Kasvatuskumppanuus näkyväksi : Kodin ja päiväkodin välinen yhteistyö

Tekijä: Sari Töyräs Opinnäytetyön nimi: Kasvatuskumppanuus näkyväksi. Kodin ja päiväkodin välinen yhteistyö Sivuja (+liitteitä): 54 +1 Opinnäytetyön kuvaus: Tavoitteena oli löytää päivähoidon yhteyteen joustavia ja saavutettavia toimintamuotoja, joiden avulla voidaan tukea vanhempia arjessa selviy¬tymisessä. Lähtökohtana olivat siis lasten ja heidän perheidensä tarpeet. Päämääränä oli tehdä kasvatuskumppanuus näkyväksi. Teoreettinen ja käsitteellinen esittely: Kehittämistyön teoreettisen viitekehyksen muodostivat kasvatuskumppanuus ja sosiaalipedagogiikka. Metodologinen esittely: Kehittämistyö on laadullinen ja kuvaileva. Aineistonke¬ruu¬menetelmänä käytin teemahaastattelua, joka toteutettiin yksityisessä päiväkodissa. Vastaajina oli 20 vanhempaa. Keskeiset tutkimustulokset: Tulokset osoittivat, että tärkeintä toimivassa yhteis¬työssä on rehellinen, aito ja luottamuksellinen suhde. Toimiva yhteistyö edellyttää, että puhutaan samoista asioista eikä vain käytetä samoja sanoja. Kumppanuuden syn¬nyn kannalta merkittävinä tekijöinä vanhemmat pitivät päivähoidon aloitusta ja päi¬vittäisiä kohtaamisia. Henkilöstö tarvitsee työnsä tueksi toimintamuotoja, koulutusta ja konsultaatiota. Johtopäätökset: Hyvä yhteistyö päivähoidossa pohjautuu toimivaan vuorovaikutuk¬seen, joka sisältää kes¬kuste¬lua ja kuuntelemista, monipuolista palautetta sekä uskal¬lusta puuttua ongelmiin. Näi¬den edellytyksiä ovat luottamus, rehellisyys ja avoimuus sekä erilaisten nä¬kemysten kun¬nioittaminen. Vanhemmat kokevat, että kokeiltujen toimintamallien avulla he pääsivät enemmän osallistumaan ja vaikuttamaan lastensa asioihin. Asiasanat: päivähoito, perhe, yhteistyö, kasvatuskumppanuus, toimintamuodotAuthor: Sari Töyräs Title: Education Partnership visible. Cooperation between home and kindergarten Pages(+appendixes): 54 +1 Thesis description: The aim was to find a day care attached to flexible and accessible forms of action that can be used to assist parents in coping with everyday life. So were the starting point for children and their families' needs. The goal was to make visible the educational partnership. Theoretical summary: Development formed the theoretical framework of the educational partnership and social pedagogy. Methodological summary: The development is a qualitative and descriptive. The data collection method used was interviews, which took place in a private kindergarten. The defendant was 20 parents. Main results: Results showed that the most important co-operation with an honest, genuine and trusting relationship. Effective collaboration requires that we speak the same things and not just use the same words. Partnership with the emergence of the importance to the parents considered the starting day-care and daily encounters. Staff need to support their work forms, training and consultation. Conclusions: Good co-operation in day care is based on the functional interaction, which includes discussions and listening, wide range of feedback and the courage to tackle problems. These conditions are trust, honesty and transparency as well as different views. Parents feel that the tried and tested approaches to more as they got to participate in and influence their children's affairs. Key words: child care, family, co-educational partnership, form

DOES MAGNETIC RESONANCE IMAGING PROVIDE SUPERIOR RELIABILITY FOR ACHILLES AND PATELLAR TENDON CROSS-SECTIONAL AREA MEASUREMENTS COMPARED WITH ULTRASOUND IMAGING?

