Nuorten tupakointi terveyden edistämisen haasteena : Kirjallisuuskatsaukseen pohjautuva oppitunnin suunnitelma 6- luokkalaisille

Opinnäytetyön tavoite oli tuottaa kirjallisuuskatsauksen avulla tietoa nuorten tupakoimattomuuden terveyshyödyistä ja tupakoinnin aiheuttamista terveysongelmista. Tarkoituksena oli laatia nuorille terveyden edistämisen oppitunnin suunnitelma, jossa käytetään kirjallisuuskatsauksesta tuotettua tietoa. Kirjallisuuskatsausta ohjaavat tutkimuskysymykset olivat: 1. Mitkä ovat tupakoimattomuuden terveyshyötyjä nuorelle? 2. Mitä terveysongelmia tupakointi aiheuttaa? Kirjallisuuskatsauksen tiedonhaku tehtiin tietokannoista Medic, Melinda ja Cinahl. Tämän lisäksi tiedonhakua toteutettiin manuaalisesti Seinäjoen Ammattikorkeakoulun kirjastossa. Aineisto koostui suurimmaksi osaksi suomenkielisistä teema- sekä katsausartikkeleista. Mukana on myös 1 englanninkielinen väitöskirja. Kirjallisuuskatsauksen tulosten mukaan tupakoimattomuuden terveyshyötyjä nuorelle ovat riskien pienentyminen, elämänlaadun edistyminen sekä keuhkosyövän epätodennäköisyys. Tupakoinnista aiheutuvia terveysongelmia ovat tupakan haitat, passiivisen tupakoinnin haitat sekä tupakansavun haitat. Kirjallisuuskatsauksen tuloksia hyödynnettiin 6- luokkalaisten terveyden edistämisen oppitunnin suunnitelmassa. Oppitunnilla käytetään nuoria aktivoivia opetusmenetelmiä. Oppitunnin suunnitelmaa voidaan hyödyntää jatkossa kuudesluokkalaisten terveyden edistämisen opetuksessa sekä nuorten terveyttä edistävässä hoitotyössä.The objective of this thesis was to use a literature review to get information regard-ing the health benefits of not smoking and health problems caused by smoking. The aim was to create a health promotion lesson plan for 6th grade students, us-ing the results of a literature review. The research questions in this study were: 1. What are adolescents’ health benefits of not smoking? 2. What are the health problems caused by smoking? The data gathering for the literature review was carried out from the databases Medic, Melinda and Cinahl. Some information was also collected from the library of Seinäjoki University of Applied Sciences. The material consisted mostly of Finnish theme and review articles. In addition, one thesis written in English was used. Based on the results of the literature review, the benefits of not smoking for young people are smaller risks, better quality of life and improbability of lung can-cer. Harms caused by smoking are passive smoking, cigarette smoke and health problems. The results of the literature review were used when 6th grade students’ health promotion lesson plan was planned. Teaching methods that activate adolescents are used during the lesson. This lesson plan can be used in the future for 6th grade students’ health promotion teaching, as well as in adolescents’ health pro-motion nursing

