Classification, comorbidity, heredity, and risk factors of female sexual dysfunctions

Female sexual dysfunctions, including desire, arousal, orgasm and pain problems, have been shown to be highly prevalent among women around the world. The etiology of these dysfunctions is unclear but associations with health, age, psychological problems, and relationship factors have been identified. Genetic effects explain individual variation in orgasm function to some extent but until now quantitative behavior genetic analyses have not been applied to other sexual functions. In addition, behavior genetics can be applied to exploring the cause of any observed comorbidity between the dysfunctions. Discovering more about the etiology of the dysfunctions may further improve the classification systems which are currently under intense debate. The aims of the present thesis were to evaluate the psychometric properties of a Finnish-language version of a commonly used questionnaire for measuring female sexual function, the Female Sexual Function Index (FSFI), in order to investigate prevalence, comorbidity, and classification, and to explore the balance of genetic and environmental factors in the etiology as well as the associations of a number of biopsychosocial factors with female sexual functions. Female sexual functions were studied through survey methods in a population based sample of Finnish twins and their female siblings. There were two waves of data collection. The first data collection targeted 5,000 female twins aged 33–43 years and the second 7,680 female twins aged 18–33 and their over 18–year-old female siblings (n = 3,983). There was no overlap between the data collections. The combined overall response rate for both data collections was 53% (n = 8,868), with a better response rate in the second (57%) compared to the first (45%). In order to measure female sexual function, the FSFI was used. It includes 19 items which measure female sexual function during the previous four weeks in six subdomains; desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain. In line with earlier research in clinical populations, a six factor solution of the Finnish-language version of the FSFI received supported. The internal consistencies of the scales were good to excellent. Some questions about how to avoid overestimating the prevalence of extreme dysfunctions due to women being allocated the score of zero if they had had no sexual activity during the preceding four weeks were raised. The prevalence of female sexual dysfunctions per se ranged from 11% for lubrication dysfunction to 55% for desire dysfunction. The prevalence rates for sexual dysfunction with concomitant sexual distress, in other words, sexual disorders were notably lower ranging from 7% for lubrication disorder to 23% for desire disorder. The comorbidity between the dysfunctions was substantial most notably between arousal and lubrication dysfunction even if these two dysfunctions showed distinct patterns of associations with the other dysfunctions. Genetic influences on individual variation in the six subdomains of FSFI were modest but significant ranging from 3–11% for additive genetic effects and 5–18% for nonadditive genetic effects. The rest of the variation in sexual functions was explained by nonshared environmental influences. A correlated factor model, including additive and nonadditive genetic effects and nonshared environmental effects had the best fit. All in all, every correlation between the genetic factors was significant except between lubrication and pain. All correlations between the nonshared environment factors were significant showing that there is a substantial overlap in genetic and nonshared environmental influences between the dysfunctions. In general, psychological problems, poor satisfaction with the relationship, sexual distress, and poor partner compatibility were associated with more sexual dysfunctions. Age was confounded with relationship length but had over and above relationship length a negative effect on desire and sexual satisfaction and a positive effect on orgasm and pain functions. Alcohol consumption in general was associated with better desire, arousal, lubrication, and orgasm function. Women pregnant with their first child had fewer pain problems than nulliparous nonpregnant women. Multiparous pregnant women had more orgasm problems compared to multiparous nonpregnant women. Having children was associated with less orgasm and pain problems. The conclusions were that desire, subjective arousal, lubrication, orgasm, sexual satisfaction, and pain are separate entities that have distinct associations with a number of different biopsychosocial factors. However, there is also considerable comorbidity between the dysfunctions which are explained by overlap in additive genetic, nonadditive genetic and nonshared environmental influences. Sexual dysfunctions are highly prevalent and are not always associated with sexual distress and this relationship might be moderated by a good relationship and compatibility with partner. Regarding classification, the results supports separate diagnoses for subjective arousal and genital arousal as well as the inclusion of pain under sexual dysfunctions.

