Viisi vuotta tiedonrakentamista yhteisö- ja teknologiaelementtien muovautumisen näkökulmasta

The object of this study was to examine the phenomena of a long-term Knowledge Building process. The subject was OECD/ENSI/FI-project's Knowledge Building in Knowledge Forum®3.4 environment from 8.9.2000 to 8.9.2005. Research was based on socio-cognitive and socio-cultural learning approaches and the theoretical background consisted of models of collaborative learning and knowledge processing. These theoretical applications were first structured using metaphors of language and then assembled into five main theoretical motifs. The main motifs were 1) context, 2) inter-subjective, shared area, 3) community's practices and participation, 4) developing expertise and 5) the sequential construction of processes. These themes were assembled in interpreting the results using the Mutual Shaping of Technological and Social Elements by Boczkowski (1999) as a conceptual tool. The social elements of the mutual shaping process were defined as 1) community structure, 2) discourse and 3) the meanings of activity. The technological elements were defined as 1) shared artefacts, 2) features of technology-use and 3) other technological conventions perceived in activity. The five main theoretical motifs were used as the basis for creating the research problems, which were divided into three themes: 1) shared artefacts, themes of Knowledge Building and participant formation, 2) patterns of participation and interaction and 3) the meanings of activity. As methods I used content analysis of the messages, the quantitative profiling of changes in the database, social network analysis, discourse analysis of selected message threads and theme interviews of eleven participants. Based on my study it's possible to say, that a long-term setting of this kind provides a different perspective on Knowledge Building from most of the previous research. The most valuable conclusions from the data are: 1) The centralisation of interaction in this type of setting is a feature that supports the improvement in the quality of action. 2) The participation in a long-term Knowledge Building process seems to support the concious effort on professional development and the expert-identity. 3) The quality of plasticity of the technology-in-use has implication for how the communal features of activity will develop. The agency is seen to initiate processes that in turn open up new possibilities for the quality of action on both the communal and individual levels.

Saako terveysuskoja synninpäästön? : Naispappien käsityksiä laihdutus- ja terveyskulttuurista nykyisessä mediayhteiskunnassa

Background and aims. Fatness and dieting have been the object of interest between many fields for a long time. Home economics as a discipline enables a comprehensive inspection of fatness and dieting reviewing different disciplines. In addition to the aspect where the pursuit of dieting and health is seen from the perspective of medical and health science it is also been reviewd as a social and cultural phenomena. This study contemplates the influence of history, religion, medicalization and media on dieting and health culture. The objective is to find out if the modern dieting and health culture has gathered influences from centuries ago and absorbed religious features. The stress deriving from appereance has been discussed in the public and there are many solutions conserning weight issues. The purpose of this study is to find out what personal experiences and thoughts female pastors have conserning these questions. The media – which is one of the most influential systems nowadays – has undeniably a great effect on the consumer. The goal is furthermore to estimate the effect of the media on the changing of dieting and health culture. The three main research questions are: 1. What kind of conseptions do female pastors have of dieting and health culture and of its religious features? 2. What kind of personal experiences and conseptions do female pastors have of dieting and strivines of health? 3. How do female pastors regard the image the media has supplied of dieting and health culture? Material and methods. The qualitative data was gathered in year 2009 using the halfstructured theme interview -method. The data consists of interviews conducted with specialists of spiritual matters, i.e. ten female pastors who are between 35 and 60 years old and live in the metropolitan area. The analytical procedure used is called a theory based context analysis. Results and conclusions. Results of this study show that the idealization of slimness and healthiness is a matter discussed in the public on a daily basis. The problem faced was that the media provided contradictory information regarding fatness and dieting and the standard of slimness in commercials focused on females. The pursuit of dieting and healthiness was believed to include also religious elements. In the Middle Ages and the era after that the fatness, overeating and the pleasure one gets from eating was still seen as a condemnable matter in our culture. One could say this was like a sin. The respondents believed that healthiness, healthy living, optimal eating and good looks were a matter more or less equal than a religion. This was a derivative from the fact that treasuring health has become a life stearing value for many people. In the priest’s profession dieting and the pursuit of health was seen in the light of problems arising from weight issues. In ones profession for example the unhealthy eating in festive situations was seen as a matter that leads to unnecessary weight. Another aspect was the job circumstances that limited the degree of movement. The belief was that the female pastors would in a decreasing fashion confront stress deriving from appearence in their job. Keywords: dieting, fatness, healthiness, slimness, female pastors, religion, medicalization, media

