”Loppujen lopuksi painolla ei ole merkitystä, kun itsellä on hyvä olla.” : Painon- ja elämänhallintakurssin arviointi ja kehittäminen

Tämän opinnäytetyön tarkoituksena oli arvioida Helsingin yliopiston Yliopistoliikunnan (YOL) ja Ylioppilaiden Terveydenhoitosäätiön (YTHS) yhteistyössä järjestämää Painavaa asiaa kevyestä elämästä -painon- ja elämänhallintakurssia. Tarkoitus oli antaa YOL:lle ja YTHS:lle uutta tietoa, jonka avulla he voivat kehittää kurssia. Tavoitteena oli tutkia kurssilaisten tavoitteita ja odotuksia ja niiden toteutumista. Teoriaosuudessa käydään aluksi läpi transteoreettista muutosvaihemallia ja Banduran pystyvyyden tunnetta sekä tuodaan esille, miten ne voisivat soveltua painonhallintaan. Myöhemmin teoriaosuudessa esitellään lihavuuden määritelmä ja siihen liittyviä syömishäiriöiden muotoja. Painonhallintaan kuuluvia asioita käsitellään pääasiassa liikunnan, ruokavalion ja tavoitteenasettelun pohjalta. Tutkimuksen kohderyhmän muodostivat 14 Helsingin yliopiston opiskelijaa, joiden ikäjakauma oli 22–36 vuotta. Heidän painoindeksinsä oli 30–48. Heistä 13 oli naisia ja yksi oli mies. Kurssilla ohjaajina toimivat personal trainer Juha Rautanen ja YTHS Viikin terveydenhoitaja Paula Aarnio-Tervo. Kurssilla vieraili psykologi ja kaksi ryhmäliikuntaohjaajaa. Kurssi koostui 11 tapaamiskerrasta. Tutkimusaineisto koottiin ennen kurssia ja kurssin jälkeen jaetuilla kyselylomakkeilla. Kurssilaiset olivat pääasiassa erittäin tyytyväisiä kurssiin ja kurssin ohjaajiin. Kurssilta sai riittävästi tietoa ja tukea. Kanssakurssilaiset koettiin tärkeiksi vertaistuen lähteiksi. Monella kurssilaisella tavoitteet jäivät toteutumatta, varsinkin painonpudotuksen ja ruokavaliomuutosten osalta. Suurin osa asettikin painonpudotuksen ensisijaiseksi tavoitteekseen. Suurin este omien tavoitteiden toteutumiselle näytti olevan oma elämäntilanne. Toisilla se taas saattoi edistää tavoitteiden toteumista mahdollistaen paremman sitoutumisen kurssiin ja liikunnan harrastamiseen. Painonhallintaryhmän järjestämisessä olisi syytä miettiä ryhmän yhteisiä pelisääntöjä: millainen on sitoutumisen vaatimus ja miten se asetetaan? Aiheellista voisi olla pohtia, olisiko syytä kartoittaa tarkemmin kurssilaisten muutosvalmiutta, jolloin kurssi voitaisiin rakentaa osallistujia parhaiten palvelevaksi kokonaisuudeksi?The aim of this study was to evaluate Painavaa asiaa kevyestä elämästä (“Heavy matter of a light life”) weight-, and life control course organized by the Sports Services of Helsinki University (YOL) and the Finnish Student Health Service (YTHS). This study tried to give any new information to YOL and YTHS to develop the course. The goal was to research the goals and the expectations of the course participants and find out how they were met. In the theory section, Transtheoretical Model of Change (TTM) and Bandura´s self-efficacy will be introduced and their possible applications to weight control will be pointed out. Also the definition of obesity and eating disorders related to it will be introduced. The things related to weight control, will mainly be dealt with physical activity, nutrition and goal setting. The target group was fourteen students at Helsinki University, aged 22 to 36 years. Their body mass index (BMI) varied from 30 to 48. There were thirteen female participants and one male participant. The course had two main instructors: a personal trainer, Juha Rautanen, and a nurse, Paula Aarnio-Tervo, from YTHS Viikki. There were visits also from a psychologist and two group sports instructors during the course. The course included eleven meetings. The research material was collected with questionnaires delivered before and after the course. The course participants were mostly very satisfied with the course and the instructors. The participants felt they got enough information and support. They considered the fellow participants as an important source of help and support. Many of them did not reach their goals, especially the ones set for losing weight and making nutritional changes. The biggest obstacle in order to reach the goals seemed to be participant´s personal issues of life. For the participants, who had time and energy for strong commitment, it was easier to them to reach their goals, and become physically active. When organizing a weight control group, the general rules of the group should be considered: what is the role of commitment and how is it set? It would be good to better map the readiness for change of the participants in order to build the course in the best way

