Kuntoutuksen ylemmän amk-koulutuksen kehittämishankkeet oppimisen paikkoina

Artikkelissa tarkastellaan kuntoutuksen ylemmän ammattikorkeakoulutuksen kehittämishankkeita työelämälähtöisen oppimisen paikkoina ja esitellään tutkimustuloksia kuntoutuksen ylemmän amk-koulutuksen opiskelijoiden oppimisesta kuntoutuksen kehittämishankkeissa. Opiskelijoiden kehittämishankkeet toteutuivat kuntoutuksen työyhteisöissä. Tehtävissä kehitettiin asiakaslähtöistä kuntoutustyötä, rakennettiin yhteistä kuntoutustyön viitekehystä ja edistettiin moniammatillista työskentelyä ja palvelun kustannustehokkuutta. Kehittämistyön tulos näkyi työntekijöiden työhyvinvoinnin lisääntymisenä. Työyhteisöissä kuntoutustyön kehittämisote oli tutkimuksellinen. Lopuksi kuvataan sitä, miten oppiminen pohjautui teoreettisiin lähtökohtiin ja yhteisöllisyyteen, ja johti käytännöllisten ongelmien ratkaisuun ja uusien välineiden löytämiseen

Miesopiskelijoiden identiteetti opettajaopinnoissa

Tutkimuksen tarkoituksena on kuvata, miten miesopiskelijoiden opettajaidentiteetti rakentuu opintojen ensimmäisten kuukausien aikana. Tuloksia voidaan käyttää hyväksi opettajankoulutuksen kehittämisessä. Tutkimuksen kohteena on ammatillinen opettajaopiskelija ja ammatillinen opettajankoulutus. Tutkimuksen aineisto on kerätty Hämeen ammatilliselta opettajakorkeakoululta. Tutkimukseen osallistujat seitsemän opettajaopiskelijamiestä on lähes saman ammattialan edustavia, hyvin samanlaisilla koulutustaustoiltaan opettajan pätevyyttä suorittavia opiskelijoita. Tutkimusaineisto muodostui seitsemästä oppimispäiväkirjasta, jotka oli kirjoitettu viiden kuukauden ajan opettajaopintojen aloittamisesta. Ainestolähtöinen analyysi eteni kolmivaiheisen prosessin mukaisesti. Aineiston analyysiä syvennettiin van Langenhoven ja Harrén (1999) asemoinnin käsitteen avulla. Tutkimuksen tuloksena havaittiin, että opettajaopiskelijamiesten siirtymisessä oman alansa osaajasta opettajaopiskelijaksi ja siitä edelleen opettajaksi, rakentui opintojen alussa monivaiheisesti. Opintojen alussa identiteettityö käynnistyi opiskelijoiden asemoitumisella opintoihin, opiskelukäytänteisiin, tietämiseen ja opettajuuteen. Opettajaopiskelijan identiteettityön monipuolisuuden näkyvämmäksi tekeminen opettajaopintojen alusta lähtien mahdollistaisi opiskelijoiden tietoisemman identiteettityön käynnistymisen sekä jatkumisen opettajan ammatissa

Miesopiskelijoiden identiteetti opettajaopinnoissa

Tutkimuksen tarkoituksena on kuvata, miten miesopiskelijoiden opettajaidentiteetti rakentuu opintojen ensimmäisten kuukausien aikana. Tuloksia voidaan käyttää hyväksi opettajankoulutuksen kehittämisessä. Tutkimuksen kohteena on ammatillinen opettajaopiskelija ja ammatillinen opettajankoulutus. Tutkimuksen aineisto on kerätty Hämeen ammatilliselta opettajakorkeakoululta. Tutkimukseen osallistujat seitsemän opettajaopiskelijamiestä on lähes saman ammattialan edustavia, hyvin samanlaisilla koulutustaustoiltaan opettajan pätevyyttä suorittavia opiskelijoita. Tutkimusaineisto muodostui seitsemästä oppimispäiväkirjasta, jotka oli kirjoitettu viiden kuukauden ajan opettajaopintojen aloittamisesta. Ainestolähtöinen analyysi eteni kolmivaiheisen prosessin mukaisesti. Aineiston analyysiä syvennettiin van Langenhoven ja Harrén (1999) asemoinnin käsitteen avulla. Tutkimuksen tuloksena havaittiin, että opettajaopiskelijamiesten siirtymisessä oman alansa osaajasta opettajaopiskelijaksi ja siitä edelleen opettajaksi, rakentui opintojen alussa monivaiheisesti. Opintojen alussa identiteettityö käynnistyi opiskelijoiden asemoitumisella opintoihin, opiskelukäytänteisiin, tietämiseen ja opettajuuteen. Opettajaopiskelijan identiteettityön monipuolisuuden näkyvämmäksi tekeminen opettajaopintojen alusta lähtien mahdollistaisi opiskelijoiden tietoisemman identiteettityön käynnistymisen sekä jatkumisen opettajan ammatissa

