Pertussis: infection, vaccination and gene polymorphisms

Pertussis or whooping cough is a human respiratory tract infection and a vaccine-preventable disease that is caused by Bordetella pertussis bacteria. Pertussis vaccination has been part of the Finnish national vaccine program since 1952. Despite extensive vaccinations, the incidence of pertussis has increased in many countries during the last decades. Large epidemics have been observed also in countries with high vaccine coverage. Inter-individual variation in immune responses is always encountered after vaccination. Low vaccine responses may cause vulnerability to pertussis even straight after vaccination. Reasons for low responses are not fully understood. The innate immune system is responsible for the initial recognition of pathogens and vaccine antigens. The role of innate immunity on pertussis immunity has not been thoroughly investigated. Mannose-binding lectin (MBL) and toll-like receptor 4 (TLR4) are important molecules of the innate immune system and in the recognition of pathogens. Cytokines form a signaling network that have a notable role in immune responses after infections as well as after vaccinations. Single nucleotide polymorphism (SNP) is common in genes encoding these molecules and the polymorphisms have been reported to affect vaccine response after viral and bacterial vaccines. This study investigated the gene polymorphisms of MBL2, TLR4 and interleukin (IL)-10 promoter and their association with vaccine responses after acellular pertussis (aP) vaccination in Finnish adolescents and infants. Cell-mediated immune responses were investigated ten years after the previous pertussis vaccinations in young adults. In addition, the role of MBL deficiency in pertussis infection susceptibility was evaluated. The results of this study show that subjects with TLR4 polymorphism had lower antibody production and persistence after aP vaccination compared with normal allele. A specific SNP in the TLR4 gene was associated with decreased antibody responses and persistence in adolescents after aP booster vaccination. Cell-mediated immune responses were partly detected ten years after the previous vaccination; booster vaccine clearly enhanced the responses. In addition, subjects with IL-10 polymorphism had altered cell-mediated immune responses. MBL deficiency was found to be more frequent in pertussis patients than healthy controls but the polymorphism of MBL2 was not associated with antibody responses after acellular pertussis vaccination. The novel finding of this study was that genetic variation in the innate immune system seems to play a role in altered pertussis vaccine responses as well as in pertussis infection. These new findings enlighten the mechanisms behind the low responses after pertussis vaccination and help to predict risk factors related to this phenomenon.

Ohjelmoinnin opetus peruskoulussa: toiminnallisuutta ja graafista ohjelmointikieltä hyödyntävien opetusmenetelmien vertailu

Ohjelmoinnin opettaminen yleissivistävänä oppiaineena on viime aikoina herättänyt kiinnostusta Suomessa ja muualla maailmassa. Esimerkiksi Suomen opetushallituksen määrittämien, vuonna 2016 käyttöön otettavien peruskoulun opintosuunnitelman perusteiden mukaan, ohjelmointitaitoja aletaan opettaa suomalaisissa peruskouluissa ensimmäiseltä luokalta alkaen. Ohjelmointia ei olla lisäämässä omaksi oppiaineekseen, vaan sen opetuksen on tarkoitus tapahtua muiden oppiaineiden, kuten matematiikan yhteydessä. Tämä tutkimus käsittelee yleissivistävää ohjelmoinnin opetusta yleisesti, käy läpi yleisimpiä haasteita ohjelmoinnin oppimisessa ja tarkastelee erilaisten opetusmenetelmien soveltuvuutta erityisesti nuorten oppilaiden opettamiseen. Tutkimusta varten toteutettiin verkkoympäristössä toimiva, noin 9–12-vuotiaille oppilaille suunnattu graafista ohjelmointikieltä ja visuaalisuutta tehokkaasti hyödyntävä oppimissovellus. Oppimissovelluksen avulla toteutettiin alakoulun neljänsien luokkien kanssa vertailututkimus, jossa graafisella ohjelmointikielellä tapahtuvan opetuksen toimivuutta vertailtiin toiseen opetusmenetelmään, jossa oppilaat tutustuivat ohjelmoinnin perusteisiin toiminnallisten leikkien avulla. Vertailututkimuksessa kahden neljännen luokan oppilaat suorittivat samankaltaisia, ohjelmoinnin peruskäsitteisiin liittyviä ohjelmointitehtäviä molemmilla opetus-menetelmillä. Tutkimuksen tavoitteena oli selvittää alakouluoppilaiden nykyistä ohjelmointiosaamista, sitä minkälaisen vastaanoton ohjelmoinnin opetus alakouluoppilailta saa, onko erilaisilla opetusmenetelmillä merkitystä opetuksen toteutuksen kannalta ja näkyykö eri opetusmenetelmillä opetettujen luokkien oppimistuloksissa eroja. Oppilaat suhtautuivat kumpaankin opetusmenetelmään myönteisesti, ja osoittivat kiinnostusta ohjelmoinnin opiskeluun. Sisällöllisesti oppitunneille oli varattu turhan paljon materiaalia, mutta esimerkiksi yhden keskeisimmän aiheen, eli toiston käsitteen oppimisessa aktiivisilla leikeillä harjoitellut luokka osoitti huomattavasti graafisella ohjelmointikielellä harjoitellutta luokkaa parempaa osaamista oppitunnin jälkeen. Ohjelmakoodin peräkkäisyyteen liittyvä osaaminen oli neljäsluokkalaisilla hyvin hallussa jo ennen ohjelmointiharjoituksia. Aiheeseen liittyvän taustatutkimuksen ja luokkien opettajien haastatteluiden perusteella havaittiin koulujen valmiuksien opetussuunnitelmauudistuksen mukaiseen ohjelmoinnin opettamiseen olevan vielä heikolla tasolla.

