Kriminaalihuollon tukisäätiön Oppimisvaikeuksista vapaaksi -hanke : ADHD -kuntoutuskurssin arviointi

Opinnäytetyö on tehty Kriminaalihuollon tukisäätiön Oppimisvaikeuksista vapaaksi –hankkeessa. Opinnäytetyön tarkoituksena on arvioida hankkeen vuoden 2010 tammi-kesäkuussa toteuttama ADHD –kuntoutuskurssi. Kurssi järjestettiin alle 30–vuotiaille pääkaupunkiseudun avolaitosvangeille sekä yhdyskuntaseuraamustoimistojen asiakkaille, joilla on diagnosoitu ADHD tai ainakin vahvoja ADHD -piirteitä. Kurssi toteutettiin Oppimisvaikeuksista vapaaksi -hankkeen tavoitteiden pohjalta. Sillä pyrittiin vastaamaan hankkeen asiakkaiden tarpeisiin luomalla uudenlainen tukipalvelu, jonka avulla voitaisiin auttaa asiakkaita ymmärtämään tilannettaan ja sitä kautta vähentämään haittoja heidän elämässään. Kurssille luotiin neljä päätavoitetta, joita olivat vertaistuen saaminen ja toinen toisiltaan oppiminen, tiedon saaminen ADHD:sta ja sen vaikutuksista oppimiseen ja elämään, arjen sujumista helpottavien keinojen oppiminen ja harjoitteleminen sekä tunne- ja vuorovaikutustaitojen kehittäminen. Opinnäytetyössä on vaikutteita sekä laadullisesta eli kvalitatiivisesta tutkimuksesta että arviointitutkimuksesta. Opinnäytetyötä voi kutsua myös monitahoarvioinniksi, koska arviointiaineisto on kerätty haastattelujen avulla kolmelta eri taholta, joita ovat ryhmäläiset, kurssin kaksi ohjaajaa ja projektipäällikkö. Opinnäytetyön tavoitteena on saada hyödyllistä tietoa ADHD -kuntoutuskurssin toimivuudesta käytännössä. Kurssia arvioidaan kolmesta eri näkökulmasta, joita ovat prosessin kuvaus, kurssille asetetut päätavoitteet ja kehittäminen. Teoreettisessa viitekehyksessä tarkastellaan kuntoutusta rikosseuraamusalalla sekä aikuisten ADHD –kuntoutusta. Opinnäytetyön aineisto on kerätty kurssin puolivälissä ja lopussa toteutetuista kurssilaisten haastatteluista sekä kurssin päättymisen jälkeen tehdyistä ohjaajien parihaastattelusta ja projektipäällikön haastattelusta. ADHD –kuntoutuskurssilla oli kaksi ohjaajaa ja kurssin aloitti kuusi ryhmäläistä. Kokoontumiskertoja oli yhteensä 20 ja jokaiselle kerralla oli suunniteltu oma teema, jota oli tarkoitus käsitellä erilaisten harjoitusten ja keskustelun avulla. Arvioinnin tuloksista kävi ilmi, että kurssin suunnitteluun varattu aika oli riittävä, mutta rekrytointiin olisi voinut varata enemmän aikaa. Rekrytointihaastattelut jäivät melko loppuvaiheeseen, koska kurssilaisia oli vaikea löytää. Jotta ryhmä saatiin kasaan, jouduttiin myös joustamaan kriteeristä, joka edellytti kurssille osallistujilla olevan jo valmiiksi ADHD –diagnoosi. Ryhmätoiminnan toteutukseen liittyvät asiat, kuten kokoontumisten määrä ja tapaamisten kesto, olivat toimivia, mutta niitäkin voidaan vielä kehittää jatkossa. Kurssille asetetut päätavoitteet toteutuivat eri osapuolten kokemusten mukaan hyvin. Kokonaisuudessaan kurssia pidettiin onnistuneena ja hyödyllisenä ja sille nähtiin olevan jatkossakin tarvetta.Free from learning difficulties -project by Probation Foundation Evaluation of the ADHD –rehabilitation programme This thesis is made in the Probation Foundation’s project called Free from learning difficulties. The purpose of this thesis is to evaluate the project’s ADHD rehabilitation programme which was carried through from January till June in 2010. The ADHD rehabilitation programme was organized for open institution prisoners and clients of Community Sanctions Offices under 30 years who have ADHD –diagnosis or at least strong ADHD -features. The programme was carried through by the goals of Free from learning difficulties -project. The objective of the programme was to meet the needs of the project’s clients by creating a new type of a support service using it to help the clients to understand their situation and to reduce problems in their lives. In the programme there were four main goals: obtaining peer support and learning from each other, getting knowledge of ADHD and its influences on learning and life, learning and practising the means which make everyday life easier and improving emotional- and interaction skills. In this thesis there are influences of both qualitative as well as evaluative survey. The thesis may also be called a polyhedron evaluation since the evaluation material has been gathered by using interviews from three different sources; these being the group members, two counsellors and a project manager. The goal of this thesis is to gain useful knowledge of how the ADHD rehabilitation programme works in practice. The programme can be evaluated from three different aspects which are description of the process, main goals placed for the programme and development. Rehabilitation in Criminal Sanctions and ADHD rehabilitation for adults will be examined in the theoretical portion of this thesis. The material for this thesis was collected by interviewing participants in the middle and at the end of the programme. Both counsellors and the project manager were interviewed after the programme ended. There were two counsellors at the ADHD programme and six group members who started the programme. There were a total of 20 gathering times and for each time one theme was planned to deal with means of different practices and discussions. The results of this thesis showed that there was time enough for planning but recruiting was put into practice in a fairly tight schedule. The interviews were carried out in quite a final stage since there were some difficulties to find people to be interviewed. In order to gather group members enough it was ended up in being flexible about the criteria which required former ADHD –diagnosis of the group members. Things connected to realization of the teamwork such as the amount and duration of meetings worked well, although there are some sorts of needs for development. The main goals set for the programme were carried out well from different participants’ experiences. In its entirety, the programme was considered to be successful, useful and necessary for the future

