Viitotut elämät : Kuurojen nuorten aikuisten kokemuksia viittomakielisestä elämästä Suomessa

The goal of the study is to build an image of deafness and of the lives of the deaf from their own per-spectives. The lives of deaf sign language users are analysed through the concept of identity. The start-ing point for the study is the idea that identities are moulded and structured in action and interaction and are, therefore, continuous processes. The terminology and ideas used in the present study are mostly based on Erving Goffman s (1971, 1986) work in which he sees identity as a representation of self. Via our language and our actions we build and present an image of ourselves to others and to ourselves alike. The research aims at answering the following questions concerning the lives of deaf sign language users: how do deaf people build an image of themselves as deaf people, what kind of meanings does deafness acquire in their lives, and what opportunities do they have to be perceived by others as they feel they are, i.e. to present their true self . In order to answer these questions, the narratives provided by eighteen deaf young adults, aged 25 35, in narrative interviews carried out in sign language, have been analysed. The methodology used is that of a data-based, qualitative analysis and narrative analy-sis. The study follows the lines of prior qualitative research carried out in the field of sociology of health and in the study of everyday life. The subjects are divided into three groups according to the linguistic environment dominant in the family: 1) a deaf child in a deaf family, 2) a deaf child in a hearing family using sign language, and 3) a deaf child in a hearing family where sign language was not used. The childhood family has great significance in the way a child constructs his or her identity as a deaf person. The process of construct-ing an identity in the first group can be defined as being automatic or inherited, in the second group the process can be described as being a collective/joint identity-building process, whereas in the third group the process is ambivalent and delayed. The opportunities the deaf have in building their identi-ties as deaf people have been examined through the concept of a collective story reservoir. Research shows that the deaf have, at least partly, a different collective story reservoir that they can rely on from the one the hearing have. Interaction with other deaf people and access to the collective story reservoir is important, because it enables the deaf to form an idea of their own deafness and the life of a deaf person. Three different ways of understanding deafness can be conceptualized from the narratives of the inter-viewed deaf people. In the outdated counter-narrative and the reductive narrative of deafness as an abnormality, the subjects are not capable of seeing themselves as forming part of the narratives or identifying themselves with the ways the deaf are depicted. Yet, the characterizations prevalent in them are the ones that the deaf constantly come across in their day-to-day lives. The narrative through which the subjects depict themselves and their lives can be defined as a pluralistic narrative. The plu-ralistic narrative consists of three elements: the coexistence of the world of the deaf and that of the hearing, the orientation to sign language, and the replacement of local networks with global networks. Although modern Finnish society and its varied social services and subsidy systems enable the realiza-tion of the kind of life described in the pluralistic narrative, the issues of power and inequality still frequently emerge in the narratives in which the deaf young adults described themselves and their lives. Two kinds of power mechanisms can be perceived in the descriptions: belittling and excluding power. These considerably diminish the opportunities of sign language users to create the kind of life that would reflect their personalities while limiting the chances for presenting the self to others.

Oncolytic Adenoviruses with Radiation Therapy for Treatment of Prostate Cancer

Prostate cancer is the most common cancer in males. Although many patients with localized disease can be cured with surgery and radiotherapy, advanced disease and especially castration resistant metastatic disease remains incurable, with a median life expectancy of less than 18 months. Oncolytic adenoviruses (Ads) are a new promising treatment against cancer due to their innate capacity to kill cancer cells. Viral replication in tumor cells leads to oncolysis and production of a multiplicity of new virions that are capable of further destroying cancerous tissue. Oncolytic Ads can be modified for tumor targeted infection and replication and be armed with therapeutic transgenes to maximize the oncolytic effect. Worldwide, clinical trials with oncolytic Ads have demonstrated good safety while the antitumor efficacy remains to be improved. Importantly, the best responses have been reported when oncolytic adenoviruses have been combined with standard cancer treatments, such as chemotherapy and radiation. Further, a challenge in many virotherapy approaches has been the monitoring of virus replication in vivo. Reporter genes have been extensively used as transgenes to evaluate the biodistribution of the virus and activity of specific promoters. However, these techniques are often limited to preclinical evaluation and not amenable to human use. The aim of the thesis was to find and develop new oncolytic Ads with maximum efficacy against metastatic, castration resistant prostate cancer and study them in vitro and in vivo combined to different forms of radiation therapy. Using combination therapy, we were aiming for better antitumor efficacy with reduced side effects. Capsid modified Ads for enhanced transduction were studied. Serotype 3 targeted chimera, Ad5/3, was found to have enhanced infectivity for prostate cancer and was used for developing new viruses for the study. Correlation between Ad-encoded marker peptide secretion and simultaneous viral replication was evaluated and the effects of radiotherapy on viral replication were studied in detail. We found that the repair of double strand breaks caused by ionizing radiation was inhibited by adenoviral proteins and led to autophagic cell death. Both subcutaneous models and intrapulmonary tumor models mimicking metastatic, aggressive disease were used in vivo. Virus efficacy was evaluated by intratumoral injections. Also, intravenous administration was evaluated to study the effectiveness in metastatic disease. Oncolytic adenovirus treatment led to significant tumor growth control and increased the survival rate of the mice. These results were further improved when oncolytic Ads were combined with radiation therapy. Oncolytic Ads expressing human sodium/iodide transporter (hNIS) as a transgene were evaluated for their oncolytic potency and for the functionality of hNIS in vitro and in vivo. Monitoring of viral replication was also assessed using different imaging modalities relative to clinical use. SPECT imaging of tumor-bearing mice was evaluated and combined with simultaneous CT-scanning to obtain important anatomical information on biodistribution, also in a three-dimensional form. It was shown that hNIS-expressing adenoviruses could harbour a bi-functional transgene allowing for localization and imaging of viral replication. Targeted radiotherapy was applied by systemic radioiodide administration and resulted in iodide accumulation into Ad-infected tumor. The combination treatment showed significantly enhanced antitumor efficacy in mice bearing prostate cancer tumors. In summary, the results presented above aim to provide new treatment modalities for castration resistant prostate cancer. Molecular insights were provided for better understanding of the benefits of combined radiation therapy and oncolytic adenoviruses, which will hopefully facilitate the translation of the approach into clinical use for humans.