Stone Weathering in the Monastic Building Complex on Mountain of St Aaron in Petra, Jordan.

Since 1997 the Finnish Jabal Haroun Project (FJHP) has studied the ruins of the monastery and pilgrimage complex (Gr. oikos) of Aaron located on a plateau of the Mountain of Prophet Aaron, Jabal an-Nabi Harûn, ca. 5 km to the south-west of the UNESCO World Heritage site of Petra in Jordan. The state of conservation and the damaging processes affecting the stone structures of the site are studied in this M.A. thesis. The chapel was chosen as an example, as it represents the phasing and building materials of the entire site. The aim of this work is to act as a preliminary study with regards to the planning of long-term conservation at the site. The research is empirical in nature. The condition of the stones in the chapel walls was mapped using the Illustrated Glossary on Stone Deterioration, by the ICOMOS International Scientific Committee for Stone. This glossary combines several standards and systems of damage mapping used in the field. Climatic conditions (temperature and RH %) were monitored for one year (9/2005-8/2006) using a HOBO Microstation datalogger. The measurements were compared with contemporary measurements from the nearest weather station in Wadi Musa. Salts in the stones were studied by taking samples from the stone surfaces by scraping and with the “Paper Pulp”-method; with a poultice of wet cellulose fiber (Arbocel BC1000) and analyzing what main types of salts were to be found in the samples. The climatic conditions on the mountain were expected to be rapidly changing and to differ clearly from conditions in the neighboring areas. The rapid changes were confirmed, but the values did not differ as much as expected from those nearby: the 12 months monitored had average temperatures and were somewhat drier than average. Earlier research in the area has shown that the geological properties of the stone material influence its deterioration. The damage mapping showed clearly, that salts are also a major reason for stone weathering. The salt samples contained several salt combinations, whose behavior in the extremely unstable climatic conditions is difficult to predict. Detailed mapping and regular monitoring of especially the structures, that are going remain exposed, is recommended in this work.

Theological Exegesis in the Canonical Context : Brevard S. Childs' Methodology of Biblical Theology

Modern Christian theology has been at pain with the schism between the Bible and theology, and between biblical studies and systematic theology. Brevard Springs Childs is one of biblical scholars who attempt to dismiss this “iron curtain” separating the two disciplines. The present thesis aims at analyzing Childs’ concept of theological exegesis in the canonical context. In the present study I employ the method of systematic analysis. The thesis consists of seven chapters. Introduction is the first chapter. The second chapter attempts to find out the most important elements which exercise influence on Childs’ methodology of biblical theology by sketching his academic development during his career. The third chapter attempts to deal with the crucial question why and how the concept of the canon is so important for Childs’ methodology of biblical theology. In chapter four I analyze why and how Childs is dissatisfied with historical-critical scholarship and I point out the differences and similarities between his canonical approach and historical criticism. The fifth chapter attempts at discussing Childs’ central concepts of theological exegesis by investigating whether a Christocentric approach is an appropriate way of creating a unified biblical theology. In the sixth chapter I present a critical evaluation and methodological reflection of Childs’ theological exegesis in the canonical context. The final chapter sums up the key points of Childs’ methodology of biblical theology. The basic results of this thesis are as follows: First, the fundamental elements of Childs’ theological thinking are rooted in Reformed theological tradition and in modern theological neo-orthodoxy and in its most prominent theologian, Karl Barth. The American Biblical Theological Movement and the controversy between Protestant liberalism and conservatism in the modern American context cultivate his theological sensitivity and position. Second, Childs attempts to dismiss negative influences of the historical-critical method by establishing canon-based theological exegesis leading into confessional biblical theology. Childs employs terminology such as canonical intentionality, the wholeness of the canon, the canon as the most appropriate context for doing a biblical theology, and the continuity of the two Testaments, in order to put into effect his canonical program. Childs demonstrates forcefully the inadequacies of the historical-critical method in creating biblical theology in biblical hermeneutics, doctrinal theology, and pastoral practice. His canonical approach endeavors to establish and create post-critical Christian biblical theology, and works within the traditional framework of faith seeking understanding. Third, Childs’ biblical theology has a double task: descriptive and constructive, the former connects biblical theology with exegesis, the later with dogmatic theology. He attempts to use a comprehensive model, which combines a thematic investigation of the essential theological contents of the Bible with a systematic analysis of the contents of the Christian faith. Childs also attempts to unite Old Testament theology and New Testament theology into one unified biblical theology. Fourth, some problematic points of Childs’ thinking need to be mentioned. For instance, his emphasis on the final form of the text of the biblical canon is highly controversial, yet Childs firmly believes in it, he even regards it as the corner stone of his biblical theology. The relationship between the canon and the doctrine of biblical inspiration is weak. He does not clearly define whether Scripture is God’s word or whether it only “witnesses” to it. Childs’ concepts of “the word of God” and “divine revelation” remain unclear, and their ontological status is ambiguous. Childs’ theological exegesis in the canonical context is a new attempt in the modern history of Christian theology. It expresses his sincere effort to create a path for doing biblical theology. Certainly, it was just a modest beginning of a long process.

