In search of Lost Childhood

The article is located at the Daily Sun's editorial section's subsection "Post-Log."

Metabolic syndrome in young adults – prevalence, childhood predictors and association with subclinical atherosclerosis

Background: Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including central obesity, insulin resistance, impaired glucose tolerance, hypertension and dyslipidemia. The prevalence of MetS is increasing worldwide in all age groups. MetS is associated with increased risk of cardiovascular disease and type 2 diabetes mellitus. Aims: The aim of the present study was to investigate the prevalence, secular trends and childhood predictors of MetS in young adults. Furthermore, the relations between MetS and subclinical atherosclerosis were studied and whether apolipoproteins (apo) B and A-I, C-reactive protein (CRP) and type II secretory phospholipase A2 (sPLA2) were associated with MetS, and to what extent the atherogenicity of MetS was explained by these factors. Participants and Methods: The present thesis is part of the large scale population-based, prospective study, the Cardiovascular Risk in Young Finns Study. The first cross-sectional study was conducted in 1980 and included 3,596 participants aged 3-18 years. Carotid and brachial ultrasound studies were performed for 2,283 of these participants in 2001 and 2,200 of these participants in 2007. Results: The overall prevalence of MetS in young adults aged 24-39 years in 2001 was 10-15 % and 6 years later in 30-45 year-old adults it was 15-23 % depending on the MetS definition used. Between the years 1986 and 2001, MetS prevalence increased from 1.0 % to 7.5 % (p<0.0001) in 24-year-old participants that was mostly driven by the increased central obesity. Participants with MetS had increased carotid intima-media thickness (cIMT) and decreased carotid elasticity compared to those without the syndrome. Impaired brachial flow-mediated dilatation (FMD) was not related to MetS but it modified the relationship between MetS and cIMT (P for interaction 0.023). High levels of apoB, CRP, sPLA2 and low levels of apoA-I associated with MetS in young adults. In prospective analysis both MetS and high apoB predicted (P<0.0001) incident high cIMT, defined as cIMT>90th percentile and/or plaque. The association between MetS and incident high cIMT was attenuated by ~40 % after adjustment with apoB. Conclusions: MetS is common in young adults and increases with age. Screening for risk factors, especially obesity, at an early life stage could help identify children and adolescents at increased risk of developing MetS and cardiovascular disease later in life. MetS identifies a population of young adults with evidence of increased subclinical atherosclerosis. Impaired brachial endothelial response is not a hallmark of MetS in young adults, but the status of endothelial function modifies the association between metabolic risk factors and atherosclerosis. In addition, the atherogenicity of MetS in this population assessed by incident high cIMT appears to be substantially mediated by elevated apoB.

Health Related Quality of Life after Childhood Cancer - A Finnish Nationwide survey

The purpose of this Finnish epidemiological nationwide cross-sectional study was to evaluate the Health Related Quality of Life (HRQL) of young people that have survived childhood cancer at least four years after cancer diagnosis. The study aims were (1) to increase knowledge and understanding about the relationship between childhood cancer and its treatment and HRQL of childhood cancer survivors and (2) to identify survivors who need and could benefit from ongoing long-term follow-up, as well as (3) to identify what kind of aftercare the childhood cancer survivors will possibly need. HRQL and fatigue of currently still young survivors of extracranial childhood malignancies were evaluated with self-reports and parent proxy reports. HRQL was measured with age-appropriate generic instruments: PedsQL™, SF-36, 15D, 16D and 17D. Fatigue for children and adolescents aged below 18 years was measured with the PedsQL™ Multidimensional Fatigue Scale Finnish version. PedsQL™ parent-proxy and the PedsQL™ Multidimensional Fatigue Scale Parentproxy instruments were used to assess the perception of the parents on HRQL and fatigue of their children and adolescents. Postal-survey questionnaires were mailed to 852 childhood cancer survivors aged 11-27 years and their randomly selected gender-, age and living-place matched controls, as well as under 18-year-old children´s parents. A total of 474 survivors, 595 controls, 209 survivor’s parent and 253 control’s parent replied. The mean age of survivors at the time of the study was 18.4 years. The mean length of survival was 12.3 years, and the mean age at diagnosis 5.5 years. The most of the Finnish childhood cancer survivors evaluated that their HRQL as good. Survivors rated their HRQL equal or higher than their controls. The only dimension where the survivors scored poorer than the controls was the 15D mobility dimension. Survivors of childhood cancer did not suffer from significant fatigue. There were subgroups of childhood cancer survivors who had poorer level of HRQL, and suffered from fatigue more than the reference group. The demographic factors that associated with poorer HRQL were female gender, greater weight, living alone, need of remedial education, an additional non-cancer diagnosis, survivors with siblings, and self-reported unhappiness. Disease-related factors that associated with poorer HRQL were higher age at the time of diagnosis, the diagnosis of Wilms tumor, neuroblastoma, or osteosarcoma, and treatment with stem cell transplantation. The factors associated with more fatigue in survivors were male gender, older age at evaluation, the need of remedial education at school, lower overall average grade in the latest school marks report, length of survival more than 10 years, lower HRQL-scores, and a sarcoma diagnosis. However, all the used demographic and disease related factors explained only about one third of the variation in the HRQL scores. In open questions, the survivors were most worried about their physical health, but were also worried about their mental health, cancer inheritance, late-effects, and fertility and relapse issues. It seems that there are subgroups of survivors who need and could benefit from ongoing long-term follow-up. In the future, the survivors of childhood cancer need more information about their physical and mental health, as well as on their cancer inheritance, possible late-effects including fertility issues, and on the risk of relapse.

