Lasten luvaton tuli – perusasteen oppilaat sytyttelijöinä

Tutkimus lasten ja nuorten luvattomasta tulen käsittelystä perustuu näkemykseen siitä, että ilmiöön voidaan puuttua tehokkaasti interventioin, jos toiminta havaitaan ajoissa. Ilmiötä sävyttää teon salailu ja neutralisaatio eli vähättely. Tulella tehtyjen tuhotöiden lisääntymistä ja muuttumista aggressiivisemmaksi voidaan ennalta ehkäistä ongelman tunnistamisella ja reagoimalla lasten häiriökäytökseen. Lasten ja nuorten luvatonta tulen käyttöä ei ole tutkittu Suomessa aiemmin. Työn ensimmäisessä osiossa tarkastellaan luvattomaan tulen käsittelyyn liittyviä teorioita (esim. Fineman 1980, 1995), kansainvälisiä näkökohtia, teonpiirteitä ja yksilön sisäisiä prosesseja. Lisäksi tarkastellaan perheen, koulun ja ystäväpiirin osuutta ilmiöön, niin sanotun Oregonin mallin mukaisesti (Oregon Treatment Strategies Task Force 1996, 16 – 47). Työn empiirisessä osiossa ilmiötä ja sen ilmenemistä lasten ja nuorten keskuudessa kuvataan oppilaiden, vanhempien ja opettajien näkökulmasta. Tutkimukseen osallistui 661 oppilasta perusasteen toiselta, viidenneltä ja kahdeksannelta luokalta, 341 vanhempaa ja 22 koulun työntekijää. Oppilaiden ja vanhempien aineisto kerättiin survey-tutkimuksella ja opettajat tutkittiin haastattelumenetelmällä. Lasten luvaton tulen käyttö on yleisempää kuin aiemmin on luultu. Vielä viidenteen luokkaan mennessä luvaton tulen käsittely oli yleisempää pojille kuin tytöille, mutta murrosikään tultaessa sukupuolierot vähenivät. Pojista 37 % ja tytöistä 25 % raportoi käsitelleensä tulta luvattomasti. Kaikkiaan kolmasosa oppilaista raportoi leikkineensä tulella. Yleisin tulen sytyttelypaikka oli oma koti tai kodin lähiympäristö, josta tulentekovälineet yleisimmin hankittiin pyytämällä tai ottamalla. Luvattomasti tulta käsitelleet oppilaat olivat häirinneet oppitunteja. Tilastollisesti merkitsevimmin runsasta luvatonta tulen käsittelyä ennusti omien tulentekovälineiden omistaminen ja häiriökäyttäytyminen koulussa. Vanhemmat eivät pitäneet lastensa tulen käyttöä merkittävänä vaarana. Aikuisten suhtautumista lasten luvattomaan tulen käyttöön sävytti tekojen vähättely eli neutralisaatio; vähättelyilmiö oli yhteinen sekä lapsille itselleen, vanhemmille että viranomaisille. Kasvattajilla ei ollut käytössään tehokkaita interventiomenetelmiä ongelman ratkaisemiseen. Viranomaisyhteistyöstä raportoitiin vain vähän. Pelastusviranomaisia ei juurikaan käytetty lasten luvattoman tulen käsittelyn interventiossa. Interventiota sävytti aikuisten käsitysten mukaan tapauskohtaisuus ja sattumanvaraisuus.

Personal Liberty in Psychiatric Care - Towards Service User Involvement

This study explores personal liberty in psychiatric care from a service user involvement perspective. The data were collected in four phases during the period 2000-2006 in psychiatric settings in Finland. Firstly, patient satisfaction and factors associated with user involvement were studied (n = 313). Secondly, patients’ experiences of deprivation of their liberty were explored (n = 51). Thirdly, an overview on patients’ options for lodging complaints was conducted, and all complaints (n = 4645) lodged in Finland from 2000 to 2004 were examined. Fourthly, the effects of different patient education methods on inpatients’ experiences of deprivation of liberty were tested (n = 311). It emerged that patients were quite satisfied, but reported dissatisfaction in restrictions, compulsory care and information dissemination. Patients experienced restrictions on leaving the ward and on communication, confiscation of property and coercive measures as deprivation of liberty. Patients’ experienced these interventions to be negative. In Finland, the patient complaint process is complicated and not easily accessible. In general, patient complaints increased considerably in Finland during the study period. In psychiatric care the number of complaints was quite stable and complaints led more seldom to consequences. An Internet-based patient education system was equivalent with traditional education and treatment as usual in supporting personal liberty during hospital care. This dissertation provides new information about the realization of patients' rights in psychiatric care. In order to improve patients' involvement, systematic methods to increase personal liberty during care need to be developed, the procedures for patients lodging complaints should be simplified, and patients' access to information needs to be ensured using multiple methods.