Given and News : Media discourse and the construction of community on national days

National anniversaries such as independence days demand precise coordination in order to make citizens change their routines to forego work and spend the day at rest or at festivities that provide social focus and spectacle. The complex social construction of national days is taken for granted and operates as a given in the news media, which are the main agents responsible for coordinating these planned disruptions of normal routines. This study examines the language used in the news to construct the rather unnatural idea of national days and to align people in observing them. The data for the study consist of news stories about the Fourth of July in the New York Times, sampled over 150 years and are supplemented by material from other sources and other countries. The study is multidimensional, applying concepts from pragmatics (speech acts, politeness, information structure), systemic functional linguistics (the interpersonal metafunction and the Appraisal framework) and cognitive linguistics (frames, metaphor) as well as journalism and communications to arrive at an interdisciplinary understanding of how resources for meaning are used by writers and readers of the news stories. The analysis shows that on national anniversaries, nations tend to be metaphorized as persons having birthdays, to whom politeness should be shown. The face of the nation is to be respected in the sense of identifying the nation's interests as one's own (positive face) and speaking of citizen responsibilities rather than rights (negative face). Resources are available for both positive and negative evaluations of events and participants and the newspaper deftly changes footings (Goffman 1981) to demonstrate the required politeness while also heteroglossically allowing for a certain amount of disattention and even protest - within limits, for state holidays are almost never construed as Bakhtinian festivals, as they tend to reaffirm the hierarchy rather than invert it. Celebrations are evaluated mainly for impressiveness, and for the essentially contested quality of appropriateness, which covers norms of predictability, size, audience response, aesthetics, and explicit reference to the past. Events may also be negatively evaluated as dull ("banal") or inauthentic ("hoopla"). Audiences are evaluated chiefly in terms of their enthusiasm, or production of appropriate displays for emotional response, for national days are supposed to be occasions of flooding-out of nationalistic feeling. By making these evaluations, the newspaper reinforces its powerful position as an independent critic, while at the same time playing an active role in the construction and reproduction of emotional order embodied in "the nation's birthday." As an occasion for mobilization and demonstrations of power, national days may be seen to stand to war in the relation of play to fighting (Bateson 1955). Evidence from the newspaper's coverage of recent conflicts is adduced to support this analysis. In the course of the investigation, methods are developed for analyzing large collections of newspaper content, particularly topical soft news and feature materials that have hitherto been considered less influential and worthy of study than so-called hard news. In his work on evaluation in newspaper stories, White (1998) proposed that the classic hard news story is focused on an event that threatens the social order, but news of holidays and celebrations in general does not fit this pattern, in fact its central event is a reproduction of the social order. Thus in the system of news values (Galtung and Ruge 1965), national holiday news draws on "ground" news values such as continuity and predictability rather than "figure" news values such as negativity and surprise. It is argued that this ground helps form a necessary space for hard news to be seen as important, similar to the way in which the information structure of language is seen to rely on the regular alternation of given and new information (Chafe 1994).

