Murrosiän myllerryksessä : vanhempien voimavarat ja vertaistuki

Hänninen, Hanna. Murrosiän mylleryksessä : vanhempien voimavarat ja vertaistuki. Helsinki, kevät 2013, 101 s. Diakonia-ammattikorkeakoulu, Sosiaalialan koulutusohjelma, Päihteet ja syrjäytyminen, Sosionomi (YAMK). Nuoren murrosikä on kehitysvaihe, jossa nuori kasvaa aikuiseksi monien fyysisten ja psyykkisten muutosten myötä. Nuorelle murrosikään liittyvä kehitys voi olla haastava elämänvaihe, joka heijastuu eri tavoin koko perheeseen. Tämä opinnäytetyö on syntynyt työelämän tarpeesta kehittää asiakaslähtöisiä vanhemmuutta tukevia palvelumuotoja näiden haasteiden kanssa kamppaileville murrosikäisten perheille. Opinnäytetyön tavoitteena on ymmärtää ja kuvata murrosiän ilmenemistä perheiden arjessa vanhempien näkökulmasta ja kartoittaa niitä haasteita, joita murrosiän kehitys vanhemmuudelle asettaa. Lisäksi tutkimus pyrkii selvittämään, millaisia voimavaroja murrosikäisten nuorten vanhemmilla on ja mistä he tällä hetkellä saavat tukea vanhemmuudelleen. Vertaistukeen perustuvista työmuodoista vanhemmuuden tukemisessa on saatu paljon myönteisiä kokemuksia etenkin pikkulapsiperheiden auttamisessa. Tämä opinnäytetyö on erityisesti kiinnostunut vertaistuen hyödyntämisestä myös murrosikäis-ten perheiden tukemisessa. Yhtenä työn tavoitteena on selvittää, millaista vertaistukea murrosikäisten vanhemmat saavat ja millainen merkitys vertaistuella on vanhemmille. Opinnäytetyö on laadullinen tutkimus, jonka aineisto on kerätty haastattelemalla seit-semää murrosikäisen vanhempaa. Haastatteluiden tavoitteena oli kuulla vanhempien näkökulmaa murrosikään liittyvissä kysymyksissä, ja nostaa esiin heidän kokemuksiaan palveluiden kehittämisen lähtökohdaksi. Aineisto on analysoitu pääasiassa teoriaohjaavaa sisällönanalyysiä käyttäen, mutta analyysin loppuvaiheessa on hyödynnetty myös diskurssianalyyttistä lähestymistapaa. Vanhemmat näkivät murrosiän nuoren yksilöllisenä kehitysvaiheena, jonka vaikutukset heijastuivat koko perheeseen ja edellyttivät etenkin vanhemmuudelta sopeutumista erilaisiin muutoksiin. Vanhemmat peilasivat murrosikään liittyviä kokemuksiaan monitahoisesti sekä itseensä että laajemmin vallitsevaan yhteiskunnalliseen tilanteeseen. Van-hemmilla itsellään oli monenlaisia voimavaroja, joista etenkin perheen merkitys korostui. Myös lähiyhteisö tuki monella tapaa vanhemmuutta. Vanhemmat kokivat eri tavoin saavansa yhteiskunnalta tukea vanhemmuuteensa, mutta avun hakeminen koettiin vai-keaksi ja siihen liitettiin paljon negatiivisia tunteita. Vertaistukea vanhemmat saivat ys-täviltään, työkavereiltaan sekä toisten lasten vanhemmilta, ja se koettiin voimavaroja lisääväksi ja vanhemmuutta tukevaksi. Vertaistuen toteutumiselle oli vanhempien mielestä kuitenkin liian vähän mahdollisuuksia. Vanhempien murrosikään liittyvistä kokemuksista heijastuu paljolti heidän oma vanhemmuuskuvansa, johon he suhtautuvat usein kriittisesti. Vanhemmat kaipaavat tukea vanhemmuudelleen, vaikka heillä onkin paljon voimavaroja, joiden avulla selvitä arkisista tilanteista. Murrosikäisten vanhempia tuettaessa tulisi huomio kiinnittää heidän omien voimavarojensa ja vanhemmuutensa vahvistamiseen, missä vertaistukeen perustuvat tukimuodot tulisi tulevaisuudessa nähdä yhtenä merkittävänä vaihtoehtona. Asiasanat: murrosikä, vanhemmuus, tukimuodot, vertaistuki, sosiaalinen tukiThe purpose of this study was to understand and describe how adolescence shows out in everyday life of families and what kind of challenges it sets to parenthood. The aim of this study was also to find out what kind of resources parents have and where they get support to their parenthood. This study collected information for the need of working life to develop new customer-oriented services for families that have some difficulties to survive with their adolescent. Many families with young children have benefited from peer support but there is only little information about peer support between parents of adolescents. This study also aimed to find out what kind of peer support parents have and how important it is for them. The method of approach in the study was qualitative with seven parents of adolescent participating. The material included six interviews and it was analysed by using theory driven content analysis and in part using discourse analysis. Parents thought that adolescence was an individual period of life which had influences on them and on the family. Parents also need to adjust themselves to many changes that an adolescent has to face. Parents reflected their thoughts in many ways, on themselves and on a social context. Parents had many kinds of resources to cope with adolescence and the family was the most important of them. Close people also gave them strength. They also got support from society, but it was difficult to seek any help. Parents had many negative feelings on seeking help. Parents also get a lot of peer support from their friends, workmates and parents of other adolescents. Peer support gave them more resources and assisted their parenthood. Parents thought that there were insufficient possibilities for peer support to be realized. Parents had a lot of thoughts about their parenthood and many parents were critical about themselves. Despite of the resources the parents needed many kind of support from their close people and society. It is important to pay attention to how to strengthen the parental resources in the future. Methods that rely on peer support should take ac-count of developing services for families with an adolescent