Consumer Search Behavior in High Involvement Purchases

The aim of this study is to investigate the consumer search behavior in high involvement purchases. The results of this research provide the descriptive analysis of the information search phase which is a part of the decision-making process. The study focuses on customer’s choice of the information sources, motivation behind it and different factors that influence the search behavior. Particular attention is paid to the purchase categorization and the differences in information search between products and services. The qualitative research method is chosen for this study. The data is gathered through ten theme interviews. Each participant of the interview describes his/her own search behavior in a product and a service case. The results indicate that consumer search behavior vary according to the purchase categorization, demographic, individual and situational factors. Moreover, the above-mentioned factors influence the purpose and position of the information search phase in a five-step decision making model.

Absorptive capacity of Multinational Corporation’s parent company

The objective of this paper is to contribute to the literature concerning absorptive capacity by revealing the factors affecting the absorptive capacity of MNC parent company toward subsidiary and most particularly the effects of intra-organizational antecedents. The theoretical framework is build around previous findings on knowledge sharing and absorptive capacity. The empirical part of the study is a qualitative research which includes in-depth interviews and analysis of secondary data based on a single case company. The results showed that organizational structure, internal communication, informal networks, formal networks, internationalization, human resources management, shared language, meetings, trust, participation in decision-making, level of awareness, IT system, level of adaptation to market specifications and job rotation influence parent company’s absorptive capacity. Moreover, related problems to these antecedents have been identified. Additionally, recommendations to solve these problems are formulated. In the end, directions for future research on this topic are given.

Health-related quality of life in school children: validation of instrument, child self assessment, parent-proxy assessment and school nursing documentation of health check-ups

The aims of this study were to validate an international Health-Related Quality of Life (HRQL) instrument, to describe child self and parent-proxy assessed HRQL at child age 10 to 12 and to compare child self assessments with parent-proxy assessments and school nursing documentation. The study is part of the Schools on the Move –research project. In phase one, a cross-cultural translation and validation process was performed to develop a Finnish version of Pediatric Quality of Life Inventory™ 4.0 (PedsQL™ 4.0). The process included a two-way translation, cognitive interviews (children n=7, parents n=5) and a survey (children n=1097, parents n=999). In phase two, baseline and follow-up surveys (children n=986, parents n=710) were conducted to describe and compare the child self and parent-proxy assessed HRQL in school children between the ages 10 and 12. Phase three included two separate data, school nurse documented patient records (children n=270) and a survey (children n=986). The relation between child self assessed HRQL and school nursing documentation was evaluated. Validity and reliability of the Finnish version of PedsQL™ 4.0 was good (Child Self Report α=0.91, Parent-Proxy Report α=0.88). Children reported lower HRQL scores at the emotional (mean 76/80) than the physical (mean 85/89) health domains and significantly lower scores at the age of 10 than 12 (dMean=4, p=<0.001). Agreement between child self and parent-proxy assessment was fragile (r=0,4, p=<0.001) but increased as the child grew from age 10 to 12 years. At health check-ups, school nurses documented frequently children’s physical health, such as growth (97%) and posture (98/99%) but seldom emotional issues, such as mood (2/7%). The PedsQLTM 4.0 is a valid instrument to assess HRQL in Finnish school children although future research is recommended. Children’s emotional wellbeing needs future attention. HRQL scores increase during ages between childhood and adolescence. Concordance between child self and parent-proxy assessed HRQL is low. School nursing documentation, related to child health check-ups, is not in line with child self assessed HRQL and emotional issues need more attention.