Miesopiskelijoiden identiteetti opettajaopinnoissa

Refereed article This article examines what are the issues and relations male teacher students build their teacher identity on. The research data which consists of vocational male teacher student’s learning diaries, provides these answers. The data was analysed by utilising the content based analysis. As a theoretical instrument in the analysis van Langenhoven and Harrén’s (1999) concept of positioning was used as well. As results indicate, male teacher students’ transition from their own field of expertise to a teacher student, and hence to a teacher, is built by positioning in relation to studies, study practises, knowledge and gender-based male teacherhood. To make the teacher student’s identity work more visible from the commencement of the teacher education, studies would enable more conscious launch of the identity work and to engage more deeply into the teacher profession. It would enable the use of identity as an instrument as well as the more gender-conscious operational culture.Artikkeli on läpikäynyt referee-menettelyn Tässä artikkelissa tutkimme, millaisia asioita huomioiden ja millaisten suhteiden varassa opettajaksi opiskelevat miesopiskelijat rakentavat opettajaidentiteettiä. Vastauksia etsimme aineistosta, joka koostuu ammatillisen opettajankoulutuksen miesopiskelijoiden oppimispäiväkirjamuotoisista teksteistä. Aineisto on analysoitu aineistolähtöistä sisällönanalyysia hyödyntämällä, teoreettisena apuvälineenä analyysissa on lisäksi hyödynnetty van Langenhoven ja Harrén (1999) asemoinnin käsitettä. Tuloksina esitämme, että opettajaopiskelijamiesten siirtymisessä oman alansa osaajasta opettajaopiskelijaksi ja siitä edelleen opettajaksi, rakentuu asemoitumalla suhteessa opintoihin, opiskelukäytänteisiin, tietämiseen sekä sukupuolitettuun miesopettajuuteen. Opettajaopiskelijan identiteettityön monipuolisuuden näkyvämmäksi tekeminen opettajaopintojen alusta lähtien mahdollistaisi opiskelijoiden tietoisemman identiteettityön käynnistymisen sekä syventymisen opettajan ammatissa. Se mahdollistaisi identiteetin käyttämisen työvälineenä sekä sukupuolitietoisemman toimintakulttuurin

RIP1 has a role in CD40-mediated apoptosis in human follicular lymphoma cells

CD40 is a cell surface receptor which belongs to tumor necrosis factor receptor (TNFR) family members. It transmits signals that regulate diverse cellular responses such as proliferation, differentiation, adhesion molecule expression and apoptosis. Unlike other TNFR family members (TRAIL-R, Fas-R and TNFR1), the CD40 cytoplasmic tail lacks death domain. However, CD40 is capable of inducing apoptosis in different types of cancer cells including lymphoma. The apoptotic effect of CD40 is linked to the involvement of Fas, TRAIL or receptor interacting protein 1 (RIP1) kinase. We have previously shown that CD40 activation has anti-apoptotic or apoptotic effect in follicular lymphoma (FL) cell lines. In this study, we investigated the mechanism by which CD40 mediates apoptosis in a follicular lymphoma cell line, HF4.9. We show here that CD40-induced apoptosis was dependent on caspase-8 activation because caspase-8 specific inhibitor, Z-IETD-FMK completely prevented apoptosis. Therefore, the involvement of TRAIL, Fas and RIP1 in caspase-8 activation was examined. The exogenous TRAIL-induced apoptosis was fully prevented by anti-TRAIL neutralizing antibody. However, the antibody had no effect on CD40-induced apoptosis indicating that CD40 did not induce the expression of endogenous TRAIL in HF4.9 cells. Moreover, the cells were not sensitive to Fas-mediated apoptosis. Interestingly, RIP1 specific inhibitor, necrostatin-1 decreased CD40-induced apoptosis, which showed that RIP1 has a role in caspase-8 activation. In conclusion, the survival or apoptotic effects of CD40-mediated signaling might be related to the differentiation stages of FL cells.Peer reviewe

