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  • Kosola, Silja; McCarthy, Maria C.; McNeil, Robyn; Orme, Lisa M.; Drew, Sarah; Sawyer, Susan M. (2018)
    Purpose: This study describes the early educational and vocational outcomes of Australian adolescents and young adults (AYAs) after cancer diagnosis and examines factors associated with these outcomes. Methods: Within this cross-sectional national Australian study, 196 AYAs aged 15-25 years at cancer diagnosis and within 6-24 months of diagnosis were recruited from 18 sites. Participants completed a survey that included questions about school and work outcomes, support received regarding necessary changes to education and vocation, and validated measures of anxiety, depression, and post-traumatic stress. Results: Almost half of the sample (43%) was not fully "back on track" with their previous educational and vocational plans. Post-traumatic stress and emotional symptoms were associated with poorer school/work functioning (beta = -0.95, p = 0.009 and beta = -1.27, p = 0.001, respectively). Higher PedsQL school/work functioning was associated with a slightly greater likelihood of being "back on track" with education and work plans (OR 1.03, p = 0.001). AYAs who felt well supported regarding changes to education and work plans more frequently reported receiving support from formal sources and from more sources than those who felt less supported. Unmet need of accessing an educational or vocational advisor was significantly more frequent in adult than in pediatric settings (42% vs. 17%; p = 0.024). Parents were the most common source of educational or vocational support for AYAs rather than professionals. Conclusion: This study highlights the connection between school and work participation and mental health in a national sample of AYAs with cancer. It suggests distinct benefits of educational and vocational support.
  • Kaihlanen, Anu-Marja; Elovainio, Marko; Haavisto, Elina; Salminen, Leena; Sinervo, Timo (2020)
    Background The shortage of nurses is a global issue, and turnover rates are especially high for newly graduated nurses. The transition from student to nurse is often described as challenging, and the final clinical practicum before graduation is suggested to be important in preparing graduating students for the transition. However, little is known about the actual relationships between the final clinical practicum, transition and turnover intentions. Objectives To examine whether the final clinical practicum experience is associated with the transition experience and turnover intentions of newly graduated nurses, and whether the transition experience mediates the potential relationship between the practicum and turnover intentions. Design Cross-sectional survey study. Settings The study was carried out in Finland (October–December 2018). Participants Registered nurses graduated within the past two years (n = 712). Methods A new survey instrument with five subscales was developed for measuring the final clinical practicum experience. Transition experience was measured on four scales that demonstrated the emotional, physical, socio-developmental and intellectual domains of the transition: Psychological distress, sleep quality, role conflict/ambiguity, perception of transition and educational preparation. Turnover intentions from job and profession were asked about with two questions. Structural equation modelling was used to explore the associations between the variables. The models were adjusted for multiple potential confounders. Results Final clinical practicum experience was associated with all domains of the transition experience and turnover intentions. The association between the practicum and turnover intentions was partly mediated by the emotional (psychological distress) and socio-developmental (role conflict and ambiguity) domains of the transition. Conclusions Our findings provide new evidence about the associations between the specific final clinical practicum dimensions and turnover intentions and the specific mechanisms linking this association. These results highlight the importance of final clinical practicums and suggest targets for improving nurses' transition processes during their first years in practice.
  • Loi, Silvia; Pitkänen, Joonas; Moustgaard, Heta; Myrskylä, Mikko; Martikainen, Pekka (2021)
    Although the children of first-generation immigrants tend to have better health than the native population, the health advantage of the children of immigrant families deteriorates over generations. It is, however, poorly understood where on the generational health assimilation spectrum children with one immigrant and one native parent (i.e., exogamous families) lie, to what extent family resources explain health assimilation, and whether the process of assimilation varies across health conditions. We seek to extend our understanding of the process of health assimilation by analyzing the physical and mental health of immigrant generations, assessing the role of exoga-mous family arrangements, and testing the contributions of family material and social resources to children’s outcomes. We use register-based longitudinal data on all children residing in Finland, born in 1986–2000, and alive in 2000; these data are free of report-ing bias and loss to follow-up. We estimate the risk of receiving inpatient and outpatient care for somatic conditions, psychopathological disorders, and injuries by immigrant generation status. Our results show evidence of a negative health assimilation process, with both first-and second-generation immigrant children having a higher prevalence of physical problems and particularly mental health problems than native children that is only partially explained by family resources. We find that the children of exogamous families are at especially high risk of developing psychopathological disorders. These results provide strong support for the hypothesis that children of exogamous families constitute a specific health risk group and that the impact on children’s health of family social and material resources seems to be secondary to other unobserved factors.