This study investigated the reliability of Achilles and patellar tendon cross-sectional area (CSA) measurement using ultrasound imaging (USI) and magnetic resonance imaging (MRI). Fifteen healthy adults were imaged twice on two occasions, interrupted by a tendon loading protocol. Tendon CSA segmentations were conducted by an experienced and an inexperienced rater blinded to information regarding subject, session and loading status. USI provided good test-retest reliability (intra-class correlation coefficient [ICC] 2,1 > 0.85, standard error of measurement [SEM] 5%-6%), while with MRI it was excellent (ICC 2,1 > 0.92, SEM 4%) for the experienced rater. This study suggests that MRI provides superior reliability for tendon CSA measurements compared with USI. However, the difference in reliability between the methods was small, and the results were inconclusive regarding objectivity and sensitivity to change when assessed based on the effect of loading. We concluded that both methods can be used for reliable CSA measurements of the Achilles and patellar tendons when using a highly standardized measurement protocol and when conducted by an experienced rater. (C) 2019 World Federation for Ultrasound in Medicine & Biology. All rights reserved.Peer reviewe

T2 relaxation time mapping reveals age- and species-related diversity of collagen network architecture in articular cartilage

SummaryObjectiveThe magnetic resonance imaging (MRI) parameter T2 relaxation time has been shown to be sensitive to the collagen network architecture of articular cartilage. The aim of the study was to investigate the agreement of T2 relaxation time mapping and polarized light microscopy (PLM) for the determination of histological properties (i.e., zone and fibril organization) of articular cartilage.MethodsT2 relaxation time was determined at 9.4T field strength in healthy adult human, juvenile bovine and juvenile porcine patellar cartilage, and related to collagen anisotropy and fibril angle as measured by quantitative PLM.ResultsBoth T2 and PLM revealed a mutually consistent but varying number of collagen-associated laminae (3, 3–5 or 3–7 laminae in human, porcine and bovine cartilage, respectively). Up to 44% of the depth-wise variation in T2 was accounted for by the changing anisotropy of collagen fibrils, confirming that T2 contrast of articular cartilage is strongly affected by the collagen fibril anisotropy. A good correspondence was observed between the thickness of T2-laminae and collagenous zones as determined from PLM anisotropy measurements (r=0.91, r=0.95 and r=0.91 for human, bovine and porcine specimens, respectively).ConclusionsAccording to the present results, T2 mapping is capable of detecting histological differences in cartilage collagen architecture among species, likely to be strongly related to the differences in maturation of the tissue. This diversity in the MRI appearance of healthy articular cartilage should also be recognized when using juvenile animal tissue as a model for mature human cartilage in experimental studies

Repair of osteochondral defects with recombinant human type II collagen gel and autologous chondrocytes in rabbit

SummaryObjectiveRecombinant human type II collagen (rhCII) gels combined with autologous chondrocytes were tested as a scaffold for cartilage repair in rabbits in vivo.MethodAutologous chondrocytes were harvested, expanded and combined with rhCII-gel and further pre-cultivated for 2 weeks prior to transplantation into a 4 mm diameter lesion created into the rabbit's femoral trochlea (n = 8). Rabbits with similar untreated lesions (n = 7) served as a control group.ResultsSix months after the transplantation the repair tissue in both groups filled the lesion site, but in the rhCII-repair the filling was more complete. Both repair groups also had high proteoglycan and type II collagen contents, except in the fibrous superficial layer. However, the integration to the adjacent cartilage was incomplete. The O'Driscoll grading showed no significant differences between the rhCII-repair and spontaneous repair, both representing lower quality than intact cartilage. In the repair tissues the collagen fibers were abnormally organized and oriented. No dramatic changes were detected in the subchondral bone structure. The repair cartilage was mechanically softer than the intact tissue. Spontaneously repaired tissue showed lower values of equilibrium and dynamic modulus than the rhCII-repair. However, the differences in the mechanical properties between all three groups were insignificant.ConclusionWhen rhCII was used to repair cartilage defects, the repair quality was histologically incomplete, but still the rhCII-repairs showed moderate mechanical characteristics and a slight improvement over those in spontaneous repair. Therefore, further studies using rhCII for cartilage repair with emphasis on improving integration and surface protection are required

Infrared microspectroscopic determination of collagen cross-links in articular cartilage