Cytotoxicity analyses of crovirin on LLC-MK₂ cells (A) and peritoneal macrophages (B) by trypan blue cell viability and MTS assay, respectively.

<p>No tested concentrations induced significant lost of cell viability in either cell type. Error bars represent standard deviation of the mean of 3 independent experiments.</p

Crovirin activity towards medically important trypanosomes and <i>Leishmania</i>.

a<p>The IC₅₀ and LD₅₀ values are expressed in µg/ml.</p>b<p>Selectivity Index (SI)^e was determined according to the ratio between the LC₅₀^e/IC₅₀ or LD₅₀ values. SI values, where LC₅₀>20 µg/ml.</p>c<p>Treatment period.</p>d<p>parasite/100 cells.</p><p>nd: Not determined.</p><p>Crovirin activity towards medically important trypanosomes and <i>Leishmania</i>.</p

Crovirin, a Snake Venom Cysteine-Rich Secretory Protein (CRISP) with Promising Activity against Trypanosomes and <i>Leishmania - Figure 1 </i>

<p>(<b>A</b>) <b>Crovirin purification from Cvv venom using a reverse phase analytical C₈ column, where the protein was eluted as peak 3.</b> (<b>B</b>) SDS-PAGE analysis of peak 3 (lane B) containing the purified crovirin protein under reducing conditions. The gel was stained with Coomassie blue. Lane A, molecular weight markers. (<b>C</b>) MALDI-TOF mass spectrometry analyses of the intact protein yielded a molecular mass of 24,893.64 Da. The peaks of 12,424.36 and 12,477.62 Da correspond to doubly-charged (z = 2) cationic forms of crovirin.</p

Adipose Tissue-Derived Mesenchymal Stromal Cells Protect Mice Infected with <i>Trypanosoma cruzi</i> from Cardiac Damage through Modulation of Anti-parasite Immunity

<div><p>Background</p><p>Chagas disease, caused by the protozoan <i>Trypanosoma cruzi</i> (<i>T</i>.<i>cruzi</i>), is a complex disease endemic in Central and South America. It has been gathering interest due to increases in non-vectorial forms of transmission, especially in developed countries. The objective of this work was to investigate if adipose tissue-derived mesenchymal stromal cells (ASC) can alter the course of the disease and attenuate pathology in a mouse model of chagasic cardiomyopathy.</p><p>Methodology/Principal Findings</p><p>ASC were injected intraperitoneally at 3 days post-infection (dpi). Tracking by bioluminescence showed that cells remained in the abdominal cavity for up to 9 days after injection and most of them migrated to the abdominal or subcutaneous fat, an early parasite reservoir. ASC injection resulted in a significant reduction in blood parasitemia, which was followed by a decrease in cardiac tissue inflammation, parasitism and fibrosis at 30 dpi. At the same time point, analyses of cytokine release in cells isolated from the heart and exposed to <i>T</i>. <i>cruzi</i> antigens indicated an anti-inflammatory response in ASC-treated animals. In parallel, splenocytes exposed to the same antigens produced a pro-inflammatory response, which is important for the control of parasite replication, in placebo and ASC-treated groups. However, splenocytes from the ASC group released higher levels of IL-10. At 60 dpi, magnetic resonance imaging revealed that right ventricular (RV) dilation was prevented in ASC-treated mice.</p><p>Conclusions/Significance</p><p>In conclusion, the injection of ASC early after <i>T</i>. <i>cruzi</i> infection prevents RV remodeling through the modulation of immune responses. Lymphoid organ response to the parasite promoted the control of parasite burden, while the heart, a target organ of Chagas disease, was protected from damage due to an improved control of inflammation in ASC-treated mice.</p></div

Cytokine release in non-infected and infected mice in response to <i>T</i>. <i>cruzi</i> antigens (tAg).

