Valjakkoajotuomarin kouluttautumisopas

Opinnäytetyön tavoitteena ja tarkoituksena oli koota olemassa oleva hajanainen koulutusmateriaali ja sen pohjalta tuottaa koulutusopas suomalaisten valjakkoajotuomarien koulutukseen, tuomaritehtävien hoitamiseen sekä jatkokouluttautumiseen; tehdä valjakkotuomarin urapolku ja muistilista tuomaritehtävien hoitamista varten kilpailuissa. Työssä hyödynnettiin olemassa olevaa Suomen Ratsastajainliiton koulutusmateriaalia (lähinnä muihin ratsastuslajeihin tarkoitettua) sekä kansainvälisen ratsastajainliiton (FEI) kurssirunkoa ja materiaalia. Toimivia valjakkoajon toimihenkilöitä haastateltiin ja tehtiin kysely tulevia koulutustarpeita varten, sekä yleinen tulevaisuuden visiointiin liittyvä kartoituskysely. Työ on kehittämissuunnitelma ja tarkoitettu kansallisten ja alueellisten valjakkoajotuomareiden kouluttamiseen. Muuhun käyttöön työ soveltuu muuta materiaalia tukemaan. Samaan aikaan Suomen Ratsastajainliitossa on ollut meneillään organisaatiouudistus, kilpailujärjestelmäuudistus sekä koulutustoiminnan selkiyttäminen, johon liittyen on tehty urapolku kilpailijoille ja erikseen harrasteratsastajille. Lajikohtainen valjakkoajon urapolku, johon tämäkin opinnäytetyö osaltaan liittyy, on vielä työn alla

The Finnish day-care centre as an environment for learning social-emotional well-being

Social-emotional well-being and its support are important for young children. In this research we describe how the educators of day-care centres meet the children’s social-emotional needs during the everyday practices. The following question will be answered: How and where do the educators encounter children and how do they support children’s social-emotional well-being? The participants of the research were from four day-care centres in Kymenlaakso county and three in Päijät-Häme county. The data were gathered from the day-care centres through photographs and diaries written by the educators in Kymenlaakso and by the researchers’ observations in Päijät-Häme. The data was analysed using phenomenological and content analysis. The reflected knowledge contains information about phases of social-emotional development, feelings and needs. The educators created knowledge in several places where they observe and monitor the children and are in interaction with them. According to results, there are still visible moments or longer periods when the educators do not encounter the needs of children. Quiet children may remain invisible and all the participants of the day-care centres do not always identify categorized gender norms

Hyvinvointipalvelukokemukset tuentarvitsijan institutionaalista luottamusta rakentamassa? : Tarkastelussa lapsiperheiden vanhempien sekä nuorten aikuisten kokemukset hyvinvointipalveluista

Peer reviewe

Hyvinvointipalvelukokemukset tuentarvitsijan institutionaalista luottamusta rakentamassa? : Tarkastelussa lapsiperheiden vanhempien sekä nuorten aikuisten kokemukset hyvinvointipalveluista

Peer reviewe

Tubular cell damage may be the earliest sign of renal extrahepatic manifestation caused by Hepatitis C

Publisher Copyright: © 2021 Kaartinen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Chronic kidney disease (CKD) is one of the most well-known extrahepatic manifestations caused by hepatitis C infection (HCV). CKD is typically discovered at a late stage. HCVnephropathy may show different histopathologic patterns, as both glomerular and tubulointerstitial damage have been described. Identification of patients with early renal manifestations would be beneficial to provide treatment and avoid progression to CKD. The observational prospective single-center HCVKID study assessed the prevalence of early renal manifestations in patients with chronic HCV and compared these patients with HCVnegative healthy controls cross-sectionally. HCV-positive patients with and without renal manifestations were also compared to define biomarkers suitable for identifying early manifestations in standard clinical practice. Tubular proteinuria as judged by urine α 1-microglobulin was the most common early renal manifestation found in 11% in HCV-positive patients, followed by hematuria in 8%. Kidney filtration was statistically significantly lower among HCV-positive patients with renal manifestation according to any calculation method. There were no significant differences in duration of infection or stage of liver fibrosis between patients with or without renal manifestations. Tubular cell damage may be the earliest sign of renal dysfunction caused by HCV. Complement activation also correlates with the dysfunction, indicating of contribution to HCV-induced renal manifestations even in their early phase.Peer reviewe

Diagnostic and Prognostic Comparison of Immune-Complex-Mediated Membranoproliferative Glomerulonephritis and C3 Glomerulopathy