Ja vet int va de heter på svenska : interaktion mellan tvåspråkiga elever och deras lärare i en enspråkig klassrumsdiskurs

This is a study about language and learning aspects in the interaction between pupils and teachers in classrooms, where the majority of the pupils are bilingual. The aim of the dissertation is to develop the understanding of interactional learning possibilities and constraints in relation to a bilingual context. Language related learning is used as an overall conception which covers learning related to classroom discourse, language and subject. The empirical study has been made in a Swedish speaking school in a strongly Finnish dominated environment in the south of Finland. In the material, mainly consisting of video recorded lessons in forms one to three, the interaction between the pupils and the teachers is analysed. Building on a social constructionist perspective, where learning is regarded as a social phenomenon, situated and visible in changing participation, sequences where pupils or teachers make the language relevant are emphasised. The sequences are analysed in line with the conversation analytic (CA) approach. A fundamental result is an understanding of a monolingual classroom discourse, jointly constructed by teachers and pupils and visible in the pupils' interactionally problematized code-switching. This means that the pupils are not victims of a top-driven language policy; they are active co-constructors of the monolingual discourse. Through different repair initiations the pupils are doing interactional work in positioning themselves correctly in the monolingual discourse, which they simultaneously maintain. This work has a price in relation to time, knowledge and exactness. The pupils' problematized code-switching is often directly and shortly repaired by the teachers. This kind of repair promotes the pupils' participation and is not, as opposed to the results of research in everyday talk, dispreferred in pupil-teacher talk. When the pupils use the possibility to, in a comparatively easy way, participate and thus express their knowledge through codeswitching, and simultaneously talk a monolingual discourse into being, the teacher can, through direct repair, show an understanding in regard to the content, facilitate language learning and simultaneously confirm the pupils as competent speakers and bilingual individuals. Furthermore, significant results show that the monolingual norm has a function of a contrasting background which gives the pupils and the teachers a possibility to use language alternation as a functional and meaningful activity. The pupils use codeswitching as a way of protesting or expressing non-participation in the classroom talk. By making the pupils' bilingualism relevant, the teachers express understanding and empathy and encourage the pupils' participation in the classroom talk. Bilingualism is a nonpreferred, but functioning, resource in the interaction between pupils and teachers.

Marketing culture of Finnish research libraries : an analysis of marketing attitude, knowledge and behaviour

The aim of the present dissertation is to investigate the marketing culture of research libraries in Finland and to understand the awareness of the knowledge base of library management concerning modern marketing theories and practices. The study was based onthe notion that a leader in an organisation can have large impact on its culture. Therefore, it was considered important to learn about the market orientation that initiates at the top management and flows throughout the whole organisationthus resulting in a particular kind of library culture. The study attempts to examine the marketing culture of libraries by analysing the marketing attitudes, knowledge (underlying beliefs, values and assumptions), behaviour (market orientation), operational policies and activities, and their service performance (customer satisfaction). The research was based on the assumption that if the top management of libraries has market oriented behaviour, then their marketing attitudes, knowledge, operational policies and activities and service performance should also be in accordance. The dissertation attempts to connect all these theoretical threads of marketing culture. It investigates thirty three academic and special libraries in the south of Finland. The library director and three to ten customers from each library participated as respondents in this study. An integrated methodological approach of qualitative as well as quantitative methods was used to gain knowledge on the pertinent issues lying behind the marketing culture of research libraries. The analysis of the whole dissertation reveals that the concept of marketing has very varied status in the Finnish research libraries. Based on the entire findings, three kinds of marketing cultures were emerged: the strong- the high fliers; the medium- the brisk runners; and the weak- the slow walkers. The high fliers appeared to be modern marketing believers as their marketing approach was customer oriented and found to be closer to the emerging notions of contemporary relational marketing. The brisk runners were found to be traditional marketing advocates as their marketing approach is more `library centred¿than customer defined and thus is in line of `product orientation¿ i.e. traditional marketing. `Let the interested customers come to the library¿ was appeared to be the hallmark of the slow walkers. Application of conscious market orientation is not reflected in the library activities of the slow walkers. Instead their values, ideology and approach to serving the library customers is more in tuneof `usual service oriented Finnish way¿. The implication of the research is that it pays to be market oriented which results in higher customer satisfaction oflibraries. Moreover, it is emphasised that the traditional user based service philosophy of Finnish research libraries should not be abandoned but it needs to be further developed by building a relational based marketing system which will help the libraries to become more efficient and effective from the customers¿ viewpoint. The contribution of the dissertation lies in the framework showing the linkages between the critical components of the marketing culture of a library: antecedents, market orientation, facilitators and consequences. The dissertationdelineates the significant underlying dimensions of market-oriented behaviour of libraries which are namely customer philosophy, inter-functional coordination,strategic orientation, responsiveness, pricing orientation and competition orientation. The dissertation also showed the extent to which marketing attitudes, behaviour, knowledge were related and impact of market orientation on the serviceperformance of libraries. A strong positive association was found to exist between market orientation and marketing attitudes and knowledge. Moreover, it also shows that a higher market orientation is positively connected with the service performance of libraries, the ultimate result being higher customer satisfaction. The analysis shows that a genuine marketing culture represents a synthesis of certain marketing attitudes, knowledge and of selective practices. This finding is particularly significant in the sense that it manifests that marketing culture consists of a certain sets of beliefs and knowledge (which form a specific attitude towards marketing) and implementation of a certain set of activities that actually materialize the attitude of marketing into practice (market orientation) leading to superior service performance of libraries.

