Pedagogiset keinot autismikirjon lapsen kohtaamisen tueksi varhaiskasvatuksessa

Tiivistelmä. Tutkielmani käsittelee pedagogisia keinoja autismikirjon lapsen kohtaamisen tueksi varhaiskasvatuksessa. Autismikirjo on lisääntynyt viime vuosina ja diagnosointi tapahtuu yleensä varhaiskasvatusiässä. Varhaiskasvatuksen pohja perustuu jokaisen lapsen tuntemiselle. Autismikirjon lapsilla on kuitenkin kokemuksia kohtaamisen ulkopuolelle jäämisestä. Tutkielmani tavoitteena oli löytää keskeiset pedagogiset menetelmät, joiden avulla autismi-kirjon lapsi tulisi kohdatuksi varhaiskasvatuksessa. Toteutin tutkielmani kuvailevana, narratiivisena kirjallisuuskatsauksena. Narratiivinen kirjallisuuskatsaus kerää aikaisempaa tutkimustietoa aiheesta ja tiivistää näiden tutkimusten keskeisimmät sisällöt. Tutkielmassa hyödynsin monipuolisesti erilaisia suomalaisia ja kansainvälisiä aineistoja. Pyrin valitsemaan tutkielmaani mahdollisimman tuoretta, tieteellistä lähdekirjallisuutta. Tutkielmani tulosten mukaan keskeisimmät pedagogiset menetelmät kohtaamisen tueksi varhaiskasvatuksessa voidaan jakaa neljään osaan. Ensimmäinen osa on vuorovaikutus. Vuorovaikutuksen tueksi käytettävät menetelmät mahdollistavat autismikirjon lapsen kanssa kommunikoinnin varhaiskasvatuksessa. Tällaisia menetelmiä ovat esimerkiksi tukiviittomat ja PECS-menetelmä. Toinen osa on arjen strukturoiminen. Autismikirjon lapsen arjessa selviäminen mahdollistuu strukturoidun arjen myötä. Kolmantena tuloksieni mukaan on aistien huomioiminen. Varhaiskasvatusympäristöä luodessa tulee huomioida erilaiset aistiyliherkkyydet. Viimeisenä tuloksissani ilmenee vahvuuksien huomioiminen. Jokaisen lapsen tunteminen mahdollistaa yksilöllisen kohtaamisen. Hyödynsin tutkielmaani tehdessä monipuolisesti erilaista tutkimuskirjallisuutta. Pidän tällöin tutkielmani tuloksia luotettavana. Luotettavuutta lisää myös käytetyn aineiston tuoreus. Tutkielmastani hyötyy varhaiskasvatuksen kentällä työskentelevät henkilöt sekä autismikirjon lasten vanhemmat. Tutkielmani perusteella voidaan sanoa, että varhaiskasvatuksen resurssipula on yksi tekijä, joka haastaa autismikirjon lapsen kokonaisvaltaista kohtaamista varhaiskasvatuksessa

Interaction between parental psychosis and early motor development and the risk of schizophrenia in a general population birth cohort.

