Kuka minä olen? Narratiivinen näkökulma identiteetin rakentumiseen CP-vammaisten aikuisten kertomuksissa

Pro gradu -tutkielmani lähtökohtana on, että kertomukset välittävät ja rakentavat tietoa. Tarkastelen narratiivisesta näkökulmasta sitä, miten CP-vammaisten aikuisten identiteetti rakentuu kertomuksissa. Tutkimukseni taustalla on ajatus siitä, että yksilö voi tietoisesti muodostaa omaa identiteettiään kertomusten avulla. Aineisto on Invalidiliitto ry:n ja Suomen CP-liitto ry:n yhteisen CP-vammaisten aikuisten hyvinvointi ja kuntoutus elämänkaarella –projektin (2007–2010) myötä kerätty elämäkerta-aineisto. Aineistoni koostuu kahdenkymmenen (20) CP-vammaisen aikuisen kertomuksesta, joissa he kertovat elämästään CP-vamman kanssa, elämänvaiheistaan ja mahdollisuuksistaan yhteiskunnassa. Etsin kertomuksista yhteneväisiä teemoja ja käytän kategorioiden muodostamisessa apuna Catherine Kohler Riessmanin (2004, 2008) huomioita narratiivisesta temaattisesta analysoinnista. Vilma Hännisen (1999) esittelemien identiteettitasojen sekä Kirsi Juhilan (2004) esiintuoman leimatun identiteetin käsitteen avulla muodostan aineistosta identiteettikategorioita. Tarkastelen kertomusten avulla, millaisia tulkintoja ja merkityksiä kirjoittajat antavat CP-vammalle ja vammaisuudelle sekä tuon esiin, millaisiin identiteettikategorioihin kirjoittajien identiteetti tulkintani mukaan sijoittuu. Vammaisten ja vammattomien välinen vastakkainasettelu nousee esiin muiden kategorisointina ja kirjoittajien omana kokemuksena, mutta aina rajanveto ei ole tarpeellista. CP-vamma rajoittaa kirjoittajia tietyissä asioissa, mutta tietyissä asioissa vamma on heille rikkaus, syntymälahja. CP-vamma ilmenee vain yhtenä ominaisuutena, ja vammaisuus on hyväksytty osaksi omaa identiteettiä. Identiteetti rakentuu kertomuksissa prosessina, sillä kirjoittajat hallitsevat erilaisia ja muuttuvia identiteettejä. Kirjoittajat rakentavat sosiaalisia identiteettejä erilaisissa vuorovaikutustilanteissa. Henkilökohtainen elämä ja perhe rakentavat kirjoittajille identiteettiä, mutta he hallitsevat myös yhteiskunnallisella tasolla erilaisia rooleja. Identiteetit vaihtelevat myös elämäntilanteiden mukaan. Kirjoittajat vastustavat ”CP-vammaisen roolia”, sillä vamma yksinään ei määrittele heitä. Varsinkin elämässä koetut käännekohdat saivat kirjoittajat rakentamaan omaa identiteettiään uudelleen; CP-vamma saa merkityksensä identiteetin yhtenä osana. Tutkimuksestani käy ilmi, miten kirjoittajat kyseenalaistavat heille annetun leimatun identiteetin ja neuvottelevat itselleen vaihtelevia identiteettejä. Työni perusteella vamma määrittää heitä yhtä lailla kuin jokin muukin ominaisuus, sillä vammaisuuden ei koeta automaattisesti merkitsevän samaa asiaa kuin identiteetti.