Esimiehen ydinkompetenssit tuloksen ja työtyytyväisyyden selittäjänä – Case S-market

Työn tarkoituksena on kehittää suorittavalle esimiestasolle työkalu, millä voidaan mitata esimiehen kompetensseja. S-market esimiehen ydinosaamiset työssä jakautuvat kahteen kokonaisuuteen vuorovaikutus- ja ketjuyksikön johtamiseen. Työn tavoitteena on myös tarkastella millä esimiehen ydinosaamisella on merkitystä työtyytyväisyyteen ja yrityksen tulokseen. Tutkimus on kvantitatiivinen ja sen aineisto on verkkokyselylomakkeen avulla kerätystä 129 vastauksesta. Verkkokyselylomakkeen väittämät ovat rakennettu esimiestyön kompetensseista, jotka pohjautuvat tutkielman teoriaan. Verkkokyselyn, työtyytyväisyyden ja tuloksen lukuarvot on analysoitu tilastollisella tulostenkäsittelyohjelmalla, SPSS:llä. Työtyytyväisyystulokset ovat koottu tutkimukseen osallistuneen viidentoista S-marketin työtyytyväisyystutkimuksen tuloksista vuodelta 2008. Tuloksen mittareina tutkielmassa on käytetty samojen S-markettien työtehokkuutta ja toimintakateprosenttia vuodelta 2008. Työn tulokset vahvistivat sen, että esimiestyöllä on suora syy-seuraussuhde työtyytyväisyyteen ja tuloksellisuuteen. Tutkimustuloksien perusteella esimieskäyttämisen vaikutus työtyytyväisyyden kokemiseen on vahva. Hyvällä vuorovaikutusjohtamisella tuloksien perusteella oli vaikutusta työtyytyväisyyteen. Tuloksista kävi ilmi, että työtyytyväisyyteen esimiehen kompetensseista eniten vaikuttivat yksilöllinen huomiointi, tavoitteisiin kannustaminen ja motivointi sekä asiakaslähtöisyys. Tuloksen mittareihin eniten vaikutti tulos- ja tavoitejohtaminen. Tuloksellisuuteen vaikuttavat tutkimuksen mukaan esimiehen jämäkkä ja vaativa tavoitteisiin ohjaava toiminta sekä päätöksenteko ja organisointikyky. Tarkempien ja täsmällisimpien S-market esimiehen kompetenssien löytämiseksi kehitysehdotuksena tutkielmassa on laajemman tutkimusaineiston käsittely neljän faktorin avulla.