Pain in juvenile idiopathic arthritis : parents and children as agents of disease management

Juvenile idiopathic arthritis (JIA) is a severe childhood disease usually characterized by long-term morbidity, unpredictable course, pain, and limitations in daily activities and social participation. The disease affects not only the child but also the whole family. The family is expected to adhere to an often very laborious regimen over a long period of time. However, the parental role is incoherently conceptualized in the research field. Pain in JIA is of somatic origin, but psychosocial factors, such as mood and self-efficacy, are critical in the perception of pain and in its impact on functioning. This study examined the factors correlating and possibly explaining pain in JIA, with a special emphasis on the mutual relations between parent- and patient-driven variables. In this patient series pain was not associated with the disease activity. The degree of pain was on average fairly low in children with JIA. When the children were clustered according to age, anxiety and depression, four distinguishable cluster groups significantly associated with pain emerged. One of the groups was described by concept vulnerability because of unfavorable variable associations. Parental depressive and anxiety symptoms accompanied by illness management had a predictive power in discriminating groups of children with varying distress levels. The parent’s and child’s perception of a child’s functional capability, distress, and somatic self-efficacy had independent explanatory power predicting the child’s pain. Of special interest in the current study was self-efficacy, which refers to the belief of an individual that he/she has the ability to engage in the behavior required for tackling the disease. In children with JIA, strong self-efficacy was related to lower levels of pain, depressive symptoms and trait anxiety. This suggests strengthening a child’s sense of self-efficacy, when helping the child to cope with his or her disease. Pain experienced by a child with JIA needs to be viewed in a multidimensional bio-psycho-social context that covers biological, environmental and cognitive behavioral mechanisms. The relations between the parent-child variables are complex and affect pain both directly and indirectly. Developing pain-treatment modalities that recognize the family as a system is also warranted.

Onko varhaisen tuen päiväkoti mahdollinen? : Tutkimus varhaiskasvatuksen yhteisöllisestä kehittämisestä

Is the early childhood day care facility possible? The research considering communal development of the early education. In Finland mothers and fathers look after 400 000 pre-school children. Half of these attend day care facilities, in which 50 000 staff are employed. The aim of this research is to develop co-operation practices within the day care centre. This research refines and expands my own interest in and knowledge of day care management and content development. The basis of the research draws upon ethnographic material covering the period 1999–2005. The day care centre chosen as a central informant was the first suburban centre founded in 1963, and it provided a rich local and welfare state research perspective. It became clear that the day care facility’s co-operation practices formed the basis of bringing up children and at the same time produced a new multi-operational and multi-layered community for child participation. Adult day care centre workers bringing up the children as a professional work and solutions defining the conditions for the work are expressed in a child’s upbringing. This obviously has an impact in where as the development of communities. From the human and community scientific point of view, the group of youngest children will take up a future position as key players in communities as essential actors and reformers. The research was carried out as multiphase and multiscientific practical research and iterative data formation. The results verified that the co-operation between parents and day care staff produces important benefits for all the stakeholders. However, the day care staff has difficulties in implementing the benefits. During the research process, it became clear that conceptually day care staff saw the practices as ”very important, but not easily realised in practice”. As a result this demanded further research to address this issue and to extend this to the carefacility’s co-operation practises and their communal and social conditions. The research looks at the carefacility’s co-operation with key stakeholders. At the same time it undertakes an analytical and historical examination of carefacilitys’s with an experimental focus as two day care centres chosen as experimental objects. The results of the research showed that the benefits gained by children were determined by the day care centre’s socio-political structure and the parent’s resources. The research framework categorised early childhood education as generational and gender based structures. As part of the research, the strains endemic to these formations have been examined. The system for bringing up children was created as part of a so called welfare state project by implemented by the Day Care Act in year 1973. The law secured the subjective right for every pre-school child to have access to day care facilities. The law also introduced a labour and sosiopolitical phase and the refinement of the day care facility’s education-care concept. The latest phase that started during the early 1990´s was called the market-based social services strategy. As a result of this phase, state support was limited and the screening function of the law was relaxed. This new strategy resulted in a divisive and bureaucratic social welfare system, that individualised and segregated children and their parents, leaving some families outside the communal and welfare state benefit net. The modern day care centre is a hybrid of different aims. Children spend longer and more irregular time in day care. The families are multicultural and that requires more training for the staff. The work in day care has been enhanced, for example he level of education for the staff has been lowered and productivity has been improved. However, administrative work and different kinds of support and net work functions together with the continuous change have taken over from the work done face to face with children. Staff experiences more pressure as the management and the work load has increased. Consequently the long-term planning and daily implementation of the nuclear task of the day care facility is difficult to control. This will have an effect on both motivation and manageability of the work. Overall quality of the early childhood upbringing has been weakened. The possibilities for the near future were tested in the two day care centres chosen as an experi-ment objects. The analysis of these experiments showed that generative interaction work will benefit everyone: children, parents and employees. The main results of the research are new concepts of an early support day care centre, which can be empirically and theoretically possi-ble for development the near future. Key words: Day care facility’s co-operation practises, early childhood education as generational structure, child’s multi-operational and multi-layered community, multi-subjective operator, generative interaction work, communal composition.

