Toiminta-alueittain opiskelevien oppilaiden tavoitteiden saavutettavuus, selkeys ja mitattavuus

Artikkelissa käsitellään toiminta-alueittain opiskelevien oppilaiden yksilöllisiä tavoitteita ja niiden laatimiseen liittyvää taustaa ja tutkimusta sekä kirjoittajan pro gradu -tutkielman tuloksia. Tutkielmassa havaittiin, että tarkasteltuihin tavoitteisiin tehtiin todennäköisemmin muutoksia, jos kyseisen lukuvuoden opettaja oli opettanut oppilasta aikaisemmin. Tarkastelluissa tavoitteissa oli puutteita saavutettavuuden, selkeyden ja mitattavuuden osalta.Tavoitteiden laadun parantamiseksi esitetään ratkaisuja liittyen täydennyskoulutukseen, työvälineisiin ja perusopetuksen opetussuunnitelmaa

The annual changes of IEP's goals and the evaluation of unaltered goals of the pupils studying by the activity areas

Perusopetuksen toiminta-alueittain järjestettävä opetus on tarkoitettu niille vaativaa erityistä tu-kea tarvitseville oppilaille, jotka eivät pysty opiskelemaan oppiaineita edes yksilöllistetysti, vaan hyötyvät enemmän opetuksesta, joka painottuu edistämään oppilaan itsenäistä toimimista elämässä. Toiminta-alueet ovat motoriset taidot, kieli- ja kommunikaatio, sosiaaliset taidot, kognitiiviset taidot ja päivittäiset taidot. Kyseinen opetus edustaa kolmiportaisen tuen raskainta tukitasoa. Näiden oppilaiden osaamista ja osaamisen kehittymistä seurataan mm. henkilökoh-taisten opintojen järjestämistä koskevien suunnitelmien (HOJKS) ja lukuvuositodistusten avul-la. Toiminta-alueittain järjestettävää opetusta on tutkittu toistaiseksi melko vähän. Tässä tutkimuksessa selvitettiin, minkälaisia muutoksia toiminta-alueittain opiskelevien oppilai-den HOJKS-tavoitteisiin tehtiin sekä miten samoina säilyneitä tavoitteita arvioitiin. Aineisto koostui kuuden toiminta-alueittain opiskelevan oppilaan HOJKS-lomakkeista (n = 22) ja luku-vuositodistuksista (n = 18). Dokumentit hankittiin kahdesta koulusta ja ne olivat kahdeksan opettajan vuosien 2013–2017 välillä laatimia. Aineisto analysoitiin teoriaohjaavan sisällönana-lyysin avulla. Tutkimuksessa havaittiin, että toisen koulun oppilaiden tavoitteisiin tehtiin todennäköisemmin muutoksia, jos opettaja oli opettanut oppilasta aikaisemmin. Yksittäisiin tavoitteisiin tehtiin lä-hes poikkeuksetta ainoastaan laadullisia muutoksia. Muutokset jakautuivat neljään kategoriaan, jotka ovat oppilaalle tarjottu tuki, tavoitteeseen liittyvän toiminnan kuvaus, tavoitteen sisältö-alueen kattavuus ja vaatimustaso sekä tavoitteen sisällön täsmentyminen tai yleistyminen. Ar-vioinnit jakautuivat kolmeen kategoriaan, jotka ovat osaaminen pysyy samana, osaaminen muuttuu ja osaamisen muutosta ei voi määrittää. Suurimmasta osasta arvioinneista ei pystynyt päättelemään, kuinka lähellä oppilas oli tavoitteensa saavuttamista, vaikka arvioinnista olisikin ilmennyt lukuvuoden aikana tapahtunut kehitys. Tutkimuksen perusteella toiminta-alueittain opiskelevien oppilaiden HOJKS-tavoitteiden laati-miseen ja arviointiin tulee kiinnittää enemmän huomiota. Oppilaan kanssa työskentelevät opet-tajat ja ohjaajat eivät voi tietää, mikä on tavoitellun osaamisen taso tai kuinka oppilasta tulee ohjata, jos tavoitteeseen tehdyt muutokset eivät ole selkeitä tai mitattavia. Jos arvioinnista ei selviä, missä kohtaa oppilas etenee tavoitteessaan, on seuraavan lukuvuoden tavoitteita vaikea laatia oppilaan taitoja vastaaviksi.The National Curricula for basic education has certain regulations for pupils with intensive special education needs. The education can be arranged by the activity areas if the pupil is unable study the school subjects individually and instead benefits more from education that emphasizes on enhancing the pupils ability to function independently in daily life. The activity areas are motor skills, language and communication, social skills, cognitive skills and skills in daily functions. The education in question stands for the most demanding support level in the three-tier model. The skills and skill development of these pupils are monitored with amongst other things Individual Education Plans (IEP) and report cards. Little research has been done in teaching by the activity areas. The study showed changes that were made in the IEP's goals for pupils studying by the activity areas, as well as how the unaltered goals were evaluated. The research data consisted of the IEPs (N = 22) and report cards (N = 18) of six students studying by the activity areas. The documents were collected from two schools and were drawn up by eight teachers between the years 2013 and 2017. The research data was analysed with the help of theory-driven content analysis. It was discovered in the research that the goals of the pupils were more likely to have changed if the teacher had taught the pupil before. Almost without exception only qualitative changes were made on individual goals. The changes were divided into four different categories: the offered support for pupil, the description of the activity related to the goal, the coverage and standard of the content area of the goal as well as the clarification and spreading of the content. The changes were divided into three different categories: the skills stay the same, the skills change and the change in a skill can't be specified. Most of the evaluations did not show how close a pupil was with the succeeding of a goal, even if the evaluation had shown progress within the school year. According to the research more attention ought to be focused on the IEP's goals and the goal evaluation of the pupils studying by the activity areas. The teachers and instructors of the pupil cannot know what the current level of the desired skill is or how a pupil should be taught, if the changes made in the goal are not clear, precise or measurable. If the evaluation does not show at what stage the pupil is in his or her progress, it's difficult to match the goals of the following school year with the pupil's potential