Sähköpyörätuolin jalkaohjauslaite

Opinnäytetyömme käsitti tuotekehitysprojektin, jossa suunnittelimme, kehitimme ja valmistimme jalkaohjauslaitteen sähköpyörätuoliin. Idea tuotekehitysprojektiin tuli Pasi Mäkirannalta. Tuotekehitysprojektin ideana oli kehittää parempi ja käytännöllisempi jalkaohjauslaite. Jalkaohjauslaitteen pienestä käyttäjäryhmästä johtuen markkinoilla on vain muutama versio jalkaohjauslaitteesta. Jaoimme tuotekehitysprojektin neljään vaiheeseen: käynnistäminen, luonnostelu, kehittäminen ja viimeistely. Tämän selkeytetyn työvaihejaon koimme hyväksi pohjaksi tuotekehitysprojektille. Käynnistämisvaiheessa keräsimme tarvittavaa tietoa jalkaohjauslaittesta ja tutustuimme Pasi Mäkirannan kautta yhteen malliin. Teimme myös kehityskuvauksen, jolla hahmotimme itsellemme tuotekehitysprojektin kokonaisuutta. Luonnosteluvaiheessa mietimme vaihtoehtoisia ratkaisuja ja piirsimme useita luonnoksia. Halusimme painottaa laitteen suorituskykyä, huoltoa, turvallisuutta ja ulkönäköä. Kehittelyvaiheessa aloimme rakentamaan ensimmäistä prototyyppiä. Arvioimme ensimmäisen prototyypin heikkoudet ja ongelmat, joita pyrimme ratkaisemaan toista prototyyppiä rakennettaessa. Viimeistelyvaiheessa hiomme toisen prototyypin yksityiskohtia ja teimme kokoonpanokuvat ja rakennusohjeet. Tuotekehitysprojektissa jalkaohjauslaitetta rakentaessamme otimme huomioon myös seuraavia asioita: laitteen ergonomiset vaatimukset sekä pääkäyttäjäryhmien ALS:n ja CP-oireyhtymän asettamat vaatimukset ohjainlaitteelta. Jalkaohjauslaite on tarkoitettu niille käyttäjille, joille jalkaohjain on soveltuvin ohjainmuoto sähköpyörätuoliin. Vaikka käyttäjäryhmä on pieni, on jalkaohjain käyttäjälleen tärkeä väline, joka mahdollistaa itsenäisen liikumisen ja auttaa selvyitymään arjen toiminnoissa. Koimme vieneemme jalkaohjaimen tuotekehitysprojektia eteenpäin omalta osaltamme.

The Vulnerable Brain and Very Preterm Infants - Findings from the PIPARI-Study

Preterm birth is a risk for normal brain development. Brain maturation that normally happens in the uterus is in very preterm infants a developmental challenge during their stay in a neonatal intensive care unit (NICU). Typical brain injuries of preterm infants include ischemic injuries, brain haemorrhages, ventricular dilatation (VD), and reduced brain volumes. Brain injury is a serious complication of prematurity leading to possible long term consequences for the neurodevelopment of the very low birth weight (VLBW) infant, such as cerebral palsy (CP), hearing impairments, vision problems, and delay in cognitive development.There is a need for further studies to ascertain the potential risk factors and their causal relationships to brain vulnerability, growth and development in the increasing number of surviving VLBW infants. This thesis consists of four studies evaluating the definitions, causes and consequences of brain lesions in VLBW(<1500g) or very low gestationalage (VLGA) (gestational age <32 gestational weeks) infants. We showed that the redistribution of fetal blood flow is a risk factor for smaller brain volumes at term. In addition,we showed that brain lesions related to prematurity are not associated with increased spontaneous crying behaviour or circadian rhythm development in infancy. However, the preterm infants began to fuss more often and were held more than term infants at five months of age. Furthermore, we showed that VD is associated with brain lesions and smaller brain volumes. Therefore, brain magneticresonance imaging can be recommended for infants with VD. VD together with other brain pathology is a risk factor for the onset of developmental impairments in VLBW/VLGA infants at two years of age.

Cuticular and Suberin Polymers of Edible Plants. Analysis by Gas Chromatographic-Mass Spectrometric and Solid State Spectroscopic Methods

