Kasvuhäiriö keliakiaa sairastavilla lapsilla

Johdanto: Keliakia voi lapsilla johtaa kasvun häiriintymiseen, mutta siihen liittyvät tekijät ja sen yleisyys tunnetaan huonosti. Potilaat ja menetelmät: Tutkimusaineistona oli 530 keliakiaa sairastavaa lasta, joilta kerättiin tiedot laboratoriokokeista, oireista ja suolivauriosta. Vertailimme poikkeavasti kasvavia lapsia (182) normaalisti kasvaviin (348). Lisäksi vertailimme lapsia, joiden ainoa oire oli kasvuhäiriö niihin, joilla oli myös muita oireita. Tulokset: Kasvultaan poikkeavat olivat nuorempia ja heillä oli matalampi hemoglobiini sekä korkeammat keliakiavasta-aine ja kilpirauhasta stimuloivan hormonin pitoisuudet verrattuna normaalisti kasvaviin. Kasvuhäiriön riskiä lisäsivät seuraavat asiat: diagnoosi alle 3 vuotiaana, diagnoosi ennen vuotta 2000, vaikea tai keskivaikea suolivaurio, vaikeat oireet ja oksentelu. Kasvuhäiriöön ainoana oireena liittyi vanhempi ikä ja korkeampi hemoglobiini ja rauta sekä matalampi transglutaminaasivasta-aine pitoisuus. Päätelmät: Erityisesti ikä, vaikeat oireet ja vaikea suolivaurio olivat yhteydessä kasvuhäiriöön. Lapset, joiden ainoa oire oli kasvuhäiriö, poikkesivat selvästi niistä, joilla oli myös muita oireita.Tutkielmaan liittyvä artikkeli / Article related to the thesis: Factors associated with growth disturbance at celiac disease diagnosis in children: A retrospective cohort study. BMC Gastroenterology. 2015; 15: 125. DOI: 10.1186/s12876-015-0357-

Kertomuksen vaarat: Kokemuspuhe, eksemplumin paluu ja aikalaiskriittinen narratologia

"Meitä ei kiinnosta sinun tarinasi, vaan miksi sen kerrot!" Kertomuksen vaarat – Kokemuspuhe, eksemplumin paluu ja aikalaiskriittinen narratologia on kuuden Tampereen yliopiston kirjallisuudentutkijan kolmivuotinen hanke (2017–2019), jota rahoittaa Koneen Säätiö. Projekti yhdistää teoreettista perustutkimusta laajamittaiseen yhteistyöhön muiden tieteenalojen ja ammattiryhmien kuten journalistien, opettajien, taiteentekijöiden ja terveysalan ammattilaisten kanssa

”Tarina se on tämäkin päivitys”: Kertomuksen vaarat -projekti sosiaalisessa mediassa

Puheenvuoro nostaa esiin Kertomuksen vaarat -tutkimusprojektin kohtaamia ja käsittelemiä tiedeviestinnällisiä haasteita sosiaalisessa mediassa. Projekti loi sosiaalisessa mediassa ainutlaatuisen joukkoistamiskampanjan, jolla kerättiin esimerkkejä kertomusmuodon välineellisestä käytöstä eri elämänalueilla. Kerättyjen esimerkkien popularisoivat narratologiset analyysit hankkeen Facebook-sivulla ovat herättäneet tunnereaktioita laidasta laitaan. Katsauksessa pohditaan kirjallisuustieteen, kertomuspuheen, affektien ja sosiaalisen median suhdetta sekä analysoidaan hankkeen omia toimintatapoja. Mitä "Kertomuksen vaarojen" sometoiminnasta voisi oppia

The Finnish therapy navigator – Digital support system for introducing stepped care in Finland