BACKGROUND: Delayed motor development in infancy and family history of psychosis are both associated with increased risk of schizophrenia, but their interaction is largely unstudied. AIM: To investigate the association of the age of achieving motor milestones and parental psychosis and their interaction in respect to risk of schizophrenia. METHODS: We used data from the general population-based prospective Northern Finland Birth Cohort 1966 (n=10,283). Developmental information of the cohort members was gathered during regular visits to Finnish child welfare clinics. Several registers were used to determine the diagnosis of schizophrenia among the cohort members and psychosis among the parents. Altogether 152 (1.5%) individuals had schizophrenia by the age of 46 years, with 23 (15.1%) of them having a parent with psychosis. Cox regression analysis was used in analyses. RESULTS: Parental psychosis was associated (P<0.05) with later achievement of holding the head up, grabbing an object, and walking without support. In the parental psychosis group, the risk for schizophrenia was increased if holding the head up (hazard ratio [HR]: 2.46; degrees of freedom [df]=1; 95% confidence interval [95% CI]: 1.07-5.66) and touching the thumb with the index finger (HR: 1.84; df=1; 95% CI: 1.11-3.06) was later. In the group without parental psychosis, a delay in the following milestones increased the risk of schizophrenia: standing without support and walking without support. Parental psychosis had an interaction with delayed touching thumb with index finger (HR: 1.87; df=1; 95% CI: 1.08-3.25) when risk of schizophrenia was investigated. CONCLUSIONS: Parental psychosis was associated with achieving motor milestones later in infancy, particularly the milestones that appear early in a child's life. Parental psychosis and touching the thumb with the index finger had a significant interaction on risk of schizophrenia. Genetic risk for psychosis may interact with delayed development to raise future risk of schizophrenia, or delayed development may be a marker of other risk processes that interact with genetic liability to cause later schizophrenia.This study was supported by grants from the Brain and Behavior Research Foundation, Northern Finland Health Care Support Foundation, Sigrid Jusélius Foundation, and the Signe and Ane Gyllenberg Foundation, Finland. NFBC 1966 received financial support from the Academy of Finland (104781, 120315, 129269, 1114194, 24300796, 268336, 278286), Center of Excellence in Complex Disease Genetics and SALVE, Oulu University Hospital, Oulu, Finland, Biocenter of Oulu, Finland, University of Oulu, Finland (75617, 24002054, 2400692), Ministry of Social Affairs and Health (50459, 50691, 50842, 2749, 2465), NHLBI grant 5R01HL087679-02 through the STAMPEED program (1RL1MH083268-01), NIH/NIMH (5R01MH63706:02), ENGAGE project and grant agreement HEALTH-F4-2007-(201413), EU FP7 EurHEALTHAgeing (277849), EU FP7 EurHealth Epi-Migrant (279143), European Regional Development Fund 537/2010 (24300936) and the Medical Research Council, UK (G0500539, G0600705, G1002319, PrevMetSyn/SALVE).This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.eurpsy.2015.04.00

Sentinel lymph node biopsies in early stage oral and oropharyngeal carcinoma : a retrospective single-centre experience

The aim of this retrospective study was to analyse a consecutive series of patients with oral and oropharyngeal carcinoma who had had sentinel lymph node biopsy (SLNB) at our hospital during 2008-2017. A total of 70 patients with clinically and radiologically confirmed primary oral (n = 67) or oropharyngeal (n = 3) carcinoma, with no signs of metastatic lymph nodes preoperatively (clinically N0) were included. Patients' clinical and personal data, characteristics of the tumours, sentinel lymph node (SLN) status and outcomes were recorded. Eight patients had invaded SLN. Two patients with clear sentinel lymph node biopsies had recurrences in the cervical lymph nodes with no new primary tumour as origin. The negative predictive value (NPV) and sensitivity for SLNB were 97% and 80%, respectively. The depth of invasion was an individual predictor for cervical lymph node metastasis (p = 0.043). Single photo emission computed tomography (SPECT) detected fewer SLN in patients with invaded lymph nodes than in patients with clear lymph nodes (p = 0.018). Our data support the use of SLNB as a minimally invasive method for staging the cervical lymph nodes among patients with cN0 oral and oropharyngeal carcinoma. Our results further confirm that greater depth of invasion is associated with cervical lymph node metastases. (c) 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Influence of forest management changes and reuse of peat production areas on water quality in a northern river

In Northern Finland, the most significant land use challenges are related to bioenergy production from peat extraction and forest biomass. Increasing societal demand for bioenergy may increase production rates. However, environmental impacts of peat extraction are of increasing concern, which has led to a decline in production, thereby freeing up these areas for other uses. Using storylines for different societal futures and process-based models (PERSiST and INCA), we simulated the effect of simultaneous land use change and climate change on water quality (phosphorus, nitrogen and suspended sediments concentration). Conversion of peat extraction areas to arable land, together with climate change, may pose a risk for deterioration of ecological status. On the other hand, continuous forestry may have positive impacts on water quality. Suspended sediment concentrations in the river do not exceed water quality requirements for salmonids, but nitrogen concentrations may exceed threshold values especially during high flows. A storyline emphasizing sustainable development in energy pro-duction led to the best outcome in terms of water protection

