Miksi olen uneton? – Ohjaava keskustelu vanhusten kanssa

Uusimpien tutkimusten mukaan Suomen väestöstä unettomuudesta kärsii yli miljoona ihmistä. Ikäihmisellä unen rakenne muuttuu iän tuomien edellytysten vuoksi, mitkä jo itsessään voivat aiheuttaa unettomuutta. Iäkkään unen rakenne muuttuu niin, että syvän unen määrä vähenee ja kevyen pinnallisen unen määrä lisääntyy keski-ikäisiin verrattaessa. Kun uni on pinnallista, ihminen heräilee useammin ja herkemmin. Syvä uni taas tekee ihmiselle tunteen hyvin nukutuista yöunista. Tutkimuksista käy ilmi ihmisten tyytymättömyys unettomuuden hoidon suhteen. Yhä useammin lääkärit määräävät unilääkkeitä, eikä ihmisille täten tarjota muunlaisia keinoja unettomuuden hoitoon. Unettomuutta voidaan kuitenkin hoitaa lukuisilla muillakin menetelmillä. Lääkkeettömät hoitomenetelmät tulevatkin olla aina ensisijaisia tai yhdistettynä lääkehoidon kanssa, sillä unilääkkeet eivät saa aikaan luonnollista unta. Opinnäytetyö käsittelee ikäihmisen unettomuutta ja sen lääkkeettömiä hoitomenetelmiä. Työn tarkoituksena on lisätä vanhusten tietämystä unen merkityksestä terveydelle sekä pohtia voisiko keskustelutilaisuuksista olla hyötyä ikäihmisten unettomuuden hoidossa. Tavoitteena on lisätä vanhusten tietämystä unettomuuden lääkkeettömistä hoitomenetelmistä ja sitä kautta vaikuttaa heidän omaan kykyyn hoitaa unettomuuttaan. Työ on rajattu koskemaan primääriä unettomuutta ja siitä on rajattu pois muut uniongelmat. Opinnäytetyö on toiminnallinen ja se on toteutettu Helsingin palvelutalo Saga Helapuistossa palvelutalon asukkaille. Asukkaille pidettiin unettomuutta käsittelevä keskustelutilaisuus, missä osallistujat pääsivät puhumaan unettomuudestaan ja saamaan samalla ohjausta ja neuvontaa sen selättämiseksi lääkkeettömästi. Ryhmään osallistui kolme ikäihmistä iältään 80-90 vuotta. Opinnäytetyössä pohditaan vastaavanlaisien keskustelutilaisuuksien merkityksestä unettomuuden hoidossa. Kirjallisen palautteen perusteella keskustelutilaisuuteen osallistuvat ikäihmiset kokivat tilaisuuden hyödylliseksi itselleen sekä vastaavanlaisten tilaisuuksien järjestämisen myös tulevaisuudessa. Palautteen perusteella ryhmätilaisuus oli onnistunut ja saavuttanut tavoitteensa. Opinnäytetyössä pohditaan myös pitäisikö vanhusten unettomuuden ehkäisemisessä ja unen laadun parantamisessa satsata enemmän lääkkeettömiin apukeinoihin lisäämällä neuvontaa ja ohjausta?According to the most recent findings, more than a million Finns suffer from insomnia. The structure of the sleeping pattern changes due to ageing, and this in itself may be the cause for insomnia. As a person passes middle-age the sleeping patterns change, decreasing the amount of deep sleep and increasing the periods of shallow sleep. During the phases of shallow sleeping, an individual is more likely to wake up. Deep sleep, on the other hand, gives a sense of rest a feeling of and a night well slept. Research that has been conducted on the topic also shows the dissatisfaction of the elderly towards the existing services provided to treat insomnia. Even though drugs are usually offered, this often remains the only option. However, insomnia can be treated using alternative methods. These other, non-pharmaceutical methods should indeed be promoted primarily as treatment on their own or in combination with some mild drugs, as drugs for treating insomnia do not induce natural sleep. This thesis deals with insomnia amongst the elderly and non-drug treatment methods. The purpose of the thesis is to increase the awareness of the importance of sleep for the elderly people’s health and to consider whether discussion sessions can be useful for the treatment of insomnia. The aim is to increase the understanding of insomnia in the elderly non-pharmacological methods of treatment, and thus affects their ability to treat insomnia. The thesis has been restricted to primary insomnia, eliminating other sources of insomnia from our study. The thesis is based on functional work with the residents in Saga Helapuisto service home. A discussion session was held for the residents. The residents talked about their sleeping problems and during the session they were given guidance and information on non-drug methods to treat insomnia. The session was attended by three residents aged 80-90 years. According to the participants, sleeping drugs have always been prescribed straight away without receiving any guidance from a doctor or the medical staff concerning their sleeping difficulty beforehand. Based on the written feedback received from the participants, they felt that the session was useful and hoped for more similar sessions in the future. Hence, based on the feedback, the discussion session was successful and achieved its goal. The thesis also discusses whether more effort should be invested in non-drug treatment methods when it comes to treating and preventing insomnia in elderly people by providing advice and guidance

