Opiskelijat lastensuojelun perhehoidon tukena

Opinnäytetyön päätavoitteena oli selvittää, miten opiskelijat suhtautuvat sijaisperheissä tehtävää har-joittelua sekä sijaisvanhemmuutta kohtaan. Työn tilasi tutkija Petri Paju RAY:n ja Lastensuojelun kes-kusliiton Emma & Elias- avustusohjelmasta. Työ on kvantitatiivinen tutkimus ja sen aineisto on kerätty kyselylomakkeilla. Kohderyhmänä oli Humanistisen ammattikorkeakoulun yhteisöpedagogi- ja Jyväsky-län ammattikorkeakoulun sosionomiopiskelijoilta. Tutkimus pohjautuu vuonna 2012 tehtyyn lastensuojelulain muutokseen. Lakimuutoksen tarkoituksena on lasten sijoitusten painottuminen lapsen edunmukaisesti perhehoitoon. Tutkimuksen tarkoituksena on käsitellä lastensuojelun perhehoidon tukimuotojen kehittämistä opiskeli-joiden avulla ja muodostaa uusia näkökulmia tuen muotoihin. Tutkimuksesta selviää, kokevatko opiske-lijat sijaisperheessä tehtävän harjoittelun kehittävänä ja kiinnostavana. Samalla on saatu kerättyä tie-toa, ovatko opiskelijat kiinnostuneita sijaisvanhemmuudesta. Työ tuottaa uutta tietoa opiskelijoiden asenteista ja tietoisuudesta sijaisperheessä tehtävästä harjoitte-lusta. Työtä voidaan hyödyntää suunniteltaessa sosionomi- sekä yhteisöpedagogitutkintojen opetus-suunnitelmia ja harjoittelusisältöjä.The aim of this thesis was to find out what will the students consider the internships which took place in foster families. It also gathered the data of students interests for foster parenting. The thesis was ordered by a researcher Petri Paju from Emma & Elias programme of RAY and Central Union for Child Welfare. The study is quantitative research and the data were gathered by a questionnaire. The target group consisted of the students from JAMK University of Applied Sciences and HUMAK University of Applied Sciences. The survey is based on the changes made in the law of child welfare in 2012. The purpose of the amendment is to emphasize children’s advantages in their placements in foster care. The purpose of the survey is to deal the development of the support system in foster care with the help of students and to formulate new aspects in the support system. It points out in the survey whet-her the students consider the internships in foster families improving and interesting. In the meantime there was some data collected from the students whether they would be interested in foster parenting themselves. The thesis develops new data about students’ attitudes and awareness for an internship in a foster family. The thesis can be exploited while planning the curriculums and the contents of internships of Bachelor’s Degree of Civic Activity and Youth Work and Bachelor’s Degree of Social Services

CD34+ cell mobilization, blood graft composition, and posttransplant recovery in myeloma patients compared to non-Hodgkinʼs lymphoma patients: results of the prospective multicenter Goa study

BACKGROUND Autologous stem cell transplantation is an established treatment option for patients with multiple myeloma (MM) or non-Hodgkin?s lymphoma (NHL). STUDY DESIGN AND METHODS In this prospective multicenter study, 147 patients with MM were compared with 136 patients with NHL regarding the mobilization and apheresis of blood CD34+ cells, cellular composition of infused blood grafts, posttransplant recovery, and outcome. RESULTS Multiple myeloma patients mobilized CD34+ cells more effectively (6.3???106/kg vs. 3.9???106/kg, p?=?0.001). The proportion of poor mobilizers (peak blood CD34+ cell count 100?days) nonrelapse mortality (NRM; 6% vs. 0%, p?=?0.003). CONCLUSIONS Non-Hodgkin?s lymphoma and MM patients differ in terms of mobilization of CD34+ cells, graft cellular composition, and posttransplant recovery. Thus, the optimal graft characteristics may also be different.Peer reviewe

Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study

Background Autologous stem cell transplantation (auto-SCT) is a widely used treatment option in multiple myeloma (MM) patients. The optimal graft cellular composition is not known.Study design and methods Autograft cellular composition was analyzed after freezing by flow cytometry in 127 MM patients participating in a prospective multicenter study. The impact of graft cellular composition on hematologic recovery and outcome after auto-SCT was evaluated.Results A higher graft CD34(+) cell content predicted faster platelet recovery after auto-SCT in both the short and long term. In patients with standard-risk cytogenetics, a higher graft CD34(+) count (>2.5 x 10/kg) was linked with shorter progression-free survival (PFS; 28 vs. 46 months, p = 0.04), but there was no difference in overall survival (OS) (p = 0.53). In a multivariate model, a higher graft CD34(+)CD133(+)CD38(-) (>0.065 x 10/kg, p = 0.009) and NK cell count (>2.5 x 10/kg, p = 0.026), lenalidomide maintenance and standard-risk cytogenetics predicted better PFS. In contrast, a higher CD34(+) count (>2.5 x 10/kg, p = 0.015) predicted worse PFS. A very low CD3(+) cell count (Conclusions Autograft cellular composition may impact outcome in MM patients after auto-SCT. More studies are needed to define optimal graft composition.</div

RVD induction and autologous stem cell transplantation followed by lenalidomide maintenance in newly diagnosed multiple myeloma: a phase 2 study of the Finnish Myeloma Group

Autologous stem cell transplantation (ASCT) combined with novel agents is the standard treatment for transplant-eligible, newly diagnosed myeloma (NDMM) patients. Lenalidomide is approved for maintenance after ASCT until progression, although the optimal duration of maintenance is unknown. In this trial, 80 patients with NDMM received three cycles of lenalidomide, bortezomib, and dexamethasone followed by ASCT and lenalidomide maintenance until progression or toxicity. The primary endpoint was the proportion of flow-negative patients. Molecular response was assessed if patients were flow-negative or in stringent complete response (sCR). By intention to treat, the overall response rate was 89%. Neither median progression-free survival nor overall survival (OS) has been reached. The OS at 3 years was 83%. Flow-negativity was reached in 53% and PCR-negativity in 28% of the patients. With a median follow-up of 27 months, 29 (36%) patients are still on lenalidomide and 66% of them have sustained flow-negativity. Lenalidomide maintenance phase was reached in 8/16 high-risk patients but seven of them have progressed after a median of only 6 months. In low- or standard-risk patients, the outcome was promising, but high-risk patients need more effective treatment approach. Flow-negativity with the conventional flow was an independent predictor for longer PFS

Ixazomib, Lenalidomide, and Dexamethasone (IRD) Treatment with Cytogenetic Risk-Based Maintenance in Transplant-Eligible Myeloma: A Phase 2 Multicenter Study by the Nordic Myeloma Study Group

Scarce data exist on double maintenance in transplant-eligible high-risk (HR) newly diagnosed multiple myeloma (NDMM) patients. This prospective phase 2 study enrolled 120 transplant-eligible NDMM patients. The treatment consisted of four cycles of ixazomib–lenalidomide–dexamethasone (IRD) induction plus autologous stem cell transplantation followed by IRD consolidation and cytogenetic risk-based maintenance therapy with lenalidomide + ixazomib (IR) for HR patients and lenalidomide (R) alone for NHR patients. The main endpoint of the study was undetectable minimal residual disease (MRD) with sensitivity of −5 by flow cytometry at any time, and other endpoints were progression-free survival (PFS) and overall survival (OS). We present the preplanned analysis after the last patient has been two years on maintenance. At any time during protocol treatment, 28% (34/120) had MRD −5 at least once. At two years on maintenance, 66% of the patients in the HR group and 76% in the NHR group were progression-free (p = 0.395) and 36% (43/120) were CR or better, of which 42% (18/43) had undetectable flow MRD −5. Altogether 95% of the patients with sustained MRD −5, 82% of the patients who turned MRD-positive, and 61% of those with positive MRD had no disease progression at two years on maintenance (p < 0.001). To conclude, prolonged maintenance with all-oral ixazomib plus lenalidomide might improve PFS in HR patients