Cutin and suberin are structural and protective polymers of plant surfaces. The epidermal cells of the aerial parts of plants are covered with an extracellular cuticular layer, which consists of polyester cutin, highly resistant cutan, cuticular waxes and polysaccharides which link the layer to the epidermal cells. A similar protective layer is formed by a polyaromatic-polyaliphatic biopolymer suberin, which is present particularly in the cell walls of the phellem layer of periderm of the underground parts of plants (e.g. roots and tubers) and the bark of trees. In addition, suberization is also a major factor in wound healing and wound periderm formation regardless of the plants’ tissue. Knowledge of the composition and functions of cuticular and suberin polymers is important for understanding the physiological properties for the plants and for nutritional quality when these plants are consumed as foods. The aims of the practical work were to assess the chemical composition of cuticular polymers of several northern berries and seeds and suberin of two varieties of potatoes. Cutin and suberin were studied as isolated polymers and further after depolymerization as soluble monomers and solid residues. Chemical and enzymatic depolymerization techniques were compared and a new chemical depolymerization method was developed. Gas chromatographic analysis with mass spectrometric detection (GC-MS) was used to assess the monomer compositions. Polymer investigations were conducted with solid state carbon-13 cross polarization magic angle spinning nuclear magnetic resonance spectroscopy (13C CP-MAS NMR), Fourier transform infrared spectroscopy (FTIR) and microscopic analysis. Furthermore, the development of suberin over one year of post-harvest storage was investigated and the cuticular layers from berries grown in the North and South of Finland were compared. The results show that the amounts of isolated cuticular layers and cutin monomers, as well as monomeric compositions vary greatly between the berries. The monomer composition of seeds was found to differ from the corresponding berry peel monomers. The berry cutin monomers were composed mostly of long-chain aliphatic ω-hydroxy acids, with various mid-chain functionalities (double-bonds, epoxy, hydroxy and keto groups). Substituted α,ω-diacids predominated over ω-hydroxy acids in potato suberin monomers and slight differences were found between the varieties. The newly-developed closed tube chemical method was found to be suitable for cutin and suberin analysis and preferred over the solvent-consuming and laborious reflux method. Enzymatic hydrolysis with cutinase was less effective than chemical methanolysis and showed specificity towards α,ω-diacid bonds. According to ₁₃C CP-MAS NMR and FTIR, the depolymerization residues contained significant amounts of aromatic structures, polysaccharides and possible cutan-type aliphatic moieties. Cultivation location seems to have effect on cuticular composition. The materials studied contained significant amounts of different types of biopolymers that could be utilized for several purposes with or without further processing. The importance of the so-called waste material from industrial processes of berries and potatoes as a source of either dietary fiber or specialty chemicals should be further investigated in detail. The evident impact of cuticular and suberin polymers, among other fiber components, on human health should be investigated in clinical trials. These by-product materials may be used as value-added fiber fractions in the food industry and as raw materials for specialty chemicals such as lubricants and emulsifiers, or as building blocks for novel polymers.

The Structural Basis for inorganic Pyrophosphatase Catalysis and Regulation

Inorganic pyrophosphatases (PPases) are essential enzymes for every living cell. PPases provide the necessary thermodynamic pull for many biosynthetic reactions by hydrolyzing pyrophosphate. There are two types of PPases: integral membrane-bound and soluble enzymes. The latter type is divided into two non-homologous protein families, I and II. Family I PPases are present in all kingdoms of life, whereas family II PPases are only found in prokaryotes, including archae. Family I PPases, particularly that from Saccharomyces cerevisiae, are among the most extensively characterized phosphoryl transfer enzymes. In the present study, we have solved the structures of wild-type and seven active site variants of S. cerevisiae PPase bound to its natural metal cofactor, magnesium ion. These structures have facilitated derivation of the complete enzyme reaction scheme for PPase, fulfilling structures of all the reaction intermediates. The main focus in this study was on a novel subfamily of family II PPases (CBSPPase) containing a large insert formed by two CBS domains and a DRTGG domain within the catalytic domain. The CBS domain (named after cystathionine beta-synthase in which it was initially identified) usually occurs as tandem pairs with two or four copies in many proteins in all kingdoms of life. The structure formed by a pair of CBS domains is also known as a Bateman domain. CBS domains function as regulatory units, with adenylate ligands as the main effectors. The DRTGG domain (designated based on its most conserved residues) occurs less frequently and only in prokaryotes. Often, the domain co-exists with CBS domains, but its function remains unknown. The key objective of the current study was to explore the structural rearrangements in the CBS domains induced by regulatory adenylate ligands and their functional consequences. Two CBS-PPases were investigated, one from Clostridium perfringens (cpCBS-PPase) containing both CBS and DRTGG domains in its regulatory region and the other from Moorella thermoacetica (mt CBS-PPase) lacking the DRTGG domain. We additionally constructed a separate regulatory region of cpCBS-PPase (cpCBS). Both full-length enzymes and cpCBS formed homodimers. Two structures of the regulatory region of cpCBS-PPase complexed with the inhibitor, AMP, and activator, diadenosine tetraphosphate, were solved. The structures were significantly different, providing information on the structural pathway from bound adenylates to the interface between the regulatory and catalytic parts. To our knowledge, these are the first reported structures of a regulated CBS enzyme, which reveal large conformational changes upon regulator binding. The activator-bound structure was more open, consistent with the different thermostabilities of the activator- and inhibitor-bound forms of cpCBS-PPase. The results of the functional studies on wild-type and variant CBS-PPases provide support for inferences made on the basis of structural analyses. Moreover, these findings indicate that CBS-PPase activity is highly sensitive to adenine nucleotide distribution between AMP, ADP and ATP, and hence to the energy level of the cell. CBS-PPase activity is markedly inhibited at low energy levels, allowing PPi energy to be used for cell survival instead of being converted into heat.