Indicent reporting in shipping. Experiences and best practices for the Baltic Sea

Incident and near miss reporting is one of the proactive tools of safety management. By analyzing incidents and near misses and by corrective actions, severe accidents can potentially be avoided. Near miss and incident reporting is widely used in many riskprone industries such as aviation or chemical industry. In shipping incident and near miss reporting is required by the mandatory safety management system International Safety Management Code (ISM Code). However, in several studies the conclusion has been that incidents are reported poorly in the shipping industry. The aim of this report is to highlight the best practices for incident reporting in shipping and to support the shipping industry in the better utilization of incident reporting information. The study consists of three parts: 1) voluntary, shared reporting systems in shipping (international experiences), 2) interview study at four shipping companies in Sweden and in Finland (best practices), 3) expert workshop on incident reporting (problems and solutions). Preconditions for a functional reporting system are an existing no blame culture, commitment of the top management, feedback, good communication, training and an easy-to-use system. Although preconditions are met, problems can still appear, for example due to psychological, interpersonal or nationality-related reasons. In order to keep the reporting system functioning, the shipping company must be committed to maintain and develop the system and to tackle the problems. The whole reporting process from compiling, handling and analyzing a report, creating corrective actions and implementing them has to be handled properly in order to gain benefits from the reporting system. In addition to avoiding accidents, the functional reporting system can also offer other benefits by increasing safety awareness, by improving the overall safety and working conditions onboard, by enhancing team work and communication onboard and between ships and the land-based organization of shipping companies. Voluntary shared reporting systems are supported in the shipping industry in principle, but their development in the Baltic Sea is still in its infancy and the potential benefits of sharing the reports have not been realized. On the basis of this study we recommend that a common reporting system be developed for the Baltic Sea area which all the ships operating in the area could use regardless of their flag. Such a wider system could prevent some of the problems related to the current national systems. There would be more incident cases available in the database and this would support anonymity and thus encourage shipping companies to report to a shared database more frequently. A shared reporting system would contribute to the sharing of experiences and to the wider use of incident information in the shipping industry.

Induction practices : experiences of newly qualified teachers

The thesis consists of four studies (articles I–IV) and a comprehensive summary. The aim is to deepen understanding and knowledge of newly qualified teachers’ experiences of their induction practices. The research interest thus reflects the ambition to strengthen the research-based platform for support measures. The aim can be specified in the following four sub-areas: to scrutinise NQTs’ experiences of the profession in the transition from education to work (study I), to describe and analyse NQTs’ experiences of their first encounters with school and classroom (study II), to explore NQTs’ experiences of their relationships within the school community (study III), to view NQTs’ experiences of support through peer-group mentoring as part of the wider aim of collaboration and assessment (study IV). The overall theoretical perspective constitutes teachers’ professional development. Induction forms an essential part of this continuum and can primarily be seen as a socialisation process into the profession and the social working environment of schools, as a unique phase of teachers’ development contributing to certain experiences, and as a formal programme designed to support new teachers. These lines of research are initiated in the separate studies (I–IV) and deepened in the theoretical part of the comprehensive summary. In order to appropriately understand induction as a specific practice the lines of research are in the end united and discussed with help of practice theory. More precisely the theory of practice architectures, including semantic space, physical space-time and social space, are used. The methodological approach to integrating the four studies is above all represented by abduction and meta-synthesis. Data has been collected through a questionnaire survey, with mainly open-ended questions, and altogether ten focus group meetings with newly qualified primary school teachers in 2007–2008. The teachers (n=88 in questionnaire, n=17 in focus groups), had between one and three years of teaching experience. Qualitative content analysis and narrative analysis were used when analysing the data. What is then the collected picture of induction or the first years in the profession if scrutinising the results presented in the articles? Four dimensions seem especially to permeate the studies and emerge when they are put together. The first dimension, the relational ˗ emotional, captures the social nature of induction and teacher’s work and the emotional character intimately intertwined. The second dimension, the tensional ˗ mutable, illustrates the intense pace of induction, together with the diffuse and unclear character of a teacher’s job. The third dimension, the instructive ˗ developmental, depicts induction as a unique and intensive phase of learning, maturity and professional development. Finally, the fourth dimension, the reciprocal ˗ professional, stresses the importance of reciprocity and collaboration in induction, both formally and informally. The outlined four dimensions, or integration of results, describing induction from the experiences of new teachers, constitute part of a new synthesis, induction practice. This synthesis was generated from viewing the integrated results through the theoretical lens of practice architecture and the three spaces, semantic space, physical space-time and social space. In this way, a more comprehensive, refined and partially new architecture of teachers’ induction practices are presented and discussed.