Credit risk scorecard estimation by logistic regression

The major concern of lenders is to answer the next question: 'Who we lend to?' Until 1970s the traditional schema was used to answer this question. Traditional credit assessment relied on 'gut feel', which means that a bank clerk or manager analyses a borrower's character, collateral and ability to repay. Also, some recommendations from the borrower's employer or previous lender are used. The alternative approach is credit scoring, which is a new way to approach a customer. Credit scoring is one of the most successful applications of statistics in finance and banking industry today. It lowers the cost and time of application processing and gives flexibility in making trade off between risk and sales for financial institution. Credit scorecards are essential instruments in credit scoring. They are based on the past performance of customers with characteristics similar to a new customer. So, the purpose of a credit scorecard is to predict risk, not to explain reasons behind it. The purpose of this work is to review credit scoring and its applications both theoretically and empirically, and to end up with the best combination of variables used for default risk forecasting. The first part of the thesis is focused on theoretical aspects of credit scoring - statistical method for scorecard estimation and measuring scorecard's performance. Firstly, I explain the definition of the scorecard and underlying terminology. Then I review the general approaches for scorecard estimation and demonstrate that logistic regression is the most appropriate approach. Next, I describe methods used for measuring the performance of the estimated scorecard and show that scoring systems would be ranked in the same order of discriminatory power regardless the measure used. The goal of the second part is empirical analysis, where I apply the theoretical background discussed in the first part of the master's thesis to a data set from a consumer credit bank, which includes variables obtained from the application forms and from credit bureau data, and extracted from social security numbers. The major finding of the thesis is that that the estimated statistical model is found to perform much better than a non-statistical model based on rational expectations and managers' experience. This means that banks and financial institutions should benefit from the introduction of the statistical approach employed in the thesis

Valtion virkamiesten palkat marraskuussa 1972

Suomen virallinen tilasto (SVT

Janus kinase 2 activation mechanisms revealed by analysis of suppressing mutations

Background: Janus kinases (JAKs; JAK1 to JAK3 and tyrosine kinase 2) mediate cytokine signals in the regulation of hematopoiesis and immunity. JAK2 clinical mutations cause myeloproliferative neoplasms and leukemia, and the mutations strongly concentrate in the regulatory pseudokinase domain Janus kinase homology (JH) 2. Current clinical JAK inhibitors target the tyrosine kinase domain and lack mutation and pathway selectivity. Objective: We sought to characterize mechanisms and differences for pathogenic and cytokine-induced JAK2 activation to enable design of novel selective JAK inhibitors. Methods: We performed a systematic analysis of JAK2 activation requirements using structure-guided mutagenesis, cell-signaling assays, microscopy, and biochemical analysis. Results: Distinct structural requirements were identified for activation of different pathogenic mutations. Specifically, the predominant JAK2 mutation, V617F, is the most sensitive to structural perturbations in multiple JH2 elements (C helix [aC], Src homology 2-JH2 linker, and ATP binding site). In contrast, activation of K539L is resistant to most perturbations. Normal cytokine signaling shows distinct differences in activation requirements: JH2 ATP binding site mutations have only a minor effect on signaling, whereasJH2aCmutations reduce homomeric (JAK2-JAK2) erythropoietin signaling and almost completely abrogate heteromeric (JAK2-JAK1) IFN-gamma signaling, potentially by disrupting a dimerization interface on JH2. Conclusions: These results suggest that therapeutic approaches targeting the JH2 ATP binding site and aC could be effective in inhibiting most pathogenic mutations. JH2 ATP site targeting has the potential for reduced side effects by retaining erythropoietin and IFN-gamma functions. Simultaneously, however, we identified the JH2 aC interface as a potential target for pathway-selective JAK inhibitors in patients with diseases with unmutated JAK2, thus providing new insights into the development of novel pharmacologic interventions.Peer reviewe

