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LAUREA-AMMATTIKORKEAKOULU TIVISTELMÄ Laurea Hyvinkää Sosiaali-, terveys- ja liikunta-ala Hoitotyön koulutusohjelma Järvinen Susanna Oikarinen Ulla HYVINKÄÄN LAUREAN OPISKELIJOIDEN PSYYKKINEN HYVINVOINTI Vuosi 2009 Sivumäärä 84 Tämän opinnäytetyön tarkoituksena oli selvittää Hyvinkään Laurean opiskelijoiden psyykkistä hyvinvointia, psyykkisen hyvinvoinnin kuormitus- ja voimavaratekijöitä sekä opiskeluhuollon toimintaa opiskelijan psyykkisen hyvinvoinnin edistäjänä. Opinnäytetyön teoreettinen viitekehys käsittelee ammattikorkeakouluopiskelua työnä, opiskelukykyä, opiskelijoiden psyykkistä hyvinvointia ja sitä tukevia ja kuormittavia tekijöitä sekä opiskeluhuoltoa opiskelijoiden psyykkisen hyvinvoinnin edistäjänä. Opiskeluhuoltoon kuuluu terveydenhoitajat, erityisopettaja, opintopsykologi, opintopastori, koululääkäri, tutor-opettajat sekä –opiskelija, opintosihteerit ja opintotoimisto. Tutkimustuloksia voidaan hyödyntää opiskeluhuollon toiminnan kehittämiseen koko Laurea-ammattikorkeakoulun tasolla. Opiskeluhuollon eri jäsenet voivat käyttää tutkimuksen tuloksia työkaluinaan oman työnsä kehittämisessä. Opinnäytetyö toteutettiin kvantitatiivisia tutkimusmenetelmiä hyödyntäen. Aineisto kerättiin kevään 2009 aikana sähköisellä kyselylomakkeella. Vastaukset analysoitiin SPSS–tilasto-ohjelmalla. Kyselylomake lähetettiin kaikille Hyvinkään Laurean opiskelijoille N=1269 ja vastauksia kyselyyn tuli 260 n=260. Vastausprosentti oli 20,5. Hyvinkään Laurean opiskelijat voivat psyykkisesti hyvin. Valtaosa opiskelijoista nauttii elämästään, on onnellisia sekä iloisia. Psyykkisen hyvinvoinnin voimavaratekijöitä opiskelijoilla on paljon. Voimavaroja on positiivinen suhtautuminen opiskeluun, sosiaaliset suhteet ja yhteisöllisyys. Kuormittavia tekijöitä opiskelijoilla on kiire, vaikutusmahdollisuuksien puutteellisuus, taloudellinen tilanne, työt opintojen ohella sekä ohjauksen ja palautteen puutteellisuus. Suuri osa opiskelijoista kokee itsensä kiireiseksi, stressaantuneeksi ja väsyneeksi. Ohjausta ja palautetta opettajilta toivotaan enemmän. Opiskeluhuollon palveluista tulisi tiedottaa enemmän, jotta ne olisivat kaikkien avuntarvitsijoiden saatavilla. Avainsanat: Ammattikorkeakouluopiskelija, opiskelukyky, psyykkinen hyvinvointi, opiskeluhuolto.
AIM: This study was designed to determine whether faecal regenerating 1B protein (REG1B) concentration is associated with physical growth among 6-30-month-old children in rural Malawi. METHODS: This was a secondary analysis from a randomised controlled trial in rural Malawi in which we followed-up 790 live-born infants from birth to 30 months of age. We collected anthropometric data at the age of 6, 12, 18, 24 and 30 months. We measured faecal REG1B concentration by enzyme-linked immunosorbent assay (ELISA) technique using stool samples collected at 6, 18 and 30 months of age. We assessed the association between faecal REG1B concentration and children's physical growth using linear regression and longitudinal data analysis. RESULTS: Of 790 live-born infants enrolled, 694 (87%) with at least one faecal REG1B concentration measurement were included in the analysis. Faecal REG1B concentration was not associated with the children's concurrent length-for-age z-score (LAZ), weight-for-age z-score (WAZ), weight-for-length z-score (WLZ) and mid-upper arm circumference-for-age z-score (MUACZ) at any time point (P > 0.05), nor with a change in their anthropometric indices in the subsequent 6-month period (P > 0.05). CONCLUSIONS: Faecal REG1B concentration is not associated with LAZ, WAZ, WLZ and MUACZ among 6-30-month-old infants and children in rural Malawi.
