Positive Stress and Reflective Practice Among Entrepreneurs

While heavy stress loads seem an unavoidable aspect of entrepreneurship, the positive side of stress (often referred to as ‘eustress’) remains a neglected area of research. This paper contributes to entrepreneurship research by linking the research streams of eustress and reflective practice. As a tool for analysing and developing thoughts and actions, reflective practice plays an important role in the interpretative work essential to positive stress experiences. Following an overview of approaches to stress at work, eustress and reflective practice, the paper explores how entrepreneurs experience the role of positive stress and reflective practice in their work and describes the reflective tools utilized by entrepreneurs in promoting eustress. The research process was designed to support reflective dialogue among the 21 Finnish entrepreneurs from different fields who participated in the study, with results based mainly on qualitative interviews. Nine of the interviewed entrepreneurs also kept a positive stress diary, including a three-day physiological measurement analysing their heartbeat variability. The findings suggest that positive stress and reflective practice are intertwined in the experiences of entrepreneurs and illustrate the role of reflective practice as a crucial toolset for promoting positive stress, comprising six reflective tools: studying oneself, changing one’s point of view, putting things into perspective, harnessing a feeling of trust, regulating resources and engaging in dialogue. Individual reflective capabilities vary, and a theory-driven division of reflective practice into individual, social and contextual dimensions is considered useful in understanding those differences. The research offers a starting point for exploring how eustress and reflective practice affect the well-being of entrepreneurs.Choć duże obciążenie stresem jest nieuniknionym aspektem przedsiębiorczości, pozytywna strona stresu (często określane jako eustres) pozostaje zaniedbaną dziedziną badań. Niniejsza praca jest wkładem w badania w zakresie przedsiębiorczości poprzez łączenie strumieni badań nad eustresem z praktyką refleksyjną. Jako narzędzie do analizy i rozwoju myśli i działań, praktyka refleksyjna odgrywa ważną rolę w pracy interpretacyjnej niezbędnej dla pozytywnych doświadczeń ze stresem. Po przeglądzie podejść do stresu w pracy, eustresu i refleksyjnej praktyki, praca ta bada jak przedsiębiorcy postrzegają rolę pozytywnego stresu i praktyki refleksyjnej w pracy oraz opisuje narzędzia refleksyjne wykorzystywane przez przedsiębiorców, sprzyjające eustresowi. Proces badawczy został zaprojektowany w sposób wspierający dialog refleksyjny między 21 fińskimi przedsiębiorcami różnych branż, którzy wzięli udział w badaniu, opartym głównie na wywiadach jakościowych. Dziewięciu z badanych przedsiębiorców prowadziło również dziennik pozytywnego stresu, w tym trzydniowy pomiaru fizjologiczny, analizując zmienność pulsu. Wyniki sugerują, że pozytywny stres i praktyka refleksyjna przeplatają się z doświadczeniami przedsiębiorców oraz ilustrują rolę praktyki refleksyjnej jako kluczowego zestawu instrumentów do promowania pozytywnego stresu, składającego się z sześciu narzędzi refleksyjnych: samopoznawania, zmieniania punktu widzenia, spojrzenia perspektywicznego, wykorzystania poczucia zaufania, kontroli zasobów osobistych oraz podjęcia dialogu. Indywidualne zdolności refleksyjne są różne i podział praktyki refleksyjnej, w oparciu o teorię, na wymiar indywidualny, społeczny i kontekstowy uważa się za przydatny w zrozumieniu tych różnic. Niniejsza praca stanowić może punkt wyjścia dla dalszych badań nad eustresem i praktyką refleksyjną oraz ich wpływem na samopoczucie przedsiębiorców

Core Needle Biopsy Enhances the Activity of the CCL2/CCR2 Pathway in the Microenvironment of Invasive Breast Cancer

