Lasten ja nuorten hyvinvointi, palvelulinjan rakenne ja kustannukset

Lasten ja nuorten hyvinvointiselonteko on osa Kajaanissa vuodesta 1998 alkaen toimineen hyvinvointiselontekoryhmän toimintaa. Ryhmän tehtävänä on tuoda hyvinvoinnin ja terveyden näkökulma osaksi kaupungin strategiaa. Kajaani on liittynyt Stakesin ”Kuntastrategiat ja Lasten ja nuorten hyvinvointiselonteko” -tutkimus- ja kehittämishankkeeseen. Hankkeen tavoitteena on edistää hyvinvointia ja terveyttä tuomalla päättäjien tietoon lasten ja nuorten tämän hetken tilanne sekä hyvinvoinnin että hyvinvointipalvelujen osalta ja tekemällä ehdotuksia tarvittavista toimenpiteistä. Lisäksi tavoitteena on kehittää lasten ja nuorten hyvinvointia kuvaavia mittareita. Opinnäytetyömme aiheena on lasten ja nuorten palvelulinjojen rakenne ja kustannukset. Tutkimusaineistona oli kuuden lapsen palvelulinjakuvaukset. Lapset on luokiteltu kolmeen eri ryhmään koulumenestyksen perusteella: normaali koulumenestys, huono koulumenestys ja erityisoppilas. Tutkimusaineiston perusteella kartoitettiin kustannuksia, jotka syntyvät lasten saamista terveydenhuollon palveluista. Kustannuksia verrattiin toisiinsa ja pyrittiin selvittämään mistä kustannukset syntyvät. Tavoitteena oli selvittää kustannusten lisäksi myös millaisia kustannuseroja syntyy peruspalveluiden ja erityispalveluiden käytöstä. Kustannuksia selvittäessä tuli ilmi, ettei tuotteistamista ollut suoritettu kaikilla tutkimusalueilla joko lainkaan tai se oli tehty erilailla. Kustannusten laskemista vaikeutti lisäksi se, ettei kaikkia tietoja ollut saatavissa, koska yhtenäistä tietokantaa ei ole esimerkiksi lasten- neuvolan ja hammashuollon välillä. Palvelulinjojen kuvauksia ja niiden kustannusten laskemista on aiheellista kehittää. Tuotekustannuslaskentaa on laajennettava koko perusturvatoimialalle ja muihin kaupungin ver- tailuyksikköihin siten, että kustannuslaskenta tehdään samojen periaatteiden mukaisesti. Tutkimuksemme voisi olla lähtökohtana palvelulinjojen kuvausten ja niiden kustannusten laskemisen kehittämiselle ja vertailukelpoisten kustannustietojen saamiselle Kajaanin kaupungin, vertailukuntien ja yksityisten palveluntuottajien kesken.The report of children and adolescent welfare is a part of the welfare reporting group that has been operating in Kajaani since the year 1998. The task of the group is to highlight the point of view of health and welfare as part of the municipal strategy. Kajaani has joined a research and developing project "The Municipality Strategies and Children ´s and Adolescents´ Welfare Account" run by Stakes. The objective of the project is to promote health and welfare by making the decision-makers aware of the current situation and by making proposal for practical measures needed. Furthermore, the objective is to develop indicators which describe the welfare of the children and adolescents. The subject of our final year paper is the structure and the costs of the children and adolescent welfare service. The research material consisted of describing services provided with six children who were classified into three groups on the basis of the school success: children with normal school success, children with poor school success and children receiving special tuition. The costs of the public health were analysed on the basis of the received services. The costs were compared, and we tried to clarify where the costs originated from. The objective was, in addition to the costs, also to clarify what differences in costs occur between the use of basic services and of special services. When the costs were clarified, it turned out that commercializing had not been realized in all sectors within the range of the research or it had been done in different ways. Furthermore, the calculation of costs was made more difficult by the fact that all the information was not available because there is no uniform database existing for example between the child health clinic and the dental care. Describing the welfare services and calculating the costs require further development. The product cost accounting must be extended to the whole basic security sector and to other municipal control units so that the cost accounting follows the same principles. Our study could be a starting point for developing service descriptions and their cost calculation. It could also be a starting point for receiving comparable cost information between the town of Kajaani, control municipalities and private service producers