Light-Induced Nanoscale Deformation in Azobenzene Thin Film Triggers Rapid Intracellular Ca2+ Increase via Mechanosensitive Cation Channels

Epithelial cells are in continuous dynamic biochemical and physical interaction with their extracellular environment. Ultimately, this interplay guides fundamental physiological processes. In these interactions, cells generate fast local and global transients of Ca2+ ions, which act as key intracellular messengers. However, the mechanical triggers initiating these responses have remained unclear. Light-responsive materials offer intriguing possibilities to dynamically modify the physical niche of the cells. Here, a light-sensitive azobenzene-based glassy material that can be micropatterned with visible light to undergo spatiotemporally controlled deformations is used. Real-time monitoring of consequential rapid intracellular Ca2+ signals reveals that the mechanosensitive cation channel Piezo1 has a major role in generating the Ca2+ transients after nanoscale mechanical deformation of the cell culture substrate. Furthermore, the studies indicate that Piezo1 preferably responds to shear deformation at the cell-material interphase rather than to absolute topographical change of the substrate. Finally, the experimentally verified computational model suggests that Na+ entering alongside Ca2+ through the mechanosensitive cation channels modulates the duration of Ca2+ transients, influencing differently the directly stimulated cells and their neighbors. This highlights the complexity of mechanical signaling in multicellular systems. These results give mechanistic understanding on how cells respond to rapid nanoscale material dynamics and deformations.Peer reviewe

Internal ratings-based model introduction to a retail portfolio and its impact on a bank's capital requirement

The bank as a business tries to maximize the profit measured by the return on allocated capital (ROAC). This measure is calculated by dividing net income on capital allocated, thus the bank should both maximize net income and minimize capital allocated on the portfolio. The idea of the research is to check whether the higher return on allocated capital may be achieved if a bank calculates a capital requirement based on an internal ratings-based (IRB) approach instead of a standardized approach. The research question hypothesizes that the introduction of the IRB approach may lower the capital allocated on the retail portfolio, as the bank currently uses a standardized approach for the capital requirement calculation. In case the hypothesis is valid, the introduction of the IRB model lowers minimum capital requirements and through it, the higher ROAC is achieved. The capital requirement under the IRB approach is calculated through the estimation of the probability of default (PD) and loss given default (LGD) based on the bank's historical data. Probability of default is estimated using logistic regression and for loss given default estimation, the simple linear formula is applied due to unavailability of relevant data. The research proves that the application of the IRB approach significantly lowers bank's capital requirement and as a result increases its return on allocated capital

