Browsing by Subject "Family"

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  • Finnish Pediat Diabet Register; Turtinen, Maaret; Härkönen, Taina; Parkkola, Anna; Ilonen, Jorma; Knip, Mikael (2019)
    Aims/hypothesis In previous studies, the risk of developing familial type 1 diabetes has been reported to be more than two times higher in the offspring of affected fathers than in those of affected mothers. We tested the hypothesis that index children with an affected father may have a more aggressive disease process at diagnosis than those with other affected first-degree relatives. Methods A cross-sectional, observational study was performed using the Finnish Pediatric Diabetes Register. Clinical and metabolic characteristics, beta cell autoantibodies and HLA class II genetics were analysed from index children in Finland diagnosed before the age of 15 years between January 2003 and December 2016. Information on the presence of type 1 diabetes in first-degree relatives was collected at diagnosis using a structured questionnaire. Results Out of 4993 newly diagnosed index children, 519 (10.4%) had familial type 1 diabetes. More than 5% (n = 253, 5.1%) had an affected father, 2.8% (n = 141) had an affected mother, 1.9% (n = 95) had an affected sibling and 0.6% (n = 30) had two or more affected family members. All clinical and metabolic variables were markedly poorer in children with sporadic vs familial diabetes. The index children with an affected father or mother were younger than those with an affected sibling (median age 7.59 vs 6.74 vs 10.73 years, respectively; p <0.001). After age- and sex-adjusted analyses, index children with an affected father presented more often with ketoacidosis (9.7% vs 3.6%; p = 0.033) and had greater weight loss before diagnosis (3.2% vs 0%; p = 0.006) than those with an affected mother. Children with familial disease tested negative for all autoantibodies more often (3.5% vs 2.1%; p = 0.041) and had insulin autoantibodies more frequently (49.8% vs 42.2%; p = 0.004) than those with sporadic disease. Both major HLA risk haplotypes (DR3-DQ2 and DR4-DQ8) were more often lacking among children with sporadic vs familial disease (15.9% vs 11.2%; p = 0.006). The DR4-DQ8 haplotype was more frequent in the familial vs the sporadic group (75.7% vs 68.5%; p = 0.001) and especially among children with an affected father when compared with children with sporadic disease (77.5% vs 68.5%; p <0.05). When comparing index children with affected parents diagnosed before or after the birth of the index child, a clear male preponderance was seen among the affected parents diagnosed before the birth of the index child (fathers 66.2% vs mothers 33.8%; p = 0.006), whereas the proportion of fathers and mothers was similar if type 1 diabetes was diagnosed after the birth of the index child. Conclusions/interpretation The more severe metabolic derangement at diagnosis in children with sporadic type 1 diabetes compared with those with familial type 1 diabetes was confirmed. The higher frequency of diabetic ketoacidosis and increased weight loss at diagnosis in index children with an affected father compared with an affected mother support the hypothesis that paternal type 1 diabetes is associated with more severe disease in the offspring than maternal diabetes. The sex difference seen between affected parents diagnosed before and after the birth of the index child supports the hypothesis that maternal insulin treatment protects against type 1 diabetes.
  • Maatta, Suvi; Lehto, Reetta; Nislin, Mari; Ray, Carola; Erkkola, Maijaliisa; Sajaniemi, Nina; Roos, Eva; DAGIS Res Grp (2015)
    Background: Effective interventions that target socioeconomic status (SES) differences to avoid the potential widening of inequalities in health are needed. Children at preschool age is a valuable intervention target since sedentary behaviors, physical activity (PA), dietary behaviors, and sleep habits, jointly called the energy balance-related behaviors (EBRBs), are established in early childhood and tend to persist later in life. The interventions are most effective, when they focus on evidence-based factors. One potential factor associated with EBRBs and SES is children's stress regulation, which receives special attention in this study. Based on the socioecological approach, the combinations of multiple levels (e.g. individual, environmental, societal) of analysis and diverse methodologies (e.g. surveys, observations, biological measurements) are used to assess the healthfulness of environments (e.g. social, physical, learning, policy) in preschool and family settings. The intervention aimed to diminish SES differences in EBRBs is then conducted in the preschool setting. Methods/design: The DAGIS study is divided into two phases. The first phase comprises focus group interviews and a cross-sectional survey. Parents and preschool personnel in low SES neighborhoods participated in interviews about children's sedentary behaviors, dietary behaviors, and PA in 2014. In the cross-sectional survey beginning in autumn 2015, preschools will be recruited from a random sample of preschools in 3-5 municipalities in Southern Finland. A total of 800 children will wear an accelerometer for seven days. Children's hair and saliva samples will be taken. Parents and preschool personnel will complete questionnaires on EBRBs, social and physical environments and SES factors. The quality of preschool environment is also observed. In the second phase, an intervention targeting to narrowing SES differences in EBRBs is conducted. The effects of the intervention will be evaluated in randomised controlled trial. The implementation of the intervention will also be evaluated. Conclusion: If effective, this unique preschool-based study will be able to narrow the SES differences in preschool children's EBRBs. This study is anticipated to identify the most important modifiable factors in preschool and family environmental settings associated with children's EBRBs, especially in children from low SES backgrounds.
