Maahanmuuttajaoppilaat erityiskouluissa

Immigrant Pupils in Special Education Schools The study focused on the opinions of immigrant pupils in the 1st–9th grades of basic education in four special education schools of the City of Turku and in need of special support about the following: 1. Their difficulties in going to school in general education before the transfer to a special education school. 2. Their opinions about the transfer process to special education and the changes in their school practice after being transferred to a special education school. 3. Their experiences about their school and coping in special education school. The study strengthened the idea that immigrant pupils need positive special treatment, linguistic support, individual guidance, small teaching groups and operating models that promote well-being on their integration and education path. The central educational idea of inclusive education is based on deconstructing the power structures concerning gender, ethnicity and “race” and approval of differences in the pupils. Shifting the emphasis from the pupil to working on the learning environment has resulted in special education no longer being primarily separate special education tied to a certain place, but directing the teaching more towards individuality. The central dimension of intercultural competence of a teacher working in a multicultural class seems to be the attitudes and approaches to a different pupil; the teacher must be interculturally sensitive when facing children and young people from a foreign culture. Education and teaching affect every sector of the pupil’s well-being. Learning and learning results have a connection with teaching, education and well-being. Every sector is important for the going to school and integration of an immigrant pupil in need of special support. The basis of the study is the equality of opportunities and the humanistic idea of the human being in the Finnish education policy. The immigrant pupils selected for the study represented the following language groups: Arabian, Albanian, Somali, Russian and Vietnamese. In the four special education schools, the number of immigrant pupils belonging to these language groups (2004) totalled 104. A total of 89 pupils i.e. 86% answered the questionnaire, which is sufficient considering the generalisation of the study. Although this is basically a quantitative study, the interviewing method was used in part of the study, because the questionnaires were in Finnish and consequently, it was difficult for some immigrant pupils to understand them. Understanding the questions was also affected by the fact that the age distribution in the study was very wide (7–18). According to the results of the study, the immigrants felt that the biggest drawbacks in general education were their inability to speak Finnish and lack of concentration. The actual process of being transferred to a special education class remained unclear for immigrant pupils, and they could do very little about the transfer themselves. The results show that immigrant pupils coped well in special education school; they felt that their learning ability and concentration improved in the small groups of the special education school. They considered the individual support given in the special education schools to be useful. The lower-grade immigrant pupils had a more positive attitude towards special education school than the upper-grade immigrant pupils. In all the special education schools the immigrant pupils experienced that they were in a good position in the class; girls felt this even a little more strongly than boys. The teacher-pupil-relationship was felt to be good. School bullying being so common was a negative feature experienced by immigrant pupils, who were often targets or bullies themselves. Immigrant pupils believed in their success at school and in the opportunities offered by special education schools. Generally they were of the opinion that pupils are not labelled by special school; however, upper-grade immigrant pupils were more hesitant than lower-grade immigrant pupils. This study aimed at bringing out the immigrant pupils’ own opinions. Teaching immigrant pupils in special education schools has not been very much studied in Finland, which made the topic new and even more challenging.

Kunnan optimikoko Suomessa

Tämän diplomityön päätavoitteena on tutkia voidaanko kunnille löytää optimaalinen kokoluokka Suomessa. Työn muita tavoitteita on tutkia voidaanko vastaava optimikoko löytää myös kahdelle kunnan tehtävistä, joiksi tässä tutkimuksessa on valittu sosiaali- ja terveystoimi sekä perusopetus. Lisäksi työssä tutkitaan miten paljon maakuntien välillä on tehokkuuseroja. Tutkimusmenetelminä on käytetty laskelmia, case -analyysiä, tilinpäätösanalyysiä ja tilastollisia menetelmiä. Työssä tehokkuutta mitattiin neljällä osa-alueella, jotka olivat tehokkuus toimintakatteen suhteen, tehokkuus toimintakustannusten suhteen, sosiaali- ja terveystoimen tehokkuus sekä perusopetuksen tehokkuus. Optimikoon määrityksien yhteydessä saatuihin tehokkuuslukuihin yhdistettiin kuntakohtaiset toimintaympäristötekijät kuten työttömyys ja väestön ikäjakauma. Työn lopputulos oli, että kunnan optimikoko Suomessa olisi noin 35 tuhatta asukasta, mutta erot välillä 25-40 tuhatta asukasta olivat pienet. Kustannustietojen perusteella kaikkein tehottomin kuntakokoluokka oli alle 3 tuhannen asukkaan kuntakoko, mutta toimintaympäristötekijöiden huomioimisen jälkeen kaikkein tehottomimmaksi osoittautui suurimmat yli 120 tuhannen asukkaan kunnat.

