Abstract The purpose of the study was to examine the relationship between nursing leadership and burnout among nurses in health care as well as the incidence of multidimensional leadership and burnout in Finnish nursing. A further purpose was to test a factor structure of Multifactor Leadership Questionnaire (MLQ) and Maslach Burnout Inventory (MBI) in Finnish health care. The empirical data were gathered by postal questionnaires from nursing staff working in university, central and district hospitals, health centers as well as psychiatric and private hospitals (n = 900, response rate 73%). In addition, a follow-up study was performed at a one-year interval (n = 100, response rate 79%). After deleting unusable questionnaires, the sample consisted of 627, and the follow-up study of 78 nurses and nurse leaders. The data were analyzed with descriptive and multivariate statistical methods. Nurse leaders proved to be transformational leaders who rewarded their subordinates, but traditional active and passive management-by-exception and laissez-faire leadership also appeared in their leadership behavior. Half of the nursing staff were moderately burned out and about one tenth were highly burned out. Nearly one fifth suffered from high emotional exhaustion. Nursing leadership has both positive and negative effects on burnout among nursing staff. Rewarding transformational leadership and active management-by-exception functioned as protecting factors, and passive laissez-faire leadership as an exposing factor. However, the results suggest that the relation between leadership and burnout is complex, affected by situational factors of leadership and the ambiguous nature of burnout. The six- and three-factor structure of the MLQ as well as the three-factor structure of the MBI were empirically supported. According to psychometric properties both instruments are well applicable to Finnish health care research. The results can be used in academic leadership education and leadership training in health care organizations, as well as to improve the quality of work life and to promote work well-being. The results can also be utilized in studies applying MLQ and MBI as well as when exploring factor structure of measures and in validation studies of instruments. / Tiivistelmä Tutkimuksen tarkoituksena oli selvittää hoitotyön johtajuuden ja hoitohenkilöstön työuupumuksen yhteyttä terveydenhuollossa sekä moniulotteisen johtajuuden ja työuupumuksen esiintymistä suomalaisessa hoitotyössä. Lisäksi tarkoituksena oli testata suomalaisessa terveydenhuollossa moniulotteisen johtajuusmittarin ja kolmiulotteisen työuupumusmittarin rakennetta. Empiirinen tutkimusaineisto kerättiin postikyselyllä yliopisto-, keskus- ja aluesairaaloiden, terveyskeskusten sekä psykiatristen ja yksityisten sairaaloiden hoitohenkilöstöltä (n = 900, vastausprosentti 73). Lisäksi toteutettiin seurantakysely vuoden intervallilla (n = 100, vastausprosentti 79). Aineistosta jouduttiin poistamaan vastauksia, ja poistojen jälkeen tutkimusjoukko muodostui 627:stä ja seurantakyselyssä 78 hoitajasta ja hoitotyön esimiehestä. Aineiston analyysissä käytettiin tilastollisina kuvailevina menetelminä ristiintaulukointia, kontingenssikerrointa, χ²-testiä, Pearsonin tulomomenttikorrelaatiokerrointa, t-testiä, Mann-Whitney U-testiä, Wilcoxonin testiä, yksi- ja kaksisuuntaista varianssianalyysiä sekä Kruskal-Wallisin testiä. Monimuuttujamenetelminä olivat rakenneyhtälömallitus ja lineaarinen regressioanalyysi. Mittareiden luotettavuuden arvioinnissa käytettiin eksploratiivista ja konfirmatorista faktorianalyysiä, Cronbachin alpha -kerrointa, osiosummakorrelaatioita, osioiden välisiä korrelaatioita, Pearsonin tulomomenttikorrelaatiokerrointa ja intraclass-korrelaatiokerrointa. Hoitotyön johtajat osoittautuivat työntekijöitä palkitseviksi muutosjohtajiksi, mutta johtamiskäyttäytymisessä esiintyi myös perinteistä työntekijöiden aktiivista ja passiivista valvomista sekä välttävää johtajuutta. Eroja ilmeni johtajan iän, työkokemuksen, työtehtävän ja perustyöhön osallistumisen mukaan. Puolella hoitohenkilöstöstä esiintyi keskimääräistä ja noin kymmenesosalla voimakasta työuupumusta. Voimakkaasta emotionaalisesta väsymyksestä kärsi lähes joka viides. Hoitotyön johtajuudella on sekä myönteisiä että kielteisiä vaikutuksia hoitohenkilöstön työuupumuksen kannalta. Palkitseva muutosjohtajuus ja työntekijöiden aktiivinen valvominen toimivat työuupumukselta suojaavina tekijöinä ja passiivinen välttäminen työuupumukselle altistavana tekijänä. Tulokset viittaavat kuitenkin siihen, että johtajuuden ja työuupumuksen yhteys on kompleksinen, ja tähän vaikuttavat johtajuuden tilannetekijät ja työuupumuksen moniselitteinen luonne. Hoitohenkilöstön ikä, työllisyystilanne, työaikamuoto ja työtehtävän luonne vaikuttivat johtajuuden ja työuupumuksen yhteyteen, joka oli suhteellisen pysyvä vuoden intervallilla mitattuna. Myös johtajuus ja työuupumus osoittautuivat stabiileiksi ilmiöiksi. Johtajuusmittarin kuuden ja kolmen faktorin rakenne sekä työuupumusmittarin kolmen faktorin rakenne saivat empiiristä tukea. Mittareita voidaan pitää psykometristen ominaisuuksiensa perusteella suomalaiseen terveydenhuoltotutkimukseen soveltuvina. Tutkimustuloksia voidaan hyödyntää terveydenhuoltoalan yliopistollisessa ja terveydenhuollon organisaatioiden sisäisessä johtamiskoulutuksessa, työelämän laadun parantamisessa ja työhyvinvoinnin edistämisessä, johtajuus- ja työuupumusmittaria soveltavissa tutkimuksissa sekä laajemmin mittareiden kehittämistyössä ja validointitutkimuksissa.