Functional studies on bacterial nucleotide-regulated inorganic pyrophosphatases

CBS domains are ~60 amino acid tandemly repeated regulatory modules forming a widely distributed domain superfamily. Found in thousands of proteins from all kingdoms of life, CBS domains have adopted a variety of functions during evolution, one of which is regulation of enzyme activity through binding of adenylate-containing compounds in a hydrophobic cavity. Mutations in human CBS domain-containing proteins cause hereditary diseases. Inorganic pyrophosphatases (PPases) are ubiquitous enzymes, which pull pyrophosphate (PPi) producing reactions forward by hydrolyzing PPi into phosphate. Of the two nonhomologous soluble PPases, dimeric family II PPases, belonging to the DHH family of phosphoesterases, require a transition metal and magnesium for maximal activity. A quarter of the almost 500 family II PPases, found in bacteria and archaea, contain a 120-250 amino acid N-terminal insertion, comprised of two CBS domains separated in sequence by a DRTGG domain. These enzymes are thus named CBS-PPases. The function of the DRTGG domain in proteins is unknown. The aim of this PhD thesis was to elucidate the structural and functional differences of CBS-PPases in comparison to family II PPases lacking the regulatory insert. To this end, we expressed, purified and characterized the CBS-PPases from Clostridium perfringens (cpCBS-PPase) and Moorella thermoacetica (mtCBS-PPase), the latter lacking a DRTGG domain. Both enzymes are homodimers in solution and display maximal activity against PPi in the presence of Co2+ and Mg2+. Uniquely, the DRTGG domain was found to enable tripolyphosphate hydrolysis at rates similar to that of PPi. Additionally, we found that AMP and ADP inhibit, while ATP and AP4A activate CBSPPases, thus enabling regulation in response to changes in cellular energy status. We then observed substrate- and nucleotide-induced conformational transitions in mtCBS-PPase and found that the enzyme exists in two differentially active conformations, interconverted through substrate binding and resulting in a 2.5-fold enzyme activation. AMP binding was shown to produce an alternate conformation, which is reached through a different pathway than the substrate-induced conformation. We solved the structure of the regulatory insert from cpCBS-PPase in complex with AMP and AP4A and proposed that conformational changes in the loops connecting the catalytic and regulatory domains enable activity regulation. We examined the effects of mutations in the CBS domains of mtCBS-PPase on catalytic activity, as well as, nucleotide binding and inhibition.

