Att planera, genomföra och utvärdera språkberikad verksamhet inom småbarnspedagogiken

Tämän pro gradu tutkielman aihe on kielirikasteisen toiminnan suunnittelu, toteuttaminen ja arviointi varhaiskasvatuksessa. Tutkimus on toteutettu toimintatutkimuksena vaasalaisen päiväkodissa, jossa työskentelin varhaiskasvatuksen opettajana keväällä 2021. Lähtökohta tutkimukselle oli kiinnostus kielirikasteista toimintaa kohtaan ja mahdollisuus yhdistää työ ja opiskelu mielekkäällä tavalla. Vaasan kaupungin varhaiskasvatussuunnitelmassakin mainittava Kieliystävät – Språkvänner toiminta toimi lähtökohtana tälle tutkimukselle. Tutkimuksen tavoitteena oli kartoittaa toimivia ja mielekkäitä toimintatapoja ja menetelmiä kielirikasteisen toiminnan toteuttamisessa varhaiskasvatuksessa. Tutkimuksen materiaali koostuu kahdesta osasta. Ensimmäinen osa koostuu muistiinpanoista, joita kirjoitin tutkimuksen suunnittelu- ja toteuttamisvaiheessa. Tutkimusmateriaalin toinen osa koostuu lapsiryhmän henkilökunnan näkemyksistä ja käsityksistä kielirikasteisesta toiminnasta. Tutkielman teoreettinen viitekehys koostuu kahdesta osasta. Ensimmäisessä osassa perehdytään kaksikieliseen opetukseen sekä kielenopetuksen eri muotoihin varhaiskasvatuksessa. Tässä osassa esitellään myös Kieliystävät-toiminta Vaasan kaupungin varhaiskasvatuksessa. Toinen osa käsittelee varhaiskasvatuksen toimintakulttuuria sekä sen toimintatapoja. Tulokset osoittavat, että kaikki tämän tutkimuksen keskiössä olleet toimintatavat koettiin toimiviksi. Nämä toimintatavat ovat laulut, kirjat, tervehdykset sekä yksittäiset sanat. Mielekkäimmäksi toimintatavaksi koettiin laulut. Kielirikasteinen toiminta antaa hyvät lähtökohdat toimia kielitietoisesti päiväkodin arjessa

Kohti psykoosia ja sen yli : mielenterveysmeemit ja hyvinvoinnin tulkintojen etiikka

Peer reviewe

Prolyl oligopeptidase inhibition activates autophagy via protein phosphatase 2A

Prolyl oligopeptidase (PREP) is a serine protease that has been studied particularly in the context of neurode-generative diseases for decades but its physiological function has remained unclear. We have previously found that PREP negatively regulates beclinl-mediated macroautophagy (autophagy), and that PREP inhibition by a small-molecule inhibitor induces clearance of protein aggregates in Parkinson's disease models. Since autophagy induction has been suggested as a potential therapy for several diseases, we wanted to further characterize how PREP regulates autophagy. We measured the levels of various kinases and proteins regulating beclin1-autophagy in HEK-293 and SH-SY5Y cell cultures after PREP inhibition, PREP deletion, and PREP overexpression and restoration, and verified the results in vivo by using PREP knock-out and wild-type mouse tissue where PREP was restored or overexpressed, respectively. We found that PREP regulates autophagy by interacting with protein phosphatase 2A (PP2A) and its endogenous inhibitor, protein phosphatase methylesterase 1 (PME1), and activator (protein phosphatase 2 phosphatase activator, PTPA), thus adjusting its activity and the levels of PP2A in the intracellular pool. PREP inhibition and deletion increased PP2A activity, leading to activation of deathassociated protein kinase 1 (DAPK1), beclin1 phosphorylation and induced autophagy while PREP overexpression reduced this. Lowered activity of PP2A is connected to several neurodegenerative disorders and cancers, and PP2A activators would have enormous potential as drug therapy but development of such compounds has been a challenge. The concept of PREP inhibition has been proved safe, and therefore, our study supports the further development of PREP inhibitors as PP2A activators.Peer reviewe

Home and mental ill-health: Twenty dimensions

In the context of psychiatric rehabilitation and care, home is often associated with health. In the context of deinstitutionalization, however, home has increasingly become the primary site of psychiatric suffering. Drawing on a two-year ethnographic research project with a drama group for young adult mental healthcare service users living in supported housing facilities, this paper presents twenty dimensions of home through which mental ill-health can be approached as a bodily experienced, and discursively and medically structured form of being in the world. These dimensions are here offered as a framework for further exploration of the social, spatial, temporal, structural and embodied aspects of psychiatric suffering