Pyhä Kolminaisuus vai pilven reunalla istuva partasuu? : Jumalakuva evankelisluterilaisissa ja ortodoksissa 1.–4.-luokan uskonnon oppikirjoissa 1970–80- ja 2000-luvuilla

A concept of god is a wholeness that an individual experiences as God. The Christian concept of god is based on triune God: Father, Son, and the Holy Spirit. The concept of god is examined in different kinds of contexts particularly between the 1940's and the 1970's. Many researches of school books have widely been made in Finland, but, however, only a few from the point of view of the concept of god. Considering this, the concept of god in the school books of Evangelical Lutheran and Orthodox religion from first to fourth grade in 1970–80 and 2000 is examined in this survey. Additionally, the concept of god in curricula between years 1970 and 2004 is studied. The perspective on the concept of god is the change in the course of time and denominational emphasis. As a first hypothesis, God the Father is represented in books in 21st century as a kind and loving figure. As a second hypothesis, the Trinity and the Holy Spirit get more space in Orthodox books comparing with the Lutheran books. Twelve school books of Evangelical Lutheran and Orthodox religion from first to fourth grade were used as a research material. The books were from four different series between the years 1978 and 2005. Teacher's guidebooks and student's exercise books were left outside of this survey. The research material was analyzed by using abductive content analysis and methodological triangulation. This study included both qualitative and quantitative aspects. The classification system which defined the classifying of concept of god from the research material was consisted of the basis of research material, former reseach, and subtext of used theories. The number of mentions in concept of god was higher in books from the 21st century. In Lutheran books, the change was seen as a growth of the category of God the Father. In Orthodox books, the trend was opposite: the category of Jesus the Son had grown. Differing from the presupposition, the features of loving God in new books had less emphasis than in older books in both churces. The mentions of the Holy Spirit and Trinity were marginal. In the Orthodox books, the categories were bigger, as it was presupposed. It could be seen, that the books confirmed the legalistic period of the concept of god on 3rd and 4th grades. The mentions of concept of god in curriculas have diminished and generalized. The diminution was seen most radically in the curriculum from the year 1994. The results tell something about social changes and views of innovation in curricula. In books the change was not perceived that bright. The idea of the concept of god getting shrank and decreased during the time can be refused.

"Monesti on tullut ajateltua, että ihana, kamala kakara!" : Huomioidaanko päiväkodissa kansainvälisesti adoptoituun lapseen ja adoptioon liittyviä erityispiirteitä?

The purpose of this study was to examine the conceptions adoptive parents and kindergarten teachers have of adopted children in day care. Earlier Finnish research concerning international adoption has discussed adoption, adopted children and adoptive parents from the point of view of identity, racism and school. There has hardly been any research in Finland concerning adoption from the point of view of day care. The study focuses on how the special characteristics of adopted children are taken into consideration in day care. The ecological theory, in which a child's growth and learning environments are studied as part of the broader environment, provided the theoretical framework for the study. The study was based also on a second theory: intercultural competence or the capacity to interact with different people taking into consideration their individual characteristics and situations so that one understands and is understood. The first research problem consisted of describing the conceptions adoptive parents and day care teachers have of the special characteristics of adopted children. The second research problem was to examine adopted parents' expectations of kindergarten and of kindergarten teachers. The third research problem was to find out what kind of support day care teachers think they need when working with adopted children. The study focused on 20 adoptive parents and 15 kindergarten teachers. Research material was collected in the form of essay writings amounting to a total of 73 pages. The respondents wrote about their experiences with the help of a supporting questionnaire. The research method was qualitative and narrative. The results of the study show that adoptive parents have similar conceptions of adopted children's special characteristics concerning their character, social competence, adaptation and appearance. Adoptive parents had a better understanding of the dynamics of attachment than kindergarten teachers, in this study. When describing the special characters of adopted children, the teachers regarded adopted children in particular as needing special support. According to the results of the study, adoptive parents feel adoption matters and adoptive parenthood are something quite new and bewildering to day care teachers. Adoptive parents did not feel they got any support from the kindergarten in their parenthood. Adoptive parents regarded as particularly important the start of day care and the familiarisation process during which adopted children need time and special support due to earlier experiences of separation and abandonment. The findings of the study show that kindergarten teachers have little knowledge of adoption and the significance of adoption for a child's growth and development. Kindergarten teachers felt at a loss in dealing with adoption issues and clearly need additional support in the matter.

