Noin yksivuotiaan lapsen kehitys : havainnointivideo lasten toimintaterapian opetukseen

Lasten toimintaterapia perustuu lapsen normaalin kehityksen ymmärtämiseen ja arvostamiseen. Pystyäkseen pätevästi arvioimaan lapsia toimintaterapeutin täytyy olla tietoinen niistä tämänhetkisistä käsityksistä ja teorioista, jotka koskevat lapsen kehitystä. Tällainen taustatieto auttaa suunnittelemaan lapsen toimintaterapian sisältöä. Opinnäytetyöni tavoitteena oli tehdä havainnointivideo noin yksivuotiaan lapsen kehityksestä lasten toimintaterapian opetuksessa käytettäväksi. Video on rajattu koskemaan noin yksivuotiaan lapsen kehitystä. Työni tarkoituksena on auttaa toimintaterapian opiskelijoita lapsen kehityksen oppimisessa. Opinnäytetyöni muoto on toiminnallinen opinnäytetyö. Se sisältää tuotoksen eli havainnointivideon ja opinnäytetyöraportin. Opinnäytetyöprosessini sisälsi erilaisia vaiheita. Ensin perehdyin niihin lapsen kehitykseen liittyviin teorioihin, joita lasten toimintaterapian opetuksessa käytetään. Näitä teorioita ovat Moseyn kehityksellinen viitekehys ja sensorisen integraation teoria kehityksestä ja ne toimivat työni viitekehyksinä. Jäsensin lapsen kehityksen osa-alueita toimintakokonaisuuksien ja taitojen avulla. Seuraavaksi ryhdyin lapsen kehitykseen liittyvien teorioiden pohjalta suunnittelemaan, kuvaamaan ja editoimaan videota. Raportissani kuvaan kaikki opinnäytetyöprosessini vaiheet ja perustelen vaiheiden järjestyksen ja sisällön, sekä arvioin omaa opinnäytetyöprosessiani. Havainnointivideossa näkyy niitä kehityksen tasoja ja vaiheita, jossa noin yksivuotias lapsi työssä käyttämieni viitekehysten mukaan on. Uskon, että havainnointivideoni voi toimia hyvin ainakin opiskelijoiden virittäytymisessä lapsen kehityksen ja sen eri osa-alueiden opiskeluun. Avainsanat oppiminen, lapsen kehitys, havainnointivideo

Traitement des epilepsies réfractaires: rôle de la stimulation electrique [Treatment of pharmacoresistant epilepsy: stimulated refractoriness].

Antiepileptic drugs allow controlling seizures in 70% of patients. For the others, a presurgical work-up should be undertaken, especially if a focal seizure origin is suspected; however, only a fraction of pharmacoresistant patients will be offered resective (curative) surgery. In the last 15 years, several palliative therapies using extra- or intracranial electrical stimulations have been developed. This article presents the vagal nerve stimulation, the deep brain stimulation (targeting the mesiotemporal region or the thalamus), and the cortical stimulation "on demand". All show an overall long-term responder rate between 30-50%, but less than 5% of patients becoming seizure free. It is to hope that a better understanding of epileptogenic mechanisms and of the implicated neuronal networks will lead to an improvement of these proportions.

Treatment of autoinflammatory diseases: results from the Eurofever Registry and a literature review.

