequent when observed in chat rooms than self-reported. Additionally, an underlying lowered sexual age preference seems to be a motivating factor on a group level in adults who solicit youth. We concluded that directed prevention efforts should be made on pedophiliarelated websites. Additionally, the role of situational factors, especially sexual arousal in persons with a pedo- or hebephilic sexual interest should be investigated further in the context of online sexual solicitation.

The Impact of Neonatal Antibiotic Exposure on Atopic Sensitisation by the Age of 12 Months

Varhaislapsuuden antibioottialtistuksen vaikutus atooppiseen herkistymiseen 12 kuukauden ikään mennessä Bakteerien vaikutus terveyteen on merkittävä: ne ovat toisaalta hengenvaarallisten infektioiden aiheuttajia, mutta samanaikaisesti niiden läsnäolo on välttämätöntä terveen immuunipuolustuksen kehittymiseksi. Ensimmäisen elinvuoden aikana suoliston bakteerikanta on altis ulkoisten tekijöiden vaikutuksille. Varhaislapsuuden antibioottihoidolla voi olla tuhoisat seuraukset eri bakteerilajien suhteille, ja sen tiedetään altistavan erilaisille immuunivälitteisille sairauksille, kuten atopialle. Ei ole kuitenkaan selvitetty, onko tämä vaikutus johtunut käynnissä olevan infektion aiheuttamista muutoksista kehittyvään immuunijärjestelmään vai onko siihen ollut syynä infektioon aloitettu antibioottihoito. Tässä tutkimuksessa selvitettiin eroja kahden, varhaista antibioottihoitoa saaneen ryhmän välillä ja päätetapahtumaksi katsottiin myöhemmin lapsuudessa ilmenevä atopiataipumus. Toinen ryhmä sai antibioottihoitoa kliinisesti todistettuun bakteeri-infektioon (varhaiseen sepsikseen). Toinen ryhmä taas sai antibioottihoidon pelkästään infektioepäilyyn eli ns. empiirisen hoidon, joka lopetettiin alle viiden vuorokauden kuluessa kun katsottiin, ettei oireiden taustalla ollutkaan bakteeri-infektiota. Mukana vertailussa oli lisäksi ryhmä, joka ei saanut lainkaan varhaista antibioottihoitoa. Antibioottihoidon pitkäaikaisvaikutusta arvioitiin ihon prick-testillä, joka kertoo atopiaan liittyvästä IgE-välitteisestä herkistymisestä. Varhaisella antibioottihoidolla tarkoitetaan tässä alle 72 tunnin sisällä syntymästä alkanutta hoitoa G-penisilliinin ja gentamysiinin yhdistelmällä. Tutkimuksen aineisto koostui 755 vastasyntyneen lapsen seurantadatasta, joka saatiin neljän käynnissä olevan allergian ehkäisytutkimuksen aineistosta. Tutkimuksen mukaanottokriteereinä pidettiin sitä, että saatavilla oli tiedot sekä mahdollisen antibioottialtistuksen kestosta että ihon prick-testituloksesta joko 6 tai 12 kuukauden iässä. Tulokset analysoitiin logistisella regressioanalyysillä huomioiden mahdolliset sekoittavat tekijät: äidin allergia, ennenaikaisuus, tutkimusprobiootti, imetyksen kesto, äidin raskauden aikainen tupakointi ja synnytystapa. Potilasryhmässä, joka sai antibioottihoitoa ilman samanaikaista infektiota, nähtiin tilastollisesti merkittävästi vähemmän positiivisia prick-testituloksia verrattuna lapsiin, jotka eivät altistuneet antibiooteille. Tulos on merkittävä, sillä se osoittaa, että varhaisella antibioottihoidolla on kauaskantoisia vaikutuksia kehittyvään immuunijärjestelmään.