3 - 5-vuotiaiden lukemaan oppiminen : montessorivälineet kielellisen tietoisuuden ja varhaisen lukitaidon edistäjinä

Aims. The beginning point of this research was confusion between studies claiming, that children mature Metalinguistic to read at 6-7 of age, and the fact, that in Montessori playschools children easily start writing and reading at age 3 to 5. Aim was also find out how conception of slow Metalinguistic development has started, and if there is some evidence of phoneme awareness of reading of young children in the field of research of reading. Aim was also seek evidence of the sensitive period of reading as Montessori described it. The research also wanted to turn up, if phoneme awareness only develops in children, who work with graphemes and with reading, or could it be found in children, who do not. The mean was to research how the Montessori reading material supports child’s Metalinguistic development, when child begins learning to read. The research plans to represent knowledge about how young children learn to write and read. Methods. Research performed in ordinary kindergarten and in Montessori playschool in Espoo. In kindergarten observed six children, age 3-4, at eight grapheme-rhyme sessions from January to April 2007, and conducting a test based on Chaney’s (1992) study of phoneme awareness of young children. In Montessori kindergarten were observed 17 children about their phoneme awareness and reading competition from January 2007 to March 2008. Their developments in reading were also measured three times from 1.9.07 to 20.3.08 with classification constructed for this study, loosely based on Chall’s (1983) reading stages. The Montessori reading material was analyzed about the influence they have to a child’s Metalinguistic development. This was done based to theory and its concepts from the field of research of reading; phoneme awareness, morphological, syntactical and semantic consciousness. Results and conclusions. Research proved that children 3-5 have naturally developed phoneme awareness. In kindergarten and in Montessori playschool children between 2 and 4 could do phoneme synthesis, and in the latter they also could do phoneme segmentation of words. Montessori reading material guided children gradually, except to read, also to observe and absorb Metalinguistic knowledge. Children learned to write and read. At the last evaluating day almost 50 % of children write and read clauses or stories, and 82 % could read at least words. Children can develop Metalinguistic awareness, while using the Montessori materials for learning to write and read. To reach literacy is easy for children because of their phoneme awareness.

The Development of the Concept of Music Education in Estonian Kindergartens, 1905-2008 : a Historical–Critical Overview