Trends in Emergency Department Visits and Surgeries due to Traumatic Brain Injury During the COVID-19 Pandemic in Finland

We aim to evaluate the changes in the incidence of TBI, trauma craniotomies, and craniectomies during the COVID-19 pandemic in Finland. This retrospective register study was conducted at three Finnish hospitals. We retrieved the numbers of emergency department (ED) visits, inpatient admissions, and trauma craniotomies and craniectomies due to TBI in the adult population from 2017 to 2020.We calculated the incidences per 100 000 inhabitants and compared the year 2020 to the reference years (2017–2019) by incidence rate ratios (IRR) with 95% confidence intervals. The incidence of TBI-related ED visits during the study period compared to the reference years started to decrease in March 2020 (IRR 0.86, CI: 0.73–1.02), and the lowest incidence was seen in April 2020 (IRR 0.83, CI: 0.68–1.01). The incidence of ED visits showed a second decrease in December (IRR 0.80, CI: 0.67–0.96). The incidence of concussion decreased during the national lockdown in March (IRR 0.80, CI 0.66–0.97). The incidence of ED visits due to TBI decreased after the declaration of national lockdown in spring 2020 and showed a second decrease during regional restrictions in December. In addition, the incidence of neurosurgically treated TBI decreased during restaurant restrictions in the spring.Peer reviewe

Anchoring Belonging Through Material Practices in Participatory Arts-Based Research

How do people understand belonging and what kinds of stances toward belonging do they take? What kind of knowledge or ways of knowing (EISNER, 2008) does artistic practice yield about belonging? We ask these questions in this article, which is based on the research project Crossing Borders, in which we used participatory arts-based methods to study belonging. We invited participants to explore the notion of belonging in three parallel workshops drawing on different art forms, film, writing and visual arts. The goal of the workshops was for each participant to produce an artwork that deals with belonging.In the article, we identify four stances that the participants expressed toward the concept of belonging and explore the ways in which their ideas were manifested in the artworks. We analyze the workshop discussions, the participants' interviews and the artworks, and demonstrate on both the conceptual and material level that artistic practice can provide extremely nuanced and situated knowledge, or ways of knowing, about belonging. We argue that the artworks anchor the ever-shifting stances into material forms and expressions. Artistic practice is thus one way of defining and contextualizing the fluid concept of belonging.Was wird unter Zugehörigkeit verstanden und welche Standpunkte finden sich hierzu? Welches Wissen und welche Wissensarten (EISNER 2008) erbringen künstlerische Praktiken? In unserem Beitrag beschäftigen wir uns mit diesen Fragen ausgehend von dem Projekt "Crossing Borders", in dem wir partizipative kunstbasierte Verfahren zur Erforschung von Zugehörigkeit nutzten. Wir luden Teilnehmer*innen ein, ihr Verständnis von Zugehörigkeit in drei parallelen Workshops zu explorieren entlang unterschiedlicher Zugangsweisen (Film, Schreiben, Bilder/Zeichnungen). Ziel war, dass für jede*n in jedem Workshop ein künstlerisches Produkt entstehen sollte, das von Zugehörigkeit handelte. Hiervon ausgehend haben wir vier mögliche Standpunkte mit Blick auf das Konzept der Zugehörigkeit eruiert und untersucht, in welcher Weise diese einen Ausdruck in den künstlerischen Produkten der Teilnehmenden fanden. Zusätzlich fassen wir die Ergebnisse aus den Workshop-Diskussionen und aus Einzelinterviews zusammen und zeigen konzeptuell und an Materialien, dass aus künstlerische Praktiken sehr feines und situiertes Wissen über Zugehörigkeit resultieren kann, und dass wechselnde Standpunkte hierzu in materiellen Ausdrucksformen verankert werden können. So können kunstbasierte Verfahren helfen, das fluide Konzept von Zugehörigkeit zu bestimmen und zu kontextualisieren

