The function and mechanisms of action of ghrelin and obestatin in ovarian cancer

In this study, we have demonstrated that the preproghrelin derived hormones, ghrelin and obestatin, may play a role in ovarian cancer. Ghrelin and obestatin stimulated an increase in cell migration in ovarian cancer cell lines and may play a role in cancer progression. Ovarian cancer is the leading cause of death among gynaecological cancers and is the sixth most common cause of cancer-related deaths in women in developed countries. As ovarian cancer is difficult to diagnose at a low tumour grade, two thirds of ovarian cancers are not diagnosed until the late stages of cancer development resulting in a poor prognosis for the patient. As a result, current treatment methods are limited and not ideal. There is an urgent need for improved diagnostic markers, as well better therapeutic approaches and adjunctive therapies for this disease. Ghrelin has a number of important physiological effects, including roles in appetite regulation and the stimulation of growth hormone release. It is also involved in regulating the immune, cardiovascular and reproductive systems and regulates sleep, memory and anxiety, and energy metabolism. Over the last decade, the ghrelin axis, (which includes the hormones ghrelin and obestatin and their receptors), has been implicated in the pathogenesis of many human diseases and it may t may also play an important role in the development of cancer. Ghrelin is a 28 amino acid peptide hormone that exists in two forms. Acyl ghrelin (usually referred to as ghrelin), has a unique n-octanoic acid post-translational modification (which is catalysed by ghrelin O-acyltransferase, GOAT), and desacyl ghrelin, which is a non-octanoylated form. Octanoylated ghrelin acts through the growth hormone secretagogue receptor type 1a (GHSR1a). GHSR1b, an alternatively spliced isoform of GHSR, is C-terminally truncated and does not bind ghrelin. Ghrelin has been implicated in the pathophysiology of a number of diseases Obestatin is a 23 amino acid, C-terminally amidated peptide which is derived from preproghrelin. Although GPR39 was originally thought to be the obestatin receptor this has been disproven, and its receptor remains unknown. Obestatin may have as diverse range of roles as ghrelin. Obestatin improves memory, inhibits thirst and anxiety, increases pancreatic juice secretion and has cardioprotective effects. Obestatin also has been shown to regulate cell proliferation, differentiation and apoptosis in some cell types. Prior to this study, little was known regarding the functions and mechanisms of action ghrelin and obestatin in ovarian cancer. In this study it was demonstrated that the full length ghrelin, GHSR1b and GOAT mRNA transcripts were expressed in all of the ovarian-derived cell lines examined (SKOV3, OV-MZ-6 and hOSE 17.1), however, these cell lines did not express GHSR1a. Ovarian cancer tissue of varying stages and normal ovarian tissue expressed the coding region for ghrelin, obestatin, and GOAT, but not GHSR1a, or GHSR1b. No correlations between cancer grade and the level of expression of these transcripts were observed. This study demonstrated for the first time that both ghrelin and obestatin increase cell migration in ovarian cancer cell lines. Treatment with ghrelin (for 72 hours) significantly increased cell migration in the SKOV3 and OV-MZ-6 ovarian cancer cell lines. Ghrelin (100 nM) stimulated cell migration in the SKOV3 (2.64 +/- 1.08 fold, p <0.05) and OV-MZ-6 (1.65 +/- 0.31 fold, p <0.05) ovarian cancer cell lines, but not in the representative normal cell line hOSE 17.1. This increase in migration was not accompanied by an increase in cell invasion through Matrigel. In contrast to other cancer types, ghrelin had no effect on proliferation. Ghrelin treatment (10nM) significantly decreased attachment of the SKOV3 ovarian cancer cell line to collagen IV (24.7 +/- 10.0 %, p <0.05), however, there were no changes in attachment to the other extracellular matrix molecules (ECM) tested (fibronectin, vitronectin and collagen I), and there were no changes in attachment to any of the ECM molecules in the OV-MZ-6 or hOSE 17.1 cell lines. It is, therefore, unclear if ghrelin plays a role in cell attachment in ovarian cancer. As