Effect of emotions on consumer decision-making in a high involvement product adoption context

This thesis was written in order participate in the emergent discussion on the role of emotions in consumer decision-making. The goal of the thesis was to find out which emotions affect consumer decision-making, how these emotions relate to traditional process models of consumer decision-making, and how emotions and other factors affect consumer decision-making. The thesis is placed into a context of high involvement product adoption. The empirical research was conducted according to a qualitative methodology, which combined video diaries and face-to-face or Skype interviews as data collection methods. The case product category was dancing poles, and four women participated in the study. The central results indicate that emotion and cognition walk hand in hand in consumer decision-making, that consumers experience a variety of emotions during a decision-making process, and that emotions have an important effect on consumer decision-making and consumer behavior.

IFLAn presidentti Ingrid Parent vieraili Suomessa

IFLAn presidentti Ingrid Parent vieraili Suomessa maaliskuussa 2012 käyden esittäytymässä yliopisto- ja kirjastoihmisille sekä medialle.

Customer involvement in lean startup principles: case of game development studio

The objective of this thesis is to better understand customer’s role in lean startup methodology. The aim is to find out how customers are involved in lean startup methodology implantation and increase the likelihood of new venture survival. This study emphasizes the usage of customers in shaping of new product development processes within companies, through iteration and constant communication. This communication facilitates the development of features that are requested by the customers and enhances the prospects of the new venture. The empirical part of the study is a single qualitative case study that uses action research to implement the lean startup methodology into a pre-revenue venture and examines its customer involvement processes. The studied case company is Karaoke d.o.o., developing a game called kParty. The study used the theory discussed in the literature review: customer involvement (in the survey and interviews conducted for the lean startup methodology), lean principles (through the implementation of lean startup methodology) and lean startup methodology, which are the central building parts of this thesis as a whole. The thesis contributes to the understanding of customer involvement in lean startup methodology, while giving practical implications of customer orientation and product market fitting.

Sphingosine-1-phosphate-evoked invasion of follicular thyroid cancer cells : evidence for the involvement of HIF-Iα, MMP2 and MMP9

Sphingolipids are widely expressed molecules, which traditionally were considered to have majorly structural properties. Nowadays, however, they are implicated in a wide range of different biological processes. The bioactive lipid sphingosine 1-phosphate (S1P) has emerged during the past decade as one of the most studied molecules due to its proliferative and pro-migratory abilities both during normal physiology and in the pathology of a subset of different diseases. Migration and invasion of cancer cells require changes in cell behavior and modulation of the tissue microenvironment. Tumor aggressiveness is markedly enhanced by hypoxia, in which hypoxia inducible transcription factors 1-2α (HIF-1-2α) are activated to promote metabolism, proliferation and migration. Invasion requires degradation of the extracellular matrix (ECM) achieved by several degrading and remodeling enzymes. Matrix metalloproteinases (MMPs) are broadly expressed and well accepted as proteolytic enzymes with essential roles both in normal physiology and in pathology. Previously, S1P was shown to strongly evoke migration of follicular ML-1 thyroid cancer cells. The objective of this study was to further investigate and understand the mechanisms behind this regulation. In the first project it was demonstrated that S1P enhances the expression and activity of HIF-1α. S1P enhanced the expression of HIF-1α by increasing its synthesis and stability. The S1P-increased HIF-1α was mediated via S1P3, Gi/0, PI3K, PKCβI, ERK1/2, mTOR and translation factors p70S6K and eIF4E. Finally, it was shown that HIF-1α mediated S1P-induced migration. The ECM is constituted of a complex and coordinated assembly of many types of proteins. In order to be able to invade, cells need to break down the ECM, therefore several key players in this event were investigated in the second project. S1P increased the secretion and activity of MMP2 and MMP9 via S1P-receptor 1 and 3 and that these MMPs participated in the S1P-facilitated invasion of ML-1 cells. In this interplay, calpains and Rac1 were involved, both of which are crucial players in migration and invasion. The prognosis for some types of thyroid cancer is relatively good. However, there are forms of thyroid cancers, for which there are no treatments or the current available treatments are inefficient. Thus, new medical interventions are urgently needed. In the third project the significance of the S1P-receptor modulating drug FTY720, which is currently used for the treatment of multiple sclerosis (MS), was studied. The effect of FTY720 was tested on several thyroid cancer cell lines, and it inhibited the proliferation and invasion of all cancer cell lines tested. In ML-1 cells, FTY720 attenuated invasion by blocking signaling intermediates important for migration and invasion of the cells. Moreover, FTY720 inhibited the proliferation of ML-1 cells by increasing the expression of p21 and p27, hence, inducing cell arrest in G1 phase of the cell cycle. Thus, it can be suggested that FTY720 could be used in the treatment of thyroid cancer.