Eteisvärinän riskitekijät ja ehkäiseminen

Teema : eteisvärinä. English summaryPeer reviewe

The Russian invasion of Ukraine selectively depolarized the Finnish NATO discussion

The Russian invasion of Ukraine in 2022 dramatically reshaped the European security landscape. In Finland, public opinion on NATO had long been polarized along the left-right partisan axis, but the invasion led to a rapid convergence of the opinion toward joining NATO. We investigate whether and how this depolarization took place among polarized actors on Finnish Twitter. By analyzing retweeting patterns, we find three separated user groups before the invasion: a pro-NATO, a left-wing anti-NATO, and a conspiracy-charged anti-NATO group. After the invasion, the left-wing anti-NATO group members broke out of their retweeting bubble and connected with the pro-NATO group despite their difference in partisanship, while the conspiracy-charged anti-NATO group mostly remained a separate cluster. Our content analysis reveals that the left-wing anti-NATO group and the pro-NATO group were bridged by a shared condemnation of Russia's actions and shared democratic norms, while the other anti-NATO group, mainly built around conspiracy theories and disinformation, consistently demonstrated a clear anti-NATO attitude. We show that an external threat can bridge partisan divides in issues linked to the threat, but bubbles upheld by conspiracy theories and disinformation may persist even under dramatic external threats

How far are vowel formants from computed vocal tract resonances?

13 pages, 1 figure, 3 tablesWe compare numerically computed resonances of the human vocal tract with formants that have been extracted from speech during vowel pronunciation. The geometry of the vocal tract has been obtained by MRI from a male subject, and the corresponding speech has been recorded simultaneously. The resonances are computed by solving the Helmholtz partial differential equation with the Finite Element Method (FEM). Despite a rudimentary exterior space acoustics model, i.e., the Dirichlet boundary condition at the mouth opening, the computed resonance structure differs from the measured formant structure by $\approx$ 0.7 semitones for [i] and [u] having small mouth opening area, and by $\approx$ 3 semitones for vowels [a] and [ae] that have a larger mouth opening. The contribution of the possibly open velar port has not been taken into considaration at all which adds the discrepancy for [a] in the present data set. We conclude that by improving the exterior space model and properly treating the velar port opening, it is possible to computationally attain four lowest vowel formants with an error less than a semitone. The corresponding wave equation model on MRI-produced vocal tract geometries is expected to have a comparabale accuracy.Non peer reviewe

Predicting the stability of early employment with its timing and childhood social and health-related predictors : a mixture Markov model approach

To extend work careers, it is important to focus on all working-aged people including young adults. The aim of this study was to identify typical patterns of work participation among young adults after their first entry into the labour market and to examine whether the timing of entry together with parental and own socio-economic position and health predict early work participation. More in-depth understanding of early careers and their early determinants is important to plan targeted interventions and to promote more stable work participation among young adults. We used the Finnish Birth Cohort 1987 including data from several registers from all 59,476 children born in 1987 as well as their parents, followed until 2015. We estimated a mixture Markov model that allowed for joint identification of latent classes of labour-market attachment, estimation of labour-market transitions within classes, and prediction of class membership using childhood social and health-related determinants. We observed that the first entry into the labour market as measured by six months in continuous employment was not a permanent entry for many, not only due to negative reasons such as unemployment and ill health but also due to more voluntary reasons such as studies. Individuals entering the labour market at a later age were more likely to be in continuous employment thereafter. More advantaged background predicted exits due to studies or - when following a late entry - stable employment, while disadvantaged background factors predicted more unstable work and long-term exits from the labour market.Peer reviewe

Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication

Background We aim to shed light on long-term subjective outcomes after re-operations for failed fundoplication. Methods 1809 patients were operated on for hiatal hernia and/or gastroesophageal reflux disease (GERD) at the Helsinki University Hospital between 2000 and 2017. 111 (6%) of these had undergone a re-operation for a failed antireflux operation. Overall, HRQoL was assessed in 89 patients at the latest follow-up using the generic 15D (c) instrument. The results were compared to a sample of the general population, weighted to reflect the age and gender distribution of patients. Disease-specific HRQoL was assessed using the GERD-HRQoL questionnaire. We studied variation in the overall HRQoL with respect to disease-specific HRQoL and known patients' parameters using univariate and multivariable linear regression models. Results The median postoperative follow-up period was 9.3 years. All patients were operated on laparoscopically (6% conversion rate), and 87% were satisfied with the re-operation. Postoperative complications were minimal (5%). Twelve patients (11%) underwent a second re-operation. The median GERD-HRQoL score was nine. In multivariable analysis, four variables were independently associated with the 15D score, suggesting a decrease in the 15D score with increasing GERD-HRQoL score, increasing Charlson Comorbidity Index (CCI) and the presence of chronic pain syndrome (CPS) and depression. Conclusion Re-do LF is a safe procedure in experienced hands and may offer acceptable long-term alleviation in patients with recurring symptoms after antireflux surgery. Decreased HRQoL in the long run is related to recurring GERD and co-morbidities.Peer reviewe

