Diabeetikkolapsi päivähoidossa : Koulutusprojekti varhaiskasvatushenkilöstölle

Opinnäytetyön tarkoituksena oli toteuttaa varhaiskasvatushenkilöstölle koulutusprojekti tyypin 1 diabetesta sairastavan lapsen hoidosta varhaiskasvatuksessa. Tavoitteena oli tarjota varhaiskasva-tushenkilöstölle diabetestietämystä ja ratkaisukeinoja, joita he voivat soveltaa omassa työssään tyypin 1 diabetesta sairastavan lapsen hoitopäivän aikana. Koulutusprojektin toisena tavoitteena oli lisätä alle kouluikäisen, tyypin 1 diabetesta sairastavan lapsen turvallisuutta ja hoidon sujuvuutta esikoulu- ja hoitopäivän aikana. Koulutusprojektissa suunniteltiin ja toteutettiin koulutus varhaiskasvatushenkilöstölle yhteistyönä Keski-Pohjanmaan keskussairaalan lasten diabeteshoitajan kanssa. Koulutus pidettiin 4.–5.1.2016. Koulutukseen osallistui koko varhaiskasvatushenkilöstö, joista puolet ensimmäisenä ja toinen puoli toisena koulutuspäivänä. Koulutuksen sisältö oli rajattu alle kouluikäisen lapsen diabeteksen hoidon keskeisiin asioihin. Koulutukseen laadittiin koulutusmateriaali. Koulutuksen valmistelussa ja toteutuksessa sovellettiin konstruktivistista oppimiskäsitystä. Varhaiskasvatushenkilöstölle toteutettiin lyhyt kysely, jonka tarkoituksena oli selvittää varhaiskasvatushenkilöstön aikaisempaa tietoperustaa tyypin 1 diabeteksesta. Kyselyn tulosten perusteella koulutukselle varatun ajan puitteissa voitiin keskittyä olemassa olevan tarpeen mukaisiin tyypin 1 diabeteksen hoidon osa-alueisiin. Opinnäytetyön tietoperusta koostuu diabeteksen ja sen hoidon kokonaisvaltaisesta käsittelemisestä keskittyen tyypin 1 diabeteksen hoitoon lapsella. Tietoperustan toisessa osa-alueessa käsitellään varhaiskasvatusta ja pitkäaikaissairasta lasta varhaiskasvatuksessa. Opinnäytetyöhön sisältyy kooste koulutusprojektista sen eri vaiheissaan sekä raportointi ja arviointi. Varhaiskasvatushenkilöstö antoi koulutustilaisuuden päätteeksi kirjallisen palautteen, jonka mukaan henkilöstö koki koulutuksen tarpeelliseksi ja tärkeäksi. Koulutusprojektin arvioinnissa käytettiin varhaiskasvatushenkilöstön, varhaiskasvatuspäällikön ja lasten diabeteshoitajan antamaa kirjallista palautetta sekä projektin arvioinnissa käytettävää aineistoa.The aim of the thesis was to carry out a training project to early childhood education staff for the treatment of type 1 diabetes in children in early childhood education. The target was to afford in-formation of diabetes and answers to the early childhood education staff which they can apply in their own work during children’s day care with type 1 diabetes. The training project’s second target was to increase safety of under school age children with type 1 diabetes and fluency of care during kindergarten and day care. In the training project training was planned and carried out to the early childhood education in coop-eration with the children’s diabetes nurse from Central Hospital of Central Ostrobothnia. The train-ing was held on 4.–5. January 2016. In the training participated all the early childhood staff, half of them on first and the other half on the second training day. The content of the training was restricted to the essential points in treatment of under school-age children with type 1 diabetes. For the train-ing the training material was designed. In the preparation and implementation of the training the constructivist notion of learning was applied. Among the early childhood staff was carried out a short inquiry the aim of which was to find out previous knowledge basis for type 1 diabetes of the early childhood staff. On the grounds of results of the inquiry, within the framework of time allocat-ed to the training it was focused on treatment sections of type 1 diabetes which were in accordance with existing needs. The theoretical basis of the thesis consists of diabetes and its treatment is comprehensive coverage focusing on children’s type 1 diabetes treatment. The other part of theoretical basis is covering early childhood education and children with chronic disease in early childhood education. The summary of the training project with its various phases, reporting and evaluation were included in the thesis. At the end of the training event the early childhood education staff gave written feedback. Accord-ing to the feedback the staff experienced the training useful and important. In the evaluation of the training project written feedback of the early childhood education staff, manager and the children’s diabetes nurse were used, and also the material used for evaluation of the project