The combination of TRAIL and MG-132 induces apoptosis in both TRAIL-sensitive and TRAIL-resistant human follicular lymphoma cells

We have previously shown that the human follicular lymphoma cell line, HF28GFP, is sensitive to TRAIL-mediated apoptosis. Nevertheless, when the same cells overexpress anti-apoptotic Bcl-2 family protein, Bcl-xL (HF28Bcl-xL), they become resistant to TRAIL. Thus, these cell lines help us to investigate the action of novel apoptosis inducing candidate drugs. In the present study, we examined the effects of MG-132 (a proteasome inhibitor), LiCl (a glycogen synthase kinase-3 inhibitor) and/or TRAIL on pro-apoptotic Bcl-2 family proteins such as Bim and Bid. Here we demonstrate that the combination of MG-132 and TRAIL induced significant apoptotic cell death in both cell lines, HF28GFP and HF28BclxL. Apoptosis correlated with a decrease of phospho-ERK1/2, the accumulation of Bim and translocation of truncated Bid (tBid) and jBid. In addition, the combination of MG-132 and TRAIL seemed to target other apoptotic factors, which led to the accumulation of active capsase-3. Furthermore, co-stimulation of LiCl and TRAIL induced apoptosis in HF28GFP cells. However, HF28Bcl-xL cells were far less sensitive to the combinatorial effects of LiCl and TRAIL. Interestingly, we observed that LiCl did not target Bim and Bid proteins. In conclusion, these data show that targeting of pro-apoptotic Bcl-2 family proteins simultaneously through a selective proteasome inhibition might help to overcome TRAIL resistance caused by overexpression of anti-apoptotic Bcl-2 family proteins. Moreover, the data may provide new strategies to develop targeted therapies against lymphomas.Peer reviewe

Synergistic interaction in simultaneous exposure to Streptomyces californicus and Stachybotrys chartarum.

The microbial exposure associated with health complaints in moldy houses consists of a heterogeneous group of components, including both living and dead bacteria, fungi, and their metabolites and active compounds. However, little is known about the interactions between different microbes and their metabolites, although the cytotoxicity and inflammatory potential of certain individual microbes have been reported. In this study, we investigated the inflammatory responses of mouse RAW264.7 macrophages after exposure to six indoor air microbes (Aspergillus versicolor, Penicillium spinulosum, Stachybotrys chartarum, Bacillus cereus, Mycobacterium terrae, and Pseudomonas fluorescens) alone and together with the actinomycete Streptomyces californicus. The production of nitric oxide, levels of the proinflammatory cytokines tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6), and cytotoxicity were measured. The coexposure to Sta. chartarum and Str. californicus caused a synergistic increase in the production of IL-6 but not other cytokines. In further experiments, the metabolites from Sta. chartarum or from closely related fungi (atranones B and E, satratoxin G, trichodermin, 7-alpha-hydroxytrichodermol, staplabin, and SMTP-7) and the known fungal toxins sterigmatocystin, citrinin, and ochratoxin A were each tested with Str. californicus. The testing revealed a synergistic response in TNF-alpha and IL-6 production after coexposure to Str. californicus with both trichodermin and 7-alpha-hydroxytrichodermol. Finally, the synergistic inflammatory response caused by Str. californicus and trichodermin together was studied by analyzing for the presence of nuclear factor-kappa-B (NF-kappa-B) in nuclear extracts of the exposed cells. The exposure to Str. californicus induced the binding of NF-kappa-B proteins to the NF-kappa-B consensus sequence as well as to the natural NF-kappa-B site of the IL-6 promoter. Adding trichodermin to the exposure did not increase the DNA binding

A nationwide real-world study on dynamic ustekinumab dosing and concomitant medication use among Crohn's disease patients in Finland