Setting Individual Goals for Pupils with Profound Intellectual and Multiple Disabilities : Engaging in the Activity Area-Based Curriculum Making

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Sequencing of Lynch syndrome tumors reveals the importance of epigenetic alterations

Genomic instability and epigenetic aberrations are important classifiers of human tumors, yet, their interrelations are poorly understood. We used Lynch syndrome (LS) to address such relationships. Forty-five tumors (11 colorectal adenomas, 18 colorectal carcinomas, and 16 ovarian carcinomas) were profiled for CpG Island Methylator Phenotype (CIMP) and somatic mutations. All tumors showed high-degree microsatellite instability. Panel sequencing of 578 cancer-relevant genes revealed the average number of 1433, 1124, and 657 non-synonymous somatic mutations per colorectal adenoma, colorectal carcinoma, and ovarian carcinoma, respectively. Genes harboring mutations with allele frequency 25 % or higher in at least 31 % of tumors were regarded to be possible drivers. Among 72 and 10 such genes identified in colorectal and ovarian tumors, respectively, the most frequently mutated genes BRD4 and MLL2 (62 % of colorectal tumors) and ARID1A (50 % of ovarian carcinomas) are involved in epigenetic regulation. The total number of somatic mutations or mutant genes per tumor were significantly associated with CIMP. Our results suggest that even in an inherited disease, tumor type-specific epigenetic changes are significant and may result from regulatory changes (CIMP) or structural events (mutations of epigenetic regulatory genes). The findings are clinically relevant since many of the affected pathways can be therapeutically targeted.Peer reviewe

Oncogenic Potential of Bisphenol A and Common Environmental Contaminants in Human Mammary Epithelial Cells