The dissertation focuses on the development of music education in Estonian kindergartens and the factors influencing it, analysed in the historical perspective relying on post-positivist paradigm. The study is based on the factors and subjects’ views on kindergarten music education from 1905 to 2008, recorded in written sources or ascertained by means of questionnaire and interview. The dissertation deals with music’s functions, music education in retrospective, factors influencing child’s musical aptitude and development and teacher’s role in it through the prism of history. The formation of Estonian kindergarten music education and the phenomenon of its development have been researched by stages: the first manifestations of music in kindergarten in 1905 - 1940; the formation of the concept of music education in 1941 - 1967 and the application of a unified system in 1968 - 1990. The work also outlines innovative trends in music education at the end of the last millennium and the beginning of this century, in 1991 - 2008. The study relies on a combined design and an analysis of historical archival material and empirical data. The empirical part of the study is based on the questionnaire (n=183) and interviews (n=18) carried out with kindergarten music teachers. The data has been analysed using both qualitative and quantitative methods. The subject of the research is the content and activity types of kindergarten music education and the role of music teacher in their implementation. The study confirmed that fundamental changes took place in Estonian kindergarten music education due to the change in political power in the 1940s. Following the example of the Soviet system of education, music in kindergarten became an independent music educational orientation and the position of a professionally trained music teacher was established (1947). It was also confirmed that in the newly independent Estonian Republic under the influence of innovative trends a new paradigm of music education arose from the traditional singing-centred education towards the more balanced use of music activity types (attaching importance to the child-centred approach, an increase in the number and variety of activity types). The most important conclusions made in the dissertation are that there has been improvement and development deriving from contemporary trends in the clear concept that has evolved in Estonian kindergarten music education over a century; professionally trained music teachers have had a crucial role in shaping it; and kindergarten music education is firmly positioned as a part of preschool education in Estonian system of education. Key words: early childhood music education, history of music education, kindergarten music education, early childhood music teachers

Lapsi ulkomailta – vanhempien rooli adoptiolapsen identiteetin kehityksessä

The importance of open discussion with the adopted child and his parents about adoption and ethnicity is often emphasized in adoption literature (Kirk 1964; Grotevant 1999; Carli & Dalen 1999). The child should have the possibility of constructing a harmonious view of himself, which consists of his history before adoption, ethnicity and the social environment’s conception of him. The purpose of this study was to examine the Finnish adoptive parents’ supportive role in relation to their child’s adoptive and ethnic identity and the social environment’s disposition to the child as witnessed by the parents. The first research problem was to find out how the parents support their child’s adoptive identity formation. The second problem was to find out if the parents want to support the child’s ethnic identity. The third problem was regarding the environment’s disposition to the child and family. The hypothesis was that Finnish adoptive parents are well aware of the problems of adoption and they have been well selected, so they have the aspirations and skills to help their child with his identity formation. The focus of this study was on Finnish parents who had adopted internationally, from whom 58 answers were obtained. The data was collected with an Internet based questionnaire. The questions were mostly qualitative. The analysis was directed by the theory, so that the analysis units were obtained from the main questions of international adoption and identity formation. The results expressed that the adoptive parents want to support their child’s adoption identity. They accept their child’s questions regarding his history, and that they did not want to conceal any details about their child’s life, even if they felt that it was a sensitive issue for them. The main problem was that there was no information available on the child’s history. Contact with the biological parents was almost impossible because there was hardly any information on them. Instead the parents were in contact with the children’s home because they felt that it had an important role as the child’s former home. The parents felt that the child’s birth culture was of importance and they mainly offered aspects of it informally daily. Parents who stressed their child’s Finnish identity were concerned that their child would not form a feeling of being Finnish. However, the majority wished that their child would have a multicultural identity. The parents felt that the environment regarded the child positively and the possibility of upcoming problems was tackled by discussing them beforehand with the child and environment.

"Sitte se menee koulus" : Eri kieli- ja kulttuuritaustaisen lapsen suomen kielen taito esiopetuksen päättövaiheessa