SISÄINEN VALVONTA JA VAARALLISET TYÖYHDISTELMÄT

Työn tavoitteena on määrittää Crocs Nordic Oy:n talousosaston sisällä tapahtuvia vaarallisia työyhdistelmiä. Lisäksi tuotetaan kaaviokuvaus, joissa eritellään talousosaston eri työtehtävien toimintoja. Vaarallisista työ yhdistelmistä tehdään myös listaus, jossa käydään lyhyesti läpi miksi yhdistelmä on vaarallinen, kuka sen suorittaa sekä annamme suosituksen vaarallisen työ yhdistelmän poistamisesta. Määrittelemme lisäksi vaarallisen työ yhdistelmän, väärinkäytöksen tunnusmerkistön sekä annamme esimerkkejä hyvästä töiden eriyttämisestä eli vaarallisten työyhdistelmien välttämisestä. Teoria osassa käsitellään sisästä valvontaa, corporate governancea sekä riskienhallintaa. Lisäksi teoriaan on sisällytetty vaarallistentyöyhdistelmien määrittelyä. Vaarallisten työyhdistelmien kartoittaminen toteutettiin talousoston työntekijöiden työtehtävien selostuksen avulla. Työtehtävien sisällöstä poimitaan teoriataustan avulla vaaralliset työyhdistelmät. Näistä laaditaan listaus, jossa selvitetään miksi työyhdistelmä on vaarallinen sekä annetaan ehdotus vaarallisen työyhdistelmän poistamiseksi. Lopuksi laaditaan johtopäätökset työn toteutuksesta sekä löydetyistä epäkohdista. Kehitystyöstä selvisi, että yrityksen talousosaston sisällä on monia vaarallisia työyhdistelmiä. Useimmat näistä liittyivät yrityksen maksuliikenteeseen sekä kirjanpidon kirjauksiin. Yrityksen johdon tulevat toimet toiminnan kehittämiseksi määrittävät opinnäytetyön lopullisen arvon.The aim of this thesis was to study and determine dangerous task combinations within the finance department of Crocs Nordic Oy. A schematic presentation of the various job functions in the finance department was also produced. The thesis contains a listing of the hazardous work combinations. The survey also discusses why the task combinations are dangerous and who are the personnel conducting the jobs. In addition, the survey also defines the term “dangerous task combination” and the hallmarks of possible abuse. The theoretical part of the thesis discusses internal control, corporate governance and risk management. The definition of dangerous task combinations is also included to the theoretical part of the thesis. The survey about dangerous task combinations was carried out by drawing up a schematic presentation of the job functions within the finance department of Crocs Nordic Oy. For the presentation job descriptions were drawn. Based on the presentation a listing of dangerous task combinations was drawn up. This was then developed further by specifying the conflicting duties. A proposal to eliminate the dangerous task combinations was also made. In the results a conclusion about dangerous task combinations, work execution and found mal administration was drawn up. In this section of the thesis it is stated that the company's finance department contains a variety of dangerous task combinations. Most of these are related to the company's payment transactions and accounting records. It is also pointed out that the true value of the thesis is defined by the actions taken and decisions made by the management of Crocs Nordic Oy after studying this thesis