Kulttuurin ja liikunnan hyvinvointivaikutukset osaksi päätöksenteko- ja ohjausjärjestelmää

Opetus- ja kulttuuriministeriön asettama työryhmä selvitti, miten kulttuurin ja liikunnan hyvinvointivaikutukset otetaan osaksi päätöksenteko- ja ohjausjärjestelmää. Kulttuurin ja liikunnan hyvinvointia lisäävä ja pahoinvointia ennaltaehkäisevä vaikutus ovat tutkitusti kiistämättömiä faktoja. Muun muassa väestön ikääntymisen ja elintapamuutosten seurauksena sosiaali- ja terveysmenot kasvavat. Valtion lisääntyvä rahoitus korjaaviin toimenpiteisiin hyvinvointialueille uhkaa viedä voimavaroja kuntien ja muiden toimijoiden ennaltaehkäiseviltä toimilta. Uhkaavan kehityksen kääntäminen edellyttää systeemistä muutosta. Työryhmä esittää strategisen sekä projekti- ja hanketason toimenpiteitä. Valtion ohjausjärjestelmää esitetään muutettavan ilmiöpohjaiset kokonaisuudet tunnistavaksi ja tutkittuun tietoon sekä luotettavaan dataan perustuvaan vaikuttavuuteen perustuvaksi. Hallitusohjelmaan esitetään Kansallinen toimintakyky -ohjelmaa, jossa painopisteenä on kulttuurin ja liikunnan ennaltaehkäisevä toiminta. Toimenpiteiden painopistettä esitetään siirrettäväksi tarjonnasta kysynnän lisäämiseen esimerkiksi Kansallinen hyvinvointikortti -sovelluksella. Analyysin ja toimenpide-ehdotusten ohella raportti on osin ensimmäinen kokonaiskuvaus kulttuurin ja liikunnan toimintakentästä.Julkaisu on päivitetty 27.3.2023, s. 5

Keratoendotheliitis Fugax Hereditaria : A Novel Cryopyrin-Associated Periodic Syndrome Caused by a Mutation in the Nucleotide-Binding Domain, Leucine-Rich Repeat Family, Pyrin Domain-Containing 3 (NLRP3) Gene

PURPOSE: To describe the phenotype and the genetic defect in keratoendotheliitis fugax hereditaria, an autosomal dominant keratitis that periodically affects the corneal endothelium and stroma, leading in some patients to opacities and decreased visual acuity. DESIGN: Cross-sectional, hospital-based study. METHODS: PATIENT POPULATION: Thirty affected and 7 unaffected subjects from 7 families, and 4 sporadic patients from Finland. OBSERVATION PROCEDURES: Ophthalmic examination and photography, corneal topography, specular microscopy, and optical coherence tomography in 34 patients, whole exome sequencing in 10 patients, and Sanger sequencing in 34 patients. MAIN OUTCOME MEASURES: Clinical phenotype, disease causing genetic variants. RESULTS: Unilateral attacks of keratoendotheliitis typically occurred 1-6 times a year (median, 2.5), starting at a median age of 11 years (range, 5-28 years), and lasted for 1-2 days. The attacks were characterized by cornea pseudoguttata and haze in the posterior corneal stroma, sometimes with a mild anterior chamber reaction, and got milder and less frequent in middle age. Seventeen (50%) patients had bilateral stroma! opacities. The disease was inherited as an autosomal dominant trait. A likely pathogenic variant c.61G > C in the NLRP3 gene, encoding cryopyrin, was detected in all 34 tested patients and segregated with the disease. This variant is present in both Finnish and non-Finnish European populations at a frequency of about 0.02% and 0.01%, respectively. CONCLUSION: Keratoendotheliitis fugax hereditaria is an autoinflammatory cryopyrin-associated periodic syndrome caused by a missense mutation c.61G > C in exon 1 of NLRP3 in Finnish patients. It is additionally expected to occur in other populations of European descent. ((c) 2018 The Author(s). Published by Elsevier Inc.Peer reviewe