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Tiivistelmä. Moderni työelämä ja sen vaatimukset ovat muokanneet työntekijöiden ja organisaatioiden tarpeita. Yhteiskunnan ja teknologian kehittyessä yhä useampi työ vaatii tietointensiivistä asiantuntijaosaamista. Pätevistä työntekijöistä kilpaillaan kovempaa kuin koskaan aiemmin ja työntekijät ovat päättävässä asemassa työnantajaa valittaessa. Samanaikaisesti vakituisen ja pitkäaikaisen työsuhteen arvostus on vähenemässä, kun työntekijät haluavat kehittyä monipuolisesti ja edetä urallaan. Tämä yhtälö on aiheuttanut haasteen työntekijöiden sitouttamisessa ja vaihtuvuuden hallinnassa. Tämän pro gradu -tutkielman tavoitteena on tutkia miten psykologinen sopimus vaikuttaa työntekijän organisaatiositoutumiseen. Tutkimuksessa paneudutaan erityisesti psykologisen sopimuksen laiminlyönnin ja organisaatiositoutumisen yhteyteen. Psykologista sopimusta tarkastellaan työntekijän näkökulmasta. Tutkimuksen teoreettinen viitekehys luotiin monipuolisen aiemman tutkimuksen perusteella. Teoreettisessa viitekehyksessä tunnistettiin psykologisen sopimuksen muodostuminen, sen erilaiset alalajit ja sisältö sekä elinkaari. Lisäksi viitekehyksessä käsiteltiin psykologisen sopimuksen ja motivaation sekä organisaatiositoutumisen yhteyttä. Tutkimuksen empiirinen osuus toteutettiin puolistrukturoiduilla teemahaastatteluilla, jotka toteutettiin videon välityksellä. Tutkimukseen osallistui neljä asiantuntijatehtävissä työskentelevää henkilöä, jotka olivat lähiaikoina vaihtaneet työnantajaa ja täten myös päättäneet sekä luoneet uuden psykologisen sopimuksen. Tutkimuksen empiirisessä osiossa pyrittiin täydentämään ja laajentamaan teoreettisen viitekehyksen perusteella tehtyä mallia psykologisen sopimuksen ja organisaatiositoutumisen yhteydestä. Täydennetyssä mallissa otettiin huomioon myös työnantajabrändin ja organisaation ulkoisen viestinnän vaikutus, työntekijän kehittyminen ja eteneminen sekä koko psykologisen sopimuksen elinkaaren aikaisten tekijöiden huomioiminen organisaatiositoutumisessa. Tutkimuksella pyritään liikkeenjohdollisesti herättämään organisaatioiden ymmärrys psykologisen sopimuksen tärkeydestä työntekijöiden vaihtuvuuden hallinnassa. Tutkimuksen kontribuutiona voidaan pitää aiempaa tutkimusta laajempaa käsitystä psykologisen sopimuksen ja organisaatiositoutumisen yhteydestä sekä siihen vaikuttavista tekijöistä. Tutkimustulokset kuvastavat modernia työelämää ja täten täydentävät aiemmin luotua, uuden psykologisen sopimuksen mallia. Lisäksi tutkimustulokset auttavat työntekijöitä hahmottamaan psykologisen sopimuksen käsitettä ja sen sisältöä, keskustelemaan molemminpuolisista odotuksista ja velvollisuuksista sekä seuraamaan psykologisen sopimuksen toteutumista.