Protective and Return-Seeking Parents : The Power of Language in Child Abduction Law

The aim of this chapter is to bring together two distinct regulatory spheres: child abduction law and the law of protection against violence against women and children. Using discourse analysis, we analyse how the key concepts of child abduction and protection against violence depict the actions and the parent, and what kind of effects these conceptualisations have on the lives of the parents. Focus is on the language of the central legal instruments, the Convention and the Brussels IIa Regulation, finding that their gender-neutral terminology of child abduction and swift return is ill-suited for cases in which there have been allegations of violence. The chapter also comments on the gendered terminology of Abducting mothers in the POAM project that does not fairly reflect the plight of mothers who are victims of violence. ‘In the language of international law on violence against women, protection against violence has become a key concept. The European Court of Human Rights (ECtHR) has in several cases tried to consolidate the requirements of the Haque Convention and the protection of private and family life according to the European Convention of Human Rights (ECHR), but due to different starting points this has been a difficult task.Peer reviewe

Growing up unequal : Socioeconomic disparities in mental disorders throughout childhood in Finland

Problems in mental health and socioeconomic health inequalities during childhood and adolescence are receiving important scientific and political attention. This in mind, we study how current family income and parental education are associated with psychiatric disorders among children in a well-developed welfare state, Finland. To gain a deeper understanding of how these disparities develop through early life course, we study the differences between genders, age groups, types of mental disorders, and also take into account the role of parental mental disorders. We exploit high-quality Finnish register data containing the whole population aged 4–17 with information on their families and parents. Our results of linear probability models show that lower parental education is consistently associated with higher probability of mental disorders throughout childhood, although some gender and disorder-specific differences are also identified. Interestingly, household income is related to mental health in more complex ways, having both negative and positive associations with psychiatric disorders. Inequalities are stronger among boys than girls, and the strongest associations are found among boys aged 7–12 and girls aged 13–17. Parental mental disorders increase the risk of children's psychiatric disorders but do not explain socioeconomic disparities. Considering the negative effects of mental problems on socioeconomic outcomes, inequalities in childhood mental health can be expected to reinforce other social inequalities in later life and should therefore be a focus of interventions

The Implementation of Mindfulness-Based Programs in the Swedish Healthcare System—A Qualitative Study

BACKGROUND: As the provision of Mindfulness-Based Programs (MBPs) in health care settings progresses, more research is needed to develop guidelines and structures for implementation in various contexts. This study is part of a larger project were MBP provision in Sweden is explored. OBJECTIVE: The objective is to provide knowledge for the next steps of MBP implementation both in Sweden and internationally. The specific aim of the study is to explore how MBP teachers and other relevant stakeholders experience the implementation of MBP. METHODS: Qualitative in-depth interviews were conducted with 15 MBP providers and 2 other stakeholders from a range of health care settings in Sweden. RESULTS: The results, presented in 3 themes, provide insights into the factors that are crucial for facilitating or hindering MBP implementation; (1) MBP teachers and their training, including the importance of champion individuals and the benefit and shortcomings of various forms of MBP; (2) Patients and patient referrals, including patient characteristics and referral pathways; (3) Organizational prerequisites to successful implementation, highlighting the importance of financial factors and managers’ and colleagues’ knowledge and acceptance of MBP; and (4) the need for structural changes, including future recommendations on quality assessment and guidelines. CONCLUSION: This study highlights the need for national guidelines for MBP provision and teacher training pathways, as well as improved availability of teacher training. Also, the benefit of a stepped-care model of MBP provision is indicated by the findings. Finally, increasing awareness of MBPs among referrers, managers, and the public may enable successful implementation

