Osallistujien kokemuksia OMA-ohjelmasta: vankien kokemuksia Rikosseuraamuslaitoksen kuntouttavasta toimintaohjelmasta

Opinnäytetyön tarkoituksena oli tutkia OMA (Omaehtoisen muutoksen ohjelma) -ohjelmaan osallistuvien kokemuksia OMA-hankkeessa uudistetusta OMA-ohjelmasta. Opinnäytetyössä selvitettiin osallistujien yleisiä kokemuksia OMA-ohjelmasta sekä kuinka osallistujien yksilöllisyys on huomioitu siinä. Opinnäytetyön toimeksiantajana oli Kriminaalihuollon tukisäätiö. OMA-ohjelma on väkivaltarikollisille tarkoitettu kuntouttava toimintaohjelma, jonka tavoitteena on vaikuttaa rikoksentekijän yhteiskunnan vastaisiin ja väkivaltaisiin ajattelumalleihin, tunteiden hallintaongelmiin ja kyvyttömyyteen hahmottaa omaa väkivaltaista käyttäytymistä. Kuntouttavien toimintaohjelmien tavoitteena on tukea rikollisia pääsemään irti rikollisuudesta, joten opinnäytetyön teoreettisena viitekehyksenä on desistanssi eli rikollisuudesta irrottautuminen. Opinnäytetyötä varten haastateltiin seitsemää OMA-ohjelman pilottiryhmien osallistujaa. Aineisto kerättiin teemahaastatteluilla ja analysoitiin sisällönanalyysilla. Osallistujien kokemusten mukaan OMA-ohjelma tukee muutoksessa kohti väkivallattomuutta. Tulosten mukaan osallistujat pitävät OMA-ohjelman toteutusta ja työskentelytapoja pääsääntöisesti hyvinä. Osallistujat otettiin OMA-ohjelmassa huomioon yksilöllisinä persoonina sekä heidän yksilölliset tilanteensa oli otettu huomioon kuntoutuspolkuja suunnitellessa. Opinnäytetyöni tuloksia voidaan käyttää OMA-hankkeen kehittämistyössä. Lisäksi opinnäytetyötä voivat hyödyntää OMA-ohjaajat sekä muut ohjelman parissa työskentelevät

Mandibular widening in hemifacial microsomia: A roentgen stereometric study of 11 patients with the aid of metallic implants

Introduction: Our objective was to study mandibular widening in untreated subjects with hemifacial microsomia. Methods: From the 3-dimensional files at the Department of Plastic and Reconstructive Surgery, Skane University Hospital in Malmo, Sweden, data of 11 subjects (3 girls, 8 boys) with hemifacial microsomia were retrieved. Their age range was 9 years 2 months to 13 years 2 months at the first examination. The mean observation period was 5 years 2 months. Each subject was studied by roentgen stereophotogrammetry with the aid of metallic implants. Results: A significant widening of the mandible was found, with a mean total change of 0.31 mm (range, 0.08-0.79 mm) and a mean annual change of 0.07 mm (range, 0.03-0.12 mm). In 2 subjects, narrowing of the mandible was found: -0.16 and -0.23 mm. Conclusions: The mandible got wider during adolescence in 9 of our subjects with hemifacial microsomia but to a lesser extent than has been reported in subjects without hemifacial microsomia and from ordinary orthodontic clinics. Sex difference was not addressed. It was suggested that chewing (forces and patterns) was responsible for the mandibular widening in our subjects; this is in line with previous research. (Am J Orthod Dentofacial Orthop 2012;141:S88-91

Von Langenbeck or Wardill procedures for primary palatal repair in patients with isolated cleft palate--speech results

Sixty-six patients operated on for isolated cleft palate were evaluated as adults, and their speech was assessed clinically. Forty-four had undergone a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at the age of 18 months. Speech was judged subjectively by the patients themselves, and perceptual assessment was made by three speech pathologists. The remaining speech problems, mainly hypernasality, were moderate or severe in 7 (16%) of the patients in the von Langenbeck group, and in 7 (32%) in the Wardill group. On the other hand, the patients in the Wardill group had fewer fistulas closed, and fewer velopharyngoplasties. There were no significant differences between the two methods regarding speech in adulthood. The Wardill method produced significantly more scar tissue clinically, which carries the potential risk of inhibition of facial growth. The present speech results will therefore be weighed against the outcome of maxillofacial growth for these patients

Adult skeletal profile in isolated cleft palate: a comparison of the von Langenbeck and Wardill procedures for primary repair of the palate

Sixty-four adult patients operated on for isolated cleft palate were evaluated with regard to facial skeletal morphology using conventional radio-cephalometry. Dental occlusion was assessed clinically. Forty-two had had a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at 18 months. The mean error of the method was 0.7 degree for angular, and 0.9 mm for linear, measurements. The group with clefts had less maxillary prognathism (s-n-ss), more maxillary inclination (NSL/NL), more retroclined lower incisors (ILI/ML), and shorter total and upper facial heights (n-gn, n-sp) compared with the reference group. Multiple regression analysis was used to evaluate differences between the two treatment regimens. Explanatory variables in addition to surgical technique were sex, severity of cleft, and presence of a velopharyngeal flap. Only one variable, lower incisor inclination (ILI/ML), was different for the two regimens. Ten (24%) in the von Langenbeck group had a lateral cross-bite compared with one (5%) in the Wardill group. Other variables in a multivariate regression analysis were affected by sex and severity of cleft to various degrees. This study showed no obvious differences in facial skeletal morphology that could be attributed to surgical technique. Factors other than technique, including sex, age, and severity of cleft merit attention