Perceptions of corporate social responsibility: A case study of the perceived contents and outcomes

CSR has been subject of broad debate and research over the decades and has gained attention recently. The purpose of this thesis is to find out how companies perceive CSR. In addition this thesis is researching what is CSR in Finnish companies, how do companies measure CSR, what are the effects of CSR and how companies perceive those effects and what actors and factors support CSR. This research is a case study where altogether nine informants from seven companies were interviewed. This research is qualitative case study implemented with theme interviews. The analysis method is content analysis. Several interesting issues emerged from the empirical findings. CSR is playing pivotal role in companies values, vision and mission. CSR was perceived differently in companies but also mutual points emerged. The role of stakeholders is essential in CSR. In addition the communication with stakeholders was seen very important. Companies perceived that they can gain many benefits when acting responsibly for instance in issues related to cost reduction, reputation and personnel. However measuring these effects from CSR point of view was seen challenging. Other CSR related challenges are for example change and lack of resources. When considering empirical findings from a theoretical point of view, three interesting issues emerged. CSR reports play an important role in measuring and developing of CSR. However, this is not the case with all companies and some of them argued that reporting has too much attention nowadays when talking about CSR. The benefits of CSR are mostly related to responsive CSR. However maybe in a long-term follow-up strategic CSR related competitive advantage benefits could be more easily noticed. Many different issues supported CSR. Some issues are driven by outside of companies like NGO`s and media and some inside like the motivation of personnel and management. Vastuullista liiketoimintaa on tutkittu vuosien saatossa laajalti ja se on saanut viime vuosina erityisen paljon huomiota. Tämän pro gradu –tutkielman tavoitteena on selvittää, miten yritykset kokevat vastuullisen liiketoiminnan. Tämän lisäksi tutkimuksessa selvitetään, mitä vastuullinen liiketoiminta suomalaisissa yrityksissä tarkoittaa, miten yritykset mittaavat omaa vastuullisuuttaan, mitkä ovat vastuullisuuden vaikutukset, miten yritykset kokevat vastuullisuuden vaikutukset ja mitkä tekijät tukevat vastuullisen liiketoiminnan syntyä. Tutkimus toteutettiin haastattelemalla yhdeksää suomalaisen yrityksen yritysvastuusta vastaavaa tai sen kanssa työskentelevää henkilöä seitsemästä eri organisaatiosta loppuvuodesta 2014 ja alkuvuodesta 2015. Tutkimus on laadullinen, teemahaastatteluilla toteutettu haastattelututkimus. Aineisto on analysoitu teemoittain. Tutkimusaineiston perusteella vaikuttaa siltä, että vastuullinen liiketoiminta on tärkeässä roolissa yritysten arvoissa, visiossa ja missiossa. Yritysvastuu koettiin yrityksissä erilailla, mutta myös yhtäläisyyksiä on nähtävissä. Sidosryhmien rooli on erittäin tärkeä yritysvastuusta puhuttaessa ja myös kommunikointi sidosryhmien kanssa nousi tärkeäksi aiheeksi. Yritykset kokivat saavuttavansa monia hyötyjä vastuullisesta toiminnasta kuten kustannussäästöihin, maineeseen ja työntekijöihin liittyvissä asioissa. Näiden hyötyjen mittaaminen yritysvastuun näkökulmasta koettiin kuitenkin haasteelliseksi. Muita vastuullisuuteen liittyviä haasteita olivat esimerkiksi siihen liittyvä muutos sekä niukat resurssit. Tutkimuksen johtopäätöksistä nousi esille kolme merkittävää seikkaa. Vastuullisuusraportoinnin koettiin olevan hyödyllinen yritysvastuun mittaamisessa ja kehittämisessä. Kaikki yritykset eivät kuitenkaan olleet tätä mieltä ja osa koki raportoinnin saavan liian paljon huomiota nykypäivänä. Yritysten kokemat hyödyt vastuullisuuteen liittyen syntyivät pääosin reaktiivisesta vastuullisuudesta. Tässä kohdin on kuitenkin huomionarvoista mainita, että strategisen vastuullisuuden hyödyt olisivat saattaneet nousta paremmin esille pidemmän aikavälin tutkimuksessa. Yritysvastuun syntyä tukevia tekijöitä löytyi monia. Osa tekijöistä oli yrityksen ulkopuolisia kuten kansalaisjärjestöt ja media ja jotkut taas kumpusivat yrityksen sisältä esimerkiksi työntekijöiden ja johdon motivaatio.