Collagen forms an organized network in articular cartilage to give tensile stiffness to the tissue. Due to its long half-life, collagen is susceptible to cross-links caused by advanced glycation end-products. The current standard method for determination of cross-link concentrations in tissues is the destructive high-performance liquid chromatography (HPLC). The aim of this study was to analyze the cross-link concentrations nondestructively from standard unstained histological articular cartilage sections by using Fourier transform infrared (FTIR) microspectroscopy. Half of the bovine articular cartilage samples (n = 27) were treated with threose to increase the collagen cross-linking while the other half (n = 27) served as a control group. Partial least squares (PLS) regression with variable selection algorithms was used to predict the cross-link concentrations from the measured average FTIR spectra of the samples, and HPLC was used as the reference method for cross-link concentrations. The correlation coefficients between the PLS regression models and the biochemical reference values were r = 0.84 (p <0.001), r = 0.87 (p <0.001) and r = 0.92 (p <0.001) for hydroxylysyl pyridinoline (HP), lysyl pyridinoline (LP), and pentosidine (Pent) cross-links, respectively. The study demonstrated that FTIR microspectroscopy is a feasible method for investigating cross-link concentrations in articular cartilage. (C) The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.Peer reviewe

Obstructive sleep apnoea-related respiratory events and desaturation severity are associated with the cardiac response

Obstructive sleep apnoea (OSA) causes, among other things, intermittent blood oxygen desaturations, increasing the sympathetic tone. Yet the effect of desaturations on heart rate variability (HRV), a simple and noninvasive method for assessing sympathovagal balance, has not been comprehensively studied. We aimed to study whether desaturation severity affects the immediate HRV.MethodsWe retrospectively analysed the electrocardiography signals in 5-min segments (n=39 132) recorded during clinical polysomnographies of 642 patients with suspected OSA. HRV parameters were calculated for each segment. The segments were pooled into severity groups based on the desaturation severity (i.e.the integrated area under the blood oxygen saturation curve) and the respiratory event rate within the segment. Covariate-adjusted regression analyses were performed to investigate possible confounding effects.ResultsWith increasing respiratory event rate, the normalised high-frequency band power (HFNU) decreased from 0.517 to 0.364 (p&lt;0.01), the normalised low-frequency band power (LFNU) increased from 0.483 to 0.636 (p&lt;0.01) and the mean RR interval decreased from 915 to 869 ms (p&lt;0.01). Similarly, with increasing desaturation severity, the HFNUdecreased from 0.499 to 0.364 (p&lt;0.01), the LFNUincreased from 0.501 to 0.636 (p&lt;0.01) and the mean RR interval decreased from 952 to 854 ms (p&lt;0.01). Desaturation severity-related findings were confirmed by considering the confounding factors in the regression analyses.ConclusionThe short-term HRV response differs based on the desaturation severity and the respiratory event rate in patients with suspected OSA. Therefore, a more detailed analysis of HRV and desaturation characteristics could enhance OSA severity estimation

Success Rate and Technical Quality of Home Polysomnography With Self-Applicable Electrode Set in Subjects With Possible Sleep Bruxism

Using sleep laboratory polysomnography (PSG) is restricted for the diagnosis of only the most severe sleep disorders due to its low availability and high cost. Home PSG is more affordable, but applying conventional electroencephalography (EEG) electrodes increases its overall complexity and lowers the availability. Simple, self-administered single-channel EEG monitors on the other hand suffer from poor reliability. In this study, we aimed to quantify the reliability of self-administrated home PSG recordings conducted with a newly designed ambulatory electrode set (AES) that enables multichannel EEG, electrooculography, electromyography, and electrocardiography recordings. We assessed the sleep study success rate and technical quality of the recordings performed in subjects with possible sleep bruxism (SB). Thirty-two females and five males aged 39.6 +/- 11.6 years (mean +/- SD) with self-reported SB were recruited in the study. Self-administrated home PSG recordings with two AES designs were conducted (n = 19 and 21). The technical quality of the recordings was graded based on the proportion of interpretable data. Technical failure rate for AES (both designs) was 5% and SB was scorable for 96.9% of all recorded data. Only one recording failed due to mistakes in self-applying the AES. We found that the proportion of good quality self-administrated EEG recordings is significantly higher when multiple channels are used compared to using a single channel. Sleep study success rates and proportion of recordings with high quality interpretable data from EEG channels of AES were comparable to that of conventional home PSG. Self-applicable AES has potential to become a reliable tool for widely available home PSG.Peer reviewe