Objective: To assess the feasibility and evaluate the performance of a relaunched colorectal cancer (CRC) screening programme with different cut-offs for men and women. Design: Population-based registry study. Setting: Nine municipalities in Finland which started CRC screening with faecal immunochemical test (FIT) in April 2019 with cut-off levels 70 µg Hg/g faeces for men and 25 µg Hg/g faeces for women. Participants: Men (n=13 059) and women (n=14 669) aged 60–66 years invited to screening during the first programme year. Outcome measures: Participation rates, positivity rates, detection rates of CRC and advanced adenoma (AA), and positive predictive values (PPV) of FIT for CRC and AA. Results: Altogether 21 993 invitees returned stool samples. The participation rate of women (83.4%; 95% CI 82.8 to 84.0) was significantly higher than that of men (74.7%; 95% CI 73.9 to 75.4). The positivity rates were 2.4% (2.2 to 2.7) and 2.8% (2.5 to 3.1), respectively. In total, 37 CRCs and 116 AAs were detected. The detection rates of CRC and AA per 1000 participants were 1.8 (1.1 to 2.9) and 7.2 (5.6 to 9.1) for men and 1.6 (0.9 to 2.4) and 3.8 (2.8 to 5.0) for women. The PPVs per 100 positive tests were 6.6 (4.0 to 10.3) and 25.7 (20.6 to 31.4) for men and 6.4 (3.9 to 9.8) and 15.5 (11.6 to 20.2) for women. Conclusions: The chosen FIT strategy narrowed the gap in the diagnostic performance between men and women especially in the detection of CRC. The participation rates were excellent. The levels of positivity and detection rates were moderate and need further action. The results indicate that gender-specific protocols can be introduced to organised CRC screening. It is yet to be seen whether they are more effective than a uniform screening protocol.

Background: Cervical cancer elimination through human papillomavirus (HPV) vaccination programs requires the attainment of herd effect. Due to its uniquely high basic reproduction number, the vaccination coverage required to achieve herd effect against HPV type 16 exceeds what is attainable in most populations. We have compared how gender-neutral and girls-only vaccination strategies create herd effect against HPV16 under moderate vaccination coverage achieved in a population-based, community-randomized trial. Methods and findings: In 2007–2010, the 1992–1995 birth cohorts of 33 Finnish communities were randomized to receive gender-neutral HPV vaccination (Arm A), girls-only HPV vaccination (Arm B), or no HPV vaccination (Arm C) (11 communities per trial arm). HPV16/18/31/33/35/45 seroprevalence differences between the pre-vaccination era (2005–2010) and post-vaccination era (2011–2016) were compared between all 8,022 unvaccinated women

Cannabis use during adolescence is associated with an increased risk of developing psychosis. According to a current hypothesis, this results from detrimental effects of early cannabis use on brain maturation during this vulnerable period. However, studies investigating the interaction between early cannabis use and brain structural alterations hitherto reported inconclusive findings. We investigated effects of age of cannabis initiation on psychosis using data from the multicentric Personalized Prognostic Tools for Early Psychosis Management (PRONIA) and the Cannabis Induced Psychosis (CIP) studies, yielding a total sample of 102 clinically-relevant cannabis users with recent onset psychosis. GM covariance underlies shared maturational processes. Therefore, we performed source-based morphometry analysis with spatial constraints on structural brain networks showing significant alterations in schizophrenia in a previous multisite study, thus testing associations of these networks with the age of cannabis initiation and with confounding factors. Earlier cannabis initiation was associated with more severe positive symptoms in our cohort. Greater gray matter volume (GMV) in the previously identified cerebellar schizophrenia-related network had a significant association with early cannabis use, independent of several possibly confounding factors. Moreover, GMV in the cerebellar network was associated with lower volume in another network previously associated with schizophrenia, comprising the insula, superior temporal, and inferior frontal gyrus. These findings are in line with previous investigations in healthy cannabis users, and suggest that early initiation of cannabis perturbs the developmental trajectory of certain structural brain networks in a manner imparting risk for psychosis later in life.