Urine beta2-microglobulin is an early marker of renal involvement in LPI. (Virtsan beta2-mikroglobuliini on varhaisen vaiheen markkeri LPI-taudin munuaiskomplikaatioiden havaitsemisessa.)

Lysinurinen proteiini-intoleranssi (LPI) on suomalaiseen tautiperintöön kuuluva kationisten aminohappojen, arginiinin, ornitiinin ja lysiinin, kuljetushäiriö suolen ja munuaistubulusten basolateraalisilla kalvoilla. Arginiinin ja ornitiinin puute aiheuttaa häiriöitä ureasyklin toiminnassa, aterian jälkeistä hyperammonemiaa ja proteiiniaversiota. Lysiinin puute vaikuttaa mm. kasvuun ja puolustusmekanismeihin. Hoidossa keskeistä on vähäproteiininen ruokavalio ja L-sitrulliinilisä, joka parantaa ureasyklin toimintaa. Koska LPI-tauti on kuvattu vasta 1960-luvulla, sen luonnollinen kulku tunnetaan vielä huonosti. Tautiin liittyvistä komplikaatioista vakavimmat ovat toistaiseksi tuntemattomalla mekanismilla kehittyvä keuhkojen alveolaarinen proteinoosi ja munuaisongelmat. Suomalaisista LPI-potilaista noin kolmanneksella on havaittu merkkejä munuaisten vajaatoiminnasta, ja muutamilla potilailla munuaisongelmat ovat edenneet loppuvaiheen munuaistautiin (ESRD) saakka. Potilaiden munuaisongelmia tutkittiin viimeksi vuonna 2007. Tämän tutkimuksen tarkoitus oli selvittää, onko LPI-potilaiden munuaisfunktio olennaisesti muuttunut seuranta-aikana 2007-2013. LPI-potilaiden seuranta on valtakunnallisesti keskitetty Turun yliopistollisen keskussairaalan (Tyks) lastenklinikan aineenvaihduntapoliklinikalle. Seurannassa on 41 potilasta, jotka käyvät Tyks:ssä 1—2 kertaa vuodessa. Tässä tutkimuksessa analysoitiin näiden LPI-potilaiden sairaskertomuksia ja laboratoriotutkimuksia. Kiinnostuksen kohteena olivat erityisesti verenpaine, munuaisten toimintatestit, virtsan proteiini- ja aminohappopitoisuudet ja plasman sitrulliinipituisuus. Munuaisten vajaatoiminnan kehitystä arvioitiin seuraamalla seerumin kystatiini C:n, kreatiniinipitoisuuksien ja virtsan beta2-mikroglobuliinipitoisuuksien muutoksia ajan funktiona. Tutkimuksessa havaittiin, että seuranta-ajan loppuun mennessä suurimmalla osalla potilaista oli merkkejä munuaisten vajaatoiminnasta ja osalle potilaista oli kehittynyt vakava munuaisvaurio, joka vaati dialyysihoitoa tai munuaissiirron. Munuaisongelmien määrä oli lisääntynyt seuranta-aikana, vaikka potilaiden munuaisfunktiota oli seurattu säännöllisesti ja riskitekijöitä hoidettu. Sitrulliiniannostuksella ei näyttänyt olevan yhteyttä munuaisten vajaatoiminnan kehittymiseen. Munuaissiirtopotilaista yksi potilas menetti siirrännäisen, muutoin elinsiirtopotilaiden munuaisfunktio on säilynyt tyydyttävänä. Lisäksi havaittiin, että virtsan beeta-2-mikroglobuliinimäärityksellä pystytään havaitsemaan munuaisten vajaatoiminta varhaisessa vaiheessa tässä potilasryhmässä.