Introduction: The need to improve quick access to effective psychological treatments is urgent. Success requires effective tools for identifying what kind of therapies an individual is likely to benefit from and managing a comprehensive therapy offering that matches an individual’s needs. First-line therapies initiative (Terapiat etulinjaan–toimintamalli) is a national initiative started 2020 in Finland. It aims to help Finnish regions in building locally sustainable stepped care systems and providing the support services needed. One key service of First-line therapies initiative is the Finnish therapy navigator (FTN). The FTN is a digital tool to help assess individual needs for psychosocial treatments and to build a regionally sustainable stepped care treatment offering, as part of the national reform of social and health services. This paper describes the development, content, implementation and feasibility of the FTN. Materials and Methods: The system was piloted in six regions in Finland between October 2021 and May 2022, with a catchment area of around 600 000. The feasibility data was collected from professionals (n = 48) using the system at 1 and 4 months after implementation, and from the anonymous FTN responses (n = 2630). Results: Professionals estimated the FTN had a positive impact on their work, quality of assessment and notes, and patient experience at 1 month after starting to use the FTN. Satisfaction scores improved further at 4 months, and 93% of users wanted to keep FTN as a permanent tool. The mean time patients used to fill the FTN was 24 minutes; 75% of clinical interviews lasted under 30 minutes. The FTN provides important data on treatment seekers. In our sample 57% of respondents scored between 10-19 points on PHQ-9 and 59% between 5-14 on GAD-7, suggesting mild-to-moderate depressive and anxiety symptoms. 28% reported no previous psychosocial treatments and 33% previous treatments shorter than 6 months. Thus, it seems that a significant proportion of treatment seekers in Finland could benefit from readily available, short-term, evidence-based psychosocial treatments that the First-line therapies initiative supports. Conclusions: FTN is a feasible tool for first assessment of mental health issues in primary care. Implemented and localized using the manualized co-creation process results in very high user satisfaction and acceptability of the system. The FTN provides important real-time data on mental health treatment seekers to support service development and planning. The First-line therapies model that includes introducing FTN in combination with regionally adapted care pathway development, education in short evidence-based psychological interventions and increase in use of digital support systems appears a feasible way to build regionally sustainable stepped systems.publishedVersionPeer reviewe

The Finnish therapy navigator – Digital support system for introducing stepped care in Finland

Introduction: The need to improve quick access to effective psychological treatments is urgent. Success requires effective tools for identifying what kind of therapies an individual is likely to benefit from and managing a comprehensive therapy offering that matches an individual’s needs. First-line therapies initiative (Terapiat etulinjaan–toimintamalli) is a national initiative started 2020 in Finland. It aims to help Finnish regions in building locally sustainable stepped care systems and providing the support services needed. One key service of First-line therapies initiative is the Finnish therapy navigator (FTN). The FTN is a digital tool to help assess individual needs for psychosocial treatments and to build a regionally sustainable stepped care treatment offering, as part of the national reform of social and health services. This paper describes the development, content, implementation and feasibility of the FTN. Materials and Methods: The system was piloted in six regions in Finland between October 2021 and May 2022, with a catchment area of around 600 000. The feasibility data was collected from professionals (n = 48) using the system at 1 and 4 months after implementation, and from the anonymous FTN responses (n = 2630). Results: Professionals estimated the FTN had a positive impact on their work, quality of assessment and notes, and patient experience at 1 month after starting to use the FTN. Satisfaction scores improved further at 4 months, and 93% of users wanted to keep FTN as a permanent tool. The mean time patients used to fill the FTN was 24 minutes; 75% of clinical interviews lasted under 30 minutes. The FTN provides important data on treatment seekers. In our sample 57% of respondents scored between 10-19 points on PHQ-9 and 59% between 5-14 on GAD-7, suggesting mild-to-moderate depressive and anxiety symptoms. 28% reported no previous psychosocial treatments and 33% previous treatments shorter than 6 months. Thus, it seems that a significant proportion of treatment seekers in Finland could benefit from readily available, short-term, evidence-based psychosocial treatments that the First-line therapies initiative supports. Conclusions: FTN is a feasible tool for first assessment of mental health issues in primary care. Implemented and localized using the manualized co-creation process results in very high user satisfaction and acceptability of the system. The FTN provides important real-time data on mental health treatment seekers to support service development and planning. The First-line therapies model that includes introducing FTN in combination with regionally adapted care pathway development, education in short evidence-based psychological interventions and increase in use of digital support systems appears a feasible way to build regionally sustainable stepped systems.publishedVersionPeer reviewe

Airborne Laser Scanning Outperforms the Alternative 3D Techniques in Capturing Variation in Tree Height and Forest Density in Southern Boreal Forests