Introdução: As extrassístoles ventriculares e supraventriculares (EV e ESSV) são frequentes e muitas vezes sintomáticas. O íon magnésio (Mg) desempenha um papel importante na fisiologia do potencial de ação transmembrana celular e do ritmo cardíaco. Objetivo: Avaliar se a administração do Pidolato de Magnésio (PMg) em pacientes com EV e ESSV é superior ao placebo (P) na melhora dos sintomas e densidade das extrassístoles(DES). Métodos: Estudo duplo-cego, randomizado, com 90 pacientes sintomáticos consecutivos, com mais de 240/EV ou ESSV ao Holter de 24 horas e selecionados para receber P ou PMg. Para avaliar a melhora da sintomatologia, foi feito um questionário categórico e específico de sintomas relacionado às extrassístoles. Foi considerada significante uma redução de mais de 70% na DES por hora após o tratamento. A dose do PMg foi de 3,0g/dia por 30 dias, equivalente a 260mg do elemento Mg. Nenhum paciente tinha cardiopatia estrutural ou insuficiência renal. Resultados: Dos 90 pacientes estudados, 49 eram do sexo feminino (54,4%). A faixa etária variou de 16 a 70 anos. No grupo PMg, 77,8% dos pacientes tiveram redução maior que 70%, 6,7% deles entre 50% a 70% e, somente 13,3% dos pacientes com redução menor que 50% na DES . No grupo P, 44,4% dos pacientes tiveram melhora de apenas 30% na frequência de extrassístoles (p<0,001). A melhora dos sintomas foi alcançada em 91,1% dos pacientes do grupo PMg, comparada com somente 15,6% do grupo P(p<0,001). Conclusão: A suplementação de Mg por via oral reduziu a DES, resultando em melhora dos sintomas. Estudos clínicos e moleculares são necessários para avaliar o Mg intracelular e orientar quanto às necessidades diárias deste íon, evidenciar as prováveis deficiências e esclarecer melhor como prevenir e tratar pacientes com extrassístoles sintomáticas e sem cardiopatia estrutural. / Introduction: Premature ventricular and supraventricular complexes (PVC and PsVC) are frequent and often symptomatic. The magnesium (Mg) ion plays a role in the physiology of cell membranes and cardiac rhythm. Objective: We evaluated whether the administration of Mg Pidolate (MgP) in patients with PVC and PsVC is superior to placebo (P) in improving symptoms and arrhythmia frequency. Methods: Randomized double-blind study with 90 consecutive symptomatic patients with more than 240 PVC or PsVC on 24-hour Holter monitoring who were selected to receive placebo or MgP. To evaluate symptom improvement, a categorical and a specific questionnaire for symptoms related to PVC and PsVC was made. Improvement in premature complex density (PCD) per hour was considered significant if percentage reduction was >=70% after treatment. The dose of MgP was 3.0 g/day for 30 days, equivalent to 260mg of Mg element. None of the patients had structural heart disease or renal failure. Results: Of the 90 patients, 49 were female (54,4%). Ages ranged from 16 to 70 years old. In the MgP group, 77.8% of patients had a PCD reduction >70%, 6,7% of them from 50% to 70%, and only 13.3% <50%. In the P group, 44,4% showed slight improvement, <30%, in the premature complexes frequency (p<0.001). Symptom improvement was achieved in 91.1% of patients in the MgP group, compared with only 15.6% in the P group (p<0.001). Conclusions: Oral Mg supplementation decreases PCD, resulting in symptom improvement. Clinical and molecular studies are needed to evaluate intracellular Mg and develop better targets for the daily needs of this ion, show probable deficiencies, and explain how to prevent and better treat patients with symptomatic premature ventricular, and supraventricular complexes and no apparent heart disease.