Mikkelin Pursialan pohjavesialueen haitta-aineet

Mikkelin talousvedestä kahden kolmasosan tullessa Pursialan pohjavesialueelta on alueen suojeleminen tärkeää. Pohjaveden laatua uhkaavat etenkin alueella sattuneet pohjavedenpilaantumistapaukset. Merkittävimmät pohjaveden pilaantumistapaukset ovat VAPO Oy:n sahan aiheuttama pohjaveden pilaantuminen kloorifenoleilla (CP) ja VR:n ratapölkkykyllästämön aiheuttama pohjaveden pilaantuminen kreosoottiöljyllä sekä Rinnekadun Nesteen aiheuttama pohjaveden pilaantuminen MTBE:llä. Alueella on tehty tutkimuksia ja kunnostuksia pilaantumiin liittyen, mutta näiden tuloksia ei ole aikaisemmin koottu yhteen. Tämän työn tavoitteena oli koota tulokset samaan aineistoon. Työssä keskityttiin kloorifenolien leviämisen tarkasteluun sen Pursialan pohjavedenottamolle muodostaman suurimman uhan vuoksi. Kallioperätietojen, maanpintatietojen ja näytetietojen pohjalta laadittiin myös pienoismalli CP-pilaantuman leviämisen kokonaiskuvan hahmottamiseksi. Työn tavoitteena oli lisäksi tehdä riskitarkastelua CP-pilaantumaan liittyen ja etsiä keinoja hallita havaittuja riskejä. Riskinhallintaan liittyen työssä tutkittiin kloorifenoleilla pilaantuneen alueen maaperä- ja kalliotietoja sekä pohjaveden laatutietoja. Pursialan pohjavedessä on runsaasti rautaa ja mangaania sekä aggressiivista hiilihappoa. Pohjaveden pH on alueella noin 6,5, lämpötila noin 7,5 ºC ja happipitoisuus noin 0,7 mg/l. Pursialan kaupunginalueen kallioperässä on havaittavissa VAPO Oy:n sahalta vedenottamolle etenevä kalliopainanne, jota pitkin CP etenee. Alueen kallioperä on kiillegneissiä, jossa on pohjois–etelä-suuntaista rakoilua. Maaperätuloksien perusteella on havaittavissa vettä hyvin johtavien maakerrosten jatkuminen koko vedenottamon ja sahan välisen matkan, mikä tarkoittaa, että CP-pitoisella pohjavedellä voi olla aiemmin oletettua nopeampikin yhteys sahalta vedenottamolle. Suurin CP-pitoisuus noin 100 000 µg/l on mitattu KY-5-altaan kohdalle asennetun M14-pohjavesiputken pohjasta. Talousvesiasetuksen raja-arvo CP:lle on 10 µg/l. Sahan ja vedenottamon puolivälissä on havaittu yli 10 000 µg/l meneviä CP-pitoisuuksia. Suurin vedenottamon kaivoista (kaivo 10) mitattu pitoisuus on 149 µg/l. Jakotukilta raakavedestä otetuissa näytteissä tai talousvedessä ei ole kuitenkaan havaittu talousvesiasetuksen ylittäviä CP-pitoisuuksia. Pienoismallin perusteella CP sijaitsee sahan alueella lähellä kallionpintaa ja hajaantuu koko pohjavesipatjaan vedenottamolle päin mentäessä. CP-mittaustuloksissa on havaittavissa pulssimaisuutta. Tämä johtuu todennäköisesti Saimaan pinnan vaihtelun seurauksena muuttuvasta rantaimeytyneen pohjaveden määrästä. Saimaan pinnan nousu näyttäisi tuloksien perusteella nostavan CP-pitoisuuksia saha-alueella ja laskevan lähellä vedenottamoa. Pohjaveden pintatietojen perusteella tehdyn tarkastelun mukaan pohjavesi voi kulkeutua sahalta vedenottamolle parhaimmillaan noin vuodessa. Työssä arvioitiin KY-5–liuoksen vuosittaiseksi käyttömääräksi noin 648–970 m3. Allassakkaa arvioitiin syntyneen yhteensä noin 10–31 m3. Pohjaveteen arvioitiin joutuneen toiminnan aikana yhteensä noin 3 000–4 000 kg CP:tä. Kloorifenolit esiintyvät pohjavedessä lähes täysin kloorifenolaatteina. Kloorifenolien hajoaminen ja muuntuminen pohjavedessä on epätodennäköistä. Käsitteellisen mallin mukaan kloorifenolipilaantuman suurimmat riskit aiheutuvat kloorifenolien mahdollisuudesta pilata Pursialan vedenottamon talousvesi. Tällä hetkellä riskejä hallitaan kloorifenolien leviämisen tarkkailulla, sahan ja vedenottamon puolivälissä sijaitsevalla koepumppauksella sekä varautumalla aktiivihiilijauheen syöttöön talousvesiprosessiin. Koepumppauksen avulla on saatu ylös tällä hetkellä noin 69 kg kloorifenoleita. Tutkimuksen perusteella suositeltavimmat riskinhallintatoimet tulevaisuudessa ovat sahalla sijaitseva kunnostuspumppaus, sahan ja vedenottamon väliin sijoittuva suojapumppaus- ja vesiverhoyhdistelmä sekä sahan rannan kautta tapahtuvan rantaimeytymisen estäminen.