Dysregulation of glucose metabolism is an early event in sporadic Parkinson's disease

AbstractUnlike most other cell types, neurons preferentially metabolize glucose via the pentose phosphate pathway (PPP) to maintain their antioxidant status. Inhibiting the PPP in neuronal cell models causes cell death. In rodents, inhibition of this pathway causes selective dopaminergic cell death leading to motor deficits resembling parkinsonism. Using postmortem human brain tissue, we characterized glucose metabolism via the PPP in sporadic Parkinson's disease (PD), Alzheimer's disease (AD), and controls. AD brains showed increased nicotinamide adenine dinucleotide phosphate (NADPH) production in areas affected by disease. In PD however, increased NADPH production was only seen in the affected areas of late-stage cases. Quantifying PPP NADPH-producing enzymes glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase by enzyme-linked immunosorbent assay, showed a reduction in the putamen of early-stage PD and interestingly in the cerebellum of early and late-stage PD. Importantly, there was no decrease in enzyme levels in the cortex, putamen, or cerebellum of AD. Our results suggest that down-regulation of PPP enzymes and a failure to increase antioxidant reserve is an early event in the pathogenesis of sporadic PD

Polydopamine Nanoparticles Prepared Using Redox-Active Transition Metals

Autoxidation of dopamine to polydopamine by dissolved oxygen is a slow process that requires highly alkaline conditions. Polydopamine can be formed rapidly also in mildly acidic and neutral solutions by using redox-active transition-metal ions. We present a comparative study of polydopamine nanoparticles formed by autoxidation and aerobic or anaerobic oxidation in the presence of Ce(IV), Fe(III), Cu(II), and Mn(VII). The UV-vis spectra of the purified nanoparticles are similar, and dopaminechrome is an early intermediate species. At low pH, Cu(II) requires the presence of oxygen and chloride ions to produce polydopamine at a reasonable rate. The changes in dispersibility and surface charge take place at around pH 4, which indicates the presence of ionizable groups, especially carboxylic acids, on their surface. X-ray photoelectron spectroscopy shows the presence of three different classes of carbons, and the carbonyl/carboxylate carbons amount to 5-15 atom %. The N 1s spectra show the presence of protonated free amino groups, suggesting that these groups may interact with the pi-electrons of the intact aromatic dihydroxyindole moieties, especially in the metal-induced samples. The autoxidized and Mn(VII)-induced samples do not contain metals, but the metal content is 1-2 atom % in samples prepared with Ce(IV) or Cu(II), and ca. 20 atom % in polydopamine prepared in the presence of Fe(III). These differences in the metal content can be explained by the oxidation and complexation properties of the metals using the general model developed. In addition, the nitrogen content is lower in the metal-induced samples. All of the metal oxidants studied can be used to rapidly prepare polydopamine at room temperature, but the possible influence of the metal content and nitrogen loss should be taken into account

Comparing in situ turbidity sensor measurements as a proxy for suspended sediments in North-Western European streams

Climate change in combination with land use alterations may lead to significant changes in soil erosion and sediment fluxes in streams. Optical turbidity sensors can monitor with high frequency and can be used as a proxy for suspended sediment concentration (SSC) provided there is an acceptable calibration curve for turbidity measured by sensors and SSC from water samples. This study used such calibration data from 31 streams in 11 different research projects or monitoring programmes in six Northern European countries. The aim was to find patterns in the turbidity-SSC correlations based on stream characteristics such as mean and maximum turbidity and SSC, catchment area, land use, hydrology, soil type, topography, and the number and representativeness of the data that are used for the calibration. There were large variations, but the best correlations between turbidity and SSC were found in streams with a mean and maximum SSC of >30-200 mg/l, and a mean and maximum turbidity above 60-200 NTU/FNU, respectively. Streams draining agricultural areas with fine-grained soils had better correlations than forested streams draining more coarse-grained soils. However, the study also revealed considerable differences in methodological approaches, including analytical methods to determine SSC, water sampling strategies, quality control procedures, and the use of sensors based on different measuring principles. Relatively few national monitoring programmes in the six countries involved in the study included optical turbidity sensors, which may partly explain this lack of methodological harmonisation. Given the risk of future changes in soil erosion and sediment fluxes, increased harmonisation is highly recommended, so that turbidity data from optical sensors can be better evaluated and intercalibrated across streams in comparable geographical regions