The current trend towards large-scale research projects with big quantities of data from multiple sources require robust and efficient data handling. This thesis explores techniques for automatizing research data pipelines. Specifically, two tasks related to automation within a long-term research project in cognitive neuroscience are addressed. The first task is to develop a tool for automatic transcribing of paper-based questionnaires using computer vision. Questionnaires containing continuous scales, so called visual analog scales (VASs), are used extensively in e.g. psychology. Despite this, there currently exists no tool for automatic decoding of these types of questionnaires. The resulting computer vision system for automatic questionnaire transcribing we present, called "VASReader", reliably detects VAS marks with an accuracy of 98%, and predicts their position with a mean absolute error of 0.3 mm when compared to manual measurements. The second task addressed in this thesis project is to investigate whether machine learning can be used to detect anomalies in Magnetic Resonance Imaging (MRI) data. An implementation of the unsupervised anomaly detection technique Isolation Forest shows promising results for the detection of anomalous data points. The model is trained on image quality metric (IQM) data extracted from MRI. However, it is concluded that the site of scanning and MRI machine model used affect the IQMs, and that the model is more prone to classify data points originating from machines and institutions that have less support in the database as anomalous. An important conclusion from both tasks is that automation is possible and can be a great asset to researchers, if an appropriate level and type of automation is selected.

No description available.

No description available.

Using questionnaire survey generated data from a single school district, this study investigated the effects of family factors, peer factors, school problem behaviors, and psychosocial factors on adolescents' use of or abstinence from alcohol, marijuana, and other drugs. Following a review of literature, a theoretical framework incorporating family socialization theory was use to operationalize variables, develop indices, and generate hypotheses to be tested, as well as develop a general model of adolescent alcohol and other drug use and abstinence, incorporating the predictor variables. Using SPSSx procedures, factor analysis was used to develop the indices; the hypotheses were tested using Oneway Analysis of Variance (ANOVA) and F-ratio tests associated with regression analysis. The path analysis models were developed using multiple regression analysis and bivariate decomposition tables. For both junior high school students and high school students, users of alcohol, marijuana, and other drugs were found to score higher on the Family Factors index, the Peer Factors index, School Problems index, and the Psychosocial Factors index. The model differed between alcohol and marijuana users, defining the conditions under which an adolescent is more likely to use or abstain from marijuana. While both family and peer factors effected the adolescents' choices of use or abstinence, the strongest predictor of use/abstinence was the peer use and attitudes factor. Family factors tended to be stronger in the younger age/grade levels than in the higher age/grade levels, as predicted from the theoretical framework.

