Natural history of celiac disease-associated antibodies and progression to overt disease in children at increased genetic risk

Background: Celiac disease is a lifelong, gluten-sensitive, autoimmune-mediated chronic enteropathy, tightly associated with risk alleles at the HLA class II genes. Aims: This study was carried out as a part of the population-based Type 1 Diabetes Prediction and Prevention (DIPP) Project. The first aim was to study the natural history of celiac disease-associated antibodies before the diagnosis of celiac disease was made. The second aim was to describe when and in which order celiac disease-associated and type 1 diabetes-associated antibodies appeared in children with genetic risk for both diseases. Subjects and Methods: Antibodies against tissue transglutaminase (TGA) and other celiac disease-associated antibodies were measured in serum samples collected at 3- to 12-month intervals of children at genetic risk for celiac disease who participated in the DIPP project. Celiac disease was confirmed by duodenal biopsy. Type 1 diabetes-associated antibodies were measured in all samples that had been collected. Overt disease was diagnosed according to World Health Organization criteria. Follow-up continued until a diagnosis of type 1 diabetes or until the end of a defined follow-up period. Results: TGA appeared in children at genetic risk for celiac disease only after the first year of life, but anti-gliadin antibodies often emerged significantly earlier, at age 6 months. The data show that spontaneous disappearance of celiac disease-associated antibodies, transient or persisting, is a common phenomenon, at least in prepubertal children. In children with genetic susceptibility to type 1 diabetes and celiac disease, celiac disease-associated antibodies usually develop earlier than the type 1 diabetes-associated antibodies. Conclusions: The transient nature of celiac disease-associated antibodies emphasizes the significance of establishing seropositivity repeatedly in screening detected celiac disease before gastroscopy and duodenal biopsy are considered and emphasized the importance of duodenal biopsy for diagnosing celiac disease.

Kitkat katkat

Sanat: Kanteletar.

Innovations of ageing and societal transition : Dynamics of change of the socio-technical regime of ageing

