”Borta bra men heppa häst”. En fallstudie om hur eleverna, föräldrarna och läraren upplever språkberikad undervisning på svenska i en finskspråkig klass

Tutkielmani aiheena on oppilaiden, heidän vanhempiensa sekä opettajan odotukset ja kokemukset kielirikasteisesta opetuksesta, joka tapahtuu ruotsin kielellä suomenkielisen koulun ensimmäisellä luokalla. Kielirikasteinen opetus oli tutkimusajankohtana ollut käynnissä luokassa yhden syyslukukauden sekä muutaman viikon kevätlukukaudesta. Tutkielmani on laadullinen tapaustutkimus. Aineistoni koostuu oppilaiden ikätason huomioon ottavasta kyselytutkimuksesta sekä vanhempien kyselytutkimuksesta. Kyselyyn vastasi 22 oppilasta ja 34 vanhempaa. Aineistoon kuuluu myös opettajan puolistrukturoitu tutkimushaastatteluhaastattelu. Olen myös havainnoinut kielirikasteista tuntia sekä käyttänyt osia opettajan haastattelusta kuvatakseni kielirikasteista opetustuntia. Tämän olen tehnyt luodakseni mahdollisuuden peilata odotuksia ja kokemuksia itse toimintaa vasten. Analyysimenetelmänäni on sisällönanalyysi ja käytän fenomenologista metodia tausta- ajatuksenani. Näiden avulla ryhmittelen ja tarkastelen esiin nousevia teemoja, sekä pyrin luomaan kokonaiskuvan eri toimijaryhmien odotuksista ja kokemuksista. Tutkimukseni osoittaa, että oppilaiden kokemukset kielirikasteisesta opetuksesta ovat pääosin positiivisia tai neutraaleita. Esiin nousseet negatiiviset tuntemukset liittyvät kielen tuottamiseen. Vanhempien ja opettajan odotukset liittyvät pääasiassa itse kielitaitoon ja kielenoppimiseen, kieleen tutustumiseen sekä positiivisen asenteen luomiseen kieltä ja kielenoppimista kohtaan. Heidän kokemuksensa liittyvät innokkuuden huomaamiseen lapsissa sekä kielen tarttumiseen. Opettajalla on myös kielen tuottamiseen liittyviä odotuksia opetuksen myöhemmässä vaiheessa. Eri ryhmien odotukset ja kokemukset antavat tarvittavaa tietoa siitä, miten kielirikasteiseen opetukseen suhtaudutaan ja miten sitä voidaan edelleen kehittää.fi=Opinnäytetyö kokotekstinä PDF-muodossa.|en=Thesis fulltext in PDF format.|sv=Lärdomsprov tillgängligt som fulltext i PDF-format

Exocrine pancreas function decreases during the progression of the beta-cell damaging process in young prediabetic children

Objective: The function of the exocrine pancreas is decreased in patients with type 1 diabetes but it is not known when this defect develops. The current study set out to determine whether the reduced exocrine function becomes manifest after the initiation of islet autoimmunity. Methods: The study was nested in the prospective Type 1 Diabetes Prediction and Prevention study where children with human leukocyte antigen (HLA)-conferred susceptibility are observed from birth. Elastase-1 levels were analyzed from stool samples collected at the time of seroconversion to islet autoantibody positivity and at diagnosis of type 1 diabetes, as well as from samples taken from matched control children of similar age. Results: Elastase levels were lower in case children at the time of the diagnosis of diabetes when compared to the control children. However, elastase concentrations did not differ between cases and controls at the time when autoantibodies appeared. Conclusion: The results suggest that the defect in the exocrine function develops after the appearance of islet autoantibodies. Further studies are needed to assess whether reduced elastase levels predict rapid progression of islet autoimmunity to clinical disease.Peer reviewe

Risk factors of short-term survival in the aged in elective colon cancer surgery : a population-based study

Purpose Patients aged > 80 years represent an increasing proportion of colon cancer diagnoses. Selecting patients for elective surgery is challenging because of possibly compromised health status and functional decline. The aim of this retrospective, population-based study was to identify risk factors and health measures that predict short-term mortality after elective colon cancer surgery in the aged. Methods All patients > 80 years operated electively for stages I-III colon cancer from 2005 to 2016 in four Finnish hospitals were included. The prospectively collected data included comorbidities, functional status, postoperative surgical and medical outcomes as well as mortality data. Results A total of 386 patients (mean 84.0 years, range 80-96, 56% female) were included. Male gender (46% vs 35%, p = 0.03), higher BMI (51% vs 37%, p = 0.02), diabetes mellitus (51% vs 37%, p = 0.02), coronary artery disease (52% vs 36%, p = 0.003) and rheumatic diseases (67% vs 39%, p = 0.03) were related to higher risk of complications. The severe complications were more common in patients with increased preoperative hospitalizations (31% vs 15%, p = 0.05) and who lived in nursing homes (30% vs 17%, p = 0.05). The 30-day and 1-year mortality rates were 6.0% and 15% for all the patients compared with 30% and 45% in patients with severe postoperative complications (p <0.001). Severe postoperative complications were the only significant patient-related variable affecting 1-year mortality (OR 9.60, 95% CI 2.33-39.55, p = 0.002). Conclusions The ability to identify preoperatively patients at high risk of decreased survival and thus prevent severe postoperative complications could improve overall outcome of aged colon cancer patients.Peer reviewe

Health-Related Quality of Life after Restorative Proctocolectomy : A Cross-Sectional Study

Background and Aims: Patients undergoing restorative proctocolectomy have often suffered from active ulcerative colitis which should be remembered when assessing quality of life after operation. The aim of this study was to explore health-related quality of life after restorative proctocolectomy in those with poor or good pouch function and to compare that to patients with active or inactive ulcerative colitis and to the general population. Material and Methods: Altogether, 282 restorative proctocolectomy patients were investigated. The control group comprised 408 ulcerative colitis patients from the local register. Generic 15D and disease-specific inflammatory bowel disease questionnaire health-related quality of life instruments were used. Population-based data were available for 15D. Pouch function was evaluated with oresland score and colitis activity with simple clinical colitis activity index. Results: 15D results showed that patients with good pouch function had health-related quality of life similar to that of the general population. Health-related quality of life with inflammatory bowel disease questionnaire was equally good in patients with good pouch function (n = 131; 70%) and inactive colitis (n = 95; 63%), and equally impaired in patients with poor pouch function (n = 56; 30%) and active colitis (n = 18; 12%). Conclusion: The majority of patients had health-related quality of life comparable to that in general population. Most patients with active ulcerative colitis are likely to improve their health-related quality of life after successful surgery. These findings are important when informing colitis patients about life after surgery.Peer reviewe

Kan typ 1-diabetes förebyggas med ett vaccin?

Diabetes. English summary

Surgical and functional outcomes and survival following Colon Cancer surgery in the aged : a study protocol for a prospective, observational multicentre study

BackgroundThe number of colorectal cancer patients increases with age. The decision to go through major surgery can be challenging for the aged patient and the surgeon because of the heterogeneity within the older population. Differences in preoperative physical and cognitive status can affect postoperative outcomes and functional recovery, and impact on patients' quality of life.Methods / designA prospective, observational, multicentre study including nine hospitals to analyse the impact of colon cancer surgery on functional ability, short-term outcomes (complications and mortality), and their predictors in patients aged >= 80years. The catchment area of the study hospitals is 3.88 million people, representing 70% of the population of Finland. The data will be gathered from patient baseline characteristics, surgical interventional data, and pre- and postoperative patient-questionnaires, to an electronic database (REDCap) especially dedicated to the study.DiscussionThis multicentre study provides information about colon cancer surgery's operative and functional outcomes on older patients. A further aim is to find prognostic factors which could help to predict adverse outcomes of surgery.Trial registrationClinicalTrials.gov (NCT03904121). Registered on 1 April 2019.Peer reviewe

Urbanization reduces transfer of diverse environmental microbiota indoors

Expanding urbanization is a major factor behind rapidly declining biodiversity. It has been proposed that in urbanized societies, the rarity of contact with diverse environmental microbiota negatively impacts immune function and ultimately increases the risk for allergies and other immune-mediated disorders. Surprisingly, the basic assumption that urbanization reduces exposure to environmental microbiota and its transfer indoors has rarely been examined. We investigated if the land use type around Finnish homes affects the diversity, richness, and abundance of bacterial communities indoors. Debris deposited on standardized doormats was collected in 30 rural and 26 urban households in and near the city of Lahti, Finland, in August 2015. Debris was weighed, bacterial community composition determined by high throughput sequencing of bacterial 16S ribosomal RNA (rRNA) gene on the Illumina MiSeq platform, and the percentage of four different land use types (i.e., built area, forest, transitional, and open area) within 200 m and 2000 m radiuses from each household was characterized. The quantity of doormat debris was inversely correlated with coverage of built area. The diversity of total bacterial, Proteobacterial, Actinobacterial, Bacteroidetes, and Firmicutes communities decreased as the percentage of built area increased. Their richness followed the same pattern except for Firmicutes for which no association was observed. The relative abundance of Proteobacteria and particularly Gammaproteobacteria increased, whereas that of Actinobacteria decreased with increasing built area. Neither Phylum Firmicutes nor Bacteroidetes varied with coverage of built area. Additionally, the relative abundance of potentially pathogenic bacterial families and genera increased as the percentage of built area increased. Interestingly, having domestic animals (including pets) only altered the association between the richness of Gammaproteobacteria and diversity of Firmicutes with the built area coverage suggesting that animal ownership minimally affects transfer of environmental microbiota indoors from the living environment. These results support the hypothesis that people living in densely built areas are less exposed to diverse environmental microbiota than people living in more sparsely built areas.Peer reviewe