A child learns new things, creates social relationships and participates in play with the help of language. How can a child overcome these challenges if the surrounding language is not his mother tongue? The objective of learning a new language in the Pre-school education is an active bilingualism in all fields of the language. Theoretical context of the research rises from bilingualism, learning a language, language skills and evaluating them. Object of the research was to understand language skills of a child from a different linguistic and cultural background in the final stage of Pre-school education and to clarify how learning Finnish was supported during the Pre-school year. Answers to the research issues will be searched with the following questions: 1) What kind of language skills does a child from a different linguistic and cultural backgrounds have at the final stage of Pre-school education?, 1.1) What kind of listening comprehension skills?, 1.2) What kind of speech and vocabulary skills?, 1.3) What kind of structural skills?, 2) What kind of individual differences are there in language skills of children from different linguistic and cultural backgrounds?, and 3) How has a child from a different linguistic and cultural background been supported in learning Finnish during the Pre-school education? The view of language skills in this research is holistic even though it will be analysed in separate fields. The aim of this research is to form an overall impression of Finnish skills of the children participating in the research. Eight Pre-school-aged children with different linguistic and cultural backgrounds and their kindergarten teachers participated in this research. The children had taken part in Finnish activities for about three years. The research material consists of the test series (KITA), which evaluate children’s language skills – and of the questionnaire to the kindergarten teachers. The purpose of the questionnaire was to provide additional information on children’s language skills in Pre-school teaching situations and on supporting Finnish in Pre-school education. This research is qualitative and processing of the material is based on content analysis. According to the kindergarten teachers, the children’s social language skills were sufficient to cope in everyday life but children needed assistance with longer instructions. The same phenomenon could also be seen with the KITA tests – in which long and abstract instructions turned out to be difficult. Individual differences of the children were perceived in productivity skills, which were realised in fluent or influent speech. The children were supported in learning Finnish individually, in small-groups and in the activities of a whole group. ‘Finnish as the second language’ small-groups were the most common form of support in learning the language. The support at understanding activities was emphasized in whole group situations as well as in individual situations while assisting the child’s language skills. Generally, the children’s language skills were in the same level with developing basic language skills. The data of this research help to understand children’s language skills after three years of adopting Finnish. The results can be utilised in planning and evaluation of teaching another language.

Early Childhood Caries and a Community Trial of its Prevention in Tehran, Iran

Varhaislapsuuden karies ja sen ehkäisy kehittyvän terveydenhuollon maassa Varhaislapsuuden karies on merkittävä kansanterveysongelma varsinkin lapsirikkaissa maissa ja väestöissä. Karieksen hoitaminen vie paljon voimavaroja ja aiheuttaa mittavia taloudellisia seuraamuksia. Karies voi ilmaantua lapselle jo vauvaikäisenä, pian ensimmäisten maitohampaiden puhjettua suuhun. Alle 3-vuotiaiden karieksesta on kuitenkin niukasti tilastotietoja. Maailman terveysjärjestökin suosittaa tietojen keräämistä vasta 3-vuotiaiden ikäryhmästä. Heistä kariesta sairastaa Suomessa 16 %, Yhdysvalloissa 25 %, Englannissa 30 %, Iranissa 46 % ja Saudi-Arabiassa 61 %. Tämä väitöstutkimus selvitti karieksen esiintymistä ja sen vaaratekijöitä 1─3-vuotiailla Teheranissa. Lisäksi tutkimus arvioi perusterveydenhuoltoon sisällytetyn karieksen ehkäisyn tuloksellisuutta. Tutkimuskohteiksi arvottiin Teheranista 18 neuvolaa. Jokaisessa oltiin 4 päivää, jolloin kaikkia rokotuksiin tulleita 1─3-vuotiaita äiteineen pyydettiin osallistumaan tutkimukseen. Kahta lukuun ottamatta kaikki äidit suostuivat, ja aineistoon tuli kaikkiaan 504 lasta äiteineen. Kaikki 1-vuotiaat, 242 lasta äiteineen, valittiin karieksen ehkäisykokeiluun. Sitä varten neuvolat jaettiin kolmeen ryhmään, joista kaksi (A ja B) oli koeryhmiä ja yksi (C) oli vertailuryhmä. Tutkimus alkoi äidin haastattelulla. Siinä selvitettiin perheen koulutus- ja tulotaso sekä lapsen ruokinnasta imetyksen kesto, yösyötöt ja päiväaikaan nautitut makeat. Vielä kysyttiin lapsen ja äidin suuhygieniatavoista ja äidin kokemuksista lapsen suun puhdistamisessa. Sitten hammaslääkäri tutki lapsen suun ja kirjasi karieksen ja hammasplakin esiintymät. Suun tutkimuksen jälkeen äiti ja lapsi siirtyivät rokotushuoneeseen. Koeryhmissä (A ja B) äidit saivat terveydenhoitajalta suunterveyttä koskevan esitteen ja kehotuksen lukea se huolellisesti. Lisäksi ryhmässä A terveydenhoitaja kertoi suun ja hampaiden terveydenhoidosta saman esitteen avulla, ja neuvolan henkilökunta muistutti suunhoidon tärkeydestä puhelimitse kahdesti seuraavan puolen vuoden kuluessa. Vertailuryhmässä äideille ei annettu suunhoidon ohjeita. Kaikissa ryhmissä äitejä muistutettiin seuraavan rokotuskerran ajankohdasta, muttei mainittu tulevaa toista hammastarkastusta. Varhaislapsuuden kariesta sairasti ikäryhmästä riippuen 3─26 % tutkituista 1─3-vuotiaista, ja 65─76 %:lla oli hammasplakkia. Äideistä 68 % harjasi hampaansa päivittäin ja 39 % puhdisti lapsensa suun päivittäin. Mitä useammin äiti harjasi omat hampaansa, sitä paremmin hän huolehti lapsen suun puhtaudesta. Rintaruokinta oli yleistä eikä lisännyt kariesvaaraa. Yöllä pullomaitoa saavilla karies oli 5 kertaa yleisempää kuin muilla. Neuvolassa saatu ohjeistus ehkäisi selvästi karieksen syntyä puolen vuoden kokeessa.