OBJECTIVE: To evaluate the response to treatment of autoinflammatory diseases from an international registry and an up-to-date literature review. METHODS: The response to treatment was studied in a web-based registry in which clinical information on anonymised patients with autoinflammatory diseases was collected retrospectively as part of the Eurofever initiative. Participating hospitals included paediatric rheumatology centres of the Paediatric Rheumatology International Trial Organisation network and adult centres with a specific interest in autoinflammatory diseases. The following diseases were included: familial Mediterranean fever (FMF), cryopyrin-associated periodic syndromes (CAPS), tumour necrosis factor (TNF)-receptor associated periodic syndrome (TRAPS), mevalonate kinase deficiency (MKD), pyogenic arthritis pustulosis acne (PAPA) syndrome, deficiency of interleukin-1 receptor antagonist (DIRA), NLRP12-related periodic fever and periodic fever aphthosis pharyngitis adenitis (PFAPA) syndrome. Cases were independently validated by experts for each disease. A literature search regarding treatment of the abovementioned diseases was also performed using Medline and Embase. RESULTS: 22 months from the beginning of the enrolment, complete information on 496 validated patients was available. Data from the registry in combination with evidence from the literature confirmed that colchicine is the treatment of choice for FMF and IL-1 blockade for DIRA and CAPS. Corticosteroids on demand probably represent a valid therapeutic strategy for PFAPA, but also for MKD and TRAPS. Patients with poorly controlled MKD, TRAPS, PAPA or FMF may benefit from IL-1 blockade; anti-TNF treatment may represent a possible valuable alternative. CONCLUSIONS: In the absence of high-grade evidence, these results could serve as a basis for therapeutic guidelines and to identify candidate drugs for future therapeutic trials.

Del prestatge a la web: la transformació de la formació de les col·leccions a les biblioteques universitàries

L’existència d’una xarxa mundial de comunicacions ubiqua i barata que cada vegada més permet obtenir documents de manera fàcil i gratuïta requerirà una transformació de les pràctiques de la formació de col·leccions a les biblioteques universitàries. Això estarà impulsat per una sèrie d’avenços específics, que inclouen la digitalització de continguts; el desenvolupament de repositoris d’impresos; el desenvolupament de lectors de llibres electrònics i de l’edició mitjançant la impressió sota demanda; el creixement de l’accés obert; els reptes per establir estructures d’edició acadèmica; i el creixement de noves formes d’activitats acadèmiques basades en l’obertura i la productivitat social. Si les biblioteques universitàries volen tenir èxit, hauran de desmuntar les col·leccions impreses patrimonials; passar de la selecció de llibres ítem a ítem a la compra sota demanda i a les subscripcions; gestionar la transició cap a revistes d’accés obert; centrar-se en conservar ítems únics; i desenvolupar nous mecanismes per finançar una infraestructura nacional.

Haemophilia registry of the Medical Committee of the Swiss Hemophilia Society. Update and annual survey 2010-2011.

The Haemophilia Registry of the Swiss Haemophilia Society was created in the year 2000. The latest records from October 31st 2011 are presented here. Included are all patients with haemophilia A or B and other inherited coagulation disorders (including VWD patients with R-Co activity below 10%) known and followed by the 11 paediatric and 12 adult haemophilia treatment or reference centers. Currently there are 950 patients registered, the majority of which (585) having haemophilia A. Disease severity is graded according to ISTH criteria and its distribution between mild, moderate and severe haemophilia is similar to data from other European and American registries. The majority (about two thirds) of Swiss patients with haemophilia A or B are treated on-demand, with only about 20% of patients being on prophylaxis. The figure is different in paediatrics and young adults (1st and 2nd decades), where 80 to 90% of patients with haemophilia A are under regular prophylaxis. Interestingly enough, use of factor concentrates, although readily available, is rather low in Switzerland, especially when taking the country's GDP into account: The total amount of factor VIII and IX was 4.94 U pro capita, comparable to other European countries with distinctly lower incomes (Poland, Slovakia, Hungary). This finding is mainly due to the afore mentioned low rate of prophylactic treatment of haemophilia in our country. Our registry remains an important instrument of quality control of haemophilia therapy in Switzerland.

Hemophilia Registry of the Medical Committee of the Swiss Hemophilia Society: Update and Annual Survey 2008.