There is an ample epidemiological evidence to support the role of environmental contaminants such as bisphenol A (BPA) in breast cancer development but the molecular mechanisms of their action are still not fully understood. Therefore, we sought to analyze the effects of three common contaminants (BPA; 4-tert-octylphenol, OP; hexabromocyclododecane, HBCD) on mammary epithelial cell (HME1) and MCF7 breast cancer cell line. We also supplied some data on methoxychlor, MXC; 4-nonylphenol, NP; and 2-amino-1-methyl-6-phenylimidazo [4–b] pyridine, PhIP. We focused on testing the prolonged (two months) exposure to low nano-molar concentrations (0.0015–0.0048 nM) presumed to be oncogenic and found that they induced DNA damage (evidenced by upregulation of pH2A.X, pCHK1, pCHK2, p-P53) and disrupted the cell cycle. Some agents induced epigenetic (methylation) changes of tumor suppressor genes TIMP3, CHFR, ESR1, IGSF4, CDH13, and GSTP1. Obviously, the accumulation of these molecular alterations is an essential base for cancer development. Consistent with this, we observed that these agents increased cellular invasiveness through collagen. Cellular abilities to form colonies in soft agar were increased for MCF7. Toxic agents induced phosphorylation of protein kinase such as EGFR, CREB, STAT6, c-Jun, STAT3, HSP6, HSP27, AMPKα1, FAK, p53, GSK-3α/β, and P70S6 in HME1. Most of these proteins are involved in potential oncogenic pathways. Overall, these data clarify the molecular alterations that can be induced by some common environmental contaminants in mammary epithelial cells which could be a foundation to understand environmental carcinogenesis

DNA methylation changes and somatic mutations as tumorigenic events in Lynch syndrome-associated adenomas retaining mismatch repair protein expression

Background: DNA mismatch repair (MMR) defects are a major factor in colorectal tumorigenesis in Lynch syndrome (LS) and 15% of sporadic cases. Some adenomas from carriers of inherited MMR gene mutations have intact MMR protein expression implying other mechanisms accelerating tumorigenesis. We determined roles of DNA methylation changes and somatic mutations in cancer-associated genes as tumorigenic events in LS-associated colorectal adenomas with intact MMR. Methods: We investigated 122 archival colorectal specimens of normal mucosae, adenomas and carcinomas from 57 LS patients. MMR-deficient (MMR-D, n 49) and MMR-proficient (MMR-P, n 18) adenomas were of particular interest and were interrogated by methylation-specific multiplex ligation-dependent probe amplification and Ion Torrent sequencing. Findings: Promoter methylation of CpG island methylator phenotype (CIMP)-associated marker genes and selected colorectal cancer (CRC)-associated tumor suppressor genes (TSGs) increased and LINE-1 methylation decreased from normal mucosa to MMR-P adenomas to MMR-D adenomas. Methylation differences were statistically significant when either adenoma group was compared with normal mucosa, but not between MMR-P and MMR-D adenomas. Significantly increased methylation was found in multiple CIMP marker genes (1612, NEUROGI,CRABP1, and CDKN2A) and TSGs (SERPI and SFRP2) in MMR-P adenomas already. Furthermore, certain CRC-associated somatic mutations, such as KRAS, were prevalent in MMR-P adenomas. Interpretation: We conclude that DNA methylation changes and somatic mutations of cancer-associated genes might serve as an alternative pathway accelerating LS-associated tumorigenesis in the presence of proficient MMR. Fund: Jane and Aatos Erkko Foundation, Academy of Finland, Cancer Foundation Finland, Sigrid juselius Foundation, and HiL1FE. (C) 2019 Published by Elsevier B.V.Peer reviewe

Immunoprofiles and DNA Methylation of Inflammatory Marker Genes in Ulcerative Colitis-Associated Colorectal Tumorigenesis

Immunological and epigenetic changes are interconnected and contribute to tumorigenesis. We determined the immunoprofiles and promoter methylation of inflammation-related genes for colitis-associated colorectal carcinomas (CA-CRC). The results were compared with Lynch syndrome (LS)-associated colorectal tumors, which are characterized by an active immune environment through inherited mismatch repair defects. CA-CRCs (n = 31) were immunohistochemically evaluated for immune cell scores (ICSs) and PDCD1 and CD274 expression. Seven inflammation-associated genes (CD274, NTSR1, PPARG, PTGS2, PYCARD, SOCS1, and SOCS2), the repair gene MGMT, and eight standard marker genes for the CpG Island Methylator Phenotype (CIMP) were investigated for promoter methylation in CA-CRCs, LS tumors (n = 29), and paired normal mucosae by multiplex ligation-dependent probe amplification. All but one CA-CRCs were microsatellite-stable and all LS tumors were microsatellite-unstable. Most CA-CRCs had a high ICS (55%) and a positive CD274 expression in immune cells (52%). NTSR1 revealed frequent tumor-specific hypermethylation in CA-CRC and LS. When compared to LS mucosae, normal mucosae from patients with CA-CRC showed significantly higher methylation of NTSR1 and most CIMP markers. In conclusion, CA-CRCs share a frequent ICShigh/CD274pos expression pattern with LS tumors. Elevated methylation in normal mucosa may indicate field cancerization as a feature of CA-CRC-associated tumorigenesis