This paper deals with the Skolt Saami passive verb suffixes -j- and -õõvvâ- (e.g. mott-j-ed ‘change (intr.)’, rottš-õõvvâ-d ‘be pulled’) cognate with North Saami -o(j)- and -uvva- (e.g. dahkk-o-t ‘be done’, muhttaš-uvva-t ‘change (intr.)’) as well as Finnish -u- ~ -y- (e.g. käänt-y-ä ‘turn (intr)’). The research material has two complementary parts: a dialectal dictionary and a speech corpus. The semantics of the relevant verbs in the material is examined. The main distinction is made between intentional passives (true passives having a volitional agent) and automative passives (actions that happen spontaneously or by accident, anticausatives). The results show that at least the suffix -jed and to a lesser extent -õõvvâd are mainly used to mark automative passives, but some instances of intentional passives are also found as well as some cases that are ambiguous between the two. The suffix -õõvvâd is used in the passive function more rarely than the suffix -jed and it has more functions.

In schizophrenia, neurocognitive subtypes can be distinguished based on cognitive performance and they are associated with neuroanatomical alterations. We investigated the existence of cognitive subtypes in shortly medicated recent onset psychosis patients, their underlying gray matter volume patterns and clinical characteristics. We used a K-means algorithm to cluster 108 psychosis patients from the multi-site EU PRONIA (Prognostic tools for early psychosis management) study based on cognitive performance and validated the solution independently (N = 53). Cognitive subgroups and healthy controls (HC; n = 195) were classified based on gray matter volume (GMV) using Support Vector Machine classification. A cognitively spared (N = 67) and impaired (N = 41) subgroup were revealed and partially independently validated (Nspared = 40, Nimpaired = 13). Impaired patients showed significantly increased negative symptomatology (pfdr = 0.003), reduced cognitive performance (pfdr pfdr p = 0.01) separating impaired patients from HC revealed increases and decreases across several fronto-temporal-parietal brain areas, including basal ganglia and cerebellum. Cognitive and functional disturbances alongside brain morphological changes in the impaired subgroup are consistent with a neurodevelopmental origin of psychosis. Our findings emphasize the relevance of tailored intervention early in the course of psychosis for patients suffering from the likely stronger neurodevelopmental character of the disease.

Large scale human papillomavirus (HPV) vaccination against the most oncogenic high‐risk human papillomavirus (HPV) types 16/18 is rapidly reducing their incidence. However, attempts at assessing if this leads to an increase of nonvaccine targeted HPV types have been hampered by several limitations, such as the inability to differentiate secular trends. We performed a population‐based serological survey of unvaccinated young women over 12 years. The women were under 23‐years‐old, residents from 33 communities which participated in a community‐randomised trial (CRT) with approximately 50% vaccination coverage. Serum samples were retrieved pre‐CRT and post‐CRT implementation. Seropositivity to 17 HPV types was assessed. HPV seroprevalence ratios (PR) comparing the postvaccination to prevaccination era were estimated by trial arm. This was also assessed among the sexual risk‐taking core group, where type replacement may occur more rapidly. In total, 8022 serum samples from the population‐based Finnish Maternity Cohort were retrieved. HPV types 16/18 showed decreased seroprevalence among the unvaccinated in communities only after gender‐neutral vaccination (PR16/18A = 0.8, 95% CI 0.7‐0.9). HPV6/11 and HPV73 were decreased after gender‐neutral vaccination (PR6/11A = 0.8, 95% CI 0.7‐0.9, PR73A = 0.7, 95% CI 0.6‐0.9, respectively) and girls‐only vaccination (PR6/11B = 0.8, 95% CI 0.7‐0.9, PR73B = 0.9, 95% CI 0.8‐1.0). HPV68 alone was increased but only after girls‐only vaccination (PR68B = 1.3, 95% CI 1.0‐1.7, PRcore68B = 2.8, 95% CI 1.2‐6.3). A large‐scale, long‐term follow‐up found no type replacement in the communities with the strongest reduction of vaccine HPV types. Limited evidence for an increase in HPV68 was restricted to girls‐only vaccinated communities and may have been due to secular trends (ClinicalTrials.gov number: NCT00534638).