Prospective multicentre cohort trial on acute appendicitis and microbiota, aetiology and effects of antimicrobial treatment: study protocol for the MAPPAC (Microbiology APPendicitis ACuta) trial

Introduction Based on the epidemiological and clinical data, acute appendicitis can present either as uncomplicated or complicated. The aetiology of these different appendicitis forms remains unknown. Antibiotic therapy has been shown to be safe, efficient and cost-effective for CT-confirmed uncomplicated acute appendicitis. Despite appendicitis being one of the most common surgical emergencies, there are very few reports on appendicitis aetiology and pathophysiology focusing on the differences between uncomplicated and complicated appendicitis. Microbiology APPendicitis ACuta (MAPPAC) trial aims to evaluate these microbiological and immunological aspects including immune response in the aetiology of these different forms also assessing both antibiotics non-responders and appendicitis recurrence. In addition, MAPPAC aims to determine antibiotic and placebo effects on gut microbiota composition and antimicrobial resistance.Methods and analysis MAPPAC is a prospective clinical trial with both single-centre and multicentre arm conducted in close synergy with concurrent trials APPendicitis ACuta II (APPAC II) (per oral (p.o.) vs intravenous+p.o. antibiotics, NCT03236961) and APPAC III (double-blind trial placebo vs antibiotics, NCT03234296) randomised clinical trials. Based on the enrolment for these trials, patients with CT-confirmed uncomplicated acute appendicitis are recruited also to the MAPPAC study. In addition to these conservatively treated randomised patients with uncomplicated acute appendicitis, MAPPAC will recruit patients with uncomplicated and complicated appendicitis undergoing appendectomy. Rectal and appendiceal swabs, appendicolith, faecal and serum samples, appendiceal biopsies and clinical data are collected during the hospital stay for microbiological and immunological analyses in both study arms with the longitudinal study arm collecting faecal samples also during follow-up up to 12 months after appendicitis treatment.</p

Mitochondrial genome-wide analysis of nuclear DNA methylation quantitative trait loci

Mitochondria have a complex communication network with the surrounding cell and can alter nuclear DNA methylation (DNAm). Variation in the mitochondrial DNA (mtDNA) has also been linked to differential DNAm. Genome-wide association studies have identified numerous DNAm quantitative trait loci, but these studies have not examined the mitochondrial genome. Herein, we quantified nuclear DNAm from blood and conducted a mitochondrial genome-wide association study of DNAm, with an additional emphasis on sex- and prediabetes-specific heterogeneity. We used the Young Finns Study (n = 926) with sequenced mtDNA genotypes as a discovery sample and sought replication in the Ludwigshafen Risk and Cardiovascular Health study (n = 2317). We identified numerous significant associations in the discovery phase (P < 10(-9)), but they were not replicated when accounting for multiple testing. In total, 27 associations were nominally replicated with a P < 0.05. The replication analysis presented no evidence of sex- or prediabetes-specific heterogeneity. The 27 associations were included in a joint meta-analysis of the two cohorts, and 19 DNAm sites associated with mtDNA variants, while four other sites showed haplogroup associations. An expression quantitative trait methylation analysis was performed for the identified DNAm sites, pinpointing two statistically significant associations. This study provides evidence of a mitochondrial genetic control of nuclear DNAm with little evidence found for sex- and prediabetes-specific effects. The lack of a comparable mtDNA data set for replication is a limitation in our study and further studies are needed to validate our results.Peer reviewe

Mapping the human genetic architecture of COVID-19

The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-19(1,2), host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases(3-7). They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.Peer reviewe