Teaching and learning addition and subtraction bridging through ten using a structural approach

An eight-month-long intervention based on the idea of using a structural approach to addition and subtraction, and particularly bridging through ten, was implemented in Swedish Grade 1. A goal was that at the end of Grade 1, students would solve tasks like 15–7= using part-whole relations of numbers. In this paper, we report on learning outcomes from task-based interviews with intervention and control groups before, immediately after and one year after the intervention, to investigate long-term effects and whether students used a structural approach when solving tasks in Grade 2. Results show that students in the intervention group increased their learning outcomes the most and to a larger extent solved tasks in higher number ranges using a structural approach.This work was supported by the Swedish Institute for Educational Research [Grant number 2018-00038]

Effect of Mesophase Order on the Dynamics of Side Group Liquid Crystalline Polymers

Rheology and X-ray scattering were employed to probe the viscoelastic properties and structural transitions of model cyano-biphenyl-based side-group liquid−crystalline polymers (SGLCPs) with molecular weights ranging from 91 to 1900 kg/mol. Temperature-dependent rheological data show a rapid change in dynamics over a small temperature range. Small-angle X-ray scattering reveals these changes to be associated with an isotropic to smectic transition with an appreciable biphasic region. The presence of a biphasic region is attributed to inhomogeneity in chain structure resulting from incomplete attachment of mesogens to every monomeric unit in the SGLCP polymer. While isotropic and smectic phase data may be separately time−temperature shifted to create master curves for the individual phases, we argue against attempts to achieve superposition between the two phases in the high-frequency regime, since smectic ordering may not simply slow the dynamics but also increase the modulus of the sample. Molecular weight has a strong influence on rheology in the isotropic phase, where an entanglement plateau emerges; however, the smectic-phase rheology is dominated by the layer structure and is fairly insensitive to molecular weight

Kestävät jalat : Kettujen jalkaterveyden kehityshanke (2016-2018)

201

Kestävät jalat - kettujen jalkaterveyden kehityshanke

Raportti nro 1201

Health Status of Visitors and Temporary Residents, United States

Education, policy, and interventions to promote visitor health are needed

Molecularly Imprinted Polymers: Present and Future Prospective

Molecular Imprinting Technology (MIT) is a technique to design artificial receptors with a predetermined selectivity and specificity for a given analyte, which can be used as ideal materials in various application fields. Molecularly Imprinted Polymers (MIPs), the polymeric matrices obtained using the imprinting technology, are robust molecular recognition elements able to mimic natural recognition entities, such as antibodies and biological receptors, useful to separate and analyze complicated samples such as biological fluids and environmental samples. The scope of this review is to provide a general overview on MIPs field discussing first general aspects in MIP preparation and then dealing with various application aspects. This review aims to outline the molecularly imprinted process and present a summary of principal application fields of molecularly imprinted polymers, focusing on chemical sensing, separation science, drug delivery and catalysis. Some significant aspects about preparation and application of the molecular imprinting polymers with examples taken from the recent literature will be discussed. Theoretical and experimental parameters for MIPs design in terms of the interaction between template and polymer functionalities will be considered and synthesis methods for the improvement of MIP recognition properties will also be presented

A trial to evaluate the effect of the sodium–glucose co‐transporter 2 inhibitor dapagliflozin on morbidity and mortality in patients with heart failure and reduced left ventricular ejection fraction (DAPA‐HF)

Background: Sodium–glucose co‐transporter 2 (SGLT2) inhibitors have been shown to reduce the risk of incident heart failure hospitalization in individuals with type 2 diabetes who have, or are at high risk of, cardiovascular disease. Most patients in these trials did not have heart failure at baseline and the effect of SGLT2 inhibitors on outcomes in individuals with established heart failure (with or without diabetes) is unknown. Design and methods: The Dapagliflozin And Prevention of Adverse‐outcomes in Heart Failure trial (DAPA‐HF) is an international, multicentre, parallel group, randomized, double‐blind, study in patients with chronic heart failure, evaluating the effect of dapagliflozin 10 mg, compared with placebo, given once daily, in addition to standard care, on the primary composite outcome of a worsening heart failure event (hospitalization or equivalent event, i.e. an urgent heart failure visit) or cardiovascular death. Patients with and without diabetes are eligible and must have a left ventricular ejection fraction ≤ 40%, a moderately elevated N‐terminal pro B‐type natriuretic peptide level, and an estimated glomerular filtration rate ≥ 30 mL/min/1.73 m2. The trial is event‐driven, with a target of 844 primary outcomes. Secondary outcomes include the composite of total heart failure hospitalizations (including repeat episodes), and cardiovascular death and patient‐reported outcomes. A total of 4744 patients have been randomized. Conclusions: DAPA‐HF will determine the efficacy and safety of the SGLT2 inhibitor dapagliflozin, added to conventional therapy, in a broad spectrum of patients with heart failure and reduced ejection fraction

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline