Browsing by Subject "intervention"

ABSTRACT Purpose; The investigators hypothesized that the role of alcohol in facial fracture etiology and patients’ daily life may be underestimated. Methods; A prospective cross-sectional study was conducted. Alcohol consumption habits were evaluated according to brief intervention and the data was collected with a constructed questionnaire and interview. After review of the patient records, a case-related data collection was performed with the primary predictor variables being mechanism of injury; fracture type; associated injury (any). Outcome variables were alcohol involved in injury (yes/no) and heavy alcohol use (yes/no). The explanatory variables were gender and age. Descriptive and bivariate statistics were computed, and the P value was set at .05. Results; A total of 166 patients were included in the study. 55% of patients reported being under the influence of alcohol during the injury. Alcohol was involved most often in males (P = .0006) and younger age groups (P < .0001); however, it was present in 22% of the cases among the elderly as well. 17% of patients reported heavy alcohol use habits. The majority of the interpersonal violence events had taken place under the influence of alcohol (84%, P < .0001). Patients who were under the influence of alcohol during injury were more often heavy users (P < .0001). There was no correlation between alcohol involvement during injury and associated injuries or type of fracture. Conclusions; The role of alcohol among facial fracture etiology is considerably high. A brief intervention of alcohol should be included routinely in patient care to identify and, if necessary, address the patient's alcohol use in heavy drinkers and to obtain more evidence about the role of alcohol in facial fracture etiology.

Fear of falling (FOF) and falling are urgent public health and economical challenges. Approxi-mately half of the elderly people experience FOF regardless of whether they had experienced fall or not. Increasing level of FOF can lead to self-induced restriction in mobility, physical func-tioning and activities of daily living (ADLs). Avoidance of activities weakens elderly's perfor-mance, well-being and increases the risk of falling. One-third of people over 65 years fall. For elderly 80 % of injuries are falls. Falls results in fractures, hospitalization, FOF, depression, loss of independence, premature residential care admission and even death in older persons. Number of falls has quadrupled over the past 25 years. Incidence of falling will increase in the future, as world population of people aged 65 and older is projected to increase to 997 million. Exercise is an essential method to maintain mobility, reduce FOF and prevent incidence of falling among community-dwelling elderly. “Strength in Old Age Programme” is a health enhancing exercise program (2005-2015) coordinated by the Age Institute. The project promotes independent living and quality of life (QOL) for elderly with weakened functional ability. A questionnaire was mailed to programmes’ participants consisting of questions about demographic and socio-economic status, health and well-being, physical activity habits and self-reported health improvements after participating the exercise group in April 2015. The aims of this study were 3-fold: first to identify biological, socio-economic, health and well-being, and behavioral factors affecting FOF and falling; second, to study perceived health improvements effect on FOF and falling; and last to investigate the complex association between FOF and falling. The key achievement was that “Strength in Old Age Programme” improved physical activity of elderly people involved in the study and affected biological, socio-economic and behavioral risk factors. This resulted in improvement in physical, functional, psychological and social domains reducing perceived FOF. Particularly good results in FOF reduction were seen in the participants who had higher age, were living alone and had lower socio-economic status. The incidence of falling was reduced through balance improvement in the exercise group. Similar yet smaller changes were observed in more vulnerable participants having poorer health and well-being related status. It would be important to influence the attitudes of elderly and motivate them proactively increase their physical activity to maintain balance, mobility, muscle strength, ADLs, health and well-being.

Purpose. In the context of rapid digitalization and the need to develop students’ 21st century skills, acquiring a growth mindset is essential. A person with a growth mindset believes that, for example, intelligence and creativity are malleable and develop through persistent practice. The purpose of this investigation was to first, explore Finnish 7th grade students’ mindsets related to intelligence and giftedness. Secondly, this study investigated students’ mindsets relation to academic achievement in mathematics and mother tongue, as well as students’ educational aspirations. Thirdly, this investigation examined how the mindsets are related to students’ sociodigital competence beliefs and perceived digital school practices. Finally, findings of a mindset intervention conducted in a Finnish educational context, which targeted mindsets in intelligence, giftedness and creativity, are reported. Method. Data for Study A was collected with a questionnaire, which was answered by 1059 7th grade students in Helsinki. The questionnaire assessed students’ intelligence and giftedness mindsets, educational aspirations, sociodigital competence beliefs and perceived digital school practices. A TwoStep cluster analysis was used to locate natural intelligence and giftedness mindset groups from the data. Next, two-way ANOVA’s were utilized: identified mindset groups and gender were independent variables and academic achievement in mathematics and mother tongue, educational aspirations, as well as sociodigital competence beliefs and perceived digital school practices were dependent variables. In Study B 21 students answered a questionnaire on intelligence, giftedness and creativity mindsets before and after the intervention. Differences between pre- and post-test were analyzed using a paired samples t-test. Results and significance. The results indicated that 7th graders had a strong growth mindset in intelligence and giftedness, yet groups of fixed, mixed and growth mindsets were found. Moreover, a growth mindset in intelligence and giftedness was positively related to students’ academic achievement in both mathematics and mother tongue as well as their educational aspirations. Further, a fixed mindset in giftedness indicated higher technical sociodigital competence beliefs. Similarly, students with a fixed mindset in both intelligence and giftedness perceived there to be more sociodigital school practices. Study B found that only students’ creativity-related mindsets changed significantly. The investigation proposes that schools should more strongly support students’ growth mindsets and their creative and academic sociodigital competences as they are a relevant part of the 21st century skills.

Syftet med den här magisteravhandlingen är att utvärdera Familjeskolan POP® som insats vid barns utmanande beteende ur ett föräldraperspektiv. Genom en enkätundersökning undersöks föräldrars upplevelser före, direkt efter samt tre månader efter deltagande i Familjeskolan POP®. Enkäterna analyseras med en mixed methods-approach, dvs. en kombination av kvalitativa och kvantitativa metoder. Undersökningen har tre övergripande forskningsfrågor: 1) hur upplever föräldrarna familjens situation innan deltagandet i Familjeskolan POP®? 2) hur upplever föräldrarna familjens situation efter deltagandet i Familjeskolan POP® samt 3) vilka effekter verkar Familjeskolan POP® ha ur ett föräldraperspektiv? Svaren på de två första forskningsfrågorna utgör en bas för besvarandet av den sista forskningsfrågan. Genom att utgå ifrån systemteoretiska och huvudsakligen ekokulturella ansatser identifieras kategorierna ”vardag” samt ”föräldraskap och uppfostran”. Dessa används som grund för de empiriska analyserna. Analysen visar att familjens situation inte av föräldrarna upplevs vara mycket svår innan deltagandet i Familjeskolan POP®, men att familjen ändå belastas på olika sätt när ett barn uppfattas ha ett utmanande beteende. Föräldrarna är oroliga över familjens vardag, som bedöms vara tämligen utmanande och stressig. Detta återspeglas negativt i familjens ork och atmosfär, och är i samband med uppfattningar om att olika vardagliga färdigheter inte fungerar så bra för barnet. Föräldrarna oroar sig över barnets relation till sig själv, sina föräldrar samt till andra vuxna och barn. Samtidigt upplevs responsen kring barnet från daghemmet i huvudsak som positiv. Analysen visar även att föräldrarna i medeltal inte ger sitt eget föräldraskap ett lågt vitsord. Vitsordet är i samband med upplevelserna av hur utmanande vardagen bedöms vara. Samtidigt visar analyserna att föräldrarna upplever en avsaknad av fungerande handlingsmodeller samt att de problematiserar sin negativa växelverkan med barnen som även upplevs påverka förälderns eget beteende negativt. Föräldrarna är också oroliga över den egna orken i en utmanande vardag. Det stöd som föräldrarna efterlängtar är ett sådant som riktar sig till hela familjen. Föräldrarna eftersträvar därmed bl.a. nya redskap såväl för vardagen som för sitt föräldraskap. Föräldrarna önskar också en bättre förståelse för sina barn samt ett referensstöd av andra föräldrar. Studien visar på en positiv förändring i familjens situation efter deltagandet i Familjeskolan POP®. Vardagen bedöms då av föräldrarna som mindre utmanande och barnets beteende i både daghemmet och i olika vardagliga situationer bedöms fungera bättre. Föräldrarna tilldelar i medeltal sig ett bättre vitsord för sitt föräldraskap. Trots att det fortfarande förekommer en oro över bl.a. att vardagen är tung, över att den egna orken inte skall räcka till samt för barnet och dess beteende, tyder resultatet ändå på att föräldrarnas upplevelser av vardagen samt av föräldraskap och uppfostran har främjats av deltagandet i Familjeskolan. Utvärderingen av Familjeskolan POP®:s effekter ur ett föräldraperspektiv visar sammantaget att stödprogrammet bidrar till att främja familjens situation och huvudsakligen uppfyller föräldrars egna förväntningar och programmets målsättningar. Familjeskolan POP® upplevs medföra en långsiktig positiv förändring i barnets beteende, stärkta resurser i föräldraskapet, en långvarig nytta för föräldrarna samt ett sådant referensstöd som föräldrarna efterlängtar. Dessutom upplevs föräldrarnas förståelse för såväl barnet som sig själva ha ökat. Trots att en del aspekter av Familjeskolan POP® problematiseras även efter ett deltagandet, upplevs programmet som helhet vara till nytta.

Tutkimuksessa selvitettiin autismiluokan oppilaiden fyysisen väkivaltakäyttäytymiseen yhteydessä olevia oppilas- ja opetusympäristötekijöitä. Tutkimuksen kohderyhmänä oli kaikki Suomen autismiluokkien oppilaat ja vertailuryhminä oli EHA1- ja EHA2- luokan oppilaita. Tutkimusote oli kvantitatiivinen, tutkimusaineisto kerättiin kyselylomakkeilla. Tutkimuskyselyyn vastasivat luokkien opettajat. Aineiston käsittelyssä pääasialliset analyysimenetelmät olivat faktori-, varianssi- ja regressioanalyysi. Tutkimuksen pääongelmat: 1. Millaista on tutkituilla oppilailla esiintynyt fyysinen väkivaltakäyttäytyminen? 2. Millaiset oppilastekijät ovat yhteydessä fyysiseen väkivaltakäyttäytymiseen? 3. Miten luokkatoiminnot ja autismiluokan henkilökunnan toiminta ovat yhteydessä oppilaiden fyysiseen väkivaltakäyttäytymiseen? Tutkimustulokset osoittivat, että autismiluokan oppilaiden fyysinen väkivaltakäyttäytyminen oli huomattavasti vertailuryhmien (EHA1 Ja EHA2) oppilaita runsaampaa. Autismiluokan oppilaiden yleisimpiä fyysisen väkivaltakäyttäytymisen muotoja olivat toisiin kohdistuneet lyömiset, puremiset, raapimiset tukistamiset ja tönimiset. Itseen kohdistui eniten puremista ja lyömistä. Autistien akateemiset taidot olivat tutkimuksen mukaan selvästi heidän sosiaalisia taitojaan paremmat. Runsaimmin fyysistä väkivaltakäyttäytymistä raportoitiin olevan niillä autismiluokan oppilailla, joilla oli hyvät akateemiset, mutta heikot sosiaaliset taidot. Väkivaltakäyttäytymistä edeltävissä tilanteissa ja toiminnoissa korostui yleisimmin yllätys-, siirtymis- ja odottamistilanteet. Väkivaltaa edeltävät vuorovaikutustilanteet olivat pääosin henkilökunnan johtamia käskynantotilanteita. Näissä tilanteissa oppilasta ohjattiin vaatimuksilla tai kielloilla. Fyysiseen väkivaltatilanteeseen puuttumiseen käytetyistä välittömistä interventiomenetelmistä yleisin oli fyysinen ohjaaminen. Tällä ohjausmuodoilla oli heikoin oppilaan rauhoittumista edistävä vaikutus. Parhaimmat intervention vaikutukset saatiin huomiotta jättämisellä tai huomion siirtämisellä muualle. Tutkimuksen teoreettinen viitekehys perustui pääosin Kauffmanin sosiaalis-kognitiiviseen väkivaltateoriaan ja Schoplerin autistien häiriökäyttäytymistä kuvaavaan malliin. Kokonaisotos autismiluokan oppilaista antoi hyvän kuvan koko Suomen autismiluokilla esiintyvästä fyysisen väkivallan ilmiöstä. Tutkimuksen käytäntöön sovellettavuus liittyy autistien opetuksen kehittämiseen, fyysisen väkivaltakäyttäytymisen ennaltaehkäisyn suunnittelutyössä ja opetushenkilökunnan väkivallan kohtaamisen tukemiseen