Multifrequency VLBI Observations of Selected Active Galactic Nuclei

In this dissertation, active galactic nuclei (AGN) are discussed, as they are seen with the high-resolution radio-astronomical technique called Very Long Baseline Interferometry (VLBI). This observational technique provides very high angular resolution (_ 10−300 = 1 milliarcsecond). VLBI observations, performed at different radio frequencies (multi-frequency VLBI), allow to penetrate deep into the core of an AGN to reveal an otherwise obscured inner part of the jet and the vicinity of the AGN’s central engine. Multi-frequency VLBI data are used to scrutinize the structure and evolution of the jet, as well as the distribution of the polarized emission. These data can help to derive the properties of the plasma and the magnetic field, and to provide constraints to the jet composition and the parameters of emission mechanisms. Also VLBI data can be used for testing the possible physical processes in the jet by comparing observational results with results of numerical simulations. The work presented in this thesis contributes to different aspects of AGN physics studies, as well as to the methodology of VLBI data reduction. In particular, Paper I reports evidence of optical and radio emission of AGN coming from the same region in the inner jet. This result was obtained via simultaneous observations of linear polarization in the optical and in radio using VLBI technique of a sample of AGN. Papers II and III describe, in detail, the jet kinematics of the blazar 0716+714, based on multi-frequency data, and reveal a peculiar kinematic pattern: plasma in the inner jet appears to move substantially faster that that in the large-scale jet. This peculiarity is explained by the jet bending, in Paper III. Also, Paper III presents a test of the new imaging technique for VLBI data, the Generalized Maximum Entropy Method (GMEM), with the observed (not simulated) data and compares its results with the conventional imaging. Papers IV and V report the results of observations of the circularly polarized (CP) emission in AGN at small spatial scales. In particular, Paper IV presents values of the core CP for 41 AGN at 15, 22 and 43 GHz, obtained with the help of the standard Gain transfer (GT) method, which was previously developed by D. Homan and J.Wardle for the calibration of multi-source VLBI observations. This method was developed for long multi-source observations, when many AGN are observed in a single VLBI run. In contrast, in Paper V, an attempt is made to apply the GT method to single-source VLBI observations. In such observations, the object list would include only a few sources: a target source and two or three calibrators, and it lasts much shorter than the multi-source experiment. For the CP calibration of a single-source observation, it is necessary to have a source with zero or known CP as one of the calibrators. If the archival observations included such a source to the list of calibrators, the GT could also be used for the archival data, increasing a list of known AGN with the CP at small spatial scale. Paper V contains also calculation of contributions of different sourced of errors to the uncertainty of the final result, and presents the first results for the blazar 0716+714.

Cognitive Development of Very Low Birth Weight Children from Infancy to Pre-school Age

The survival of preterm born infants has increased but the prevalence of long-term morbidities has still remained high. Preterm born children are at an increased risk for various developmental impairments including both severe neurological deficits as well as deficits in cognitive development. According to the literature the developmental outcome perspective differs between countries, centers, and eras. Definitions of preterm infant vary between studies, and the follow-up has been carried out with diverse methods making the comparison less reliable. It is essential to offer parents upto-date information about the outcome of preterm infants born in the same area. A centralized follow-up of children at risk makes it possible to monitor the consequences of changes in the treatment practices of hospitals on developmental outcome. This thesis is part of a larger regional, prospective multidisciplinary follow-up project entitled “Development and Functioning of Very Low Birth Weight Infants from Infancy to School Age” (PIeniPAinoisten RIskilasten käyttäytyminen ja toimintakyky imeväisiästä kouluikään, PIPARI). The thesis consists of four original studies that present data of very low birth weight (VLBW) infants born between 2001 and 2006, who are followed up from the neonatal period until the age of five years. The main outcome measure was cognitive development and secondary outcomes were significant neurological deficits (cerebral palsy, CP, deafness, and blindness). In Study I, the early crying and fussing behavior of preterm infants was studied using parental diaries, and the relation of crying behavior and cognitive and motor development at the age of two years was assessed. In Study II, the developmental outcome (cognitive, CP, deafness, and blindness) at the age of two years was studied in relation to demographic, antenatal, neonatal, and brain imaging data. Development was studied in relationship to a full-term born control group born in the same hospital. In Study III, the stability of cognitive development was studied in VLBW and full-term groups by comparing the outcomes at the ages of two and five years. Finally, in Study IV the precursors of reading skills (phonological processing, rapid automatized naming, and letter knowledge) were assessed for VLBW and full-term children at the age of five years. Pre-reading skills were studied in relation to demographic, antenatal, neonatal, and brain imaging data. The main findings of the thesis were that VLBW infants who fussed or cried more in the infancy were not at greater risk for problems in their cognitive development. However, crying was associated with poorer motor development. The developmental outcome of the present population was better that has been reported earlier and this improvement covered also cognitive development. However, the difference to fullterm born peers was still significant. Major brain pathology and intestinal perforation were independent significant risk factors for adverse outcome, also when several individual risk factors were controlled for. Cognitive development at the age of two years was strongly related with development at the age of five years, stressing the importance of the early assessment, and the possibility for early interventions. Finally, VLBW children had poorer pre-reading skills compared with their full-term born peers, but the IQ was an important mediator even when children with mental retardation were excluded from the analysis. The findings suggest that counseling parents about the developmental perspectives of their preterm infant should be based on data covering the same birth hospital. Neonatal brain imaging data and neonatal morbidity are important predictors for developmental outcome. The findings of the present study stress the importance of both short-term (two years) and long-term (five years) follow-ups for the individual, and for improving the quality of care.