The Swiss Haemophilia Registry of the Medical Committee of the Swiss Haemophilia Society was established in 2000. Primarily it bears epidemiological and basic clinical data (incidence, type and severity of the disease, age groups, centres, mortality). Two thirds of the questions of the WFH Global Survey can be answered, especially those concerning use of concentrates (global, per capita) and treatment modalities (on-demand versus prophylactic regimens). Moreover, the registry is an important tool for quality control of the haemophilia treatment centres. There are no informations about infectious diseases like hepatitis or HIV, due to non-anonymisation of the data. We plan to incorporate the results of the mutation analysis in the future.

Size-dependent recombination dynamics in ZnO nanowires.

A deep understanding of the recombination dynamics of ZnO nanowires NWs is a natural step for a precise design of on-demand nanostructures based on this material system. In this work we investigate the influence of finite-size on the recombination dynamics of the neutral bound exciton around 3.365 eV for ZnO NWs with different diameters. We demonstrate that the lifetime of this excitonic transition decreases with increasing the surface-to-volume ratio due to a surface induced recombination process. Furthermore, we have observed two broad transitions around 3.341 and 3.314 eV, which were identified as surface states by studying the dependence of their life time and intensitiy with the NWs dimensions.

Long-Term Safety of Canakinumab in Patients with Gouty Arthritis.

Background/Purpose: Gouty arthritis (GA) is a chronic inflammatory disease. Targeting the inflammatory pathway through IL-1_ inhibition with canakinumab (CAN) may provide significant long-term benefits. CAN safety versus triamcinolone acetonide (TA) over initial 24 weeks (blinded study) for patients (pts) with history of frequent attacks (_3 in year before baseline) was reported earlier from core (_-RELIEVED [_-REL] and _-REL-II) and first extension (E1) studies1. Herein we present full 18-month long-term CAN safety data, including open-label second extension (E2) studies. Methods: GA pts completing _-REL E1 and _-REL-II E1 studies1 were enrolled in these 1-year, open-label, E2 studies. All pts entering E2, whether randomized to CAN or TA, received CAN 150 mg sc on demand upon new attack. Data are presented only for pts randomized to CAN, and are reported cumulatively, i.e. including corresponding data from previously reported core and E1 studies. Long-term safety outcomes and safety upon re-treatment are presented as incidence rate per 100 patient-years (pyr) of study participation for AEs and SAEs. Deaths are reported for all pts (randomized to CAN or TA). Selected predefined notable laboratory abnormalities are shown (neutrophils, platelets, liver and renal function tests). Long-term attack rate per year is also provided. Results: In total, 69/115 (60%) and 72/112 (64.3%) of the pts randomized to CAN in the two core studies entered the two E2 studies, of which 68 and 64 pts, respectively completed the E2 studies. The 2 study populations had differing baseline comorbidity and geographic origin. Lab data (not time adjusted) for neutropenia appears worse after retreatment in _-REL E2, and deterioration of creatinine clearance appears worse after retreatment (Table 1). The time-adjusted incidence rates for AEs were 302.4/100 pyr and 360/100 pyr, and for SAEs were 27.9/100 pyr and 13.9/100 pyr in _-REL E2 and _-REL-II E2 respectively (Table 1). The time-adjusted incidence rates of any AEs, infection AEs, any SAEs, and selected SAEs before and after re-treatment are presented in Table 1. Incidence rates for AEs and SAEs declined after re-treatment, with the exception of SAEs in _-REL-II E2, which increased from 2.9/100 pyr to 10.9/100 pyr (no infection SAEs after retreatment in _-REL-II E2, and other SAEs fit no special pattern). In the total safety population (N_454, core and all extensions), there were 4 deaths, 2 in the core studies previously reported1 and 2 during the _-REL E2 study (one patient in the CAN group died from pneumonia; one patient in the TA group who never received CAN died of pneumococcal sepsis). None of the deaths was suspected by investigators to be study drug related. The mean rates of new attacks per year on CAN were 1.21 and 1.18 in _-REL E2 and in _-REL-II E2. Conclusion: The clinical safety profile of CAN upon re-treatment was maintained long-term with no new infection concerns

