11 resultados para Perinatal Outcomes
em Doria (National Library of Finland DSpace Services) - National Library of Finland, Finland
Resumo:
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.
Resumo:
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.
Resumo:
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.
Resumo:
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.
Resumo:
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.
Resumo:
Bipolar disorder (BPD) is a severe mental disorder associated with considerable morbidity and mortality. Prenatal insults have been shown to be associated with later development of mental disorders and there is a growing interest in the potential role of prenatal and perinatal risk factors in the development of BPD. The aims of this thesis were to describe the overall study design of the Finnish Prenatal Study of Bipolar Disorders (FIPS-B) and demographic characteristics of the sample. Furthermore, it was aimed to examine the association of parental age, parental age difference, perinatal complications and maternal smoking during pregnancy with BPD. This thesis is based on FIPS-B, a nested case-control study using several nationwide registers. The cases included all people born in Finland between January 1st 1983 and December 31st 1998 and diagnosed with BPD according to the Finnish Hospital Discharge Register (FHDR) before December 31st 2008. Controls for this study were people who were without BPD, schizophrenia or diagnoses related to these disorders, identified from the Population Register Centre (PRC), and matched two-fold to the cases on sex, date of birth (+/- 30 days), and residence in Finland on the first day of diagnosis of the matched case. Conditional logistic regression models were used to examine the association between risk factors and BPD. This study included 1887 BPD cases and 3774 matched controls. The mean age at diagnosis was 19.3 years and females accounted for 68% of the cases. Mothers with the lowest educational level had the highest odds of having BPD in offspring. Being born in Eastern and Southern region of Finland increased the odds of having BPD later in life. A U-shaped distribution of odds ratio was observed between paternal age and BPD in the unadjusted analysis. Maternal age and parental age difference was not associated with BPD. Birth by planned caesarean section was associated with increased odd of BPD. Smoking during pregnancy was not associated with BPD in the adjusted analyses. Region of birth and maternal educational level were associated with BPD. Both young and old father’s age was associated with BPD. Most perinatal complications and maternal smoking during pregnancy were not associated with BPD. The findings of this thesis, considered together with previous literature, suggest that the pre- and perinatal risk factor profile varies among different psychiatric disorders.
Resumo:
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.