Thymic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1

Objective MEN1 is associated with an increased risk of developing tumors in different endocrine organs. Neuroendocrine tumors of the thymus (TNETs) are very rare but often have an aggressive nature. We evaluated patients with MEN1 and TNET in three university hospitals in Finland. Design/Methods We evaluated patient records of 183 MEN1-patients from three university hospitals between the years 1985-2019 with TNETs. Thymus tumor specimens were classified according to the new WHO 2021 classification of TNET. We collected data on treatments and outcomes of these patients. Results There were six patients (3.3%) with MEN1 and TNET. Five of them had the same common gene mutation occurring in Finland. They originated from common ancestors encompassing two pairs of brothers from sequential generations. The mean age at presentation of TNET was 44.7 +/- 11.9 years. TNET was classified as atypical carcinoid (AC) in five out of six patients. One patient had a largely necrotic main tumor with very few mitoses and another nodule with 25 mitoses per 2 mm(2), qualifying for the 2021 WHO diagnosis of large cell neuroendocrine carcinoma (LCNEC). In our patients, the 5-year survival of the TNET patients was 62.5% and 10-year survival 31.3%. Conclusion In this study, TNETs were observed in one large MEN1 founder pedigree, where an anticipation-like earlier disease onset was observed in the most recent generation. TNET in MEN1 patients is an aggressive disease. The prognosis can be better by systematic screening. We also show that LCNEC can be associated with TNET in MEN1 patients.Peer reviewe

Long-term health-related quality of life in persons diagnosed with an insulinoma in Finland 1980-2010

Objective Insulinomas are rare pancreatic neoplasms, which can usually be cured by surgery. As the diagnostic delay is often long and the prolonged hyperinsulinemia may have long-term effects on health and the quality of life, we studied the long-term health-related quality of life (HRQoL) in insulinoma patients. Design, patients and measurements The HRQoL of adults diagnosed with an insulinoma in Finland in 1980-2010 was studied with the 15D instrument, and the results were compared to those of an age- and gender-matched sample of the general population. The minimum clinically important difference in the total 15D score has been defined as +/- 0.015. The clinical characteristics, details of insulinoma diagnosis and treatment, and the current health status of the subjects were examined to specify the possible determinants of long-term HRQoL. Results Thirty-eight insulinoma patients participated in the HRQoL survey (response rate 75%). All had undergone surgery with a curative aim, a median of 13 (min 7, max 34) years before the survey. The insulinoma patients had a clinically importantly and statistically significantly better mean 15D score compared with the controls (0.930 +/- 0.072 vs 0.903 +/- 0.039, P = .046) and were significantly better off regarding mobility, usual activities and eating. Among the insulinoma patients, younger age at the time of survey, higher level of education and smaller number of chronic diseases were associated with better overall HRQoL. Conclusions In the long term, the overall HRQoL of insulinoma patients is slightly better than that of the general population.Peer reviewe

Long-term morbidity and mortality in patients diagnosed with an insulinoma

Objective: Insulinomas are rare functional pancreatic neuroendocrine tumours. As previous data on the long-term prognosis of insulinoma patients are scarce, we studied the morbidity and mortality in the Finnish insulinoma cohort. Design: Retrospective cohort study. Methods: Incidence of endocrine, cardiovascular, gastrointestinal and psychiatric disorders, and cancers was compared in all the patients diagnosed with an insulinoma in Finland during 1980-2010 (n = 79, including two patients with multiple endocrine neoplasia type 1 syndrome), vs 316 matched controls, using the Mantel-Haenszel method. Overall survival was analysed with Kaplan-Meier and Cox regression analyses. Results: The median length of follow-up was 10.7 years for the patients and 12.2 years for the controls. The long-term incidence of atrial fibrillation (rate ratio (RR): 2.07 (95% CI: 1.02-4.22)), intestinal obstruction (18.65 (2.09-166.86)), and possibly breast (4.46 (1.29-15.39) and kidney cancers (RR not applicable) was increased among insulinoma patients vs controls, P < 0.05 for all comparisons. Endocrine disorders and pancreatic diseases were more frequent in the patients during the first year after insulinoma diagnosis, but not later on. The survival of patients with a non-metastatic insulinoma (n = 70) was similar to that of controls, but for patients with distant metastases (n = 9), the survival was significantly impaired (median 3.4 years). Conclusions: The long-term prognosis of patients with a non-metastatic insulinoma is similar to the general population, except for an increased incidence of atrial fibrillation, intestinal obstruction, and possibly breast and kidney cancers. These results need to be confirmed in future studies. Metastatic insulinomas entail a markedly decreased survival.publishedVersionPeer reviewe