Discourses on educational support in the context of general upper secondary education

After basic education, the Finnish educational system divides into separate types of upper secondary schools – general and vocational. Vocational schools have long traditions of educating young people with support needs and arranging special education. General upper secondary schools are instead considered to serve ‘academically orientated’ students, and these schools do not necessarily have established support practices. In this article, we examine how the needs of support are discussed in general upper secondary education, and what kinds of meanings they get in a school’s everyday practices. The article is based on an ethnographic study of educational support, study counselling and societal inclusion. Our analysis highlights the school’s study culture as strongly academic, where diverse support practices are not part of the picture. The current resources shape support as an individual and separate addition to general teaching, even though, according to education policy aims, support should be communal and inclusive.Peer reviewe

Religion as a Human Right and a Security Threat – Investigating Young Adults’ Experiences of Religion in Finland

The emergence of religiously -motivated terrorist attacks and the increasing xenophobia expressed in Europe concern religions in many ways. Questions related to religion also lie at the core of educational aims and practices used to create national cohesion and understanding about different types of values and worldviews. However, despite the topicality of the issue, we have little knowledge about the ways in which young adults experience religions in a secular state. In order to contribute to the discussion regarding the relationships between religion, nationality, security, and education, this study focuses on investigating how politically active young adults experience the role of religions in Finnish society. The qualitative data of this study were collected from young adults (18–30-year- olds) through an online questionnaire distributed through political youth organisations. The content analysis of the responses (altogether 250 respondents) identified five main orientations towards religions. The findings highlight the importance of providing young people with education about different faiths and worldviews for reducing prejudices, especially those related to Islam. The findings also highlight the need to address in education and society the possible but not as self-evident relationship between violence and religion, and to do this more explicitly than is currently done.Peer reviewe

Religion as a Human Right and a Security Threat—Investigating Young Adults’ Experiences of Religion in Finland

The emergence of religiously motivated terrorist attacks and the increasing xenophobia expressed in Europe concern religions in many ways. Questions related to religion also lie at the core of educational aims and practices used to create national cohesion and understanding about different types of values and worldviews. However, despite the topicality of the issue, we have little knowledge about the ways in which young adults experience religions in a secular state. In order to contribute to the discussion regarding the relationships between religion, nationality, security, and education, this study focuses on investigating how politically active young adults experience the role of religions in Finnish society. The qualitative data of this study were collected from young adults (18–30-year-olds) through an online questionnaire distributed through political youth organisations. The content analysis of the responses (altogether 250 respondents) identified five main orientations towards religions. The findings highlight the importance of providing young people with education about different faiths and worldviews for reducing prejudices, especially those related to Islam. The findings also highlight the need to address in education and society the possible but not as self-evident relationship between violence and religion, and to do this more explicitly than is currently done

Religion as a Human Right and a Security Threat—Investigating Young Adults’ Experiences of Religion in Finland

The emergence of religiously motivated terrorist attacks and the increasing xenophobia expressed in Europe concern religions in many ways. Questions related to religion also lie at the core of educational aims and practices used to create national cohesion and understanding about different types of values and worldviews. However, despite the topicality of the issue, we have little knowledge about the ways in which young adults experience religions in a secular state. In order to contribute to the discussion regarding the relationships between religion, nationality, security, and education, this study focuses on investigating how politically active young adults experience the role of religions in Finnish society. The qualitative data of this study were collected from young adults (18–30-year-olds) through an online questionnaire distributed through political youth organisations. The content analysis of the responses (altogether 250 respondents) identified five main orientations towards religions. The findings highlight the importance of providing young people with education about different faiths and worldviews for reducing prejudices, especially those related to Islam. The findings also highlight the need to address in education and society the possible but not as self-evident relationship between violence and religion, and to do this more explicitly than is currently done

Including or Excluding Religion and Worldviews in Schools? Finnish Teachers' and Teacher Students' Perceptions