Kloorifenoleja sisältävien jätevesien AOP-käsittely

Kirjallisuustyössä tutkittiin tehostetun hapetuksen menetelmiä (engl. Advanced Oxidation Processes, AOPs) kloorifenolien käsittelyssä. Tutkittava aine valittiin US EPA:n (United States Environmental Protection Agency) ympäristölle haitallisten aineiden listalta. Työssä tutkitut AOP-menetelmät olivat otsonointi kasvatetussa pH:ssa, O3/H2O2-prosessi, fotolyyttinen otsonointi (O3/UV), H2O2/UV-prosessi ja Fenton-prosessi (H2O2+Fe2+). AOP-käsittelyssä OH-radikaalien oletetaan pääosin aiheuttavan epäpuhtauksien hapettumisen. Kirjallisuustyössä tutkittiin OH-radikaaleihin vaikuttavien parametrien, kuten pH:n, lämpötilan sekä hapettimien ja hapetettavan aineen konsentraatioiden vaikutusta kloorifenolien hapetusprosessissa. Työn tarkoituksena oli selvittää tehokkain AOP-käsittely kloorifenoleja sisältävien jätevesien käsittelylle. AOP-käsittelyjen tehokkuutta verrattiin hajoamisnopeusvakioiden, puoliintumisaikojen sekä hapettimen kemikaalikulutuksen ja kustannuksen perusteella. Fenton-prosessin ja otsonoinnin pH:ssa 9 todettiin olevan tehokkaimpia menetelmiä kloorifenolien hapetuksessa. Fenton-prosessin hapetusnopeus oli tehokkaampaa 4-CP:n ja 2,4-DCP:n hapetuksessa, kun taas otsonointi pH:ssa 9 hapetti nopeammin 2,3,4,6-TeCP:n ja 2,4,6-TCP:n. Kustannustehokkuuden perusteella Fenton-prosessi oli otsonointia tehokkaampi. Parhaan menetelmän valinta kloorifenoleiden poistamiseksi oli vaikeaa, sillä useissa tutkimuksissa oli tutkittu vain yhtä menetelmää. Lisäksi eri tutkimuksissa käytetyt prosessiolosuhteet olivat erilaiset, joka hankaloitti tutkimusten vertailua. Lopullinen AOP-menetelmän valinta tulisikin suorittaa vasta laboratoriotutkimusten jälkeen.

Sustainable linguistic repository built on DSpace

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Solid-state reference and ion-selective electrodes : towards portable potentiometric sensing

Potentiometric sensors are very attractive tools for chemical analysis because of their simplicity, low power consumption and low cost. They are extensively used in clinical diagnostics and in environmental monitoring. Modern applications of both fields require improvements in the conventional construction and in the performance of the potentiometric sensors, as the trends are towards portable, on-site diagnostics and autonomous sensing in remote locations. The aim of this PhD work was to improve some of the sensor properties that currently hamper the implementation of the potentiometric sensors in modern applications. The first part of the work was concentrated on the development of a solid-state reference electrode (RE) compatible with already existing solid-contact ion-selective electrodes (ISE), both of which are needed for all-solid-state potentiometric sensing systems. A poly(vinyl chloride) membrane doped with a moderately lipophilic salt, tetrabutylammonium-tetrabutylborate (TBA-TBB), was found to show a satisfactory stability of potential in sample solutions with different concentrations. Its response time was nevertheless slow, as it required several minutes to reach the equilibrium. The TBA-TBB membrane RE worked well together with solid-state ISEs in several different situations and on different substrates enabling a miniature design. Solid contacts (SC) that mediate the ion-to-electron transduction are crucial components of well-functioning potentiometric sensors. This transduction process converting the ionic conduction of an ion-selective membrane to the electronic conduction in the circuit was studied with the help of electrochemical impedance spectroscopy (EIS). The solid contacts studied were (i) the conducting polymer (CP) poly(3,4-ethylienedioxythiophene) (PEDOT) and (ii) a carbon cloth having a high surface area. The PEDOT films were doped with a large immobile anion poly(styrene sulfonate) (PSS-) or with a small mobile anion Cl-. As could be expected, the studied PEDOT solid-contact mediated the ion-toelectron transduction more efficiently than the bare glassy carbon substrate, onto which they were electropolymerized, while the impedance of the PEDOT films depended on the mobility of the doping ion and on the ions in the electrolyte. The carbon cloth was found to be an even more effective ion-to-electron transducer than the PEDOT films and it also proved to work as a combined electrical conductor and solid contact when covered with an ion-selective membrane or with a TBA-TBB-based reference membrane. The last part of the work was focused on improving the reproducibility and the potential stability of the SC-ISEs, a problem that culminates to the stability of the standard potential E°. It was proven that the E° of a SC-ISE with a conducting polymer as a solid contact could be adjusted by reducing or oxidizing the CP solid contact by applying current pulses or a potential to it, as the redox state of the CP solid-contact influences the overall potential of the ISE. The slope and thus the analytical performance of the SC-ISEs were retained despite the adjustment of the E°. The shortcircuiting of the SC-ISE with a conventional large-capacitance RE was found to be a feasible instrument-free method to control the E°. With this method, the driving force for the oxidation/reduction of the CP was the potential difference between the RE and the SC-ISE, and the position of the adjusted potential could be controlled by choosing a suitable concentration for the short-circuiting electrolyte. The piece-to-piece reproducibility of the adjusted potential was promising, and the day-today reproducibility for a specific sensor was excellent. The instrumentfree approach to control the E° is very attractive considering practical applications.

