Vasopressin excites interneurons to suppress hippocampal network activity across a broad span of brain maturity at birth

During birth in mammals, a pronounced surge of fetal peripheral stress hormones takes place to promote survival in the transition to the extrauterine environment. However, it is not known whether the hormonal signaling involves central pathways with direct protective effects on the perinatal brain. Here, we show that arginine vasopressin specifically activates interneurons to suppress spontaneous network events in the perinatal hippocampus. Experiments done on the altricial rat and precocial guinea pig neonate demonstrated that the effect of vasopressin is not dependent on the level of maturation (depolarizing vs. hyperpolarizing) of postsynaptic GABA(A) receptor actions. Thus, the fetal mammalian brain is equipped with an evolutionarily conserved mechanism well-suited to suppress energetically expensive correlated network events under conditions of reduced oxygen supply at birth.Peer reviewe

Eettisten ongelmien tunnistaminen naistentautien poliklinikalla : työntekijän näkökulma

Kippola, Henna; Lankinen, Jenna & Lindfors, Laura. Eettisten ongelmien tunnistaminen Naistentautien poliklinikalla -työntekijän näkökulma. Helsinki, kevät 2013, 52 sivua, 2 liitettä. Diakonia-ammattikorkeakoulu. Terveysalan koulutusohjelma, hoitotyön suuntautumisvaihtoehto, sairaanhoitaja (AMK). Tämän opinnäytetyön tarkoituksena on selvittää Kätilöopiston sairaalan, naistentautien poliklinikan eettisiä ongelmakohtia hoitotyössä ja hoitohenkilökunnan välillä sekä niiden ongelmien ratkaisukeinoja. Eettisiä ongelmia pohdimme erityisesti naistentautien näkökulmasta. Opinnäytetyömme tavoitteena oli koota aiemman teorian ja tutkimustulosten pohjalta raportti poliklinikan henkilökunnalle, jotta he tiedostaisivat yleisimpiä ristiriitatilanteita hoitotyössä ja pystyisivät kehittämään herkkyyttään tunnistaa eettisiä ongelmia ja ratkaisemaan niitä yhdessä. Tutkimus toteutettiin kvalitatiivisena kyselytutkimuksena. Aineisto kerättiin puolistrukturoidulla teemakyselylomakkeella, joka jaettiin saatekirjeineen 30:lle naistentautien poliklinikan hoitajalle kirjekuoressa. Kyselyyn vastasi 16 hoitajaa, mikä on hieman yli puolet. Tutkimustuloksia analysoitiin sisällönanalyysillä. Tutkimukseen osallistuneet hoitohenkilökunnan jäsenet vastasivat kysymyksiin avoimesti omien kokemustensa pohjalta. Tuloksista nousi esiin hoitajien hyvä ammattieettisten ohjeiden ja eettisten ristiriitojen tunnistaminen potilastyössä. Tärkeinä eettisinä arvoina hoitajat pitivät potilaslähtöisyyttä sekä potilaan arvostamista ja kunnioittamista. Raskaudenkeskeytyspotilaat koettiin haastavimmaksi potilasryhmäksi. Moniammatillisen tiimin tuki koettiin tärkeäksi eettisten ongelmien ratkaisemisessa. Vastaajat nostivat esille hyviä kehittämisideoita toimivan työyhteisön kehittämiseksi. Asiasanat: etiikka, hoitotyö, ammattietiikka, naistentaudit, ongelmat, tunnistaminen, ongelmanratkaisu, kvalitatiivinen tutkimusKippola, Henna; Lankinen, Jenna and Lindfors, Laura. Indentification of ethical problems gynecological clinic in Kätilöopisto Maternity Hospital -nurses perspective. 52 p., 2 appendices. Language: Finnish. Helsinki, Spring 2013. Diaconia University of Applied Sciences. Degree Programme in Nursing. Nursing, Nurse (UAS). The purpose of this thesis was to describe ethical problems in nursing as expe-rienced by the nurses. The task was to create a report for the work community of their ethical problems and disagreements of ethical values in nursing. We used previous studies and theory to support our research. The study was conducted as a qualitative research. The material was collected by means of open interviews and semi-structured inquiries. Inquiries were dis-tributed for thirty nurses at the gynecological clinic. We received more than half of all inquries that were distributed. We analyzed our research results by using content analysis. The respondents answered the question very open-minded from their own ex-periences. Research results brought out that the respondents were aware of their own professional ethical instructions and ethical disagreement in nurs-ing. They mentioned that the most important ethical values were patient-orientation and respect for the patient. Nurses experienced the abortion patients the most challenging patient group. The multi-professional team was seen as an important support for resolving ethical problems. Nurses also mentioned very good developing ideas for the community. Keywords: ethics, nursing ethics, gynecological nursing, ethical problem-solving methods, qualitative research metho