The use of core needle biopsy (CNB) as a means to verify malignancy preoperatively is a paradigm in current breast cancer care, and the risk of enhancing tumor development by this procedure has been considered insignificant. Experimental work in mice has shown preoperative biopsies to increase tumor supportive elements in the microenvironment, whereas, in humans, the impact of CNB on the host’s immunologic response has not been investigated. In this pilot study, we compared the expression of CCL2/CCR2 pathway components at the protein level in samples from CNBs to those from the corresponding resected tumors from 52 patients with primary breast cancer. We found an increased expression of CD163, CD14 and CCR2 in monocytes/macrophages and a slight decrease of CCL2 in the malignant epithelium in the tumors after the biopsy. The increased infiltration of immunosuppressive monocytes/macrophages and the decreased tumor cell CCL2 expression, presumably due to the CCR2 availability-dependent CCL2 internalization, suggest that CNB enhances the activity of the CCL2/CCR2 pathway, and this finding warrants confirmatory examination. The switch in the context-dependent role of CCL2 on the polarization of macrophages may lead to increased tumor supportive function both locally and in the peripheral immune machinery. The future directions in breast cancer should include early interventions to support the tumor surveillance of the host

Oiva työkalupakki nuorille klassikoiden selättämiseen

Maria Laakso: Taltuta klassikko! Kuvittanut Johanna Rojola. Helsinki: Tammi, 2019, 216 s

Economic perspectives on blanket and selective dry cow therapy

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High expression of CCL2 in tumor cells and abundant infiltration with CD14 positive macrophages predict early relapse in breast cancer

Macrophages are important for the function of the innate immune system, and in solid tumors, they represent a significant proportion of the tumor mass. Tumor-associated macrophages (TAM) have a M2 phenotype and show a multitude of pro-tumoral functions, promoting tumor cell survival, proliferation, and dissemination. CCL2, synthesized by tumor and stromal cells, initiates a chemokine cascade inducing these processes. We studied by immunohistochemistry (IHC) the frequency of TAMs and CCL2 expressing cells in three groups of primary tumor (PT)-recurrence (R) pairs, where relapse was recorded within 2years (group 1), between 5 and 10years (group 2), and after 10years (group 3). In our study all established breast cancers were heavily infiltrated by CD68 positive cells. Both in PTs and in R lesions the infiltration was more abundant in the peritumoral than in the intratumoral stroma. The mean frequency of M2 marker and CD14 positive cells in the intratumoral stroma and CCL2 expressing tumor cells was higher in the Rs as compared to the corresponding PTs. In PTs, a high frequency of CD14 positive cells and a high expression of CCL2 by tumor cells was associated with an early recurrence. The findings support the current understanding of immune cell orchestrated development, progression and metastatic spread of breast cancer. Our study showed that a high frequency of CCL2 positive tumor cells and CD14 positive TAMs are significant risk factors for rapid tumor recurrence. Potential targets for intervention are discussed.Peer reviewe

Kauhu ja lukijuus lastenkirjallisuudessa: Dialogimuotoon kirjoitettu katsaus

Erilaiset pelot ovat osa lapsen normaalia kehitystä, mutta lapsuusajan pelkoihin suhtaudutaan usein vähättelevästi. Lasten- ja nuorten kauhukirjallisuuden kautta työstetään kuitenkin sekä kehityksellisiä pelkoja että eettisiä kysymyksiä. Esimerkiksi näin keskustelevat Susanne Ylönen ja Päivi Heikkilä-Halttunen dialogimuotoon kirjoitetussa katsauksessaan kauhusta ja lukijuudesta lastenkirjallisuudessa. Kauhu pitää varpaillaan niin lapsilukijat kuin varsinkin heidän lukukokemuksiaan vartioivat aikuiset. Ylönen ja Heikkilä-Halttunen marssittavat keskustelussaan lukijan eteen kummituksia, mörköjä, vampyyreita ja muita hämärän, pimeän ja pelon hahmoja