The objective of this study is to better understand the relationship between forest structure and point cloud features generated from certain airborne and space borne sensors. Point cloud features derived from airborne laser scanning (ALS), aerial imagery (AI), WorldView-2 imagery (WV2), TerraSAR-X, and Tandem-X (TDX) data were classified as features characterizing forest height and density as well as variation in tree height. Correlations between these features and field-measured attributes describing forest height, density and tree height variation were investigated at plot scale. From the field-measured attributes, basal area (G) and the number of trees per unit area (N) were used as forest density indicators whereas maximum tree height (H-max) and standard deviation in tree height (H-std) were used as indicators for forest height and tree height variation, respectively. In the analyses, field observations from 91 sample plots (32 m x 32 m) located in southern Finland were used. Even though ALS was found to be the most accurate data source in characterizing forest structure, AI, WV2, and TDX were also capable of characterizing forest height at plot scale with correlation coefficients stronger than 0.85. However, ALS was the only data source capable of providing separate features for characterizing also the variation in tree height and forest density. Features related to forest height, generated from the other data sources besides ALS, also provided strongest correlation with the forest density attributes and variation in tree height, in addition to H-max. Due to these more diverse characterization capabilities, forest structural attributes can be predicted more accurately by using ALS, also in the areas where the relation between the attributes of interest is not solely dependent on forest height, compared to the other investigated 3D remote sensing data sources.Peer reviewe

Airborne laser scanning outperforms the alternative 3D techniques in capturing variation in tree height and forest density in southern boreal forests.

ArticleBaltic Forestry. 24(2): 268-277. (2018)journal articl

Common Inflammation-Related Candidate Gene Variants and Acute Kidney Injury in 2647 Critically Ill Finnish Patients

Acute kidney injury (AKI) is a syndrome with high incidence among the critically ill. Because the clinical variables and currently used biomarkers have failed to predict the individual susceptibility to AKI, candidate gene variants for the trait have been studied. Studies about genetic predisposition to AKI have been mainly underpowered and of moderate quality. We report the association study of 27 genetic variants in a cohort of Finnish critically ill patients, focusing on the replication of associations detected with variants in genes related to inflammation, cell survival, or circulation. In this prospective, observational Finnish Acute Kidney Injury (FINNAKI) study, 2647 patients without chronic kidney disease were genotyped. We defined AKI according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We compared severe AKI (Stages 2 and 3, n = 625) to controls (Stage 0, n = 1582). For genotyping we used iPLEX(TM) Assay (Agena Bioscience). We performed the association analyses with PLINK software, using an additive genetic model in logistic regression. Despite the numerous, although contradictory, studies about association between polymorphisms rs1800629 in TNFA and rs1800896 in IL10 and AKI, we found no association (odds ratios 1.06 (95% CI 0.89-1.28, p = 0.51) and 0.92 (95% CI 0.80-1.05, p = 0.20), respectively). Adjusting for confounders did not change the results. To conclude, we could not confirm the associations reported in previous studies in a cohort of critically ill patients.Peer reviewe

Heme oxygenase-1 repeat polymorphism in septic acute kidney injury

Acute kidney injury (AKI) is a syndrome that frequently affects the critically ill. Recently, an increased number of dinucleotide repeats in the HMOX1 gene were reported to associate with development of AKI in cardiac surgery. We aimed to test the replicability of this finding in a Finnish cohort of critically ill septic patients. This multicenter study was part of the national FINNAKI study. We genotyped 300 patients with severe AKI (KDIGO 2 or 3) and 353 controls without AKI (KDIGO 0) for the guanine-thymine (GTn) repeat in the promoter region of the HMOX1 gene. The allele calling was based on the number of repeats, the cut off being 27 repeats in the S-L (short to long) classification, and 27 and 34 repeats for the S-M-L2 (short to medium to very long) classification. The plasma concentrations of heme oxygenase-1 (HO-1) enzyme were measured on admission. The allele distribution in our patients was similar to that published previously, with peaks at 23 and 30 repeats. The S-allele increases AKI risk. An adjusted OR was 1.30 for each S-allele in an additive genetic model (95% CI 1.01-1.66; p = 0.041). Alleles with a repeat number greater than 34 were significantly associated with lower HO-1 concentration (p<0.001). In septic patients, we report an association between a short repeat in HMOX1 and AKI risk