Administration of Bifidobacterium animalis subsp. lactis BB-12 and xylitol with a novel pacifier in early childhood

Probiotic bifidobacteria are used in the prevention and treatment of childhood diseases. On the other hand, these bacteria are also connected to dental caries. The purpose of the present work was to test a food supplement containing Bifidobacterium animalis subsp. lactis BB-12 (B. lactis BB-12) and xylitol, and to investigate its health effects, properties and safety when used in a novel pacifier in early childhood. In a double-blind, placebo-controlled trial, newborn infants (n=163) were assigned randomly to receive B. lactis BB-12, xylitol, or sorbitol from the age of 1– 2 monthsto 2 years with a pacifier or a spoon. Children were followed up to four years of age. A part of the parents participating in the clinical trial evaluated the feasibility of the novel administration method. The pattern of tablet release from the pouch of the pacifier was tested in adults. The food supplement tablet containing B. lactis BB-12 and xylitol could be delivered in a safe and controlled way with the novel pacifier. The early administration of B. lactis BB-12 did not result in permanent oral colonization of this probiotic or affect the colonization of mutans streptococci in early childhood. Moreover, B. lactis BB-12 did not increase the occurrence of caries. Controlled administration of B. lactis BB-12 significantly reduced the incidence of respiratory infections during the first eight months of life in a Finnish population with breastfed infants. To conclude, administration of B. lactis BB-12 in early childhood is safe with regard to the future dental health of the child. In addition, B. lactis BB-12 may add to the protection against respiratory infections provided by human breast milk in infancy.

Partnerships in sustainable urban development : experiences from Sweden and Finland

This thesis examines partnerships in sustainable urban development projects. Achievement of urban development requires the involvement of several parties. The cooperation of the actors of sustainable urban development is achieved by forming partnerships. The purpose of this study is to find solutions and best practices for the management of partnerships in sustainable residential development projects by examining partnerships and their success factors in sustainable urban development. The impact of the roles, responsibilities and interactions of actors taking part in the processes of creating sustainable urban development in outcomes of these development projects and thus on the overall success of accomplishing sustainable development raises the question of how to manage these collaborations. In order to be able to find the best ways of organizing sustainable urban development projects, it is crucial to have the knowledge of how the interactions between all the parties involved in the development can be managed successfully to give the best outcomes. The main research question of this study is: What are the characteristics of successful partnerships in sustainable urban development projects? In order to answer this question, the success factors in partnerships between actors of sustainable urban development are analyzed. In addition, challenges related to these partnerships are examined to get a more comprehensive view of the features of these collaborative ventures and the obstacles that have to be overcome to ensure the successfulness of cooperation. The research approach is multiple case study comprising four cases. The empirical data has been gathered through theme interviews from four different sustainable residential district projects in Sweden and Finland. A comparative analysis of the cases is performed, based on which seven success factors of partnerships in sustainable urban development supported by the prevailing theories are formulated. In addition, challenges faced by projects regarding the partnerships are discussed.

A university fund for Article Processing Charges - experiences from Lund University

Presentation at the Nordic Perspectives on Open Access and Open Science seminar, Helsinki, October 15, 2013

Quality enhancement in teacher education : Tanzanian teacher educators’ conceptions and experiences

The overall aim of this study was to investigate and examine teacher educators’ conceptions and experiences of quality of teacher education. The research interest therefore was two-fold: a) to deepen understanding of the concept quality and b) scrutinize experiences of teacher educators of quality enhancement. To achieve this ambition the study was conducted in the context of a newly established university college-based teacher education in Tanzania. Two research questions guided the study. The first focused on investigating how teacher educators conceived quality in the domain of teacher education and the second intended to explore teacher educators’ experiences of quality enhancement. The theoretical framework of the study centered on the concepts of teacher education, quality, and criteria for quality enhancement. Phenomenographic and phenomenological approaches under the main umbrella of qualitative research design were selected. Twenty five teacher educators participated in the study. Interviews were used for the collection of the data. The results of the first research question, in brief, indicate that teacher educators’ conceptions of quality are expressed in two main categories, namely, outstanding academic scholarship and adequate professional scholarship. Quality as outstanding academic scholarship was illustrated by two subcategories: excellence and positive transformation. While the former was composed of two aspects, the latter was demonstrated by three aspects. Quality as adequate professional scholarship was described in three sub-categories. The first was improved teaching competency, consisting of two aspects. The second was conscious research orientation, which is displayed by three aspects, and the last was enhancing the ability to reflect, represented by two aspects. The results of the second research question, which focused on exploring teacher educators’ experience of quality enhancement, were classified into two main categories of description: insufficient programs of teacher education and unsatisfactory professional development of teacher educators. From the two categories, the strengths, weaknesses, opportunities and challenges related to programs of educating teachers, particularly curriculum development and implementation, and the professional development of educators, were exposed. Since the ambition of conducting the study was to deepen the understanding by producing insight that would act as a platform for appraising and enhancing the quality of teacher education, the results hopefully can be used for the development of the quality of teacher education in Tanzania.