Clever-1 positive macrophages in breast cancer

Purpose Common Lymphatic Endothelial and Vascular Endothelial Receptor 1 (Clever-1) is expressed by a subset of immunosuppressive macrophages and targeting the receptor with therapeutic antibodies has been shown to activate T-cell-mediated anti-cancer immunity. The aim of this research was to study Clever-1 expression in breast cancer. Specifically, how Clever-1 + macrophages correlate with clinicopathologic factors, Tumor Infiltrating Lymphocytes (TILs) and prognosis. Methods Tissue microarray blocks were made from 373 primary breast cancer operation specimens. Hematoxylin and Eosin (H&E-staining) and immunohistochemical staining with Clever-1, CD3, CD4 and CD8 antibodies were performed. Differences in quantities of Clever-1 + macrophages and TILs were analyzed. Clever-1 + cell numbers were correlated with 25-year follow-up survival data and with breast cancer clinicopathologic parameters. Results Low numbers of intratumoral Clever-1 + cells were found to be an independent adverse prognostic sign. Increased numbers of Clever-1 + cells were found in high grade tumors and hormone receptor negative tumors. Tumors that had higher amounts of Clever-1 + cells also tended to have higher amounts of TILs. Conclusion The association of intratumoral Clever-1 + macrophages with better prognosis might stem from the function of Clever as a scavenger receptor that modulates tumor stroma. The association of Clever-1 + macrophages with high number of TILs and better prognosis indicates that immunosuppression by M2 macrophages is not necessarily dampening adaptive immune responses but instead keeping them in control to avoid excess inflammation.Peer reviewe

Metaplastic carcinoma of the breast : Prognosis and response to systemic treatment in metastatic disease

Background: Metaplastic breast carcinomas (MpBCs) are rare, aggressive breast cancers. Due to the scant literature of this disease most guidelines do not give recommendation for this entity. The aim of the study was to review the clinicopathologic features, treatment, and outcomes of the patients with MpBC treated at our institution. Material and methods: We searched databases for patients with histologically confirmed MpBC from 2002 to 2016. Results: A total of 78 patients with MpBC were included in the study. All histological material was reviewed by an experienced breast pathologist. Most tumors were grade 3 (83%) and triple negative (85%). Eighty-two percent were node negative. Sixty-four percent received adjuvant chemotherapy. The 5-year disease free survival was 63% and 5-year breast cancer specific overall survival was 61%. Tumor size and mixed metaplastic histology were associated with worse outcome in this patient group. One third of the patients (n = 28) had metastatic disease at initial presentation or developed metastases at follow-up. The lungs were the most common site of first distant recurrence. Half (n = 14) of these patients received palliative chemotherapy. Of those only 6% (n = 2) had partial response and 18% had stable disease as best response to treatment. The median overall survival time with metastatic disease was only 3.4 months. Conclusion: MpBC is an aggressive type of breast cancer with poor outcome despite low nodal involvement and aggressive local and systemic therapy. Tumor response to palliative systemic chemotherapy remains poor for MpBC patients.Peer reviewe

Resection margins and local recurrences in breast cancer : Comparison between conventional and oncoplastic breast conserving surgery

Background: This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques. Material and methods: We reviewed 1800 consecutive patients with primary invasive breast cancer (N =1707) or ductal carcinoma in situ (N = 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012. Results: Conventional BCS was performed in 1189 (66.1%) patients, oncoplastic BCS in 611 (33.9%). Various oncoplastic techniques were used. Patients with oncoplastic BCS had more often multifocal (p There was no difference, however, in surgical margins (p = 0.578) or reoperation rates (p = 0.430) between the groups. A total of 152 (8.4%) patients were reoperated because of insufficient margins, 96 (8.1%) in the conventional, 56 (9.2%) in the oncoplastic BCS group. The median follow-up time was 75 (2-94) months. There was no difference in local recurrence-free survival between the conventional and oncoplastic BCS groups (log-rank test, p = 0.172). Conclusions: Oncoplastic BCS was used for larger, multifocal and more aggressive tumours. Nevertheless, no difference in reoperation rate or local recurrences were found. Oncoplastic BCS is as safe as conventional BCS enabling breast conserving for patients who otherwise were candidates for mastectomy. (C) 2019 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.Peer reviewe