Study of sleep and evaluation of sumatriptan and rizatriptan in the acute treatment of migraine in children and adolescents

Migraine is a common disease in children and adolescents, affecting roughly 10% of school-aged children. Recent studies have revealed an increasing incidence of childhood migraine, but migraine remains an underrecognized and undertreated condition in the pediatric population. Migraine attacks are painful and disabling and can affect a child´s life in many ways. Effective drug treatment is usually needed. The new migraine drugs, triptans, were introduced at the beginning of the 1990s and have since been shown to be very effective in the treatment of migraine attacks in adults. Although they are widely used in adults, the acute treatment of migraine in children and adolescents is still based on paracetamol and nonsteroidal anti-inflammatory drugs. Some children can control their attacks satisfactorily with simple analgesics, but at least one-third need more powerful treatments. When this thesis work commenced, hardly any information existed on the efficacy and safety of triptans in children. The study aim of the thesis was to identify more efficient treatments of migraine for children and adolescents by investigating the efficacy of sumatriptan nasal spray and oral rizatriptan compared with placebo in them. Sleep has an impact on migraine in many aspects. Despite the clinical relevance and common manifestation of sleep in the context of migraine in children, very little research data on the true frequency of sleep exist. As sleeping is so often related to childhood migraine, it can be a confounding factor in clinical drug trials of migraine treatments in children and adolescents. How the results of a sleeping child should be analyzed is under continual debate. The aim of the thesis was also to clarify this as well as to evaluate the frequency of sleeping during migraine attacks in children and factors affecting frequency. Both nasal sumatriptan and oral rizatriptan were effective (superior to placebo), and well tolerated in treatment of migraine attacks in children and adolescents aged 8-17 and 6-17 years, respectively. No serous adverse effects were observed. The results of this work suggest that nasal sumatriptan 20 mg and rizatriptan 10 mg can be effectively and safely used to treat migraine attacks in adolescents aged over 12 years if more effective drugs than NSAIDs are needed. No difference was observed in efficacy or safety of nasal sumatriptan and rizatriptan between children aged younger than 12 years and older children, but because the treated number of patients under 12 years is still small, more studies are needed before sumatriptan or rizatriptan can be recommended for use in this population. Sleeping during migraine attacks was very common, and most children at least occasionally slept during an attack. Falling asleep was especially common in children under eight years of age and during the first hour after the onset of attack. Children who were able to sleep soon after attack onset were more likely pain-free at two hours. Sleeping probably both improves recovery from a migraine attack and is a sign of headache relief. Falling asleep should be classified as a sign of headache relief in clinical drug trials when studying migraine treatments in children and adolescents.