Public Employees Leadership Institute Final Report, August 2011

Public agencies in Iowa are continually challenged with reduced staff levels, reduced budgets, and increased expectations for services provided. Responding to these demands requires a well-informed and coordinated team that includes professionals, supervisors, technicians, lead workers, and workers. Becoming a coordinated team requires the training and interaction to produce a common foundation to build upon. In 2007, a training program did not exist in the state to provide this level of training for existing or upcoming managers and leaders of public agencies. The Iowa Local Technical Assistance Program (LTAP), in conjunction with Iowa public agency representatives, set out to provide that foundation by developing the Iowa Public Employees Leadership Academy, which was renamed the Public Employees Leadership Institute in July 2011. The Institute is an on-demand, online training program designed to create better (or new) leaders and supervisors for Iowa’s public agencies. The Institute provides a curriculum to train the next generation of leaders, who will replace existing leaders when retirements occur. Through the Institute, Iowa LTAP will provide a coordinated, structured, non-credit educational program available for a modest fee. The techniques and skills offered through the Institute can apply to all who wish to develop or sharpen their leadership and management abilities. This will be true whether the participants are employed in the public or private sector. The 14 courses that were developed and are being offered are as follows: Supervisory Techniques and Skills, Team Development, Communications Skills, Leadership Skills, Community Service/Customer Orientation, Legal Understanding, Fundamentals of Government, Finance, Resource Management, Operations and Maintenance, Basic Management, Emergency Management, Project Management, and Winter Maintenance Management.

Electronic Bulletin Board System, HR-345, 1998

The primary objectives of the Electronic Bulletin Board System (BBS) project were to: (1) Provide an electronic communication tool which would link city and county engineering offices to each other and to other governmental agencies for messaging and data sharing; (2) Provide a dial-up site for reference information or files accessible on-demand; and (3) Provide a "stepping stone" to the world of electronic data transfer, recognizing that most local government employees face a huge complex of technology with limited knowledge of computers and communications tools. The system was designed to be as simple as possible, and to require minimal equipment and software cost to the users. The original system was an Apex 386/25 computer with MS-DOS 5.0 software and the final configuration was an HP Vectra XM Pentium 90 with MS-NT 3.51 and Mustang - Wildcat 5.0 software. The users of the BBS were county engineers and their staff, offices in the central office of the Iowa Department of Transportation (DOT) and Resident Construction Engineers at the Iowa DOT. Much of the activity was between the county engineers, and their staffs, and the Iowa DOT offices with which they have ongoing business activities. The BBS contained files for mapping, Internet e-mail service, Accident Location Analysis System (ALAS) data, Iowa DOT bid lettings, and Autocad and Intergraph maps and standards. The 800 line calls were recorded and gave the best indication of the usage and the trends that were being followed. The usage tended to be higher in the winter months when design activities are occurring and lower in the summer months when the construction is in progress. The project was judged a success. The BBS did provide a "stepping stone" to the world of electronic data transfer.

Tuning In to Sound: Frequency-Selective Attentional Filter in Human Primary Auditory Cortex.

Cocktail parties, busy streets, and other noisy environments pose a difficult challenge to the auditory system: how to focus attention on selected sounds while ignoring others? Neurons of primary auditory cortex, many of which are sharply tuned to sound frequency, could help solve this problem by filtering selected sound information based on frequency-content. To investigate whether this occurs, we used high-resolution fMRI at 7 tesla to map the fine-scale frequency-tuning (1.5 mm isotropic resolution) of primary auditory areas A1 and R in six human participants. Then, in a selective attention experiment, participants heard low (250 Hz)- and high (4000 Hz)-frequency streams of tones presented at the same time (dual-stream) and were instructed to focus attention onto one stream versus the other, switching back and forth every 30 s. Attention to low-frequency tones enhanced neural responses within low-frequency-tuned voxels relative to high, and when attention switched the pattern quickly reversed. Thus, like a radio, human primary auditory cortex is able to tune into attended frequency channels and can switch channels on demand.