Estimation of articular cartilage properties using multivariate analysis of optical coherence tomography signal

SummaryObjectiveThe aim was to investigate the applicability of multivariate analysis of optical coherence tomography (OCT) information for determining structural integrity, composition and mechanical properties of articular cartilage.DesignEquine osteochondral samples (N = 65) were imaged with OCT, and their total attenuation and backscattering coefficients (μt and μb) were measured. Subsequently, the Mankin score, optical density (OD) describing the fixed charge density, light absorbance in amide I region (Aamide), collagen orientation, permeability, fibril network modulus (Ef) and non-fibrillar matrix modulus (Em) of the samples were determined. Partial least squares (PLS) regression model was calculated to predict tissue properties from the OCT signals of the samples.ResultsSignificant correlations between the measured and predicted mean collagen orientation (R2 = 0.75, P < 0.0001), permeability (R2 = 0.74, P < 0.0001), mean OD (R2 = 0.73, P < 0.0001), Mankin scores (R2 = 0.70, P < 0.0001), Em (R2 = 0.50, P < 0.0001), Ef (R2 = 0.42, P < 0.0001), and Aamide (R2 = 0.43, P < 0.0001) were obtained. Significant correlation was also found between μb and Ef (ρ = 0.280, P = 0.03), but not between μt and any of the determined properties of articular cartilage (P > 0.05).ConclusionMultivariate analysis of OCT signal provided good estimates for tissue structure, composition and mechanical properties. This technique may significantly enhance OCT evaluation of articular cartilage integrity, and could be applied, for example, in delineation of degenerated areas around cartilage injuries during arthroscopic repair surgery

Towards a Deeper Understanding of Sleep Stages through their Representation in the Latent Space of Variational Autoencoders

Artificial neural networks show great success in sleep stage classification, with an accuracy comparable to human scoring. While their ability to learn from labelled electroencephalography (EEG) signals is widely researched, the underlying learning processes remain unexplored. Variational autoencoders can capture the underlying meaning of data by encoding it into a low-dimensional space. Regularizing this space furthermore enables the generation of realistic representations of data from latent space samples. We aimed to show that this model is able to generate realistic sleep EEG. In addition, the generated sequences from different areas of the latent space are shown to have inherent meaning. The current results show the potential of variational autoencoders in understanding sleep EEG data from the perspective of unsupervised machine learning

Beat-to-beat cardiac repolarization lability increases during hypoxemia and arousals in obstructive sleep apnea patients

Obstructive sleep apnea (OSA) is associated with the progression of cardiovascular diseases, arrhythmias, and sudden cardiac death (SCD). However, the acute impacts of OSA and its consequences on heart function are not yet fully elucidated. We hypothesized that desaturation events acutely destabilize ventricular repolarization, and the presence of accompanying arousals magnifies this destabilization. Ventricular repolarization lability measures, comprising heart rate corrected QT (QTc), short-time-variability of QT (STVQT), and QT variability index (QTVI), were calculated before, during, and after 20,955 desaturations from lead II electrocardiography signals of 492 patients with suspected OSA (52% men). Variations in repolarization parameters were assessed during and after desaturations, both with and without accompanying arousals, and groupwise comparisons were performed based on desaturation duration and depth. Regression analyses were used to investigate the influence of confounding factors, comorbidities, and medications. The standard deviation (SD) of QT, mean QTc, SDQTc, and STVQT increased significantly (P < 0.01), whereas QTVI decreased (P < 0.01) during and after desaturations. The changes in SDQT, mean QTc, SDQTc, and QTVI were significantly amplified (P < 0.01) in the presence of accompanying arousals. Desaturation depth was an independent predictor of increased SDQTc (β = 0.405, P < 0.01), STVQT (β = 0.151, P < 0.01), and QTVI (β = 0.009, P < 0.01) during desaturation. Desaturations cause acute changes in ventricular repolarization, with deeper desaturations and accompanying arousals independently contributing to increased ventricular repolarization lability. This may partially explain the increased risk of arrhythmias and SCD in patients with OSA, especially when the OSA phenotype includes high hypoxic load and fragmented sleep