Lapsen neurologinen tutkiminen Touwenin menetelmällä

Opinnäytetyön tarkoituksena oli tehdä ohjekirja Touwenin testistä. Touwenin testin avulla voidaan tehdä laaja-alainen ja yksityiskohtainen neurologinen tutkimus lapselle. Tutkimus kohdistuu erityisesti lieviin neurologisiin poikkeavuuksiin (Minor Neurological Dysfunctions, MND). Tulosten avulla lapset jaotellaan neurologisesti normaaleihin, lievästi poikkeaviin (Simple MND), merkittävästi poikkeaviin (Complex MND) ja CP-vammaa sairastaviin lapsiin. Tutkittavia osa-alueita ovat asento ja lihasjänteys, refleksit, tahattomat liikkeet, koordinaatio ja tasapaino, hienomotoriikka, liitännäisliikkeet, tuntoaisti ja aivohermojen toiminta. Lasten hermosto on nopeasti kehittyvä ja laadullisesti erilainen kuin aikuisilla, sillä lapsen neurologinen kehitys on vielä kesken. Tämä täytyy huomioida lapsen neurologisessa tutkimuksessa ja tulosten tulkinnassa. Touwenin testi on suunnattu erityisesti 4-13-vuotiaille lapsille. Motoriset vaikeudet voivat vaikuttaa fyysiseen ja sosiaaliseen aktiivisuuteen sekä mielenterveyteen. Monesti niillä on yhteys myös oppimis- ja käytöshäiriöihin. Motorisen kehityksen merkittävät häiriöt olisi tärkeä löytää mahdollisimman varhain, jotta näiden lasten kehitystä voitaisiin tukea. Motorisia toimintahäiriöitä on huomattavasti enemmän lapsilla, jotka ovat syntyneet ennen raskausviikkoa 32 ja joiden syntymäpaino on alhainen. Tämän vuoksi keskosten neurologisen kehityksen seuranta on erityisen tärkeää.

Meditationes sancti evangelii 5

Invokaatio: Deo duce.

Prediction of neurodevelopment and neuromotor trajectories in very preterm born children up to 11 years of age: PIPARI Study

Very preterm birth is a risk for brain injury and abnormal neurodevelopment. While the incidence of cerebral palsy has decreased due to advances in perinatal and neonatal care, the rate of less severe neuromotor problems continues to be high in very prematurely born children. Neonatal brain imaging can aid in identifying children for closer follow-up and in providing parents information on developmental risks. This thesis aimed to study the predictive value of structural brain magnetic resonance imaging (MRI) at term age, serial neonatal cranial ultrasound (cUS), and structured neurological examinations during the longitudinal follow-up for the neurodevelopment of very preterm born children up to 11 years of age as a part of the PIPARI Study (The Development and Functioning of Very Low Birth Weight Infants from Infancy to School Age). A further aim was to describe the associations between regional brain volumes and long-term neuromotor profile. The prospective follow-up comprised of the assessment of neurosensory development at 2 years of corrected age, cognitive development at 5 years of chronological age, and neuromotor development at 11 years of age. Neonatal brain imaging and structured neurological examinations predicted neurodevelopment at all age-points. The combination of neurological examination and brain MRI or cUS improved the predictive value of neonatal brain imaging alone. Decreased brain volumes associated with neuromotor performance. At the age of 11 years, the majority of the very preterm born children had age-appropriate neuromotor development and after-school sporting activities. Long-term clinical follow-up is recommended at least for all very preterm infants with major brain pathologies.