The purpose of this dissertation is to examine the dynamics of the socio-technical system in the field of ageing. The study stems from the notion that the ageing of the population as a powerful megatrend has wide societal effects, and is not just a matter for the social and health sector. The central topic in the study is change: not only the age structures and structures of society are changing, but also at the same time there is constant development, for instance, in technologies, infrastructures and cultural perceptions. The changing concept of innovation has widened the understanding of innovations related to ageing from medical and assistive technological innovations to service and social innovations, as well as systemic innovations at different levels, which means the intertwined and co-evolutionary change in technologies, structures, services and thinking models. By the same token, the perceptions of older people and old age are becoming more multi-faceted: old age is no longer equated to illnesses and decline, but visions of active ageing and a third age have emerged, which are framed by choices, opportunities, resources and consumption in later life. The research task in this study is to open up the processes and mechanisms of change in the field of ageing, which are studied as a complex, multi-level and interrelated socio-technical system. The question is about co-effective elements consisting of macro-level landscape changes, the existing socio-technical regime (the rule system, practices and structures) and bottom-up niche-innovations. Societal transitions do not account for the things inside the regime alone, or for the long-term changes in the landscape, nor for the radical innovations, but for the interplay between all these levels. The research problem is studied through five research articles, which offer micro-level case studies to macro-level phenomenon. Each of the articles focus on different aspects related to ageing and change, and utilise various datasets. The framework of this study leans on the studies of socio-technical systems and multi-level perspective on transitions mainly developed by Frank Geels. Essential factors in transition from one socio-technological regime to another are the co-evolutionary processes between landscape changes, regime level and experimental niches. Landscape level changes, like the ageing of the population, destabilise the regime in the forms of coming pressures. This destabilization offers windows for opportunity to niche-innovations outside or at fringe of the regime, which, through their breakthrough, accelerate the transition process. However, the change is not easy because of various kinds of lock-ins and inertia, which tend to maintain the stability of the regime. In this dissertation, a constructionist approach of society is applied leaning mainly to the ideas of Anthony Giddens’ theory of structuration, with the dual nature of structures. The change is taking place in the interplay between actors and structures: structures shape people’s practices, but at the same time these practices constitute and reproduce social systems. Technology and other material aspects, as part of socio-technical systems, and the use of them, also take part in the structuration process. The findings of the study point out that co-evolutionary and co-effective relationships between economic, cultural, technological and institutional fields, as well as relationships between landscape changes, changes in the local and regime-level practices and rule systems, are a very complex and multi-level dynamic socio-technical phenomenon. At the landscape level of ageing, which creates the pressures and triggers to the regime change, there are three remarkable megatrends: demographic change, changes in the global economy and the development of technologies. These exert pressures to the socio-technical regime, which as a rule system is experiencing changes in the form of new markets and consumer habits, new ways of perceiving ageing, new models of organising the health care and other services and as new ways of considering innovation and innovativeness. There are also inner dynamics in the relationships between these aspects within the regime. These are interrelated and coconstructed: the prevailing perceptions of ageing and innovation, for instance, reflect the ageing policies, innovation policies, societal structures, organising models, technology and scientific discussion, and vice versa. Technology is part of the inner dynamics of the sociotechnological regime. Physical properties of the artefacts set limitations and opportunities with regard to their functions and uses. The use of and discussion about technology, contributes producing and reproducing the perceptions of old age. For societal transition, micro-level changes are also needed, in form of niche-innovations, for instance new services, organisational models or new technologies, Regimes, as stabilitystriven systems, tend to generate incremental innovations, but radically new innovations are generated in experimental niches protected from ‘normal’ market selection. The windows of opportunity for radical novelties may be opened if the circumstances are favourable for instance by tensions in the socio-technical regime affected by landscape level changes. This dissertation indicates that a change is taking place, firstly, in the dynamic interactionbetween levels, as a result of purposive action and governance to some extent. Breaking the inertia and using the window of opportunity for change and innovation offered by dynamics between levels, presupposes the actors’ special capabilities and actions such as dynamic capabilities and distance management. Secondly, the change is taking place the socio-technological negotiations inside the regime: interaction between technological and social, which is embodied in the use of technology. The use of technology includes small-level contextual scripts that also participate in forming broader societal scripts (for instance defining old age at the society level), which in their turn affect the formation of policies for innovation and ageing. Thirdly, the change is taking place by the means of active formation of the multi-actor innovation networks, where the role of distance management is crucial to facilitate the communication between actors coming from different backgrounds as well as to help the niches born outside the regime to utilise the window of opportunity offered by regime destabilisation. This dissertation has both theoretical and practical contributions. This study participates in the discussion of action-oriented view on transition by opening up of the socio-technological, coevolutionary processes of the multi-faceted phenomenon of ageing, which has lacked systematic analyses. The focus of this study, however, is not on the large-scale coordination and governance, but rather on opening up the incremental elements and structuration processes, which contribute to the transition little by little, and which can be affected to. This increases the practical importance of this dissertation, by highlighting the importance of very tiny, everyday elements in the change processes in the long run.

Varjo : Sibelius-Akatemian kopio

Esittäjätiedot ja vuosiluvut saatu Yleisradiolta sillä oletuksella että kyseessä on juuri tämä 1981 esitys (nauhakotelossa Ylen nauhanumero, jota ei kuitenkaan löydy Ylen tietokannasta).

Kärsivällinen Sokrates : 3-näytöksinen koominen ooppera = Den tålmodige Sokrates : komisk opera i 3 akter

Sibelius-Akatemian konserttisarja kevät 1980. Julkinen kenraaliharjoitus la 16.2. klo 14.