Haemophilia registry of the medical committee of the Swiss Haemophilia Society. Update and annual survey 2009.

The Swiss Haemophilia Registry of the Medical Committee of the Swiss Haemophilia Society started in 1996 but was set as an internet-based, double password-protected facility in the year 2000. With the inclusion of patients' data from two new centres in 2009, we assume a coverage rate of about 90% of all patients with inherited bleeding disorders in our country. Data concerning the phenotype and genotype of the disorder, its severity, its therapy, the prevalence of inhibitors are readily available to the registered users, allowing quality control of haemophilia therapy at a national level, but also rapid care of the patient visiting the emergency room of another treatment centre. Basing on the available data, about two thirds of the WFH global survey can be answered; the mortality statistics shows that bleeding remains a cause of death in haemophiliacs, also in the 21th century. The Registry allows for comparisons with international datasets, especially with respect to treatment (prophylaxis vs. on-demand therapy), factor consumption and costs.

Pysäköintihallien pakokaasupäästöjen mittaaminen ja ilmanvaihdon ohj

Henkilöautojen pakokaasut sisältävät satoja eri yhdisteitä, joista monet ovat ihmisen terveydelle haitallisia. Pysäköintihallien ilmanlaatua on tähän asti mitattu pääasiassa hiilimonoksidiantureilla, jolloin ilmanvaihtokoneita on voitu käyttää tarvepohjaisesti. Parantunut pakokaasujen puhdistustekniikka on vähentänyt perinteisesti haitallisimmaksi koettujen hiilimonoksidin ja typenoksidien määräpakokaasuissa. Tästä johtuen hiilidioksidin määrä pysäköintihallissa voi kohota haitalliselle tasolle ennen kuin hiilimonoksidianturit reagoivat tilanteeseen. Tässä diplomityössä tarkasteltiin pysäköintihallien ilmanlaatua ja hiilidioksidiantureiden edellytyksiä toimia ilmanvaihdon ohjauksessa. Hiilimonoksidi- ja hiilidioksidipitoisuuksia mitattiin Kampin ja Koskikeskuksen pysäköintihalleissa. Tuloksissa esitetään hiilimonoksidin ja hiilidioksidin riippuvuus ilmanvaihdon tehosta ja pysäköintihallin liikenteen määrästä. Johtopäätöksissä on kuvattu ehdotus hiilidioksidiantureiden käytöstä pysäköintihallien ilmanvaihdon ohjauksessa.

IPSec in 3G packet switched domain

Diplomityö käsittelee IPSec-protokollan (IP Security Protocol) implementointia UMTS:n (Universal Mobile Telecommunications System) pakettikytkentäiseen verkkoon. Runkoverkkoa käytetään mobiilikäyttäjän datan siirtämiseen sekä verkkoelementtien väliseen ohjausinformaation välitykseen. Koska UMTS:n runkoverkot ovat IP-pakettikytkentäisiä verkkoja, IPSec-protokollaa voidaan käyttää lähetettyjen IP-datasähkeiden suojaamiseen. IPSec- ja IKE-protokollien (Internet Key Exchange) käyttö on koettu monimutkaiseksi kiinteissä verkoissa. Tämän saman ongelman edessä tulevat olemaan myös operaattorit, kun he alkavat rakentaa UMTS-verkkojaan. On kuitenkin muistettava se, että tulevaisuudessa lähes kaikki data mukaanlukien ääni ja video on tarkoitus siirtää IP-protokollan avulla. IP-teknologiaan perustuva tiedonsiirron kasvu lisää IPSec-protokollan merkitystä ei ainoastaan runkoverkossa mutta myös radioliityntäverkoissa sekä SS7-merkinantoverkoissa (Signaling System No. 7). Diplomityö on tehty osaksi diplomi-insinöörin tutkintoa Lappeenrannan teknillisessä yliopistossa. Työ on tehty Nokia Networksin palveluksessa Helsingissä, vuosien 2002 ja 2003 välisenä aikana.