Tonsillotomy

Sleep-disordered breathing (SDB) constitutes the most common indication for tonsil surgery. For a long time, the only performed tonsil procedure was tonsillectomy (TE) which reserves relatively high morbidity, and many patients suffer from complications, most often postoperative haemorrhage. Hence, tonsillotomy (TT), the less invasive method of tonsil surgery, has gained popularity in recent years. However, Finnish studies on TT are still lacking. This thesis aimed to examine TT – its utility in children – and to discuss the potential benefits and disadvantages of TT compared to TE. The first study analysed the trends in tonsil surgery over a 10-year period and evaluated the effects of these changes on the incidence of tonsil surgery complications and specialist service costs. TTs were started at the Department of Otorhinolaryngology, Helsinki University Hospital, in 2009, and since 2011, TT has become a more common method in the treatment of SDB in children than TE. Consequently, the incidence of complications has decreased, thereby lowering hospital costs. In the second study, the postoperative recovery after TT and TE was evaluated and compared in a prospective cohort of children. All the recovery-related outcomes showed a tendency towards faster recovery after monopolar TT than TE; for children who had undergone TT, the need for analgesics was shorter, and they were able to return to normal activities earlier than children who had undergone TE. The third study examined the health-related quality of life (HRQoL) and the costs of use of health care in children operated with TT. The results of this study were compared to those of an earlier cohort of children operated on with TE. Both TT and TE improved HRQoL in children with SDB and reduced health care service needs and sick leave days. There was no difference in the mean total hospital costs between TT and TE in the one-year follow-up. The fourth study histologically evaluated the differences in tissue from children with re-hypertrophy of tonsils after TT and those with tonsillar hyperplasia without a history of earlier surgery. Also, the incidence of reoperations and potential predictive factors for tonsillar regrowth were assessed retrospectively. There was no evidence of severe chronic inflammation or scarring in the regrown tonsils. The incidence for resurgery was low (1.9%), and young age seemed to be a predictive factor for tonsillar regrowth. This study confirmed the superiority of TT over TE in several aspects: the recovery from surgery was faster and less painful after TT than after TE, and the rate of complication was lower. TT improved HRQoL and reduced visits of health care. The incidence of resurgery because of tonsillar regrowth was low.Nielurisojen liikakasvun aiheuttama kuorsaus ja hengityskatkokset ovat hyvin tyypillisiä oireita lapsilla. Aikaisemmin nielurisaleikkaukset tehtiin syystä riippumatta nielurisojen kokopoistoina, joka tarkoittaa nielurisojen poistamista kapseleineen lihaskerrokseen saakka. Kokopoistosta toipuminen on hidasta ja kivuliasta, lisäksi siihen liittyy riski jälkiverenvuodosta, joka voi olla vaarallinen erityisesti lapsille. Viime vuosina on otettu käyttöön nielurisojen osapoistoleikkaus, johon on kansainvälisissä tutkimuksissa osoitettu liittyvän pienempi jälkiverenvuotoriski sekä nopeampi toipuminen. Suomessa tehtyjä tutkimuksia aiheesta ei ole. Tutkimuksen tavoitteena oli tutkia nielurisan osapoistoleikkausta, sen tehokkuutta ja turvallisuutta lapsilla, ja verrata edellä mainittuja tekijöitä nielurisan kokopoistoon. Ensimmäisessä osatyössä kartoitettiin nielurisakirurgian muutoksia 10 vuoden aikana HYKS Korva-, nenä- ja kurkkutautien -klinikalla ja selvitettiin muutosten vaikutuksia komplikaatioiden esiintyvyyteen ja erikoissairaanhoidon kustannuksiin. Nielurisan osapoistoleikkaukset aloitettiin vuonna 2009, ja vuodesta 2011 osapoisto on ollut käytetympi menetelmä lasten suurentuneiden nielurisojen aiheuttamien oireiden hoidossa kuin kokopoisto. Muutoksen seurauksena todettiin lasten nielurisaleikkauksiin liittyvien komplikaatioiden vähentyneen merkittävästi. Myös osapoiston kustannusten todettiin olevan pienemmät verrattuna kokopoistoon. Toisessa osatyössä seurattiin lasten toipumista nielurisakirurgian jälkeen ja havaittiin, että diatermialaitteella tehdyn osapoiston jälkeen lapset toipuivat nopeammin, kärsivät vähemmän kivusta kuin lapset, joille oli tehty kokopoistoleikkaus. Kolmannessa osatyössä tutkittiin osapoiston vaikutusta lasten elämänlaatuun ja terveydenhuollon kustannuksiin sekä verrattiin tuloksia aikaisemmin kokopoistolla hoidettujen lapsien tuloksiin. Elämänlaatu parani yhtäläisesti molemmissa ryhmissä eikä vuoden seurannassa havaittu eroa kustannuksissa toimenpiteiden välillä. Neljännessä osatyössä selvitettiin, eroaako nielurisan osapoiston jälkeen uudelleen kasvaneen risan histologinen rakenne tavanomaisesta suurentuneesta nielurisasta. Lisäksi selvitettiin 11 vuoden aikana leikattujen lasten uusintaleikkausriskiä sekä siihen vaikuttavia tekijöitä. Histologiset tutkimukset osoittivat, että uudelleen kasvaneissa nielurisoissa ei ollut merkkejä lisääntyneestä kroonisesta tulehduksesta tai arpimuodostuksesta. Riski uusintaleikkaukseen oli matala (1.9 %), nuori ikä leikkaushetkellä vaikutti olevan yhteydessä suurempaan uusintaleikkausriskiin. Tutkimuksemme osoitti, että kokopoistoon verrattuna nielurisan osapoisto on lapsen eduksi, leikkauksesta toipuu nopeammin ja kivut ovat vähäisempiä ja komplikaatioita esiintyy vähän. Toimenpiteen seurauksena lasten elämänlaatu parani ja terveydenhuollon käynnit nieluoireiden vuoksi vähenivät. Uusintaleikkauksen tarve nielurisojen uudiskasvun vuoksi oli pieni