"Sitte se menee koulus" : Eri kieli- ja kulttuuritaustaisen lapsen suomen kielen taito esiopetuksen päättövaiheessa

A child learns new things, creates social relationships and participates in play with the help of language. How can a child overcome these challenges if the surrounding language is not his mother tongue? The objective of learning a new language in the Pre-school education is an active bilingualism in all fields of the language. Theoretical context of the research rises from bilingualism, learning a language, language skills and evaluating them. Object of the research was to understand language skills of a child from a different linguistic and cultural background in the final stage of Pre-school education and to clarify how learning Finnish was supported during the Pre-school year. Answers to the research issues will be searched with the following questions: 1) What kind of language skills does a child from a different linguistic and cultural backgrounds have at the final stage of Pre-school education?, 1.1) What kind of listening comprehension skills?, 1.2) What kind of speech and vocabulary skills?, 1.3) What kind of structural skills?, 2) What kind of individual differences are there in language skills of children from different linguistic and cultural backgrounds?, and 3) How has a child from a different linguistic and cultural background been supported in learning Finnish during the Pre-school education? The view of language skills in this research is holistic even though it will be analysed in separate fields. The aim of this research is to form an overall impression of Finnish skills of the children participating in the research. Eight Pre-school-aged children with different linguistic and cultural backgrounds and their kindergarten teachers participated in this research. The children had taken part in Finnish activities for about three years. The research material consists of the test series (KITA), which evaluate children’s language skills – and of the questionnaire to the kindergarten teachers. The purpose of the questionnaire was to provide additional information on children’s language skills in Pre-school teaching situations and on supporting Finnish in Pre-school education. This research is qualitative and processing of the material is based on content analysis. According to the kindergarten teachers, the children’s social language skills were sufficient to cope in everyday life but children needed assistance with longer instructions. The same phenomenon could also be seen with the KITA tests – in which long and abstract instructions turned out to be difficult. Individual differences of the children were perceived in productivity skills, which were realised in fluent or influent speech. The children were supported in learning Finnish individually, in small-groups and in the activities of a whole group. ‘Finnish as the second language’ small-groups were the most common form of support in learning the language. The support at understanding activities was emphasized in whole group situations as well as in individual situations while assisting the child’s language skills. Generally, the children’s language skills were in the same level with developing basic language skills. The data of this research help to understand children’s language skills after three years of adopting Finnish. The results can be utilised in planning and evaluation of teaching another language.

Käsityötä, kotiteollisuutta ja sosiaalihuoltoa : Työtupa Aunuksessa 1941-1944

When Finland occupied East Karelian territories in Soviet Union during The Continuation War (1941 1944) Finnish people had also to take care of the inhabitants of the occupied East Karelia. For example there was a lack of clothes and shoes during the wartime. In order to facilitate clothing situation and to provide more opportunities to work for women, Finnish people founded some workshops in East Karelia. Workshops also helped to collect East Karelian craft products. One of the workshops was founded in the city of Olonets in October 1941 and it was in operation until June 1944. This workshop is the subject of this thesis. The aim of this thesis is to find out with the microhistorical approach what kind of functions the workshop of Olonets had during The Continuation War and who worked in the workshop. In this thesis I also examine women s crafts in the Olonets workshop and their meaning during the wartime. I collected the material of this thesis from different places. In February 2010 I interviewed Talvikki Lausala, the leader of the Olonets workshop, who worked in the Olonets from May 1942 to June 1944. From the Virkki Käsityömuseo I looked for objects which have been made in the workshop of Olonets. Tyyne-Kerttu Virkki collected crafts from the East Karelia when she was working in the area and in the workshop from 1941 to 1944. Archive material I found from the Finnish National archive and from the archive of the Tyyne-Kerttu Virkki -Foundation. East Karelian women and girls who were not able to do anything else came to work in the Olonets workshop. If women could not go to work outside of home, they had an option to do the same crafts at home. There were three Finnish women, Tyyne-Kerttu Virkki, Talvikki Lausala and Sofi Nyrkkö, who worked and led in the workshop of Olonets. In addition to the workshop, there was a dress maker s atelier in which clothes were made to order and soldiers uniforms were repaired, a small museum and a shop to sell products of the workshop. Craft products were also exported to Finland. Courses were organized in which Finnish women taught East Karelian crafts.