Iltapäivätoiminnan kehittäminen Turun lyseon koulun Runosmäen yksikössä

Tämän opinnäytetyön tarkoituksena on Turun lyseon koulun Runosmäen yksikön iltapäivätoiminnan kehittäminen. Iltapäiväkerho menetti omat tilansa uusien luokkien perustamisen jälkeen. Tämä on vaikeuttanut kerhon toimintaa ja häirinnyt koulun arkea. Lisäksi erityisen tuen lasten määrä on ollut iltapäiväkerhossa suuri, ja ohjaajat ovat kokeneet tarvitsevansa enemmän erityisosaamista erityisen tuen lasten kanssa toimimiseen. Opinnäytetyö on kehittämistehtävä ja tilaaja TPS Salibandy ry. Aineistonhankintamenetelminä olivat haastattelu sekä benchmarkkaus. Haastateltavina oli kolme iltapäiväkerhon ohjaajaa. Benchmarkkauksen kohteena oli Pilke päiväkodit Oy, joka järjestää iltapäivätoimintaa useissa kaupungeissa ja muokkaa toimintaansa tilanteen mukaan. Opinnäytetyössä käydään läpi erityispedagogisia keinoja erityistä tukea tarvitsevien lasten kanssa toimimiseen iltapäiväkerhossa ja etsitään ratkaisuja tilaongelmaan. Opinnäytetyön tuotoksena on selkeä ja yksinkertaistettu toimintaohje erityisen tuen lasten kanssa toimimiseen sekä lista vaihtoehtoisista toimintaympäristöistä iltapäivätoiminnan toteuttamiselle Runosmäessä

Longitudinal Metabolome-Wide Signals Prior to the Appearance of a First Islet Autoantibody in Children Participating in the TEDDY Study

Children at increased genetic risk for type 1 diabetes (T1D) after environmental exposures may develop pancreatic islet autoantibodies (IA) at a very young age. Metabolic profile changes over time may imply responses to exposures and signal development of the first IA. Our present research in The Environmental Determinants of Diabetes in the Young (TEDDY) study aimed to identify metabolome-wide signals preceding the first IA against GAD (GADA-first) or against insulin (IAA-first). We profiled metabolomes by mass spectrometry from children's plasma at 3-month intervals after birth until appearance of the first IA. A trajectory analysis discovered each first IA preceded by reduced amino acid proline and branched-chain amino acids (BCAAs), respectively. With independent time point analysis following birth, we discovered dehydroascorbic acid (DHAA) contributing to the risk of each first IA, and γ-aminobutyric acid (GABAs) associated with the first autoantibody against insulin (IAA-first). Methionine and alanine, compounds produced in BCAA metabolism and fatty acids, also preceded IA at different time points. Unsaturated triglycerides and phosphatidylethanolamines decreased in abundance before appearance of either autoantibody. Our findings suggest that IAA-first and GADA-first are heralded by different patterns of DHAA, GABA, multiple amino acids, and fatty acids, which may be important to primary prevention of T1D

Analgesic antipyretic use among young children in the TEDDY study : No association with islet autoimmunity

Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection

Early probiotic supplementation and the risk of celiac disease in children at genetic risk

Abstract Probiotics are linked to positive regulatory effects on the immune system. The aim of the study was to examine the association between the exposure of probiotics via dietary supplements or via infant formula by the age of 1 year and the development of celiac disease autoimmunity (CDA) and celiac disease among a cohort of 6520 genetically susceptible children. Use of probiotics during the first year of life was reported by 1460 children. Time-to-event analysis was used to examine the associations. Overall exposure of probiotics during the first year of life was not associated with either CDA (n = 1212) (HR 1.15; 95%CI 0.99, 1.35; p = 0.07) or celiac disease (n = 455) (HR 1.11; 95%CI 0.86, 1.43; p = 0.43) when adjusting for known risk factors. Intake of probiotic dietary supplements, however, was associated with a slightly increased risk of CDA (HR 1.18; 95%CI 1.00, 1.40; p = 0.043) compared to children who did not get probiotics. It was concluded that the overall exposure of probiotics during the first year of life was not associated with CDA or celiac disease in children at genetic risk