Young Adult Donor Bone Marrow Infusions into Female Mice Postpone Age-Related Reproductive Failure and Improve Offspring Survival

The female reproductive axis is the first major organ system of the body to fail with advancing age. In addition to a permanent cessation of fertile potential, the loss of cyclic ovarian function in humans heralds the onset of menopause, which in turn underlies the emergence of a diverse spectrum of health issues in aging women. Recently, it was reported that bone marrow (BM) transplantation (BMT) into adult female mice conditioned a week earlier with highly cytotoxic drugs rescues ovarian function and fertility. Herein we show in mice receiving no prior conditioning regimen that once-monthly infusions of BM-derived cells retrieved from young adult female donors bearing an enhanced green fluorescent protein (EGFP) transgene sustain the fertile potential of aging wild-type females long past their time of normal reproductive senescence. The fertility-promoting effects of female donor BM are observed regardless whether the infusions are initiated in young adult or middle-aged females. Although the mechanism by which BM infusions benefit the reproductive performance of aging females remains to be elucidated, the absence of EGFP-expressing offspring suggests that it does not depend on development of mature eggs derived from germline-committed cells in the donor marrow. However, donor BM-derived somatic cells accumulate in the recipients, indicating efficient donor cell engraftment without prior conditioning. These findings provide a strong impetus to further explore development of adult stem cell-based technologies to safely extend function of the female reproductive axis into advanced age without the need for toxic pre-conditioning protocols routinely used in other models of stem cell delivery

Transplantation of mesenchymal stem cells from young donors delays aging in mice

Increasing evidence suggests that the loss of functional stem cells may be important in the aging process. Our experiments were originally aimed at testing the idea that, in the specific case of age-related osteoporosis, declining function of osteogenic precursor cells might be at least partially responsible. To test this, aging female mice were transplanted with mesenchymal stem cells from aged or young male donors. We find that transplantation of young mesenchymal stem cells significantly slows the loss of bone density and, surprisingly, prolongs the life span of old mice. These observations lend further support to the idea that age-related diminution of stem cell number or function may play a critical role in age-related loss of bone density in aging animals and may be one determinant of overall longevity

Bone Marrow Transplantation Restores Follicular Maturation and Steroid Hormones Production in a Mouse Model for Primary Ovarian Failure

Recent studies suggest that bone marrow stem cells (BMSCs) are promising grafts to treat a variety of diseases, including reproductive dysfunction. Primary ovarian failure is characterized by amenorrhea and infertility in a normal karyotype female, with an elevated serum level of follicle-stimulating hormone (FSH) and a decrease level of estrogen caused by a mutation in FSH receptor (FSHR) gene. Currently, there is no effective treatment for this condition. The phenotype of FSHR (−/−) mouse, FORKO (follitropin receptor knockout), is a suitable model to study ovarian failure in humans. Female FORKO mice have elevated FSH, decreased estrogen levels, are sterile because of the absence of folliculogenesis, and display thin uteri and small nonfunctional ovaries. In this study, we determined the effects of BMSC transplantation on reproductive physiology in this animal model. Twenty four hours post BMSC transplantation, treated animals showed detectable estroidogeneic changes in daily vaginal smear. Significant increase in total body weight and reproductive organs was observed in treated animals. Hemotoxylin and eosin (H&E) evaluation of the ovaries demonstrated significant increase in both the maturation and the total number of the follicles in treated animals. The FSH dropped to 40–50% and estrogen increased 4–5.5 times in the serum of treated animals compared to controls. The FSHR mRNA was detected in the ovaries of treated animals. Our results show that intravenously injected BMSCs were able to reach the ovaries of FORKO mice, differentiate and express FHSR gene, make FSHR responsive to FSH, resume estrogen hormone production, and restore folliculogenesis