Energia ja omistajuus

Tutkimusprojektissa on tarkasteltu omistajuuden vaikutusta energialiiketoiminnassa. Työn tilaajana toimi Sähköenergialiitto ry Sener. Tutkimuksessa on tarkasteltu sähkön tuotannon, myynnin ja jakelun liiketoimintoja sekä kaukolämpöliiketoiminta. Omistajuuden vaikutusta on tarkasteltu pääasiassa yhtiöiden teknisiä ja taloudellisia tilastotietoja vertailemalla. Analyysia varten yhtiöt on jaoteltu a) liikelaitoksiin, b) osuuskuntiin, c) toimialueen kunnan tai kaupungin omistamiin osakeyhtiöihin, d) osakeyhtiöihin, joiden omistuksesta yli puolet on toimialueella; omistajina kunnat, kaupungit, asiakkaat, yhteisöt ja/tai yritykset sekä e) osakeyhtiöihin, joiden omistus on toimialueen ulkopuolella. Jaolla on pyritty tuomaan esiin omistajuuden vaikutusta asiakkaan näkökulmasta. Suuri osa energialiiketoiminnasta Suomessa on jollain muotoa julkisessa omistuksessa. Viranomaisvalvonta sääntelee sähkönjakeluyhtiöiden hinnoittelua ja laatua. Sähköverkkoyhtiöt ovat keränneet verkkopalveluiden hinnoittelulla pääosin alle viranomaisen määrittämän kohtuullisen tuottotason. Hinnoittelussa on silti eroja eri omistajaryhmien välillä. Esimerkiksi yhtiöt, joiden omistus on toimialueen eri toimijoiden hallussa, ovat hinnoitelleet verkkopalvelunsa reilusti alle sallitun. Asiakkaiden kokemaan palvelun laatuun vaikuttaa ensisijaisesti verkkoyhtiön toimintoympäristö. Sähkön myynnissä toimialueen omistajuudella voi yksittäisissä tapauksissa olla vaikutusta asiakkaan sopimushintaan. Esimerkiksi jotkut yhden kunnan/kaupungin omistamista ja toimialueen toimijoiden omistuksessa olevista yhtiöistä tarjoavat oman toimialueensa asiakkaille sähköä markkinoiden yleistä hintatasoa edullisemmin. Toimialueen omistuksesta riippumatta, asiakkaalla on pääsääntöisesti mahdollisuus saada edullisempaa sähköä kilpailuttamalla sopimus. Kaukolämmön hintoihin ja laatuun ei kohdistu muodollista viranomaisvalvontaa, eikä toimintaa ole määritelty luonnolliseksi monopoliksi vastaavalla tavalla kuin sähköverkkoliiketoimintaa. Kaukolämpötoiminta kilpailee muiden lämmitysmuotojen kanssa. Hinnat määräytyvät asiakastiheyden ja polttoaineiden hintojen perusteella. Liikelaitokset ja kuntien/kaupunkien omistuksessa olevat kaukolämpöyhtiöt ovat tarkasteluajanjaksolla olleet hinnoiltaan edullisimpia, mutta erot eri omistusmuotojen välillä ovat vähäisiä.

Enabling constructive alignment in programming instruction

In this thesis, simple methods have been sought to lower the teacher’s threshold to start to apply constructive alignment in instruction. From the phases of the instructional process, aspects that can be improved with little effort by the teacher have been identified. Teachers have been interviewed in order to find out what students actually learn in computer science courses. A quantitative analysis of the structured interviews showed that in addition to subject specific skills and knowledge, students learn many other skills that should be mentioned in the learning outcomes of the course. The students’ background, such as their prior knowledge, learning style and culture, affects how they learn in a course. A survey was conducted to map the learning styles of computer science students and to see if their cultural background affected their learning style. A statistical analysis of the data indicated that computer science students are different learners than engineering students in general and that there is a connection between the student’s culture and learning style. In this thesis, a simple self-assessment scale that is based on Bloom’s revised taxonomy has been developed. A statistical analysis of the test results indicates that in general the scale is quite reliable, but single students still slightly overestimate or under-estimate their knowledge levels. For students, being able to follow their own progress is motivating, and for a teacher, self-assessment results give information about how the class is proceeding and what the level of the students’ knowledge is.