Sense of Coherence : Determinants and consequences

ABSTRACT Sense of coherence (SOC) is a core concept within Antonovsky s salutogenic theory and is argued to be a psychological determinant of health. The present social-epidemiological study explores the associations between a wide range of generalized resistance resources of SOC among Finnish- and Swedish-speaking women and men with a view to gaining deeper insight into its developmental circumstances and determinants. Secondly, a five-year follow-up study was conducted in order to assess the stability of SOC in difficult life events. Finally the role and effect of SOC in the intentions to retire early was investigated in a prospective study. The above studies were based on two data sets: the Finnish 'Survey on Living Conditions' (ELO-94) conducted in 1994 by means of personal face-to-face interviews (N=6506), and a prospective postal survey of the 15-year Health and Social Support (HeSSup) study for which the baseline data was collected in 1998 (N=25 898) and the follow-up in 2003. The present study reveals that the level of SOC in adulthood is strongly dependent on close and successful social relationships during both childhood and adulthood, and that there is a strong association with qualitative work features. Not having a partner as well as being unable to use one s skills at work proved to threaten men s SOC in particular, whereas a lack of social support did the same for women. Otherwise, the association with generalized resistance resources turned out to be quite similar in both genders. Swedish-speaking Finns appear to have a slightly stronger SOC due to the better psycho-emotional circumstances in the childhood home and work circumstances in adulthood, in other words higher levels of generalized resistance resources compared to Finnish speakers. These language group differences did not concern any social-life factors included in the present study. The results of the five-year follow-up study suggest that SOC is not stable, and that the level clearly decreases after a negative life event. Even a strong SOC decreased during the follow-up period and, furthermore, was no more stable than a mediocre or weak SOC. There seems to be a clear and independent association with the intentions to retire early among both men and women following full adjustment. Swedish speakers appear to be less inclined to retire early than Finnish speakers. In the light of the present study, it seems that SOC is determined not only by socio-economic factors but also by close and successful social relationships during both childhood and adulthood. This applied to both genders and language groups. Interventions aimed at promoting the health of the disadvantaged should therefore focus on families with children, and extend later also to other than socio-economic spheres of life. SOC theory could also be applied in efforts to inhibit early retirement: management practices aimed at providing employees with a work environment and tasks that are comprehensible, manageable and meaningful could potentially decrease the intentions to retire early.

Jos olisin viisas niin siivoisin : Lasten luovat prosessit päiväkodissa

It has been found usually to talk in the early childhood education in connection with the creativity about arts and skills and about play. In this treatise, the creativity is approached besides play but also from the point of view of the creativity of the everyday. The starting point for the study is the view according to which the creativity is complex interaction between a creative person and an environment. The theoretical body of the study is the Componential theory of creativity of Amabile (1996). The process which is open and product which is new and suitable or acceptable were defined creative. In the opinion of many researchers, the creativity is a phenomenon that has determined in a certain time and place so the creativity is examined from the point of view of the social constructionism. As creative processes in the day nursery it has been defined pretend play, child´s involvement and children´s agentive perception which is based on the Children´s agentive perception theory of Reunamo (2007). The purpose of the study is to clarify how the child's personal factors and the social environment affect the creative processes of children in the day nursery. This Master's thesis is based on the Children' s agentive perception uncovered study led by Jyrki Reunamo (2010) which was carried out in the spring of 2010 in Keski-Uusimaa and in Hämeenlinna and Taiwan. From the study, a name has also been used "on the sources of Orientation", a research project and development project. The study includes the children's evaluation sector, the observation sector, the children's interview sector and the evaluation sector of the pedagogic environment. 891 Children 1-7 year-old by age participated in the study. All the sectors which belong to the study of Reunamo were utilized in this treatise and the Finnish day nurseries or preschool groups which had participated in the study were marked off as the target group. The main component analysis, sum variables, the correlation coefficients, Mann-Whitney s U-test and Kruskall-Wallas test were used for the statistical examination of the quantitative material. In this treatise it was noticed, both the personal properties of the child and a social environment, that they affected all the examined creative processes which also had a significant connection with each other statistically. The definition of creativity was filled best by the participative answers. However, the number of the participative answers was only 8% in the questions concerning adults. That raised the question whether an attempt should be made to have effect so that the children's better participation also in the interaction with the adults would be possible in the educational culture of the day nursery. In the further study, the conscious building of the social environment which supports the creativity from a social constructionism point of view could indeed be an interesting task. The treatise is suitable for an examination of the interaction between the child's person and a social environment especially from the point of view of the creativity.