Nokian Tehdassaaren maiseman historiaa ja arvoja

Tämän tutkimuksen kohteena on Nokialle Nokianvirtaan, Emäkosken rannalle muodostunut Tehdassaari, jossa sijaitsee yksi pirkanmaalaisen paperiteollisuuden vanhimmista keskittymistä. Työssä tutkitaan kohteen maisemahistoriaa sekä aukikirjoitetaan kohteesta löydettäviä arvoja RKY-inventoinnin käyttämien arvotuskriteerien pohjalta. Tutkimuksen pyrkimyksenä on myös tarjota ajatuksia ja ohjeistusta Tehdassaaren tulevaan kehittämiseen. Tutkimus on tapaustutkimus, ja siinä on tarkoituksena kerätä mahdollisimman laaja aineisto, jonka pohjalta halutaan tuoda esiin kohteen arvoja sekä kirjoittaa paikalle omaa maisemahistoriaa. Lähteinä ovat toimineet etenkin saaren toimijoiden yrityshistoriikit, näiden toimijoiden luomaa sosiaalista järjestystä käsittelevät tutkimukset, alueesta tehdyt inventoinnit ja selvitykset, yleisesti teollisuushistoriaa ja teollisen maiseman tutkimista ja suojelua käsittelevät julkaisut, arvottamisen problematiikkaa ja tapoja tutkivat julkaisut sekä tämänkaltaisten teollisten ympäristöjen uudelleenkäyttöä ja kehittämistä pohtivat julkaisut. Työ jakautuu kolmeen osaan: maisemahistorialliseen tarkasteluun, kohteen arvojen aukikirjoittamiseen ja pohdintaan sekä kehittävällä otteella kirjoitettuun pohdintaosioon, jossa suunnataan mielenkiinto paikan potentiaaliin ja kehittämistyössä erityisesti huomioon otettaviin seikkoihin. Arvottamisosiossa kiinnitetään huomiota myös paikan identiteettiarvoihin sekä osallistamisen käsitteeseen arvona, unohtamatta kriittisiä huomioita arvottamiseen liittyen. Kansainvälisistä teollisen kulttuuriperinnön suojeluun tähtäävistä sopimuksista esitellään osioita, joista kiinnipitäminen on kohteessa oleellista. Työn perusteella voidaan löytää kohteen tärkeimmät arvot sekä todeta, että Tehdassaaren kulttuuriympäristöllä on suuri merkitys paikallisen identiteetin ja kaupunkikuvan rakentajana sekä valtakunnallisesti merkittävänä muistomerkkinä teollisesta historiasta. Työn esittelemien toimintamallien ja -ideoiden pohjalta voi luoda perusteet, joista kiinnipitämällä voidaan säästää ja turvata paikan arvot alueen tulevillekin käyttäjille ja toimijoille

Introduction to and Screening Visit Results of the Multicenter Pediatric Crohn's Disease Growth Study.

BackgroundStatural growth impairment is more common in males with Crohn's disease (CD). We assessed sex differences in height Z score differences and bone age (BA) Z scores and characterized age of menarche in a novel contemporary cohort of pediatric CD patients undergoing screening for enrollment in the multicenter longitudinal Growth Study.MethodsCrohn's disease patients (females with chronological age [CA] 5 years and older and younger than 14 years; males with CA 6 years and older and younger than 16 years) participated in a screening visit for the Growth Study. Height BA-Z scores are height Z scores calculated based on BA. Height CA-Z scores are height Z scores calculated based on CA. The height Z score difference equals height CA-Z score minus height BA-Z score.ResultsOne hundred seventy-one patients (60% male) qualified for this analysis. Mean CA was 12.2 years. Mean height CA-Z score was -0.4, and mean height BA-Z score was 0.4 in females. Mean height CA-Z score was -0.1, and mean height BA-Z score was 0.2 in males. The absolute value of the mean height Z score difference was significantly greater in females (0.8) than males (0.3; P = 0.005). The mean BA-Z score in females (-1.0) was significantly lower than in males (-0.2; P = 0.002). The median CA at menarche was 13.6 (95% CI, 12.6-14.6) years.ConclusionsOur screening visit data suggest that standardized height gain is lower in males with skeletal maturation and delayed puberty is common in females in CD. We are investigating these findings in the ongoing Growth Study

Compositional and Temporal Changes in the Gut Microbiome of Pediatric Ulcerative Colitis Patients Are Linked to Disease Course

Evaluating progression risk and determining optimal therapy for ulcerative colitis (UC) is challenging as many patients exhibit incomplete responses to treatment. As part of the PROTECT (Predicting Response to Standardized Colitis Therapy) Study, we evaluated the role of the gut microbiome in disease course for 405 pediatric, new-onset, treatment-naive UC patients. Patients were monitored for 1 year upon treatment initiation, and microbial taxonomic composition was analyzed from fecal samples and rectal biopsies. Depletion of core gut microbes and expansion of bacteria typical of the oral cavity were associated with baseline disease severity. Remission and refractory disease were linked to species-specific temporal changes that may be implicative of therapy efficacy, and a pronounced increase in microbiome variability was observed prior to colectomy. Finally, microbial associations with disease-associated serological markers suggest host-microbial interactions in UC. These insights will help improve existing treatments and develop therapeutic approaches guiding optimal medical car

Glycosphingolipids as Receptors for Non-Enveloped Viruses

Glycosphingolipids are ubiquitous molecules composed of a lipid and a carbohydrate moiety. Their main functions are as antigen/toxin receptors, in cell adhesion/recognition processes, or initiation/modulation of signal transduction pathways. Microbes take advantage of the different carbohydrate structures displayed on a specific cell surface for attachment during infection. For some viruses, such as the polyomaviruses, binding to gangliosides determines the internalization pathway into cells. For others, the interaction between microbe and carbohydrate can be a critical determinant for host susceptibility. In this review, we summarize the role of glycosphingolipids as receptors for members of the non-enveloped calici-, rota-, polyoma- and parvovirus families

The Telehealth Enhancement of Adherence to Medication (TEAM) in pediatric IBD trial: Design and methodology

Medication nonadherence is a significant health care issue requiring regular behavioral treatment. Lack of sufficient health care resources and patient/family time commitment for weekly treatment are primary barriers to receiving appropriate self-management support. We describe the methodology of the Telehealth Enhancement of Adherence to Medication (TEAM) trial for medication nonadherence in pediatric inflammatory bowel disease (IBD). For this trial, participants 11–18 years of age will be recruited from seven pediatric hospitals and will complete an initial 4-week run in to assess adherence to a daily medication. Those who take less than 90% of their prescribed medication will be randomized. A total of 194 patients with IBD will be randomized to either a telehealth behavioral treatment (TBT) arm or education only (EO) arm. All treatment will be delivered via telehealth video conferencing. Patients will be assessed at baseline, post-treatment, 3-, 6-, and 12-months. We anticipate that participants in the TBT arm will demonstrate a statistically significant improvement at post-treatment and 3-, 6-, and 12-month follow-up compared to participants in the EO arm for both medication adherence and secondary outcomes (i.e., disease severity, patient quality of life, and health care utilization). If efficacious, the TEAM intervention could be disseminated broadly and reduce health care access barriers so that patients could receive much needed self-management intervention

ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents.

BACKGROUND:: The diagnosis of pediatric-onset IBD (PIBD) can be challenging in choosing the most informative diagnostic tests and correctly classifying PIBD into its different subtypes. Recent advances in our understanding of the natural history and phenotype of PIBD, increasing availability of serological and fecal biomarkers, and the emergence of novel endoscopic and imaging technologies taken together have made the previous Porto criteria for the diagnosis of PIBD obsolete. METHODS:: We aimed to revise the original Porto criteria utilizing an evidence-based approach and consensus process to yield specific practice recommendations for the diagnosis of PIBD. These revised criteria are based on the Paris classification of PIBD and the original Porto criteria whilst incorporating novel data, such as for serum and fecal biomarkers. A consensus of at least 80% of participants was achieved for all recommendations and the summary algorithm. RESULTS:: The revised criteria depart from existing criteria by defining two categories of ulcerative colitis (UC; typical and atypical); atypical phenotypes of UC should be treated as UC. A novel approach based on multiple criteria for diagnosing IBD-unclassified (IBDU) is proposed. Specifically, these revised criteria recommend upper GI endoscopy and ileocolonscopy for all suspected PIBD patients, with small bowel imaging (unless typical UC after endoscopy and histology) by magnetic resonance enterography (MRE) or wireless capsule endoscopy. CONCLUSIONS:: These revised Porto criteria for the diagnosis of PIBD have been developed to meet current challenges and developments in PIBD and provide up to date guidelines for the definition and diagnosis of the IBD spectrum

Prediction of complicated disease course for children newly diagnosed with Crohn's disease: a multicentre inception cohort study

Stricturing and penetrating complications account for substantial morbidity and health-care costs in paediatric and adult onset Crohn’s disease. Validated models to predict risk for complications are not available, and the effect of treatment on risk is unknown