Salivary gland cancer in Finland: Incidence, histological distribution, outcome and prognostic factors

Salivary gland cancer (SGC) is a rare cancer. The histological classification of SGC is complex and its biological behavior highly variable: it may vary from a low-grade tumor to a high-grade and often fatal malignancy. These circumstances make this cancer a diagnostic and therapeutic challenge. Older age and exposure to ionizing radiation are known risk factors. The mainstay of treatment is surgery combined with adjuvant radiation therapy, when appropriate. In addition to the histological type, the only well known prognostic factor is the TNM classification, which describes the tumor size and the amount of metastases. This study was performed using a full population-based nationwide cohort of SGC patients and tumors diagnosed in Finland in 1991-1996. The annual incidence of SGC in the entire population was, on average, 47.7 per year. By histological re-evaluation of 237 specimens the most frequent histological types were the adenoid cystic carcinoma (n=65; 27%), the mucoepidermoid carcinoma (n=45; 19%) and the acinic cell carcinoma (n=41; 17%). The highest 10-year disease-specific survival rate occurred among patients with acinic cell carcinoma (90%), followed by mucoepidermoid carcinoma (81%) and adenoid cystic carcinoma (60%). A high volume-corrected index (VCI) of Ki-67 correlated with worse survival of patients with SGC. Computer-assisted morphometric analyses of CD34-positive vessels indicated an unfavorable prognosis for patients with mucoepidermoid carcinoma and an association with poor survival among patients with acinic cell carcinoma. A high level of expression of matrix metalloproteinase-9 (MMP-9) showed a trend for a poorer prognosis in salivary duct carcinoma, and a high level of MMP-13 and a low level of MMP-1 had a trend for a poorer prognosis of patients with SGC. A low level of MMP-7 was associated with a poor prognosis of patients with acinic cell and mucoepidermoid carcinoma.

Effect of bariatric surgery on adipose tissue distribution in severely obese patients

Background and aim: Bariatric surgery leads to sustain weight loss, improve metabolic and lipids profiles and ultimately leads to remission of type 2 diabetes (T2DM) in some obese individuals. The aim of the project is to evaluate the effect of bariatric on abdominal fat distribution in severely obese T2DM and non-T2DM obese patients. Study design and methods: A total of 23 morbidly obese subjects (mean ± SD body mass index 43.0 ± 3.6 kg/m2, age 46.5 ± 9.0 years) were recruited from the lager multicenter SLEEVEPASS studies (ClinicalTrials.gov/NCT00793143). 10 healthy age-matched non-obese individuals served as controls. The obese patients were studied before and 6 months after surgery. At baseline, there were 9 T2DMs and 14 non-diabetics. After surgery, there were 5 remitters and 4 nonremitters. Whole body magnetic resonance imaging including the abdominal regions was performed for the obese subjects before and 6 months after surgery and for the controls once. Abdominal fat were compartmentalized and analyzed. Results: At 6 months of follow-up, BMI in the obese decreased significantly (from 43 ± 4 to 33 ± 2 kg/m2, p < 0.001) with substantial improvement in whole body insulin sensitivity (from 12.2 ± 5.7 to 23.3 ± 8.1 µmol/kg/min, p < 0.001). Intraperitoneal fat mass decreased by 46% (from 3.4 ± 1.1 to 1.9± 1.0 kg, p < 0.001) more than the rest of the compartments. Abdominal visceral compartments in obese correlated with glycemic status independent of surgery. Pre-surgery posterior deep and intraperitoneal fat mass were better predictors of post-surgery glycemic status in obese. Remitters showed significant improvement in whole body insulin sensitivity (from 9.1 ± 2.1 to 20.9 ± 8.4 µmol/kg/min, p = 0.02), fasting glucose decreased significant only in nonremitters (from 7.1 ± 1.1 to 6.0 ± 0.8 mmol/l, p = 0.05) after surgery. There were no differences in extraperitoneal fat mass in remitters and superficial subcutaneous fat in non-remitters but all other compartments decreased significantly 6 months after the surgery Conclusion: Both deep subcutaneous and visceral fat are important contributors to glycemic status in obese subjects. Whereas visceral fat compartments are directly involved in T2DM, superficial subcutaneous may have offered protection against T2DM in obese subjects.