Osallistava arki : opas omaiselle ikääntyneen toimintakyvyn tukemiseksi

Jokainen henkilö on oikeutettu mielekkääseen ja osallistavaan arkeen. Ikäihmistä tulee tukea arjen toiminnoissa ja kannustaa mahdollisimman itsenäiseen elämään. Opinnäytetyön toimeksiantona oli toteuttaa opas, jolla pystytään tukemaan ikääntyneiden toimintakykyä kotona. Opinnäytetyö keskittyy monimutkaisempien välineellisten toimintojen suorittamiseen arjessa, joihin lukeutuvat puhelimen käyttö, kaupassa käynti, kodinhoito, kulkuvälineillä liikkuminen, aterioiden valmistus sekä raha-asioista ja lääkkeistä huolehtiminen. Opasta voivat käyttää muun muassa ikääntyneiden omaiset, jotka kokevat kaipaavansa ideoita ja keinoja ikääntyneen toimintakyvyn tukemiseen kotona. Opinnäytetyö toteutettiin kehittämistyönä, joka aloitettiin tekemällä kirjallisuuskatsaus. Kirjallisuuskatsauksen jälkeen haastattelimme kahta ikäihmistä, jotka olivat vastikään muuttaneet omaisensa luokse asumaan. Haastattelussa keskityttiin välineellisten toimintojen suorittamiseen ja niiden toimintojen suorittamisen sujuvuuteen. Haastattelusta saadusta aineistosta muodostettiin ryhmittelytaulukot, joista nähtiin, minkälaiset asiat ikääntyneet kokivat hankaliksi toiminnoissa. Näiden tietojen perusteella kohdennettiin kirjallisuuskatsaus haasteellisiksi koettuihin asioihin ja niitä helpottavien keinojen löytämiseen. Kirjallisuuskatsauksen ja teemahaastattelujen perusteella kerättiin yhteen ne tiedot, jotka koottiin oppaaseen. Opas toteutettiin verkkosivuina. Lopulta opas pilotoitiin teettämällä verkkokysely Turun Seudun Omaishoitajat ja Läheiset Ry:lle sekä Omaishoitajat- ja Läheiset Liittoon. Verkkokyselyn tavoitteena oli arvioida muun muassa oppaan selkeyttä ja käytettävyyttä. Vastausten perusteella tehtiin muokkauksia verkkosivuihin ja tarkennettiin kohdejoukko. Kohdejoukko vaihtui pelkistä omaishoitajista kaikkiin ikääntyneiden omaisiin, jotka ovat alkaneet huolestua ikääntyneen toimintakyvystä ja kokevat tarvitsevansa vinkkejä ikääntyneen arjen helpottamiseen ja aktivoimiseen. Sivusto löytyy osoitteesta https://osallistavaarki.wordpress.comEveryone has the equal right to participate in, and enjoy, everyday activities. We should be there for the elderly in all everyday functions and encourage them to live life as independently as possible. The assignment for this thesis was to implement a guide which could be used to support the functional abilities of the elderly at home. The thesis focuses on complex instrumental activities in everyday life, which include the use of phones, shopping, housekeeping, the use of transportation, preparing meals and taking care of financial and medical matters. The guide can be used by families of the elderly who are in need of ideas and ways to support the functional ability of the elderly in their homes. The thesis was implemented as developmental work that was initiated by doing a literary review. After the literary review two interviews were executed for elderly people who had just recently moved in to live with their family. In the interviews, the focus was on carrying out instrumental activities and on how well and how fluently these activities are carried out. The information gathered from the interviews was then formed into a table of themes, which showed the matters concerning instrumental activities that were considered difficult. Based on this information the literary review was allocated to specifically focus on the matters considered difficult and to finding ways to make these matters easier. Based on the literary review and the themed interviews all the information that went in to the guide was gathered together. The guide was implemented as a website. Eventually, the guide was tested by making an online questionnaire for both Turun Seudun Omaishoitajat ja Läheiset Ry and Omaishoitajat- ja Läheiset Liitto. The aim of the questionnaire was to get information on the clarity and usability of the website. Based on the answers modifications were made to the website. The target group was specified. The target group from then on became everyone who is taking care of their elderly and have started to worry about their elderly family member’s functional ability and feel like they need more information on how to make everyday life easier and more active. The website can be found on https://osallistavaarki.wordpress.com

Multilinguals as second language learners : The impact of language background on L2 language learning

The present study aims to contribute to our common understanding of language determinism and transfer in the context of multilingual language learners in Finland. Drawing on a wealth of literature on multilingualism and second language acquisition, this master's thesis seeks to identify common error types in the speech of multilingual language learners and determine whether the multilingual background of language learners is related to the occurrence of errors in the target language (L2). The study endeavours to uncover the role of learners' dominant L1 in shaping their anticipation and production of L2 language structures. To achieve these objectives, data was collected from a sample of multilingual language learners of various language backgrounds, but primarily of Finnish-Russian heritage. The findings of this study highlight the importance of acknowledging the complexity of multilingualism in successful language acquisition and communication across cultures. The results suggest that different L1 languages may influence how learners approach L2 learning, leading to varying error patterns and levels of complexity. The study underscores the potential value of L1 as an interlanguage and the need to recognize multilingualism as an asset in L2 language learning. Given the implications of these findings for language education policy and practice, this study provides valuable insights into the fact that teachers should support multilingual learners. By identifying common error patterns and incorporating multilingualism into classroom practices, teachers can tailor their instruction to meet the needs of different types of learners. The present study also highlights the need for further exploration and research in this field to improve language education outcomes in a globalized world. This research has important implications for promoting linguistic and cultural diversity, as well as enhancing intercultural awareness and communication in an increasingly interconnected world. It is hoped that the results of this study will spark more interest and investment in multilingual education, leading to positive outcomes for learners, educators, and society as a whole