How schools navigate between the demands presented by secularisation, and the increasing plurality of religious traditions has become a very topical issue in many European countries, including Finland, in recent decades. The question is both practical and philosophical by nature because the ways in which various beliefs and values are represented in school practices and teaching content profoundly concern the educational mission of the schools. However, despite the topicality of the issue, little attention has been given to teachers' perceptions on whether public schools should, or should not, provide space for various religions and worldviews to become visible within the school life, and how schools should respond in practice to the perceived needs. In order to gain new knowledge on the topic, this study investigated Finnish teachers' and university students' (N = 181) perceptions of the representations of religions and worldviews, based on the perspectives of inclusion and exclusion. The statistical analysis revealed three factors titled as 'Religiously responsive approach', 'Secularist approach' and 'Equal visibility approach'. According to the main findings, current and future educators show various degrees of inter-religious sensitivity but principally supported the equal visibility of various traditions, rather than favouring strongly inclusivist or exclusivist practices.Peer reviewe

Siittiöiden löytyminen kivesbiopsialla atsoospermiapotilailla ja ICSI-hoitojen tulokset TAYS:ssa 2010-2019

Atsoospermialla tarkoitetaan siittiöiden puuttumista siemennesteestä toistetuissa analyyseissä. Sen esiintyvyydeksi koko miesväestössä on arvioitu noin 1 %, mutta hedelmöityshoitoihin hakeutuvissa miehissä sen esiintyvyys on noin 10–15 %. Atsoospermia jaetaan obstruktiiviseen ja non-obstruktiiviseen atsoospermiaan. Obstruktiivisessa atsoospermiassa siittiöiden kulkeutuminen siemennesteeseen on estynyt. Non-obstruktiivisessa atsoospermiassa siittiömuodostus on häiriintynyt tai sitä ei ole lainkaan. Usein näillä potilailla on korkea FSH-pitoisuus. Atsoospermiassa siittiöitä voidaan yrittää löytää kiveksestä kivesbiopsialla (TESE), joka tarkoittaa käytännössä paksuneulanäytettä suoraan kiveskudoksesta. Mikäli kivesbiopsialla löydetään siittiöitä, niitä voidaan käyttää koeputkihedelmöityshoidoissa (ICSI eli intracytoplasmic sperm injection). Aineistossamme siittiöitä löytyi noin puolelta kaikista potilaista (51,6 %). Obstruktiivisilta potilailta siittiöitä löytöi kaikilta ja non-obstruktiivisista 30,8 %:lla. Yleisin histologinen diagnoosi oli Sertoli cell only (35,9 %), jossa siittiöitä löytyi kivesbiopsiassa huonoiten (11,6 %). Tämän jälkeen yleisimmät diagnoosit olivat normaali (22,2 %), maturation arrest eli kypsymishäiriö (18,8 %) ja hypospermatogeneesi (12,0 %). Kivesvaurion histopatologia on jatkumo, joka etenee normaalista hypospermatogeneesin ja kypsymishäiriön kautta Sertoli cell only -tilanteeseen. Samalla myös siittiöiden löytymisen todennäköisyys kivesbiopsiassa heikkenee. Hypergonadotrooppisilta potilailta löytyi odotetusti huonoiten siittiöitä. Yhteys FSH:n ja siittiöiden löytymisen välillä oli tilastollisesti merkittävä (p<0,001). FSH-arvo, jonka jälkeen kivesbiopsia jää todennäköisimmin negatiiviseksi, oli 10,45 U/l. Kuitenkin korkeillakin FSH-arvoilla yksittäisiltä potilailta löytyy kivesbiopsialla siittiöitä, joten FSH:ta ei voida käyttää potilasvalinnassa kivesbiopsiaan. Aineistossa raskauksia alkoi 43 parilla eli 52,4 %:lla niistä, joilta löydettiin siittiöitä kivesbiopsiassa. Synnytys tai synnytyksiä oli 39 parilla ja synnytysprosentti oli 24,9 %. Keskenmenoprosentti oli 18,0 %