Lyömäsoittimien orkesteristemmojen harjoittelu koesoittoon

Opinnäytetyö sisältää harjoitteluohjeita kuuteen eri orkesteristemmaan, joista jokainen on eri lyömäsoittimelle. Sen päämäärä on avata koesoittotehtävien monimuotoisuutta harjoituksina sekä näyttää, mitä kaikkea on hyvä ottaa huomioon harjoitellessa. Opinnäytetyö sisältää oman esimerkin kautta annettuja ohjeita ja toteuttamisvaihtoehtoja valittuihin koesoittotehtäviin. Työ sisältää myös DVD-levyn, joka antaa visuaalista tukea ohjeistukselle.This Bachelor’s Thesis contains practice instructions for six different orchestral excerpts for six different percussion instruments. The aim of this thesis is to show the diversity of the orchestral excerpts as an exercise and also to show what you have to take into account while practicing. This thesis contains instructions given by my own example and execution options for chosen orchestral excerpts. This thesis also contains a DVD which gives visual support for the instructions.Työhöni kuuluu liitteenä DVD-levy, johon olen soittanut kaikki työssä käsittelemäni orkesteristemmojen kohdat kahdessa eri tempossa: hitaassa sekä esitystempossa

Mobilizing collective hatred through humour : Affective-discursive production and reception of populist rhetoric

This research examines the mobilization of populist rhetoric of the 2019 Finns Party election video. By focusing on both the FP’s election video (production) and Youtube users’ comments (reception), we examine the constructions and uses of social categories and humour as well as responses to their rhetorical deployment among like-minded supporters and opponents. The multimodal analysis of the production of a populist campaign video demonstrates the construction of social categories and humour through the five steps of collective hate. These humorous messages are differently received by like-minded and opposing YouTube users. Two supportive affective–discursive practices – glorification and schadenfreude – both express shared joy and laughter, but while glorification emphasizes the positive self-understanding of the in-group, schadenfreude belittles the ‘political Other’. Two opposing affective–discursive practices – irritation and scorn – place FP voters in subject positions of morally and intellectually inferior fascists, racists, and idiots. The populist message fosters expressions of social anger and polarization between FP supporters and opponents. Humour entangled with hatred encourages a sense of moral superiority in both groups. This study contributes to the current knowledge of mobilizing populist rhetoric and polarization, and responds to the call to broaden analysis of political communication in the field of multimodality.Peer reviewe

Myths, the Bible, and Romanticism as ingredients of political narratives in the Finns Party election video

Peer reviewe

Dehumanization through humour and conspiracies in online hate towards Chinese people during the COVID-19 pandemic

Since the beginning of the COVID-19 pandemic, there have been widespread conversations about the origins of the virus and who to blame for it. This article focuses on the online hate directed at Chinese and Asian people during the pandemic. Taking a critical discursive psychological approach, we analysed seven online threads related to COVID-19 and China from two Finnish websites (Suomi24 and Ylilauta) and one US (8kun) site. We identified three discursive trends associated with dehumanising Chinese populations: 'monstrous Chinese', 'immoral Chinese' and 'China as a threat', which created different forms of dehumanisation on a continuum from harsher dehumanisation to milder depersonalisation. The animalistic metaphors, coarse language, humorous frames and conspiracy beliefs worked to rhetorically justify the dehumanisation of Chinese individuals, making it more acceptable to portray them as a homogeneous and inhumane mass of people that deserves to be attacked. This study contributes to the field of discursive research on dehumanisation by deepening our knowledge of the specific features of Sinophobic hate speech.Peer reviewe

‘Pray for the fatherland!’ Discursive and digital strategies at play in nationalist political blogging.

Political blogs have come to constitute important channels for expressing nationalist and anti-immigration political views. The new forms that this rhetoric may take, comprising an intricate intermingling of verbal, digital, (audio-)visual, and communicative elements, present challenges for qualitative research. In this article we propose a way for analysing this new" nationalist political discourse from a qualitative social psychological perspective. The suggested approach combines analytical procedures form critical discursive and rhetorical psychology with social semiotic and rhetorical studies of images, completed with analytical tools and concepts from narrative psychology and research into online political communication. Using two empirical examples of nationalist and anti-immigration political blog-entries written during the 2015 refugee crisis," we show this approach enables the researcher to adequately study how such political messages are conveyed through the multitude of elements provided by the blogs. In so doing, our ultimate goal is to contribute to the analytical capacity of qualitative social psychological research into contemporary political communication and persuasion.Peer reviewe

Boosting nationalism through COVID-19 images : Multimodal construction of the failure of the 'dear enemy' with COVID-19 in the national press

Using a multimodal discursive approach, this study explores how the COVID-19 pandemic is constructed and used in press reportage to mobilize intergroup relations and national identities. We examine how press reporting about the development of COVID-19 in Sweden is cast as a matter of nationalism and national stereotyping in the Finnish press. The data consist of 183 images with accompanying headlines and captions published in two Finnish national newspapers between January 1 and August 31, 2020. We found three multimodal rhetorical strategies of stereotyping: moralizing, demonizing, and nationalizing. These strategies construct discourses of arrogant, immoral, and dangerous Swedes sourcing from national stereotypes. The study contributes to current knowledge about the work on national stereotypes by illustrating how they are used in media discourse to achieve certain rhetorical ends, such as to persuade, mitigate, or justify intergroup relations. Furthermore, the study offers insight into the multimodal constructions and functions of stereotypes.Peer reviewe