Back Office -toiminnon kehittäminen sähkötuotteelle

Y ritysten välinen kilpailu luo haasteita tehtävien kustannus tehokkaalle suorittamiselle ja lisäarvon tuottamiselle asiakkaille. Sisäisien prosessien kehittäminen luo mahdollisuuksia taloudelliselle kannattavuudelle ja mahdollisesti luo jopa uusia palveluita. Tämän tutkimustyön tavoitteena oli selvittää Back Office -toiminnon käyttöönottamisella saatuja hyötyjä Eltel Networks Pohjoinen Oy:n sähkötuotteelle ja etsiä uusia kehitysnäkökulmia sekä selkiyttää käytössä olevia toimintamalleja ja käsitteitä. Tutkimustyön teoriaosassa avataan Back Office- ja Front Office -käsitteitä sekä prosesseja. Selkiytetään asiakkaan osallistumista palveluprosessiin ja tarkastellaan prosesseissa tapahtuvaa arvon muodostumista. Työn empiirinen osio koostuu kyselytutkimuksen toteuttamisesta organisaation esimies- ja johtohenkilöille. Saatujen tulosten perusteella on muodostettu yhteenveto sekä pohdinnat kehityskohteiden esittämiseksi.Competition between the companies will create challenges for cost-effective performance of functions and added value for the customer. Among the internal processes of development creates opportunities for economic viability, and possibly even create new services. Aim of this study was to examine the Back Office -function, the benefits of putting stories Eltel Networks North Ltd's electrical product development and search for new perspectives and to clarify the existing operational models and concepts. The theoretical part of the investigation will be opened Back Office- and Front Office -concepts and processes. Clarifies the client's participation in the service process and examines the value of the formation processes take place. The empirical part consists of a survey on the implementation of the organization's leadership and management staff. Based on the results has been formed, and a summary of the deliberations highlight the development aspects

Interferon-Gamma Sensitizes the Human Salivary Gland Cell Line, HSG, to Tumor Necrosis Factor-Alpha Induced Activation of Dual Apoptotic Pathways

Activated immune cells secrete proinflammatory cytokines such as tumor necrosis factor alpha (TNF-alpha), interferon–gamma (IFN-gamma) and Fas ligand (FasL) and these cytokines have been reported to induce apoptosis in numerous cell types. Apoptotic cell death has been associated with the progression of numerous autoimmune diseases. Proinflammatory cytokines are reportedly involved in apoptosis in the salivary glands of patients with Sjögren’s syndrome (SS); an autoimmune disorder characterized by the destruction of salivary and lachrymal glands. In this study, we used the HSG cell line to determine if exposure to proinflammatory cytokines induces apoptosis in human salivary gland cells. In addition, we identified the mediators controlling the apoptotic process in response to TNF alpha and IFN gamma. TNF-alpha and IFN-gamma induced apoptosis in HSG cells and resulted in the activation of caspase 8 and the “death receptor” pathway. We further determined that caspase 9 and the “mitochondrial” pathway was also activated. Induction of the intrinsic and extrinsic pathways in HSG cells resulted in substrate cleavage by effector caspases, in particular the cleavage of alpha II spectrin, an autoantigen in Sjögren’s syndrome. Our results suggest that HSG cells provide a model system to study processes regulating proinflammatory cytokine-induced apoptotic cell death

Interferon-Gamma Sensitizes the Human Salivary Gland Cell Line, HSG, to Tumor Necrosis Factor-Alpha Induced Activation of Dual Apoptotic Pathways