Membranoproliferative glomerulonephritis (MPGN) is subdivided into immune-complex-mediated glomerulonephritis (IC-MPGN) and C3 glomerulopathy (C3G). Classically, MPGN has a membranoproliferative-type pattern, but other morphologies have also been described depending on the time course and phase of the disease. Our aim was to explore whether the two diseases are truly different, or merely represent the same disease process. All 60 eligible adult MPGN patients diagnosed between 2006 and 2017 in the Helsinki University Hospital district, Finland, were reviewed retrospectively and asked for a follow-up outpatient visit for extensive laboratory analyses. Thirty-seven (62%) had IC-MPGN and 23 (38%) C3G (including one patient with dense deposit disease, DDD). EGFR was below normal (≤60 mL/min/1.73 m2) in 67% of the entire study population, 58% had nephrotic range proteinuria, and a significant proportion had paraproteins in their serum or urine. A classical MPGN-type pattern was seen in only 34% of the whole study population and histological features were similarly distributed. Treatments at baseline or during follow-up did not differ between the groups, nor were there significant differences observed in complement activity or component levels at the follow-up visit. The risk of end-stage kidney disease and survival probability were similar in the groups. IC-MPGN and C3G have surprisingly similar characteristics, kidney and overall survival, which suggests that the current subdivision of MPGN does not add substantial clinical value to the assessment of renal prognosis. The high proportion of paraproteins in patient sera or in urine suggests their involvement in disease development

Vascular Occlusion in Kidney Biopsy Is Characteristic of Clinically Manifesting Thrombotic Microangiopathy

Thrombotic microangiopathy (TMA) can sometimes manifest only histologically. Our aim was to retrospectively compare biopsy-proven adult TMA patients showing only histological (h-TMA) or both histological and clinical (c-TMA) TMA in 2006-2017. All native kidney biopsies with TMA were included. Biopsies were re-evaluated by light and electron microscopy, and immunofluorescence. Clinical characteristics, laboratory variables, and treatments were recorded from the electronic medical database. Patients were categorized into h-TMA and c-TMA and these groups were compared. In total, 30 biopsy-proven cases among 7943 kidney biopsies were identified and, of these, 15 had h-TMA and 15 c-TMA. Mean follow-up was 6.3 y, and 73.3% had secondary hemolytic uremic syndrome (HUS) and the rest were atypical HUS. Patient characteristics, treatments, and kidney, and patient survival in the groups were similar. Statistically significant differences were found in histological variables. Vascular myxoid swelling and vascular onion-skinning were almost exclusively detected in c-TMA and, thus, vascular occlusive changes indicate clinically apparent rather than merely histological TMA. In addition, regardless of clinical presentation, kidney and patient survival times were similar in the patient groups highlighting the importance of a kidney biopsy in the case of any kidney-related symptoms.Peer reviewe

Vascular Occlusion in Kidney Biopsy Is Characteristic of Clinically Manifesting Thrombotic Microangiopathy

Thrombotic microangiopathy (TMA) can sometimes manifest only histologically. Our aim was to retrospectively compare biopsy-proven adult TMA patients showing only histological (h-TMA) or both histological and clinical (c-TMA) TMA in 2006–2017. All native kidney biopsies with TMA were included. Biopsies were re-evaluated by light and electron microscopy, and immunofluorescence. Clinical characteristics, laboratory variables, and treatments were recorded from the electronic medical database. Patients were categorized into h-TMA and c-TMA and these groups were compared. In total, 30 biopsy-proven cases among 7943 kidney biopsies were identified and, of these, 15 had h-TMA and 15 c-TMA. Mean follow-up was 6.3 y, and 73.3% had secondary hemolytic uremic syndrome (HUS) and the rest were atypical HUS. Patient characteristics, treatments, and kidney, and patient survival in the groups were similar. Statistically significant differences were found in histological variables. Vascular myxoid swelling and vascular onion-skinning were almost exclusively detected in c-TMA and, thus, vascular occlusive changes indicate clinically apparent rather than merely histological TMA. In addition, regardless of clinical presentation, kidney and patient survival times were similar in the patient groups highlighting the importance of a kidney biopsy in the case of any kidney-related symptoms

Vascular Occlusion in Kidney Biopsy Is Characteristic of Clinically Manifesting Thrombotic Microangiopathy

Thrombotic microangiopathy (TMA) can sometimes manifest only histologically. Our aim was to retrospectively compare biopsy-proven adult TMA patients showing only histological (h-TMA) or both histological and clinical (c-TMA) TMA in 2006–2017. All native kidney biopsies with TMA were included. Biopsies were re-evaluated by light and electron microscopy, and immunofluorescence. Clinical characteristics, laboratory variables, and treatments were recorded from the electronic medical database. Patients were categorized into h-TMA and c-TMA and these groups were compared. In total, 30 biopsy-proven cases among 7943 kidney biopsies were identified and, of these, 15 had h-TMA and 15 c-TMA. Mean follow-up was 6.3 y, and 73.3% had secondary hemolytic uremic syndrome (HUS) and the rest were atypical HUS. Patient characteristics, treatments, and kidney, and patient survival in the groups were similar. Statistically significant differences were found in histological variables. Vascular myxoid swelling and vascular onion-skinning were almost exclusively detected in c-TMA and, thus, vascular occlusive changes indicate clinically apparent rather than merely histological TMA. In addition, regardless of clinical presentation, kidney and patient survival times were similar in the patient groups highlighting the importance of a kidney biopsy in the case of any kidney-related symptoms