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The aim of this thesis was to study changes caused by organizational change in the client organization, and its effects on communication, well-being at work and coping with work. The purpose was to create concrete ideas to ease future change-situations and to improve communications and the well-being of employees at work. First the theorethical part of the thesis explains the theory of change and change management. After this the theory of communication and communication in change situations is discussed. In the end of theoretical part, the theory of well-being at work and the factors that well-being is built on are explored. The research part combines both qualitative and quantitative research. Surveys conducted earlier in the target company about integration and well-being at work among clerical workers represent quantitative research. Qualitative research was executed as follow-up interviews about the previous surveys among clerical workers to share their experiences about the organizational change, communication, and well-being at work. Concrete ideas were also collected. In the end of theoretical part, the ideas are summarised in the form of a figure. Based on the results there are some positive aspects, but also some elements need to be developed further regarding the well-being of employees of the client organization. The purpose of the research was achieved because the thesis was able to produce concrete ideas to develop and support the areas under research.
The aim of the study is to analyze the effect of smoking and smoking cessation on the incidence of complications among orthopedic and hand surgery patients, and to determine the feasibility of smoking cessation intervention, as well as factors predicting success in smoking cessation. Orthopedic and hand surgery patients will be invited to participate in the study, which will recruit 550 participants (at least 20% daily smokers). A participant will be defined as a daily smoker if he/she reports daily smoking and/or laboratory tests show active smoking. Data will be collected using a self-reported questionnaire and from medical records. Smokers will receive information about the benefits of smoking cessation and will be encouraged to quit. Medication or nicotine replacement therapy will be prescribed. Laboratory tests will be taken two weeks before and two weeks after surgery. Follow-up phone calls will be made at 3, 6, and 12 months after surgery. The primary outcome is any complication, defined as a prolonged stay in hospital or any additional visit to or measure taken by a health service during the 12 months after surgery. Data on complications are mainly obtained from personal health records and from the information received at the follow-up; the rest of the data will be collected from the register of healthcare-associated infections. Secondary outcomes are the number and types of complications. The sample (n=550) was calculated to observe a 10% difference in complications between smokers and non-smokers (5% alpha level and 80% power), considering a 10% drop-out rate. Logistic regression and log-linear models will be used for data analyses.
Background: The Finnish Intervention Study to Prevent Cognitive Impairment and Disability is a randomized controlled trial that has tested the efficacy of a multidomain intervention targeting modifiable risk factors to prevent cognitive impairment/dementia. A combination of healthy diet, physical, social and cognitive activity, and management of cardiovascular risks was shown to be an effective model to promote brain health among older people. The aim of this qualitative study was to explore healthcare professionals' perceptions of facilitators and barriers to implementing this lifestyle programme into health care. Methods: Four semi-structured focus group interviews were conducted among healthcare professionals working in primary care and in non-governmental organizations (N = 27). Participants were asked to discuss their perceptions of facilitators and barriers for implementing the multidomain intervention into clinical practice. Interviews were analyzed using content analysis. Results: Barriers and facilitators described by the healthcare professionals were related to infrastructure and resources, client's personal characteristics and the lifestyle intervention itself. These main categories included several sub-categories related to knowledge, motivation, resources, individualization and collaboration. The interviewees pointed out that more education on dementia prevention is needed, the work should be coordinated efficiently, resources to provide preventive health care should be adequate and multiprofessional collaboration is needed. Conclusions: Transferring a lifestyle intervention from a trial-setting to real life requires knowledge about the factors that influence effective implementation. Identifying drivers and constraints of successful implementation helps to design and tailor future prevention programmes, increases motivation and adherence and supports system change.
Aims: Joint prevention of cardiovascular disease (CVD) and dementia could reduce the burden of both conditions. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated a beneficial effect on cognition (primary outcome) and we assessed the effect of this lifestyle intervention on incident CVD (pre-specified secondary outcome). Methods and results: FINGER enrolled 1259 individuals aged 60-77 years (ClinicalTrials.gov NCT01041989). They were randomized (1:1) to a 2-year multi-domain intervention with diet, physical and cognitive activity, and vascular monitoring (n = 631), or general health advice (n = 628). National registries provided data on CVD including stroke, transient ischaemic attack (TIA), or coronary heart event. During an average of 7.4 years, 229 participants (18%) had at least one CVD diagnosis: 107 in the intervention group and 122 in the control group. The incidence of cerebrovascular events was lower in the intervention than the control group: hazard ratio (HR) for combined stroke/TIA was 0.71 [95% confidence interval (CI): 0.51-0.99] after adjusting for background characteristics. Hazard ratio for coronary events was 0.84 (CI: 0.56-1.26) and total CVD events 0.80 (95% CI: 0.61-1.04). Among those with history of CVD (n = 145), the incidence of both total CVD events (HR: 0.50, 95% CI: 0.28-0.90) and stroke/TIA (HR: 0.40, 95% CI: 0.20-0.81) was lower in the intervention than the control group. Conclusion: A 2-year multi-domain lifestyle intervention among older adults was effective in preventing cerebrovascular events and also total CVD events among those who had history of CVD.