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Proactive and Preventive Student Welfare Activities in Finnish Preschool and Elementary School: Handling of Transition to Formal Schooling and a National Anti-Bullying Program as Examples

Prerequisites and effects of proactive and preventive psycho-social student welfare activities in Finnish preschool and elementary school were of interest in the present thesis. So far, Finnish student welfare work has mainly focused on interventions and individuals, and the voluminous possibilities to enhance well-being of all students as a part of everyday school work have not been fully exploited. Consequently, in this thesis three goals were set: (1) To present concrete examples of proactive and preventive psycho-social student welfare activities in Finnish basic education; (2) To investigate measurable positive effects of proactive and preventive activities; and (3) To investigate implementation of proactive and preventive activities in ecological contexts. Two prominent phenomena in preschool and elementary school years—transition to formal schooling and school bullying—were chosen as examples of critical situations that are appropriate targets for proactive and preventive psycho-social student welfare activities. Until lately, the procedures concerning both school transitions and school bullying have been rather problem-focused and reactive in nature. Theoretically, we lean on the bioecological model of development by Bronfenbrenner and Morris with concentric micro-, meso-, exo- and macrosystems. Data were drawn from two large-scale research projects, the longitudinal First Steps Study: Interactive Learning in the Child–Parent– Teacher Triangle, and the Evaluation Study of the National Antibullying Program KiVa. In Study I, we found that the academic skills of children from preschool–elementary school pairs that implemented several supportive activities during the preschool year developed more quickly from preschool to Grade 1 compared with the skills of children from pairs that used fewer practices. In Study II, we focused on possible effects of proactive and preventive actions on teachers and found that participation in the KiVa antibullying program influenced teachers‘ self-evaluated competence to tackle bullying. In Studies III and IV, we investigated factors that affect implementation rate of these proactive and preventive actions. In Study III, we found that principal‘s commitment and support for antibullying work has a clear-cut positive effect on implementation adherence of student lessons of the KiVa antibullying program. The more teachers experience support for and commitment to anti-bullying work from their principal, the more they report having covered KiVa student lessons and topics. In Study IV, we wanted to find out why some schools implement several useful and inexpensive transition practices, whereas other schools use only a few of them. We were interested in broadening the scope and looking at local-level (exosystem) qualities, and, in fact, the local-level activities and guidelines, along with teacherreported importance of the transition practices, were the only factors significantly associated with the implementation rate of transition practices between elementary schools and partner preschools. Teacher- and school-level factors available in this study turned out to be mostly not significant. To summarize, the results confirm that school-based promotion and prevention activities may have beneficial effects not only on students but also on teachers. Second, various top-down processes, such as engagement at the level of elementary school principals or local administration may enhance implementation of these beneficial activities. The main message is that when aiming to support the lives of children the primary focus should be on adults. In future, promotion of psychosocial well-being and the intrinsic value of inter- and intrapersonal skills need to be strengthened in the Finnish educational systems. Future research efforts in student welfare and school psychology, as well as focused training for psychologists in educational contexts, should be encouraged in the departments of psychology and education in Finnish universities. Moreover, a specific research centre for school health and well-being should be established.