BACKGROUND: Insulin-like growth factor I (IGF-I) is the most important hormonal promoter of linear growth in infants and young children. OBJECTIVES: The objectives of this study were to compare plasma IGF-I concentration in a low- compared with a high-income country and characterize biological pathways leading to reduced IGF-I concentration in children in a low-income setting. METHODS: We analyzed plasma IGF-I concentration from 716 Malawian and 80 Finnish children at 6-36 mo of age. In the Malawian children, we studied the association between IGF-I concentration and their environmental exposures; nutritional status; systemic and intestinal inflammation; malaria parasitemia and viral, bacterial, and parasitic enteric infections; as well as growth at 18 mo of age. We then conducted a pathway analysis to identify direct and indirect associations between these predictors and IGF-I concentration. RESULTS: The mean IGF-I concentrations were similar in Malawi and Finland among 6-mo-old infants. At age 18 mo, the mean ± SD concentration was almost double among the Finns compared with the Malawians [24.2 ± 11.3 compared with 12.5 ± 7.7 ng/mL, age- and sex-adjusted difference in mean (95% CI): 11.8 (9.9, 13.7) ng/mL; P < 0.01]. Among 18-mo-old Malawians, plasma IGF-I concentration was inversely associated with systemic inflammation, malaria parasitemia, and intestinal Shigella, Campylobacter, and enterovirus infection and positively associated with the children's weight-for-length z score (WLZ), female sex, maternal height, mother's education, and dry season. Seasonally, mean plasma IGF-I concentration was highest in June and July and lowest in December and January, coinciding with changes in children's length gain and preceded by ∼2 mo by the changes in their WLZ. CONCLUSIONS: The mean plasma IGF-I concentrations are similar in Malawi and Finland among 6-mo-old infants. Thereafter, mean concentrations rise markedly in Finland but not in Malawi. Systemic inflammation and clinically nonapparent infections are strongly associated with lower plasma IGF-I concentrations in Malawi through direct and indirect pathways.
Inadequate diet and frequent symptomatic infections are considered major causes of growth stunting in low-income countries, but interventions targeting these risk factors have achieved limited success. Asymptomatic infections can restrict growth, but little is known about their role in global stunting prevalence. We investigated factors related to length-for-age Z-score (LAZ) at 24 months by constructing an interconnected network of various infections, biomarkers of inflammation (as assessed by alpha-1-acid glycoprotein [AGP]), and growth (insulin-like growth factor 1 [IGF-1] and collagen X biomarker [CXM]) at 18 months, as well as other children, maternal, and household level factors. Among 604 children, there was a continuous decline in mean LAZ and increased mean length deficit from birth to 24 months. At 18 months of age, the percentage of asymptomatic children who carried each pathogen was: 84.5% enterovirus, 15.5% parechovirus, 7.7% norovirus, 4.6% rhinovirus, 0.6% rotavirus, 69.6% Campylobacter, 53.8% Giardia lamblia, 11.9% malaria parasites, 10.2% Shigella, and 2.7% Cryptosporidium. The mean plasma IGF-1 concentration was 12.5 ng/ml and 68% of the children had systemic inflammation (plasma AGP concentration >1 g/L). Shigella infection was associated with lower LAZ at 24 months through both direct and indirect pathways, whereas enterovirus, norovirus, Campylobacter, Cryptosporidium, and malaria infections were associated with lower LAZ at 24 months indirectly, predominantly through increased systemic inflammation and reduced plasma IGF-1 and CXM concentration at 18 months.