<p>(A) Splenocytes from infected animals released significantly higher levels of IFN-γ and TGF-β when compared to non-infected controls. No differences were found between placebo and ASC-treated groups in IFN-γ, TNF-α and TGF-β. IL-2 levels were increased in ASC-treated samples when compared to non-infected controls. IL-6 and IL-10 were higher in the ASC group when compared to placebo and non-infected groups. (B) When stimulated with tAg, cells derived from hearts treated with ASC released less IFN-γ and more IL-10 in comparison to placebo-treated animals. Levels of TNF-α, TGF-β and IL-6 were significantly increased in the placebo group when compared to non-infected controls, while the ASC group had intermediate levels of these cytokines. IL-2 release was low and similar between the three experimental groups (*p<0.05, numbers of samples in each group were at least non-infec: 4, placebo: 5, ASC: 5).</p

Parasitism, inflammation and fibrosis in infected mice.

<p>(A) Number of parasites (x10⁵) per mL of blood as days after infection progress. The area under the parasitemia curve was calculated for each animal and plotted in (B). ASC-treated animals (n = 14) had a significantly lower AUC when compared to placebo (n = 11) (**p = 0.0022). (C-G) H&E and (H-J) Sirius Red staining of heart tissue sections. (C) Non-infected animals showed normal myocardial fibers. Infection with <i>T</i>. <i>cruzi</i> caused a significant increase in the number of mononuclear inflammatory foci (arrows) (D) and amastigote nests (arrow heads) (F). Therapy with ASC prevented myocardial inflammation (E) and reduced the number of amastigote nests in the heart (G). Additionally, fibrosis was also increased in infected animals treated with placebo (I) when compared to non-infected mice (H), as shown by collagen fibers stained in red. Treatment with ASC reduced fibrosis in infected animals (J). Quantification of inflammation (K) (n = 7, ***p = 0.0002), amastigote nests (L) (n = 3, *p = 0.015) and fibrosis (M) (n = 3, **p = 0.0083) compared to Infec+ASC, Student’s t test.</p

Magnetic resonance imaging of chagasic mice.

<p>(A) Representative magnetic resonance images in diastole. A sequence of images from the same animal is shown in each line. Observe the enlargement of the right ventricle (RV) in the placebo group. (B) RV end-diastolic volume (EDV) was significantly higher in placebo-treated when compared to ASC-treated animals. (C) RV end-systolic volume (ESV) was significantly higher in placebo-treated when compared to ASC-treated and non-infected mice. No differences were found in RV ejection fraction (EF) (D) or in left ventricular EDV (E), ESV (F) or EF (G) (*p<0.05, non-infec n = 3, placebo n = 6, ASC n = 6 for all parameters).</p

Characterization of ASC.

<p>(A) ASC were adherent to culture flaks and exhibited a fibroblast-like spindle-shaped morphology. (B) Macroscopic view of CFU-F assay showing colonies of ASC stained by Giemsa. (C) Microscopic view exemplifying one colony of ASC also stained by Giemsa. Growth of ASC in culture was exponential (D) and the curves were converted to logarithmic scale (E) to calculate population doubling time (PDT) (n = 4 in all experiments). (F-K) Histograms showing the immunophenotype of ASC by flow cytometry. (F) Dead cells were excluded from the analysis by DAPI staining. (G-K) Dashed lines represent isotype controls and the percentage of positive events is shown on the right upper quadrant. Cells were predominantly positive for CD90.2 (G) and Sca-1 (H). Expression of CD105 (I) and CD73 (J) was lower. No hematopoietic contaminants were observed since cells were negative for CD45 (K). (L-O) Differentiation of ASC. (L and N) Negative controls. Cells were cultured for 21 days in standard expansion culture medium. (M) ASC cultured in adipogenic conditions exhibited lipid vacuoles in their cytoplasm shown by Oil Red O staining (white arrows). (O) Cells cultured in osteogenic conditions exhibited calcium deposits in the extracellular matrix stained by Alizarin Red. Inserts show higher magnification images of M and O.</p

Cell tracking by bioluminescence.

<p>(A) Evaluation of luminescent signal intensity in ASC transduced with the Luciferase 2 gene <i>in vitro</i>. Numbers shown below the wells indicate the amount of cells. (B) The signal increased with cell numbers in a linear fashion (R² = 0.9914). <i>In vivo</i> images (C) and quantification (D) (n = 3) of the luminescent signal showed that cells remained in the abdominal region and that there was a progressive decrease in radiance with time. The signal disappeared within 9 days of cell injection. <i>Ex vivo</i> images (E) and quantification (F) (n = 3 per day) of the luminescent signal demonstrated that the majority of the cells migrated to the abdominal or subcutaneous fat. The signal was lower in other abdominal organs, such as the spleen and liver, and virtually absent in thoracic organs such as the heart and lungs. Quantification data in D and F are shown in logarithmic scale.</p