Goals. The writing performance level of Finnish schoolchildren, especially of boys, has been an area of concern over the past few years. The present study is part of a longitudinal intervention study (RoKKi), which has created an encouraging feedback model for trying to find ways to enhance writing skills. Research has shown that writing self-efficacy and writing performance are related, so this study will examine whether the encouraging feedback model will improve the self- efficacy of the students. A central element of the encouraging feedback model is peer feedback. The idea is that the pupils feel that attention is being paid to what they have written. Pupil experience has not figured significantly as an issue in writing research, so this study will tackle that subject as well. Methods. The study was carried out in three 5th-grade classes between autumn 2011 and autumn 2012. The established class had already used the encouraging feedback model before the study, while the treatment class started to use it at the beginning of the intervention. In the control class, the teacher gave feedback according to a more traditional manner. The data consists of four measures of self-efficacy and writing experience. They were analysed using one-way ANOVA, repeated measures ANOVA, t-tests and the equivalent nonparametric tests. Results and conclusions. The encouraging intervention didn't have a statistically significant effect on the self-efficacy beliefs of the 5th-graders. However, the self-efficacy in the established class was higher and the writing experiences were statistically significantly higher than in the other two classes. In the established class, the experiences remained positive regardless of the genre that was being exercised whereas, in the control group, not even the normally positively experienced genre of story could improve the writing experience of the boys. The intervention seemed to have a positive effect for boys in particular, but one needs to take into account that the starting level of the self-efficacy of the boys in the test class was also high, which is exceptional in the light of earlier research. In the control class, the girls had much higher levels of self-efficacy and better writing experiences than the boys whereas, in the established class, the results were quite even. The positive writing experiences and self-efficacy beliefs – and the equality of the genders – in the established class suggest that the encouraging feedback model might be of value in long-term use.

Gestational diabetes mellitus (GDM) is a condition of glucose intolerance with onset or first recognition during pregnancy, and it poses multiple health risks for both the mother and the child. The prevalence of GDM is increasing globally and effective interventions are needed to reduce the associated risks. Mobile health (mHealth) solutions have a great potential in answering this need since they are cost-effective and able to reach large groups of people. mHealth solutions might be especially effective for management of chronic conditions that require patient behavior change. Investigating intervention acceptability has an important part in the process of developing successful interventions. The aim of this thesis is to investigate the prospective acceptability of an mHealth intervention for GDM from the perspective of its potential recipients. The thesis also seeks to find out whether there are any associations between technological experience and perceptions of intervention acceptability as well as ways in which the intervention acceptability could be improved. The thesis utilizes data collected in the first phase of the eMOM GDM study, a research project with the aim of developing an mHealth intervention to support the self-management of GDM. The application acceptability was studied with semi-structured interviews with 10 women currently diagnosed with GDM. Previous technological experience was self-reported by the participants in a background questionnaire. Theory-driven content analysis was used to analyze the interviews. The results show that the intervention has high prospective acceptability from the perspective of the potential participants. For most of the domains of acceptability there is still room for improvement, and several ideas for further improving the intervention’s acceptability are discussed. The results could also indicate a possible relationship between technological experience and mHealth intervention acceptability. This thesis contributes to the development of an intervention by providing insight on the factors influencing intervention acceptability and ideas on how to improve it. The results also provide valuable information for developing future mHealth solutions for GDM. The potential association between technological experience and intervention acceptability are interesting regarding all mHealth intervention development and should be studied further.

Objectives. The research task of this study is to describe, analyse and interpret the use of “migrant student” and similar terms in two documents of an international intervention project, which aims to make assessment more equitable for “migrant students”. More specifically, this study aimed to answer the research question “In what manners is the migrant student positioned?”. Positioning involves the assignment of attributes to people, either to another individual/group or the utterer/their ingroup (Davies & Harré 1990). On top of assignment of attributes, naming and agentivising of “the migrant student” were considered to contribute to positioning, and were thus investigated as well. Methods. The material consisted of two documents, a grant proposal and an informational document for stakeholders, written by multiple authors, who are researchers. Documents were analysed with quantitative and qualitative means, namely frequency analysis of agent-verb-object combinations and discourse analysis. Both analyses drew from semiotics, semantics, and enunciative pragmatics. Results and conclusions. It was found that “migrant students” are consistently othered (Jensen 2011) - positioned as disadvantaged, incompetent and challenging. It was argued that the unfavourable positioning of the “migrant student” could serve to convince funders and stakeholders of the necessity and the success of the project, which is essential for securing academic funding. The implications of conducting educational initiatives that claim to advance equity for students, but simultaneously other them, were considered. It is suggested that academic othering may be necessitated by the structures that impact the agency of researchers. It is also recommended that future research not only explores academic othering in other academic genres, but also involves those in powerful positions in structures like universities.