Näppärien mummojen muistelukirjonta - yhteisöllistä ja voimauttavaa käsityöilmaisua

The aim of the study was to get acquainted with the activity of Näppärät Mummot, a Lahti-based crafts society, and its importance to the wellness of the members of the group. The selected aim, i.e., analyzing the wellness, largely affected the whole research process and its results. According to earlier studies in the field, different forms of craft and expressional activity promote one's wellness as well as support the work for one's identity. Based on my theoretical knowledge, my research was set out to: 1) form a general view of crafts culture within Näppärät Mummot and 2) find out how recollective craft that promotes wellness is perceived through communality, experiential activity, work for one's identity, and divided as well as undivided craft. Qualitative field work was governed by ethnographic research strategy, according to which I set out to get thoroughly familiar with the society I was studying. The methods I used to collect data were participant observation and thematic interview. I used a field diary for writing down all data I acquired through the observation. The interviewee group was formed by seven members of Näppärät Mummot. An mp3 recorder was used to record the interviews, which I transcribed later. The method for data analysis was qualitative content analysis, for which I used Weft QDA, a qualitative analysis software application. I formed themes that shed light on research tasks from the data using coding and theory-driven analysis. I kept literature and data I collected in cooperation through the whole analysis process. Lastly, drawing from the classes of meaning of therapeutic craft that I sketched by means of summarizing and classifying, I presented the central concepts that describe the main results of the study. The main results were six concepts that describe Näppärät Mummot's crafts culture and recollective craft with its wellness-beneficial effect: 1) autobiographical craft, 2) shared work for one's identity, 3) shared intention for craft, 4) craft as a partner, 5) individual manner of craft, and 6) shared improvement. Craft promoted wellness in many ways. It was used to promote inner life management in difficult times and it also provided sensations of empowerment through pleasure from craft. Expressional, shared craft also served as means of reinforcing one's identity in various ways. Expressional work for one's identity through autobiographical themes of craft represented rearranging one's life through holistic craft. A personal way of doing things also served as expressional action and work for one's identity even with divided craft. Shared work for identities meant reinforcing the identities of the members through discources of craft and interaction with their close ones. What proves the interconnection between communality and craft as well as their shared meaning is that communality motivated the members to work on their craft projects, while craft served as the means of communication between the members: communication through craft was easier than lingual communication. The results can not be generalized to apply to other groups: they are used to describe the versatile means of recollective craft to promote the well-being among the crafts society Näppärät Mummot. However, the results do introduce a new perspective to the social discussion on how cultural activities promote well-being.

Verkko-opetuksen arvot ja arviointi helsinkiläisten luokanopettajien näkökulmasta