Immunoprofiles and DNA Methylation of Inflammatory Marker Genes in Ulcerative Colitis-Associated Colorectal Tumorigenesis

Immunological and epigenetic changes are interconnected and contribute to tumorigenesis. We determined the immunoprofiles and promoter methylation of inflammation-related genes for colitis-associated colorectal carcinomas (CA-CRC). The results were compared with Lynch syndrome (LS)-associated colorectal tumors, which are characterized by an active immune environment through inherited mismatch repair defects. CA-CRCs (n = 31) were immunohistochemically evaluated for immune cell scores (ICSs) and PDCD1 and CD274 expression. Seven inflammation-associated genes (CD274, NTSR1, PPARG, PTGS2, PYCARD, SOCS1, and SOCS2), the repair gene MGMT, and eight standard marker genes for the CpG Island Methylator Phenotype (CIMP) were investigated for promoter methylation in CA-CRCs, LS tumors (n = 29), and paired normal mucosae by multiplex ligation-dependent probe amplification. All but one CA-CRCs were microsatellite-stable and all LS tumors were microsatellite-unstable. Most CA-CRCs had a high ICS (55%) and a positive CD274 expression in immune cells (52%). NTSR1 revealed frequent tumor-specific hypermethylation in CA-CRC and LS. When compared to LS mucosae, normal mucosae from patients with CA-CRC showed significantly higher methylation of NTSR1 and most CIMP markers. In conclusion, CA-CRCs share a frequent ICShigh/CD274pos expression pattern with LS tumors. Elevated methylation in normal mucosa may indicate field cancerization as a feature of CA-CRC-associated tumorigenesis

Somatic mutation profiles as molecular classifiers of ulcerative colitis-associated colorectal cancer

Ulcerative colitis increases colorectal cancer risk by mechanisms that remain incompletely understood. We approached this question by determining the genetic and epigenetic profiles of colitis-associated colorectal carcinomas (CA-CRC). The findings were compared to Lynch syndrome (LS), a different form of cancer predisposition that shares the importance of immunological factors in tumorigenesis. CA-CRCs (n = 27) were investigated for microsatellite instability, CpG island methylator phenotype and somatic mutations of 999 cancer-relevant genes ("Pan-cancer" panel). A subpanel of "Pan-cancer" design (578 genes) was used for LS colorectal tumors (n = 28). Mutational loads and signatures stratified CA-CRCs into three subgroups: hypermutated microsatellite-unstable (Group 1, n = 1), hypermutated microsatellite-stable (Group 2, n = 9) and nonhypermutated microsatellite-stable (Group 3, n = 17). The Group 1 tumor was the only one with MLH1 promoter hypermethylation and exhibited the mismatch repair deficiency-associated Signatures 21 and 15. Signatures 30 and 32 characterized Group 2, whereas no prominent single signature existed in Group 3. TP53, the most common mutational target in CA-CRC (16/27, 59%), was similarly affected in Groups 2 and 3, but DNA repair genes and Wnt signaling genes were mutated significantly more often in Group 2. In LS tumors, the degree of hypermutability exceeded that of the hypermutated CA-CRC Groups 1 and 2, and somatic mutational profiles and signatures were different. In conclusion, Groups 1 (4%) and 3 (63%) comply with published studies, whereas Group 2 (33%) is novel. The existence of molecularly distinct subgroups within CA-CRC may guide clinical management, such as therapy options.Peer reviewe