Valtioneuvoston kanslia asetti 22.4.2020 COVID-19-tiedepaneelin tukemaan valtiosihteeri Martti Hetemäen johtamaa valmisteluryhmää koronaviruskriisin haitallisten vaikutusten arviointiin ja ehkäisyyn sekä tehtyjen toimenpiteiden purkuun ja Suomen jälleenrakennukseen liittyvissä kysymyksissä. Tiedepaneeli asetettiin toimikaudelle 22.4.–31.5.2020. Tiedepaneelin tehtävänä oli auttaa valmisteluryhmää tutkittuun tietoon perustuen arvioimaan ja ennakoimaan COVID-19-kriisiin liittyviä ja siitä seuraavia vaikutuksia sosiaalisen, terveydellisen, taloudellisen ja ekologisen kestävyyden sekä yksilöiden, yhteisöjen ja yhteiskunnan resilienssin näkökulmista. Paneeli muodostettiin seuraavien alojen asiantuntijoista: kansanterveystieteet, koulutuspolitiikka, käyttäytymistiede (ml. psykologia), resilienssi, sosiaalipolitiikka, talouspolitiikka, sekä ympäristö- ja ilmastotieteet. Valtioneuvoston kanslia asetti paneelin jäsenet Tutkimuslaitosten yhteenliittymä Tulanetin, Suomen yliopistojen rehtorineuvosto Unifi ry:n ja Suomalaisen Tiedeakatemian esitysten perusteella. Lisäksi valtioneuvosto täydensi tiedepaneelia kolmella asiantuntijalla.
Abstract Aims: Joint prevention of cardiovascular disease (CVD) and dementia could reduce the burden of both conditions. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated a beneficial effect on cognition (primary outcome) and we assessed the effect of this lifestyle intervention on incident CVD (pre-specified secondary outcome). Methods and results: FINGER enrolled 1259 individuals aged 60–77 years (ClinicalTrials.gov NCT01041989). They were randomized (1:1) to a 2-year multi-domain intervention with diet, physical and cognitive activity, and vascular monitoring (n = 631), or general health advice (n = 628). National registries provided data on CVD including stroke, transient ischaemic attack (TIA), or coronary heart event. During an average of 7.4 years, 229 participants (18%) had at least one CVD diagnosis: 107 in the intervention group and 122 in the control group. The incidence of cerebrovascular events was lower in the intervention than the control group: hazard ratio (HR) for combined stroke/TIA was 0.71 [95% confidence interval (CI): 0.51–0.99] after adjusting for background characteristics. Hazard ratio for coronary events was 0.84 (CI: 0.56–1.26) and total CVD events 0.80 (95% CI: 0.61–1.04). Among those with history of CVD (n = 145), the incidence of both total CVD events (HR: 0.50, 95% CI: 0.28–0.90) and stroke/TIA (HR: 0.40, 95% CI: 0.20–0.81) was lower in the intervention than the control group. Conclusion: A 2-year multi-domain lifestyle intervention among older adults was effective in preventing cerebrovascular events and also total CVD events among those who had history of CVD.
Abstract Introduction: The 2-year Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multidomain lifestyle intervention trial (NCT01041989) demonstrated beneficial effects on cognition. We investigated whether sociodemographics, socioeconomic status, baseline cognition, or cardiovascular factors influenced intervention effects on cognition. Methods: The FINGER recruited 1260 people from the general Finnish population (60–77 years, at risk for dementia). Participants were randomized 1:1 to multidomain intervention (diet, exercise, cognition, and vascular risk management) and regular health advice. Primary outcome was change in cognition (Neuropsychological Test Battery z-score). Prespecified analyses to investigate whether participants’ characteristics modified response to intervention were carried out using mixed-model repeated-measures analyses. Results: Sociodemographics (sex, age, and education), socioeconomic status (income), cognition (Mini–Mental State Examination), cardiovascular factors (body mass index, blood pressure, cholesterol, fasting glucose, and overall cardiovascular risk), and cardiovascular comorbidity did not modify response to intervention (P-values for interaction > .05). Conclusions: The FINGER intervention was beneficial regardless of participants’ characteristics and can thus be implemented in a large elderly population at increased risk for dementia.
Kiertotalousosaamista ammattikorkeakouluihin -hanke toteutettiin yhteistyössä 19 suomalaisen ammattikorkeakoulun kanssa 1.1.2018–31.12.2020. Hankkeen toimintaa rahoitti Opetus- ja kulttuuriministeriö sekä hankkeeseen osallistuneet ammattikorkeakoulut. Artikkelikokoelmaan on koottu hankkeen toimenpiteitä ja tuloksia hankkeen ajalta. Lisää tietoa hankkeesta ja sen toiminnasta on saatavilla hankkeen nettisivuilta: www.kiertotalousAMK.fi