Tutkimuksen päätarkoitus oli hahmottaa verkko-opetuksen arvoja ja arviointia luokanopettajan näkökulmasta. Teoreettisena viitekehyksenä oli mediakasvatus ja didaktiikan käsitys opetus opiskelu oppimisprosessista. Didaktisena perustana käytettiin Kansasen ym. (2000) opettajan pedagogista ajattelua, Lahdeksen (1997) didaktiikan kehämallia sekä Uljensin (1997) opetus opiskelu oppimisprosessia. Lähtökohtana oli luokanopettajan arvioinnin kautta pohtia opetuksen, opiskelun ja oppimisen sekä tieto- ja viestintätekniikan yhtymistä koulukontekstissa. Tutkimuksen pääongelmat olivat: 1) Minkälainen oli luokanopettajan käsitys verkko-opetuksen toteuttamisesta? 2) Miten luokanopettaja arvioi verkko-opetusta? Myös ensimmäistä pääongelmaa lähestyttiin arvojen ja arvioinnin näkökulmasta. Menetelmänä käytettiin teemahaastattelua. Teemahaastattelun teemoja jäsennettiin Gallinin (2001) sosiokulttuurisen verkko-opetuksen arviointimallin sekä Tellan ja Mononen-Aaltosen (2001) mediakasvatuksen monitasomallin avulla. Aineistonkeruussa kahdeksan helsinkiläistä luokanopettajaa vastasivat lyhyeen kyselyyn, jonka jälkeen heitä haastateltiin välittömästi. Laadullisen aineiston analyysissä teemoiteltiin aineisto, ja tämän rinnalla rakennettiin aineistolähtöistä analyysiä. Näiden vuorovaikutuksesta syntyivät tutkimuksen johtopäätökset. Keskeisinä tuloksina tutkimuksessa nähtiin luokanopettajan verkko-opetukseen liittyvien arvojen kaksi eri näkökulmaa: (A) opetus opiskelu oppimismenetelmien ja -tulosten arvonäkökulma sekä (B) ns. kasvatuksellinen ja koulukulttuurin arvonäkökulma. Arvonäkökulmien pohjalta hahmotettiin johtopäätöksissä erilaisia tasoja luokanopettajan opetuksen, opiskelun ja oppimisen arvioinnista, kun tieto- ja viestintätekniikka on mukana prosessissa. Kaksi tasoa tarkennettiin verkko-opetuksen arvioinnin fokuksiksi, jotka olivat (1) teknologinen ja (2) tavoitteinen fokus. Teknologisessa arvioinnin fokuksessa (1) arviointia hallitsee huoli oppilaasta ihmisenä. Arviointi liittyy joko siihen, että oppilaan on opittava perustaidot tieto- ja viestintätekniikassa ja ymmärrettävä Internetin mahdollisuudet, tai siihen, että opettaja pyrkii suojelemaan lapsia Internetin uhkilta ja liialliselta altistumiselta esimerkiksi digitaalisille peleille. Verkko-opetuksen tavoitteinen arvioinnin fokus (2) nojaa siihen, minkälaisia tavoitteita luokanopettaja yleisesti asettaa opetukselleen, vaikka tieto- ja viestintätekniikka ei liittyisikään prosessiin. Fokuksen taustalla on myös mediakasvatuksen näkökulma tieto- ja viestintätekniikan opetuskäyttöön, jolloin keskeistä on, että opetuksen suunnittelu ja arviointi ei lähde teknologiasta käsin vaan didaktiikasta ja peda-gogisista arvoista. Verkko-opetuksen arvioinnin fokusten voidaan nähdä täydentävän toisiaan. Fokusten varioinnissa voidaan puhua luokanopettajan kohdalla todellisesta mediataidosta, joka ulottuu yli ammatillisen pätevyyden aina opettajan henkilökohtaiseen kehittymisen kaareen. Avainsanat: Verkko-opetus, arvot, arviointi, opetus-opiskelu-oppimisprosessi, opettajan pedagoginen ajattelu, tieto- ja viestintätekniikan opetuskäyttö Keywords: Network-Based Education (NBE), values, evaluation, teaching-studying-learning process, teacher's pedagogical thinking, educational use of information and communication technologies (ICT)

Sopimusohjaus ohjausmenettelynä sairaanhoitopiirin ja terveyskeskusten yksiköissä ja niiden lääkärien työssä