In the new Library Act of 2014, it is stated that public library supply should be characterized by quality. To investigate what this means for the library, I do a functional analysis of ideas of librarians' views on quality and how they work with purchasing, weeding and mediation. I have chosen to limit the essay to fiction for adults in Swedish public libraries. By combining the basal idea analysis, where I investigate librarians' ideas about quality, with an operational analysis of ideas, where I examine the effects librarians' quality ideas get for the daily work, Iwant to find out the librarians' quality ideals. The material I analyze consists of 18 questionnaires, filled out by librarians with responsibility for purchasing and / or thinning in libraries across Sweden. The analysis is done with an analytical schedule, that consists of a number of opposing ideal types taken from previous research on quality, purchasing, thinning or mediation. In this way I want to show how librarians quality idea and practical work relate to previous quality ideas and ways of working. The result shows two in many ways opposing ideas of quality: craftsmanship, where quality sits in the work's aesthetic, and impact on the reader, where quality arrisis in the meeting with the reader. Put in context, idea number one can be seen in quality definitions where quality is seen as relatively objective, where experts best can judge a work's quality. The second quality idea is often associated with a user-defined and subjective quality. One can also see how it is a special kind of impact, development, that is associated with quality. If we look instead at the operational analysis we can see how librarians, especially in the work of purchasing, promote the popular, both in terms of authors, titles and genres. The librarians purchase a lot on demand and use circulation figures to see what needs to be purchased: that which it lent much. Popularity rather than quality is what decides what should be purchased, except for literature of very low quality that is not bought at all. Also in weeding circulation figures is used; even though literature of very high quality is moved to the magazine instead of beeing weeded. Regarding the mediation of literature, librarians to some extent try to lead their users toward literature of higher quality, but they are careful not to judge neither reader or literature. When giving advice on literature, it is from one reader to another. It is important that the readers themselves choose what and how they want to read. User influence is what steer the work of purchase, weeding and mediation. The librarians quality ideas only to a very limited extent influence the librarians practical work, why I believe that it is impossible to speak of a quality ideal. Instead I want to describe the librarians' way of thinking about the library's literature as a value ideal. Furthermore, I would call the librarians value ideal a customer-driven value ideal, where the user is seen as an enlightened and well-informed customer with both the right and the knowledge to determine what the library should purchase and prioritize. This is a two years master’s thesis in Archive, Library and Museum studies.

No description available.

No / Patient-reported outcome measurement has become accepted as an important component of comprehensive outcomes research. Researchers wishing to use a patient-reported measure must either develop their own questionnaire (called an instrument in the research literature) or choose from the myriad of instruments previously reported. This article summarizes how previously developed instruments are best assessed using a systematic process and we propose a system of quality assessment so that clinicians and researchers can determine whether there exists an appropriately developed and validated instrument that matches their particular needs. These quality assessment criteria may also be useful to guide new instrument development and refinement. We welcome debate over the appropriateness of these criteria as this will lead to the evolution of better quality assessment criteria and in turn better assessment of patient-reported outcomes.

Peu d'instruments évaluent les variables cognitives sous jacentes à l'Anxiété face à la Santé (AS) ou à l'Hypocondrie. Si des instruments mesurent la tendance à l'amplification sensorielle et la conviction d'être atteint d'une maladie, aucun questionnaire n'a réussi à déceler spécifiquement les croyances générales face à la santé ou les croyances associées aux inquiétudes face à la maladie. Ces deux variables cognitives peuvent maintenir les symptômes hypocondriaques. La présente recherche a pour but d'élaborer et de valider deux questionnaires: le Questionnaire des Croyances Reliées à la Santé (QCRS) et le questionnaire Pourquoi S'Inquiéter face à la Santé (PSI-S). L'étude 1 vise à épurer les items des deux questionnaires en éliminant ceux qui sont non pertinents et la seconde étude détermine leurs qualités psychométriques. Les versions finales du QCRS et du PSI-S possèdent 19 et 13 items respectivement. Leurs indices de validité et de fidélité s'avèrent excellents. Le QCRS possède cinq composantes: (1) responsabilité, (2) santé, (3) conséquences, (4) pensée magique et (5) vulnérabilité; le PSI-S en contient deux: (1) utilité et (2) pensée magique.