ghrelin has previously been demonstrated to signal through the ERK1/2 pathway in cancer, we investigated ERK1/2 signalling in ovarian cancer cell lines. In the SKOV3 ovarian cancer cell line, a reduction in ERK1/2 phosphorylation (0.58 fold +/- 0.23, p <0.05) in response to 100 nM ghrelin treatment was observed, while no significant change in ERK1/2 signalling was seen in the OV-MZ-6 cell line with treatment. This suggests that this pathway is unlikely to be involved in mediating the increased migration seen in the ovarian cancer cell lines with ghrelin treatment. In this study ovarian cancer tissue of varying stages and normal ovarian tissue expressed the coding region for obestatin, however, no correlation between cancer grade and level of obestatin transcript expression was observed. In the ovarian-derived cell lines studied (SKOV3, OV-MZ-6 and hOSE 17.1) it was demonstrated that the full length preproghrelin mRNA transcripts were expressed in all cell lines, suggesting they have the ability to produce mature obestatin. This is the first study to demonstrate that obestatin stimulates cell migration and cell invasion. Obestatin induced a significant increase in migration in the SKOV3 ovarian cancer cell line with 10 nM (2.80 +/- 0.52 fold, p <0.05) and 100 nM treatments (3.12 +/- 0.68 fold, p <0.05) and in the OV-MZ-6 cancer cell line with 10 nM (2.04 +/- 0.10 fold, p <0.01) and 100 nM treatments (2.00 +/- 0.37 fold, p <0.05). Obestatin treatment did no affect cell migration in the hOSE 17.1normal ovarian epithelial cell line. Obestatin treatment (100 nM) also stimulated a significant increase in cell invasion in the OV-MZ-6 ovarian cancer cell line (1.45 fold +/- 0.13, p <0.05) and in the hOSE17.1 normal ovarian cell line cells (1.40 fold +/- 0.04 and 1.55 fold +/- 0.05 respectively, p <0.01) with 10 nM and 100 nM treatments. Obestatin treatment did not stimulate cell invasion in the SKOV3 ovarian cancer cell line. This lack of obestatin-stimulated invasion in the SKOV3 cell line may be a cell line specific result. In this study, obestatin did not stimulate cell proliferation in the ovarian cell lines and it has previously been shown to have no effect on cell proliferation in the BON-1 pancreatic neuroendocrine and GC rat somatotroph tumour cell lines. In contrast, obestatin has been shown to affect cell proliferation in gastric and thyroid cancer cell lines, and in some normal cell lines. Obestatin also had no effect on attachment of any of the cell lines to any of the ECM components tested (fibronectin, vitronectin, collagen I and collagen IV). The mechanism of action of obestatin was investigated further using a two dimensional-difference in gel electrophoresis (2D-DIGE) proteomic approach. After treatment with obestating (0, 10 and 100 nM), SKOV3 ovarian cancer and hOSE 17.1 normal ovarian cell lines were collected and 2D-DIGE analysis and mass spectrometry were performed to identify proteins that were differentially expressed in response to treatment. Twenty-six differentially expressed proteins were identified and analysed using Ingenuity Pathway Analysis (IPA). This linked 16 of these proteins in a network. The analysis suggested that the ERK1/2 MAPK pathway was a major mediator of obestatin action. ERK1/2 has previously been shown to be associated with obestatin-stimulated cell proliferation and with the anti-apoptotic effects of obestatin. Activation of the ERK1/2 signalling pathway by obestatin was, therefore, investigated in the SKOV3 and OV-MZ-6 ovarian cancer cell lines using anti-active antibodies and Western immunoblots. Obestatin treatment significantly decreased ERK1/2 phosphorylation at higher obestatin concentrations in both the SKOV3 (100 nM and 1000 nM) and OV-MZ-6 (1000 nM) cell lines compared to the untreated controls. Currently, very little is known about obestatin signalling in cancer. This thesis has demonstrated for the first time that the ghrelin axis may play a role in ovarian cancer migration. Ghrelin and obestatin increased cell migration in ovarian cancer cell lines, indicating that they may be a useful target for therapies that reduce ovarian cancer progression. Further studies investigating the role of the ghrelin axis using in vivo ovarian cancer metastasis models are warranted.

Giving voice to service providers who work with survivors of torture and trauma

Clinicians who support people from refugee and asylum seeking backgrounds are routinely exposed to stories of trauma as part of their work. Hearing these stories can be highly distressing for clinicians, but simultaneously provide opportunities for positive personal growth. Adopting a longitudinal qualitative design, we interviewed twelve service providers at two time points a year apart. We used a semistructured interview protocol and analyzed the data according to interpretative phenomenological analysis. Five superordinate and 19 constituent themes emerged from the analysis at Time 1 and Time 2. We found that participants were both positively and negatively affected by their work, and their experiences remained relatively stable across time. The participants highlighted the use of organizational and personal coping strategies to help minimize distress and maximize wellbeing. Adopting a broad repertoire of such strategies is not only advantageous for the service providers, but ultimately for those people they seek to assist.

Distress, coping and posttraumatic growth in refugees from Burma

Refugees flee their countries of origin due to supreme hardship and threat to life; frequently bearing witness to mass atrocity. This research is embedded in a salutogenic paradigm which emphasises strength and adjustment. Twenty-five refugees from Burma who were newly arrived in Australia were interviewed and transcripts were analysed using an Interpretive Phenomenological Analytic (IPA) approach. In addition to themes of distress, data revealed an extraordinary adaptive capacity and highlighted strengths, both individually and collectively. Specific adaptive strategies included religiousness, and a sense of duty to family, community and country. Findings have implications for policy and practice that aim to support refugees and asylum seekers.

Evaluation of a pilot-scale oil extraction from microalgae for biodiesel production

Biodiesel derived from microalgae is one of a suite of potential solutions to meet the increasing demand for a renewable, carbon-neutral energy source. However, there are numerous challenges that must be addressed before algae biodiesel can become commercially viable. These challenges include the economic feasibility of harvesting and dewatering the biomass and the extraction of lipids and their conversion into biodiesel. Therefore, it is essential to find a suitable extraction process given these processes presently contribute significantly to the total production costs which, at this stage, inhibit the ability of biodiesel to compete financially with petroleum diesel. This study focuses on pilot-scale (100 kg dried microalgae) solvent extraction of lipids from microalgae and subsequent transesterification to biodiesel. Three different solvents (hexane, isopropanol (IPA) and hexane + IPA (1:1)) were used with two different extraction methods (static and Soxhlet) at bench-scale to find the most suitable solvent extraction process for the pilot-scale. The Soxhlet method extracted only 4.2% more lipid compared to the static method. However, the fatty acid profiles of different extraction methods with different solvents are similar, suggesting that none of the solvents or extraction processes were biased for extraction of particular fatty acids. Considering the cost and availability of the solvents, hexane was chosen for pilot-scale extraction using static extraction. At pilot-scale the lipid yield was found to be 20.3% of total biomass which is 2.5% less than from bench scale. Extracted fatty acids were dominated by polyunsaturated fatty acids (PUFAs) (68.94±0.17%) including 47.7±0.43 and 17.86±0.42% being docosahexaenoic acid (DHA) (C22:6) and docosapentaenoic acid (DPA) (C22:5, ω-3), respectively. These high amounts of long chain poly unsaturated fatty acids are unique to some marine microalgae and protists and vary with environmental conditions, culture age and nutrient status, as well as with cultivation process. Calculated physical and chemical properties of density, viscosity of transesterified fatty acid methyl esters (FAMEs) were within the limits of the biodiesel standard specifications as per ASTM D6751-2012 and EN 14214. The calculated cetane number was, however, significantly lower (17.8~18.6) compared to ASTM D6751-2012 or EN 14214-specified minimal requirements. We conclude that the obtained microalgal biodiesel would likely only be suitable for blending with petroleum diesel to a maximum of 5 to 20%.

Asthma interventions in primary schools : a review

Objective To explore, in depth, the literature for evidence supporting asthma interventions delivered within primary schools and to identify any “gaps” in this research area. Methods A literature search using electronic search engines (i.e. Medline, PubMed, Education Resources Information Center (ERIC), International Pharmaceutical Abstracts (IPA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Informit) and the search terms “asthma”, “asthma intervention” and “school-based asthma education program” (and derivatives of these keywords) was conducted. Results Twenty-three articles met the inclusion criteria; of these eight were Randomised Controlled Trials. There was much variety in the type, content, delivery and outcome measures in these 23 studies. The most common intervention type was asthma education delivery. Most studies demonstrated improvement in clinical and humanistic markers, for example, asthma symptoms medication use (decrease in reliever medication use or decrease in the need for rescue oral steroid), inhaler use technique and spacer use competency, lung function and quality of life. Relatively few studies explored the effect of the intervention on academic outcomes. Most studies did not report on the sustainability or cost effectiveness of the intervention tested. Another drawback in the literature was the lack of details about the intervention and inconsistency in instruments selected for measuring outcomes. Conclusion School-based asthma interventions regardless of their heterogeneity have positive clinical, humanistic, health economical and academic outcomes.

Comparative genomics of koala, cattle and sheep strains of Chlamydia pecorum

Background Chlamydia pecorum is an important pathogen of domesticated livestock including sheep, cattle and pigs. This pathogen is also a key factor in the decline of the koala in Australia. We sequenced the genomes of three koala C. pecorum strains, isolated from the urogenital tracts and conjunctiva of diseased koalas. The genome of the C. pecorum VR629 (IPA) strain, isolated from a sheep with polyarthritis, was also sequenced. Results Comparisons of the draft C. pecorum genomes against the complete genomes of livestock C. pecorum isolates revealed that these strains have a conserved gene content and order, sharing a nucleotide sequence similarity > 98%. Single nucleotide polymorphisms (SNPs) appear to be key factors in understanding the adaptive process. Two regions of the chromosome were found to be accumulating a large number of SNPs within the koala strains. These regions include the Chlamydia plasticity zone, which contains two cytotoxin genes (toxA and toxB), and a 77 kbp region that codes for putative type III effector proteins. In one koala strain (MC/MarsBar), the toxB gene was truncated by a premature stop codon but is full-length in IPTaLE and DBDeUG. Another five pseudogenes were also identified, two unique to the urogenital strains C. pecorum MC/MarsBar and C. pecorum DBDeUG, respectively, while three were unique to the koala C. pecorum conjunctival isolate IPTaLE. An examination of the distribution of these pseudogenes in C. pecorum strains from a variety of koala populations, alongside a number of sheep and cattle C. pecorum positive samples from Australian livestock, confirmed the presence of four predicted pseudogenes in koala C. pecorum clinical samples. Consistent with our genomics analyses, none of these pseudogenes were observed in the livestock C. pecorum samples examined. Interestingly, three SNPs resulting in pseudogenes identified in the IPTaLE isolate were not found in any other C. pecorum strain analysed, raising questions over the origin of these point mutations. Conclusions The genomic data revealed that variation between C. pecorum strains were mainly due to the accumulation of SNPs, some of which cause gene inactivation. The identification of these genetic differences will provide the basis for further studies to understand the biology and evolution of this important animal pathogen. Keywords: Chlamydia pecorum; Single nucleotide polymorphism; Pseudogene; Cytotoxin

Destination image: identifying baseline perceptions of Brazil, Argentina and Chile in the nascent Australian long haul travel market

While the popularity of destination image research has increased exponentially in the literature, there has been relatively little published about perceptions held by international consumers of destinations in South America. The purpose of this paper is to report the findings of a research project that aimed to identify the baseline market perceptions of Brazil, Argentina and Chile amongst Australian residents, at the time of the emergence of this long haul market. Of interest was the extent to which Australians differentiate the three distinct countries versus perceiving the continent as a gestalt. These baseline perceptions enable the effectiveness of future marketing communications in Australia by the three national tourism offices to be monitored over time. Importance-Performance Analysis (IPA) is used as a practical analytical tool to guide decision makers. In terms of operationalising destination image, a key research finding was the very high ratio or participants using the ‘Don’t know’ (DK) option for each destination performance scale item. This finding has practical implications for the destination marketers, as well as for researchers engaged in destination image research in long haul and/or emerging markets.

Efficacy of herbicides on weedy Sporobolus grasses in the glasshouse in Australia

Twenty three herbicides including the current registered herbicides were screened for activity on pre-emergent, juvenile and mature plants of the weedy Sporobolus grass species Sporobolus pyramidalis P.Beauv. and Sporobolus fertilis (Steud.) Clayton. No new herbicides trialled effectively controlled mature plants. Propaquizafop, fluazifop-P-hutyI, flupropanate, haloxyfop-R-methyl ester, glyphosate-ipa and clethodim + haloxyfop-R-methyl ester mix showed good activity on juvenile plants while atrazine, flupropanate, dithiopyr and imazapyr where effective as pre-emergent herbicides. Further work needs to be done to define the recommended application rates for juvenile and pre-emergent plant stages and to determine the selectivity of these herbicides on native and exotic pasture grasses.

DCAF4, a novel gene associated with leucocyte telomere length

Background Leucocyte telomere length (LTL), which is fashioned by multiple genes, has been linked to a host of human diseases, including sporadic melanoma. A number of genes associated with LTL have already been identified through genome-wide association studies. The main aim of this study was to establish whether DCAF4 (DDB1 and CUL4-associated factor 4) is associated with LTL. In addition, using ingenuity pathway analysis (IPA), we examined whether LTL-associated genes in the general population might partially explain the inherently longer LTL in patients with sporadic melanoma, the risk for which is increased with ultraviolet radiation (UVR). Results Genome-wide association (GWA) meta-analysis and de novo genotyping of 20 022 individuals revealed a novel association (p=6.4×10−10) between LTL and rs2535913, which lies within DCAF4. Notably, eQTL analysis showed that rs2535913 is associated with decline in DCAF4 expressions in both lymphoblastoid cells and sun-exposed skin (p=4.1×10−3 and 2×10−3, respectively). Moreover, IPA revealed that LTL-associated genes, derived from GWA meta-analysis (N=9190), are over-represented among genes engaged in melanoma pathways. Meeting increasingly stringent p value thresholds (p<0.05, <0.01, <0.005, <0.001) in the LTL-GWA meta-analysis, these genes were jointly over-represented for melanoma at p values ranging from 1.97×10−169 to 3.42×10−24. Conclusions We uncovered a new locus associated with LTL in the general population. We also provided preliminary findings that suggest a link of LTL through genetic mechanisms with UVR and melanoma in the general population.

Polydimethylsiloxane (PDMS) modulates CD38 expression, absorbs retinoic acid and may perturb retinoid signalling

Polydimethylsiloxane (PDMS) is the most commonly used material in the manufacture of customized cell culture devices. While there is concern that uncured PDMS oligomers may leach into culture medium and/or hydrophobic molecules may be absorbed into PDMS structures, there is no consensus on how or if PDMS influences cell behaviour. We observed that human umbilical cord blood (CB)-derived CD34+ cells expanded in standard culture medium on PDMS exhibit reduced CD38 surface expression, relative to cells cultured on tissue culture polystyrene (TCP). All-trans retinoic acid (ATRA) induces CD38 expression, and we reasoned that this hydrophobic molecule might be absorbed by PDMS. Through a series of experiments we demonstrated that ATRA-mediated CD38 expression was attenuated when cultures were maintained on PDMS. Medium pre-incubated on PDMS for extended durations resulted in a time-dependant reduction of ATRA in the medium and increasingly attenuated CD38 expression. This indicated a time-dependent absorption of ATRA into the PDMS. To better understand how PDMS might generally influence cell behaviour, Ingenuity Pathway Analysis (IPA) was used to identify potential upstream regulators. This analysis was performed for differentially expressed genes in primary cells including CD34+ haematopoietic progenitor cells, mesenchymal stromal cells (MSC), and keratinocytes, and cell lines including prostate cancer epithelial cells (LNCaP), breast cancer epithelial cells (MCF-7), and myeloid leukaemia cells (KG1a). IPA predicted that the most likely common upstream regulator of perturbed pathways was ATRA. We demonstrate here that ATRA is absorbed by PDMS in a time-dependent manner and results in the concomitant reduced expression of CD38 on the cell surface of CB-derived CD34+ cells.

Parenting a child with haemophilia while living in a non-metropolitan area

The experience of living in a non-metropolitan area and parenting a child with haemophilia is relatively unknown. Using Interpretive Phenomenological Analysis (IPA), the following study explored the experiences of seven parents, from which four themes emerged: ‘bearing the brunt of diagnosis’ captures the impact of the diagnosis; ‘if you can’t help me, who can?’ reveals experiences with the health system; ‘tackling the challenge of treatment’ encompasses difficulties in adhering to the treatment regime; ‘I need you to understand’ reflects desires for others support and understanding. These themes should be considered when developing support systems and interventions for parents living in non-metropolitan areas.

Performance based planning in Queensland : A case of unintended plan-making outcomes

Performance based planning (PBP) is purported to be a viable alternative to traditional zoning. The implementation of PBP ranges between pure approaches that rely on predetermined quantifiable performance standards to determine land use suitability, and hybrid approaches that rely on a mix of activity based zones in addition to prescriptive and subjective standards. Jurisdictions in the USA, Australia and New Zealand have attempted this type of land use regulation with varying degrees of success. Despite the adoption of PBP legislation in these jurisdictions, this paper argues that a lack of extensive evaluation means that PBP is not well understood and the purported advantages of this type of planning are rarely achieved in practice. Few empirical studies have attempted to examine how PBP has been implemented in practice. In Queensland, Australia, the Integrated Planning Act 1997 (IPA) operated as Queensland's principal planning legislation between March 1998 and December 2009. While the IPA did not explicitly use the term performance based planning, the Queensland's planning system is widely considered to be performance based in practice. Significantly, the IPA prevented Local Government from prohibiting development or use and the term zone was absent from the legislation. How plan-making would be advanced under the new planning regime was not clear, and as a consequence local governments produced a variety of different plan-making approaches to comply with the new legislative regime. In order to analyse this variation the research has developed a performance adoption spectrum to classify plans ranging between pure and hybrid perspectives of PBP. The spectrum compares how land use was regulated in seventeen IPA plans across Queensland. The research found that hybrid plans predominated, and that over time a greater reliance on risk adverse drafting approaches created a quasi-prohibition plan, the exact opposite of what was intended by the IPA. This paper concludes that the drafting of the IPA and absence of plan-making guidance contributed to lack of shared understanding about the intended direction of the new planning system and resulted in many administrative interpretations of the legislation. It was a planning direction that tried too hard to be different, and as a result created a perception of land use risk and uncertainty that caused a return to more prescriptive and inflexible plan-making methods.

Vanhustenhoitajan ammatillinen rooli – avain vanhusten hyvinvointiin ja hoitajien työssä jaksamiseen

Suomessa väestön rakenne on muuttumassa ja hoitoa tarvitsevien määrä nousee jatkuvasti. Vanhustenhoito on muuttunut henkisesti ja fyysisesti yhä kuormittavammaksi ja vanhustenhoidon imago huonoksi. Tavoitteita asetetaan, mutta resurssit näiden saavuttamiseen ovat tiukassa. Tutkimuksen keskiössä olivat vanhustenhoitajien kokemukset ammatillisesta roolista. Tutkimuksen teoreettisina tukipilareina toimivat rooliteoria sekä näkemykset tunnetyöstä ja totaalisista laitoksista. Menetelmänä toimi IPA:a, jonka avulla voidaan päästä käsiksi siihen, miten tutkittavat jäsentävät maailmaansa − tässä tapauksessa ammatillista rooliaan vanhustyöntekijöinä. Tutkimuksen aineistona toimivat 8 haastattelua, jotka on kerätty vuonna 2009. Aineistosta nousi päällimmäisenä esiin hoitajan ja asukkaan välinen vuorovaikutus ja se, kuinka hoitajan on oltava ammatillisessa roolissa. Tätä vuorovaikutussuhdetta kuvattiin kaikissa kahdeksassa haastattelussa ja sitä pidettiin ammattitaidon oleellisimpana osana. Ensimmäisellä tutkimuskysymyksellä selvitettiin millaisia rooliodotuksia vanhustenhoitajat asettavat toiminnalleen. Oleellisimmat odotukset rakentuivat sen ympärille, miten vanhuksen kanssa ollaan vuorovaikutuksessa. Tilanteissa hoitajan tulisi osata oikeanlaiset tiukat, mutta toisaalta lempeät otteet, jotta vanhukset eivät passivoituisi. Nämä otteet nähtiin vanhuksen edun mukaisina, sillä ilman jämäkkää hoito-otetta vanhukset saattoivat heittäytyä täysihoitoon ja lakata pitämästä yllä päivittäisiä toimintojaan, kuten hampaiden pesua. Toinen tutkimuskysymys paneutui siihen, kokevatko vanhustenhoitajat roolinmukaisuuden tärkeäksi työssään. Lisäksi perehdyttiin siihen, miksi roolinmukaisuus koetaan tärkeänä. Haastatellut vanhustenhoitajat toivat esiin, että työstä on suoriuduttava tietyllä tavalla. Omista murheista tai mieltymyksistä huolimatta työt piti saada tehtyä. Työhön oltiin tultu vanhuksen edun vuoksi ja se oli pidettävä mielessä koko ajan. Kun hoitajat onnistuivat toimimaan rooliodotusten mukaisesti, säilyi tunnelma osastolla rauhallisena ja lääkkeitä kului vähemmän. Kolmas tutkimuskysymys pureutui siihen, voiko vanhustenhoitaja vapautua ammatillisesta roolistaan työpäivän aikana. Hoitajat kokivat, että roolista vapautuminen oli mahdollista työpäivän aikana, mutta sille annettiin tiukat rajat. Vanhusten nähden hoitajan tuli pysytellä tiukasti roolinmukaisessa odotettavassa käytöksessä. Vanhustenhoitajilla oli selkeästi erilaiset käyttäytymissäännöt niihin tilanteisiin kun oltiin osastolla potilaiden näkyvillä kuin niihin tilanteisiin joissa oltiin yksin tai kollegoiden kanssa. Tässä voidaan nähdä selkeä yhteys Goffmanin rooliteoriaan, jossa hän tuo esiin, että esityksissä on näyttämö ja takatila. Vanhainkodin tapauksessa näyttämö on osasto, jossa vanhukset ja omaiset seuraavat hoitajien toimintaa. Takatiloina sen sijaan toimivat hoitajien omat työhuoneet, taukotilat ja henkilökunnan wc, jossa työnaamio voitiin riisua hetkellisesti pois. Tärkeimmät lähteet ovat: Goffman, E. (1971). Arkielämän roolit. Oikeille jäljille rooliviidakossa ja Smith, J., Flowers, P., Larkin, M. (2009). Interpretative Phenomenological Analysis. Theory, method and research.

Lapsen sota - Evakko- ja sotalapsen sotakokemuksen fenomenologinen tutkimus

Kaikkialla maailmassa aseelliset konfliktit luovat yhä edelleen uusia lapsiuhreja. Suomen viime sodat ovat yksi esimerkki näistä. Uusien tutkijasukupolvien nousun myötä toisesta maailmansodasta tuli tutkimuksellisesti riittävän etäinen vasta 1990-luvulla. Sotilaiden, lottien ja kotirintaman naisten sodan rinnalle tuli sota lapsen näkökulmasta. Tutkielman aineisto koostuu kolmesta eläkeikäisen evakko- ja sotalapsen haastattelusta, jotka on saatu Evakkolapset ry:n kautta. Työn tarkoituksena on lisätä ymmärrystä lapsen sotakokemuksesta ja sodan monitasoisista ja pitkäkestoisista vaikutuksista lapsen elämään. Tutkielman tieteenteoreettinen pohja on fenomenologisessa psykologiassa. Lapsen kokemuksen fenomenologista tutkimusta ei ole vielä juuri tehty. Tavoitteena on ensin yksilötasolla kolmen haastateltavan lapsuuden sotakokemuksen mahdollisimman rikas kuvaaminen ja toiseksi sosiaalisella tasolla niiden mahdollisten jaettujen kokemusten löytäminen, jotka ovat yhteisiä näille kolmelle ja oletettavasti myös yleisemmin evakko- ja sotalasten keskuudessa. Kolmanneksi, näistä johtaen yhteenvedossa ja diskussiossa pyritään luomaan yhteiskunnallisella tasolla suuntaviivoja näiden kokemusten yleisempään soveltamiseen pakolais- ja maahanmuuttajatyössä. Kokemuksen jaettavuuden ja yleistämisen tunnustaminen on sosiaalipsykologiaa. Työssä luotu yhdistelmämetodi, fenomenologiapainotteinen IPA, auttaa tämän hahmottamisessa. Yhdistelmämetodi on syntynyt kahta eri fenomenologisen psykologian tutkimussuuntausta ja menetelmää vertaillen. Nämä ovat fenomenologinen ja hermeneuttinen Tulkitseva fenomenologinen analyysi eli Interpretative Phenomenological Analysis (IPA) (Smith, Flowers & Larkin, 2009) ja Amedeo Giorgin (mm. 1985) fenomenologinen menetelmä, jota Suomessa on eniten soveltanut Juha Perttula (2005). Tätä menetelmää kutsutaan siksi Perttulan ja Giorgin fenomenologiseksi menetelmäksi. Haastateltavan aidon kokemuksen esiin saaminen vaatii tutkijalta fenomenologisen metodin noudattamista sekä merkityksien ymmärtämistä, kuvausta ja tulkintaa. Työn ensimmäinen tavoite on saavutettu kolmen haastateltavan oman lapsuuden sota-ajan teemoitetulla kuvauksella. Tulosten yhteenvedossa tulee esiin, että näiden kolmen kokemuksilla on sosiaalista kaikupohjaa muissa suomalaisissa sota- ja evakkolapsissa ja myös laajemmin eurooppalaisen lapsen sodassa. Kaikkien haastateltavien mielestä kokemus lapsuuden sodasta on jättänyt syviä jälkiä ja sitä usein halutaan jakaa, jotta sen kanssa selviytyy. Ajatus näiden tulosten soveltamiskelpoisuudesta pakolaistyöhön jää tässä työssä vain idean tasolle, mutta sellaisia viitteitä tulokset vahvasti antavat.

Moniammatilliset työryhmät nuorten syrjäytymisen ehkäisyssä

Tarkastelen tutkielmassani, miten moniammatillisuus ilmenee eri ammattikuntien edustajista koostuvien työryhmien palavereissa. Palavereissa käsitellään nuorten syrjäytymistä ennaltaehkäisevään Luotsi-toimintaan tehtyjä lähetteitä ja kiinnostukseni kohteena on, minkälainen merkitys työryhmän moniammatillisuudella on nuorten tilanteiden kartoittamisessa ja onko moniammatillisella osaamisella merkitystä nuorten syrjäytymisen ehkäisemisessä. Sosiaalipsykologisesti erityisen kiinnostavaa on työryhmien vuorovaikutus ja sen merkitys nuorten tilanteiden käsittelyssä. Tutkimukseni pohjautuu sosiaalipsykologisiin, vuorovaikutusta ja ryhmädynamiikkaa käsitteleviin teorioihin ja keskeisimpinä teoreetikkoina ovat Michael Billig (1996) ja Robert Bales (1951). Tutkielmani aineistona on kolmessa Luotsi-työryhmässä nauhoitetut kuusi palaveria, joissa oli läsnä kolmen ammattikunnan edustajia (terveydenhoitajia, sosiaaliohjaajia, nuoriso-ohjaajia) sekä toiminnanjohtajia. Tutkimukseni päätutkimuskysymys oli: Miten moniammatillisuus ilmenee syrjäytymisvaarassa olevista nuorista käytävissä keskusteluissa ja palveleeko se nuorten syrjäytymisen ehkäisyä? Jos palvelee, niin miten? Analyysimenetelminä olivat aineistolähtöinen sisällönanalyysi sekä Balesin (1951) kehittämä vuorovaikutusprosessin analyysi (Interaction Process Analysis, IPA). Tutkimuksen tulokset osoittivat, että Luotsi-työryhmien lähetepalavereissa eri ammattikunnilla on tarjottavana toisiaan täydentävää ammatillista asiantuntijatietoa, jonka lisäksi eri ammattikunnilla on taipumus pohtia tarkemmin yhtä osaa nuoren elämästä siten, että nämä painotuserot myös täydentävät toisiaan. Nuorten elämäntilanteiden kokonaisvaltaiselle kartoitukselle on siis olemassa hyvät edellytykset. Moniammatillisen asiantuntijuuden hyödyntäminen nuoren syrjäytymisvaaran arvioimisessa jää kuitenkin pieneksi toisaalta sen vuoksi, että toimintaan lähetyt nuoret ovat usein toimintaan juuri kohderyhmää ja toisaalta siksi, että useimmiten Luotsi-työryhmillä oli hyvin tilaa uusille asiakkaille. Näin ollen tarve syrjäytymisvaaran arvioimiseksi syntyi vain harvoin. Moniammatillisuutta hyödynnetään kuitenkin ahkerasti kun työryhmissä mietitään, minkälaisin keinoin nuorta olisi mahdollista tukea. Työryhmien vuorovaikutus mahdollistaa useimmiten moniammatillisen asiantuntijuuden esille tuomisen, sillä ilmapiiri on pääosin positiivinen ja kannustava, jolloin ajatuksia on helppo jakaa. Työryhmissä esiintyy myös positiivista sosioemotionaalista toimintaa, jonka avulla työryhmän jäsenet kannustavat toisiaan kertomaan ajatuksistaan. Vuorovaikutukseen sisältyy kuitenkin myös riskitekijöitä, jotka saattavat haitata moniammatillisen asiantuntijuuden hyödyntämistä estämällä ryhmänjäseniä tuomaan esille mielipiteitään. Ryhmissä on esimerkiksi havaittavissa statuseroja, joiden seurauksena osallistumisaktiivisuus vaihtelee voimakkaasti ryhmänjäsenestä toiseen, eikä kaikilla ryhmänjäsenillä ole siten mahdollisuutta tuoda tietotaitoaan ryhmän käyttöön. Myös kiire asetti joissain palavereissa rajoitteita nuorten tilanteiden syvälliselle arvioimiselle. Näiden riskitekijöiden todellisia vaikutuksia nuoren edun kannalta ja niiden merkitystä subjektiivisiin kokemuksiin ryhmän vuorovaikutuksesta olisi hyvä tutkia jatkossa. Avainsanat: Moniammatillisuus, nuorten syrjäytyminen, vuorovaikutus, Interaction Process Analysis.