This study concerns the implementation of steering by contracting in health care units and in the work of the doctors employed by them. The study analyses how contracting as a process is being implemented in hospital district units, health centres and in the work of their doctors, as well as how these units carry out their operations and patient care within the restrictions set by the contracts. Based on interviews with doctors, the study analyses the realisation of operations within the units from the doctors perspective and through their work. The key result of the study is that the steering impact of contracting was not felt at the level of practical work. The contracting was implemented by assigning the related tasks to management only. The management implemented the contract by managing their resources rather than by intervening in doctors activities or the content of their tasks. The steering did not extend to improving practical care processes. This allowed the unchanged continuation of core operations in an autonomous manner and in part, protected from the impacts of contracting. In health centres, the contract concluded was viewed as merely steering the operations of the hospital district and its implementation did not receive the support of the centres. The fact that primary health care and specialised health care constitute separate contracting parties had adverse effects on the contract s implementation and the integration of care. A theoretical review unveiled several reasons for the failure of steering by contracting to alter operations within units. These included the perception steering by contracting as a weak change incentive. The doctors shunned the introduction of an economic logic and ideology into health care and viewed steering by contracting as a hindrance to delivering care to patients and a disturbance to their work and patient relationships. Contracting caused tensions between representatives of the financial administration and health care professionals. It also caused internal tensions, while it had varying impacts on different specialities, including the introduction of varying potential to influence contracts. Most factors preventing the realisation of the steering objective could have been ameliorated through positive leadership. There is a need to bridge the gap between financial steering and patient work. Key measures include encouraging the commitment of middle management, supporting leadership expertise and identifying the right methods of contributing to a mutual understanding between the cultures of financing, administration and health care. Criticism of the purchasers expertise and the view that undersized orders are due to the purchaser s financial difficulties underlines the importance of the purchaser s size. Overly detailed, product-based contracts seemed to place the focus on the quantities and costs of services rather than health impacts and efficiency of operations. Bundling contracts into larger service packages would encourage the enhancement of operations. Steering by contracting represents unexploited potential: it could function as a forum for integrated regional planning of services, and the prioritisation and integration of care, and offer an opportunity and an incentive for developing core operations.

Nicotine Dependence and Smoking Behaviour : A genetic and epidemiological study

The worldwide health burden caused by the tobacco epidemic highlights the importance of study-ing determinants of smoking behaviour and key factors sustaining nicotine dependence. Despite vast-ranging preventive efforts, smoking remains one of the most deleterious health behaviours, and its genetic and environmental factors warrant continuous investigation. The heritability of smoking behaviour and nicotine dependence has been suggested to be relatively high. Earlier smoking behaviour, nicotine dependence, socio-economic position and demographic factors have all been shown to be associated with smoking cessation. This thesis aimed to examine various aspects of smoking behaviour and nicotine dependence from an epidemiological and genetic per-spective. Data for Studies I and IV were obtained from the Older Finnish Twin Cohort, a postal health sur-vey conducted in 1975, 1981 and 1990 on same-sexed pairs and in 1996-1997 on male-female adult pairs. The number of ever-smoking participants was 8941 in Study I and 3069 in Study IV. Data for Studies II and III came from the Family Study of Cigarette Smoking - Vulnerability to Nicotine Addiction. This study is linked to the Older Finnish Twin Cohort with new data collec-tion during 2001-2006 that focused on smoking twin pairs and their family members. The meas-ures included intensive telephone interviews, blood samples and additional postal questionnaires. The numbers of ever-smoking participants was 1370 in Study II and 529 in Study III. Study I examined whether a genetic component underlies smoking behaviour among Finnish adults. Genetic factors were important in the amount smoked and smoking cessation, with about half of the phenotypic differences explained by genetic variance. A novel finding was that genetic influences on amount smoked and smoking cessation were largely independent of genetic influ-ences on age at initiation. This result has implications for defining phenotypes in the search for genes underlying smoking behaviour. Furthermore, even if smoking initiation is postponed to a later age, potential vulnerability to subsequent nicotine dependence cannot be completely inhib-ited. Study II investigated the effect of genetic and environmental factors on nicotine dependence, as measured by the novel multidimensional Nicotine Dependence Syndrome Scale (NDSS). This scale was validated in the Finnish data. The NDSS correlated highly with other established nico-tine dependence scales (FTND and DSM-IV), suggesting that this new scale would be a feasible and valid measure for identifying nicotine-dependent smokers among the ever-smoking popula-tion. About one-third of the phenotypic variation in nicotine dependence in this sample was ex-plained by genetic influences. Study III aimed at identifying chromosomal regions harbouring genes that influence smoking be-haviour and nicotine dependence. Linkage analysis of family data revealed that for smoker and nicotine dependence phenotypes as well as for co-morbidity between nicotine dependence and alcohol use signals on specific chromosome regions (chromosomes 2q33, 5q12, 5q34 7q21, 7q31, 10q25, 11p15, 20p13) exist. Results further support the hypothesis that smoking behaviour phe-notypes have a genetic background. Study IV examined associations of smoking behaviour, socio-economic position and transition of marital status with smoking cessation. Indicators of socio-economic position were important pre-dictors of smoking cessation even when adjusted for previous smoking behaviour. Getting married was associated with an increased probability of cessation in men, a finding confirmed among dis-cordant twin pairs. Thus, having a partner appears to have a positive impact on smoking cessation. In conclusion, nicotine dependence and smoking behaviour demonstrate significant genetic liabil-ity, but also substantial environmental influences among Finnish adults. Smoking initiation should be prevented or at least postponed to a later age. Although genetic factors are important in nicotine dependence and smoking behaviour, societal actions still have a primary role in tobacco control and smoking prevalence. Future studies should examine the complex interactions between genetic and environmental factors in nicotine dependence.