  • Pajari-Xiang, Laura (Helsingin yliopisto, 2021)
    The one-child policy of the People’s Republic of China created an entire generation of Chinese only-children, who have migrated abroad more often than any previous generation. However, despite the increased emigration, alongside the aging population, the Chinese elderly care system relies on the inputs of children. Therefore, there is a fundamental conflict between the filial intergenerational caregiving responsibilities and international migration processes, although some caregiving forms may be exchanged from a distance. This master’s thesis investigates how the Chinese first-generation only-child migrants who live in Finland experience caring for their parents in China. The research questions are: How do Chinese one-child transnational families practice transnational caregiving? What are the expectations and possibilities concerning caregiving? What are the elderly care arrangements like for the parents? The theoretical framework of this study consists of three dimensions of transnational caregiving: care circulation approach, transnational caregiving types, and the capacity, obligation, and negotiated commitment as factors that explain the practices of transnational caregiving. The research data consists of nine semi-structured interviews of Chinese migrants of the only-child generation. The analysis method is qualitative theory-guided content analysis. The results suggest that Chinese migrants and their parents practice transnational caregiving by exchanging emotional support. The migrants experience that their possibilities to provide care to their parents are limited. However, providing care is a cultural obligation. The future elderly care arrangements of the parents are unclear, which makes the situation stressful for the migrants. The situation is also frustrating as ideal options for arranging elderly care are lacking. If the migrants return to China to provide elderly care to their parents, they are forced to make sacrifices with their work and family. However, if they do not return to China, the alternative options of relying on institutional elderly care or hiring a maid or a nurse are not ideal either. Although the migrants value filial traditions, they desperately demand societal and policy changes that would allow them to plan the future elderly care of their parents. Based on the results, there is a demand for establishing more quality institutional elderly care services in China. There is also a need for the Finnish migration policy to allow family-based old-age migration, as some other countries do. Overall, in the current situation, the national policymaking in Finland and in China does not recognize the needs of transnational families and transnational caregivers.
  • Laukkala, Tanja; Jylhä, Pekka; Isometsä, Erkki; Koponen, Hannu; Marttunen, Mauri; Wahlbeck, Kristian; Laajasalo, Taina; Vuorio, Alpo; Pirkola, Sami (2020)
    • Suomi on kansainvälisesti verrattuna suurten itsemurhalukujen maa, vaikka viime vuosikymmeninä ¬kuolemat ovat pääsääntöisesti vähentyneet. • Itsetuhoinen käyttäytyminen liittyy useimmiten psykiatriseen sairauteen tai päihdeongelmiin. • Itsemurhayrityksen jälkeen keskeisiä ovat strukturoitu psykiatrinen arvio, turvasuunnitelman tekeminen ja aktiivinen perussairauksien hoito. • Lääkärin lakisääteiset velvoitteet ja läheisten tilanne tulee huomioida. • Psykososiaalisia, muuhun hoitoon liitettäviä lyhyitä erillisinterventioita tutkitaan aktiivisesti.
  • Karjalainen, Siiri; Keski-Rahkonen, Anna; Nyberg, Reita (2020)
    Nuoren syömishäiriö on koko perheen ongelma, jota tulisi hoitaa perheessä. Joidenkin tutkimusten perusteella laihuushäiriön perhepohjainen hoito on osoittautunut vähintään yhtä tehokkaaksi kuin yksilöterapia tai muut perheterapian muodot. Vanhemmat tarvitsevat paljon tukea jaksaakseen kannatella lastaan. Heitä ei syyllistetä, vaan pidetään voimavarana ja koulutetaan kohtaamaan syömishäiriö erilaisissa arkisissa tilanteissa. Myös vanhempien keskinäinen vertaistuki auttaa sairauden eri vaiheiden läpikäymisessä. Kouluttamalla lisää ammattilaisia tarjoamaan perhepohjaista hoitoa voitaisiin tavoittaa yhä useampia perheitä.