Stillasittande beteende, det vill säga tiden som individen tillbringar sittandes och liggandes, har ett samband med allvarliga hälsoproblem. Stillasittande beteende ökar stadigt i barndomen och 15-åriga ungdomar sitter i medeltal nio timmar per dag. Med hjälp av självbestämmandeteorin kan man öka förståelsen för vilka motivationsprocesser som reglerar stillasittande beteende. Enligt självbestämmandeteorin kan individen ha en viss motivationstyp, som beror på hur självbestämmande individens beteende är och i vilken grad individen har internaliserat omgivningens värderingar. Let’s Move It är en teoribaserad intervention för yrkesskolor, med syftet att öka elevernas fysiska aktivitet och begränsa deras stillasittande beteende. Interventionen har visat sig minska stillasittande tid i högre grad hos interventionsgruppen än kontrollgruppen. Den här magisteravhandlingen kommer att granska om motivationsprocesser kan förklara skillnaden i stillasittande tid mellan grupperna efter interventionen. Syftet med den här magisteravhandlingen är att undersöka om stillasittande beteende har ett samband med typen av motivation att begränsa stillasittande beteende samt hur interventionen påverkar motivationstyperna genom att jämföra interventionsgruppen (n = 834) med kontrollgruppen (n = 810) efter interventionen. Data analyseras med korrelations- och variansanalys samt chi-kvadrat. Resultaten tyder på att stillasittande beteende i interventionsgruppen har ett svagt, negativt samband med integrerad motivation och ett svagt, positivt samband med amotivation genast efter interventionen samt ett medelstarkt, negativt samband med integrerad motivation och ett svagt, negativt samband med amotivation ett år efter interventionen. Resultaten tyder även på att Let’s Move It-interventionen inte har påverkat typen av motivation att begränsa stillasittande beteende i interventionsgruppen jämfört med kontrollgruppen varken genast efter interventionen eller ett år efter interventionen. De förändringar som Let’s Move It-interventionen har orsakat i stillasittande beteende har inte skett på grund av förändringar i motivationen att begränsa stillasittande beteende, utan på grund av andra skillnader mellan grupperna. Interventionsgruppens minskning i stillasittande tid kan ha skett på grund av förändringar i klassmiljön och lärarnas beteende eller motivationen att öka lätt fysisk aktivitet. Fortsatt forskning kunde fokusera på att undersöka skillnader i motivationen att begränsa stillasittande mellan olika utbildningslinjer och bland ungdomar med olika socioekonomisk bakgrund.

Objectives: Sufficient vitamin D intake is important for a child’s development. In addition to bone health, it has been suggested that vitamin D may play an important part in brain development and function. However, the nutritional recommendations for vitamin D are primarily based on bone health and it is still largely unknown whether the same dose is optimal for brain development. Previous studies have shown some indication that vitamin D could be associated with neurodevelopment but the results are inconsistent and especially the amount of intervention studies is still very limited. The aim of this study was to find out if higher dosage of vitamin D supplement (1200 IU) is beneficial for neurodevelopment compared to recommended dosage (400 IU) in early childhood. Methods: The data for this study is from a large, Finnish, randomized, double-blinded, controlled trial of daily vitamin D intervention in infants (VIDI). The final sample consisted of 718 healthy children who were randomized to receive either the recommended dose (400 IU) or higher dose (1200 IU) of vitamin D daily from two weeks to 24 months of age. Neurodevelopment was evaluated at the age of 1 and/or 2 using the Ages and Stages questionnaire (ASQ) filled by the parents. Groups were compared using one-way ANOVA and mixed models. Results and conclusions: There were no differences in total neurodevelopmental scores between the recommended dose (400 IU) and higher dose (1200 IU) supplementation groups at the age of 1 or 2. Neither did the groups differ on any of the ASQ neurodevelopmental domains; communication, gross motor, fine motor, problem solving and personal-social. In addition, the change in neurodevelopment was not different between the groups over time. The results suggest that higher dose (1200 IU) of vitamin D supplementation during the first two years of life does not lead to better neurodevelopmental outcomes compared to recommended dose (400 IU). The current study supports current Nordic Nutrition Recommendations. However, more research on the association between vitamin D and neurodevelopment is still needed.