Associations among working conditions and behavioral risk factors : The Helsinki Health Study with International Comparisons

Adverse health behaviors as well as obesity are key risk factors for chronic diseases. Working conditions also contribute to health outcomes. It is possible that the effects of psychosocially strenuous working conditions and other work-related factors on health are, to some extent, explained by adverse behaviors. Previous studies about the associations between several working conditions and behavioral outcomes are, however, inconclusive. Moreover, the results are derived mostly from male populations, one national setting only, and with limited information about working conditions and behavioral risk factors. Thus, with an interest in employee health, this study was set to focus on behavioral risk factors among middle-aged employees. More specifically, the main aim was to shed light on the associations of various working conditions with health behaviors, weight gain, obesity, and symptoms of angina pectoris. In addition to national focus, international comparisons were included to test the associations across countries thereby aiming to produce a more comprehensive picture. Furthermore, a special emphasis was on gaining new evidence in these areas among women. The data derived from the Helsinki Health Study, and from collaborative partners at the Whitehall II Study, University College London, UK, and the Toyama University, Japan. In Helsinki, the postal questionnaires were mailed in 2000-2002 to employees of the City of Helsinki, aged 40 60 years (n=8960). The questionnaire data covered e.g., socio-economic indicators and working conditions such as Karasek s job demands and job control, work fatigue, working overtime, work-home interface, and social support. The outcome measures consisted of smoking, drinking, physical activity, food habits, weight gain, obesity, and symptoms of angina pectoris. The international cohorts included comparable data. Logistic regression analysis was used. The models were adjusted for potential confounders such as age, education, occupational class, and marital status subject to specific aims. The results showed that working conditions were mostly unassociated with health behaviors, albeit some associations were found. Low job strain was associated with healthy food habits and non-smoking among women in Helsinki. Work fatigue, in turn, was related to drinking among men and physical inactivity among women. Work fatigue and working overtime were associated with weight gain in Helsinki among both women and men. Finally, work fatigue, low job control, working overtime, and physically strenuous work were associated with symptoms of angina pectoris among women in Helsinki. Cross-country comparisons confirmed mostly non-existent associations. High job strain was associated with physical inactivity and smoking, and passive work with physical inactivity and less drinking. Working overtime, in turn, related to non-smoking and obesity. All these associations were, however, inconsistent between cohorts and genders. In conclusion, the associations of the studied working conditions with the behavioral risk factors lacked general patters, and were, overall, weak considering the prevalence of psychosocially strenuous work and overtime hours. Thus, based on this study, the health effects of working conditions are likely to be mediated by adverse behaviors only to a minor extent. The associations of work fatigue and working overtime with weight gain and symptoms of angina pectoris are, however, of potential importance to the subsequent health and work ability of employees.

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.