  • Lehtonen, Lasse (2017)
    Itä-Suomen hovioikeus tuomitsi kesällä 2017 terveyskeskuslääkärin kuolemantuottamuksesta ja ¬tuottamuksellisesta virkavelvollisuuden rikkomisesta päiväsakkoihin, kun hän ei ollut saanut suostutelluksi sydänoireista potilasta sairaalahoitoon ja potilas kuoli. Tapaus on herättänyt keskustelua siitä, missä kulkevat potilaan itsemääräämisoikeuden rajat suhteessa lääkärin vastuuseen.
  • Tikkanen, Minna; Pekkola, Maria; Stefanovic, Vedran (2021)
    • Suomessa todetaan vuosittain noin 150 sikiön kohtukuolemaa. • Yleisimpiä syitä ovat istukan vajaatoiminta ja siihen liittyvä kasvuhidastuma, sikiön epämuodostuma tai sairaus, infektio, istukan ennenaikainen irtoaminen ja napanuorakomplikaatio. • Kuolemansyyn selvittelyihin kuuluvat vastasyntyneen ulkoinen tarkastelu ja ruumiinavaus sekä istukan ulkoinen tarkastelu ja mikroskooppinen tutkimus. Lisäksi tutkitaan geneettiset näytteet, infektionäytteet ja äidin verinäytteet, esimerkiksi fosfolipidivasta-aineet. • Kohtukuoleman kokeneen naisen uutta raskautta leimaavat huoli ja ahdistus, jotka vaativat seurantaa ja psyykkistä tukea.
  • Ahinko, Katja; Peltonen, Reetta (2020)
  • Saramo, Samira; Koskinen-Koivisto, Eerika; Snellman, Hanna; Faculty of Arts; University Management (Suomalaisen Kirjallisuuden Seura, 2019)
    Studia Fennica Ethnologica
    With so much of the global population living on the move, away from their homelands, and in diasporic communities, death and mourning practices are inevitably impacted. Transnational Death brings together eleven cutting-edge articles from the emerging field of transnational death studies. By highlighting European, Asian, North American, and Middle Eastern perspectives, the collection provides timely and fresh analysis and reflection on people’s changing experiences with death in the context of migration over time. First beginning with a thematic assessment of the field of transnational death studies, readers then have the opportunity to delve into case studies that examine experiences with death and mourning at a distance from the viewpoints of Family, Community, and Commemoration. The chapters highlight complicated issues confronting migrants, their families, and communities, including: negotiations of burial preferences and challenges of corpse repatriation; the financial costs of providing end-of-life care, travel at times of death, and arranging culturally appropriate funerals and religious services; as well as the emotional and sociocultural weight of mourning and commemoration from afar. Overall, Transnational Death provides new insights on identity and belonging, community reciprocity, transnational communication, and spaces of mourning and commemoration.
  • Waldenström macroglobulinemia Group (2018)
    Waldenström macroglobulinemia (WM)/lymphoplasmacytic lymphoma (LPL) is a rare, chronic B-cell lymphoma with high heritability. We conduct a two-stage genome-wide association study of WM/LPL in 530 unrelated cases and 4362 controls of European ancestry and identify two high-risk loci associated with WM/LPL at 6p25.3 (rs116446171, near EXOC2 and IRF4; OR = 21.14, 95% CI: 14.40–31.03, P = 1.36 × 10 −54 ) and 14q32.13 (rs117410836, near TCL1; OR = 4.90, 95% CI: 3.45–6.96, P = 8.75 × 10 −19 ). Both risk alleles are observed at a low frequency among controls (~2–3%) and occur in excess in affected cases within families. In silico data suggest that rs116446171 may have functional importance, and in functional studies, we demonstrate increased reporter transcription and proliferation in cells transduced with the 6p25.3 risk allele. Although further studies are needed to fully elucidate underlying biological mechanisms, together these loci explain 4% of the familial risk and provide insights into genetic susceptibility to this malignancy. © 2018, The Author(s).