Activated immune cells secrete proinflammatory cytokines such as tumor necrosis factor alpha (TNF-alpha), interferon–gamma (IFN-gamma) and Fas ligand (FasL) and these cytokines have been reported to induce apoptosis in numerous cell types. Apoptotic cell death has been associated with the progression of numerous autoimmune diseases. Proinflammatory cytokines are reportedly involved in apoptosis in the salivary glands of patients with Sjögren’s syndrome (SS); an autoimmune disorder characterized by the destruction of salivary and lachrymal glands. In this study, we used the HSG cell line to determine if exposure to proinflammatory cytokines induces apoptosis in human salivary gland cells. In addition, we identified the mediators controlling the apoptotic process in response to TNF alpha and IFN gamma. TNF-alpha and IFN-gamma induced apoptosis in HSG cells and resulted in the activation of caspase 8 and the “death receptor” pathway. We further determined that caspase 9 and the “mitochondrial” pathway was also activated. Induction of the intrinsic and extrinsic pathways in HSG cells resulted in substrate cleavage by effector caspases, in particular the cleavage of alpha II spectrin, an autoantigen in Sjögren’s syndrome. Our results suggest that HSG cells provide a model system to study processes regulating proinflammatory cytokine-induced apoptotic cell death

Hypoxia Inhibits Differentiation of Lineage-Specific Rcho-1 Trophoblast Giant Cells

Defects in placental development lead to pregnancies at risk for miscarriage and intrauterine growth retardation and are associated with preeclampsia, a leading cause of maternal death and premature birth. In preeclampsia, impaired placental formation has been associated with alterations in a specific trophoblast lineage, the invasive trophoblast cells. In this study, an RT-PCR Trophoblast Gene Expression Profile previously developed by our laboratory was utilized to examine the lineage-specific gene expression of the rat Rcho-1 trophoblast cell line. Our results demonstrated that Rcho-1 cells represent an isolated, trophoblast population committed to the giant cell lineage. RT-PCR analysis revealed that undifferentiated Rcho-1 cells expressed trophoblast stem cell marker, Id2, and trophoblast giant cell markers. On differentiation, Rcho-1 cells downregulated Id2 and upregulated Csh1, a marker of the trophoblast giant cell lineage. Neither undifferentiated nor differentiated Rcho-1 cells expressed spongiotrophoblast marker Tpbpa or labyrinthine markers Esx1 and Tec. Differentiating Rcho-1 cells in hypoxia did not alter the expression of lineage-specific markers; however, hypoxia did inhibit the downregulation of the trophoblast stem cell marker Id2. Differentiation in hypoxia also blocked the induction of CSH1 protein. In addition, hypoxia inhibited stress fiber formation and abolished the induction of palladin, a protein associated with stress fiber formation and focal adhesions. Thus, Rcho-1 cells can be maintained as a proliferative, lineage-specific cell line that is committed to the trophoblast giant cell lineage on differentiation in both normoxic and hypoxic conditions; however, hypoxia does inhibit aspects of trophoblast giant cell differentiation at the molecular, morphological, and functional levels

Id2 Mediates Differentiation of Labyrinthine Placental Progenitor Cell Line, SM10

The placenta is an organ that is formed transiently during pregnancy, and appropriate placental development is necessary for fetal survival and growth. Proper differentiation of the labyrinthine layer of the placenta is especially crucial, as it establishes the fetal–maternal interface that is involved in physiological exchange processes. Although previous studies have indicated the importance of inhibitor of differentiation/inhibitor of DNA binding-2 (Id2) helix-loop-helix transcriptional regulator in mediating cell differentiation, the ability of Id2 to regulate differentiation toward the labyrinthine (transport) lineage of the placenta has yet to be determined. In the current study, we have generated labyrinthine trophoblast progenitor cells with increased (SM10-Id2) or decreased (SM10-Id2-shRNA) Id2expression and determined the effect on TGF-β-induced differentiation. Our Id2 overexpression and knockdown analyses indicate that Id2 mediates TGF-β-induced morphological differentiation of labyrinthine trophoblast cells, as Id2 overexpression prevents differentiation and Id2 knockdown results in differentiation. Thus, our data indicate that Id2 is an important molecular mediator of labyrinthine trophoblast differentiation. An understanding of the regulators of trophoblast progenitor differentiation toward the labyrinthine lineage may offer insights into events governing pregnancy-associated disorders, such as placental insufficiency, fetal growth restriction, and preeclampsia