Background Real-world evidence to support optimal ustekinumab dosing for refractory Crohn's disease (CD) patients remains limited. Data from a retrospective nationwide chart review study was utilized to explore ustekinumab dosing dynamics and optimization, identify possible clinical predictors of dose intensification, and to evaluate ustekinumab trough concentrations (TCs) and concomitant medication use in Finland. Methods Information gathered from17 Finnish hospitals included clinical chart data from 155 adult CD patients who received intravenous ustekinumab induction during 2017-2018. Data on ustekinumab dosing and TCs, concomitant corticosteroid and immunosuppressant use, and antiustekinumab antibodies were analyzed in a two-year follow-up, subject to availability. Results Among 140 patients onustekinumab maintenance therapy, dose optimization was required in 55(39%) of the patients, and 41/47 dose-intensified patients (87%) persisted on ustekinumab. At baseline, dose-intensified patient group had significantly higher C-reactive protein (CRP) levels, and at week 16, significantly lower ustekinumab TCs than in patients without dose intensification. Irrespective of dose optimization, a statistically significant reduction in the use of corticosteroids was observed at both 16 weeks and one year, coupled with an increased proportion of patients on ustekinumab monotherapy. Antiustekinumab antibodies were undetectable in all 28 samples from 25 patients collected throughout the study period. Conclusions Nearly a third of all CD patients on ustekinumab maintenance therapy, with a history of treatment-refractory and long-standing disease, required dose intensification. These patients persisted on ustekinumab and had significant reduction of corticosteroid use. Increased baseline CRP was identified as the sole indicator of dose intensification.Peer reviewe

A nationwide real-world study on dynamic ustekinumab dosing and concomitant medication use among Crohn's disease patients in Finland

Background Real-world evidence to support optimal ustekinumab dosing for refractory Crohn's disease (CD) patients remains limited. Data from a retrospective nationwide chart review study was utilized to explore ustekinumab dosing dynamics and optimization, identify possible clinical predictors of dose intensification, and to evaluate ustekinumab trough concentrations (TCs) and concomitant medication use in Finland.Methods Information gathered from17 Finnish hospitals included clinical chart data from 155 adult CD patients who received intravenous ustekinumab induction during 2017-2018. Data on ustekinumab dosing and TCs, concomitant corticosteroid and immunosuppressant use, and antiustekinumab antibodies were analyzed in a two-year follow-up, subject to availability.Results  Among 140 patients onustekinumab maintenance therapy, dose optimization was required in 55(39%) of the patients, and 41/47 dose-intensified patients (87%) persisted on ustekinumab. At baseline, dose-intensified patient group had significantly higher C-reactive protein (CRP) levels, and at week 16, significantly lower ustekinumab TCs than in patients without dose intensification. Irrespective of dose optimization, a statistically significant reduction in the use of corticosteroids was observed at both 16 weeks and one year, coupled with an increased proportion of patients on ustekinumab monotherapy. Antiustekinumab antibodies were undetectable in all 28 samples from 25 patients collected throughout the study period.Conclusions Nearly a third of all CD patients on ustekinumab maintenance therapy, with a history of treatment-refractory and long-standing disease, required dose intensification. These patients persisted on ustekinumab and had significant reduction of corticosteroid use. Increased baseline CRP was identified as the sole indicator of dose intensification.</div

Ustekinumab for Crohn's disease: a nationwide real-life cohort study from Finland (FINUSTE)

Background: Ustekinumab (UST), a human anti-IL12/23p40 monoclonal antibody, has been approved for treatment of Crohn's Disease (CD) since the end of 2016. This nationwide noninterventional, retrospective chart review explored real-life data in patients receiving UST to provide guidance in UST treatment in the era of increasing prevalence of CD. Methods: The study assessed UST treatment patterns such as dosing frequency, concomitant medication and persistence in 48 CD patients commencing UST therapy in 12 Finnish hospitals during 2017. Clinical remission and response rates were explored using a modified Harvey-Bradshaw index (mHBI) and endoscopic response via the simple endoscopic score for Crohn's disease (SES-CD) as proportions of patients at week 16 and at the end of follow-up. Results: Forty patients (83%) continued UST-treatment at the end of follow-up. At week 16, clinical response and endoscopic healing was observed, where data were available; mHBI decreased from 9 to 3 (p = .0001) and SES-CD from 12 to 3 (p = .009). Clinical benefit was achieved by 83% (19/23) at week 16 and by 76% (16/21) at the end of follow-up. The proportion of patients using corticosteroids decreased from 48% to 25% at week 16 and to 13% at the end of the follow-up. Conclusion: UST showed to be effective and persistent, inducing short-term clinical benefit and endoscopic response in this real-life nationwide study of CD patients. Significant corticosteroid tapering in patients with highly treatment refractory and long-standing CD was observed