  • Pesonen, Anu-Katriina; Lahti, Marius; Kuusinen, Tiina; Tuovinen, Soile; Villa, Pia; Hämäläinen, Esa; Laivuori, Hannele; Kajantie, Eero; Räikkönen, Katri (2016)
    Background We investigated whether maternal prenatal emotions are associated with gestational length and birth weight in the large PREDO Study with multiple measurement points of emotions during gestation. Methods Altogether 3376 pregnant women self-assessed their positive affect (PA, Positive and Negative Affect Schedule) and depressive (Center for Epidemiologic Studies Depression Scale, CES-D) and anxiety (Spielberger State Anxiety Scale, STAI) symptoms up to 14 times during gestation. Birth characteristics were derived from the National Birth Register and from medical records. Results One standard deviation (SD) unit higher PA during the third pregnancy trimester was associated with a 0.05 SD unit longer gestational length, whereas one SD unit higher CES-D and STAI scores during the third trimester were associated with 0.04-0.05 SD unit shorter gestational lengths (P-values = 42 weeks), birth weight and fetal growth were not associated with maternal prenatal emotions. Conclusions This study with 14 measurements of maternal emotions during pregnancy show modest effects of prenatal emotions during the third pregnancy trimester, particularly in the weeks close to delivery, on gestational length. From the clinical perspective, the effects were negligible. No associations were detected between prenatal emotions and birth weight.
  • Lahelma, Eero; Pietilainen, Olli; Rahkonen, Ossi; Lahti, Jouni; Lallukka, Tea (2016)
    Background: Mental symptoms are prevalent among populations, but their associations with premature mortality are inadequately understood. We examined whether mental symptoms contribute to cause-specific mortality among midlife employees, while considering key covariates. Methods: Baseline mail survey data from 2000-02 included employees, aged 40-60, of the City of Helsinki, Finland ( n = 8960, 80 % women, response rate 67 %). Mental symptoms were measured by the General Health Questionnaire 12-item version ( GHQ-12) and the Short Form 36 mental component summary ( MCS). Covariates included sex, marital status, social support, health behaviours, occupational social class and limiting long-standing illness. Causes of death by the end of 2013 were obtained from Statistics Finland ( n = 242) and linked individually to survey data pending consent ( n = 6605). Hazard ratios ( HR) and 95 % confidence intervals ( 95 % CI) were calculated using Cox regression analysis. Results: For all-cause mortality, only MCS showed a weak association before adjustments. For natural mortality, no associations were found. For unnatural mortality ( n = 21), there was a sex adjusted association with GHQ ( HR = 1.96, 95 % CI = 1.45-2.64) and MCS ( 2.30, 95 % CI = 1.72-3.08). Among unnatural causes of death suicidal mortality ( n = 11) was associated with both GHQ ( 2.20, 95 % CI = 1.47-3.29) and MCS ( 2.68, 95 % CI = 1.80-3.99). Of the covariates limiting long-standing illness modestly attenuated the associations. Conclusions: Two established measures of mental symptoms, i.e. GHQ-12 and SF-36 MCS, were both associated with subsequent unnatural, i.e. accidental and violent, as well as suicidal mortality. No associations were found for natural mortality due to diseases. These findings need to be corroborated in further populations. Supporting mental health through workplace measures may help counteract subsequent suicidal and other unnatural mortality among midlife employees.
  • Laine, Hanna; Saastamoinen, Peppiina; Lahti, Jouni; Rahkonen, Ossi; Lahelma, Eero (2014)
  • Palada, Vinko; Gilron, Ian; Canlon, Barbara; Svensson, Camilla; Kalso, Eija (2020)