Pre-maps : An Educational Programme for Reading Tactile Maps

It is demanding for children with visual impairment to become aware of the world beyond their immediate experience. They need to learn to control spatial experiences as a whole and understand the relationships between objects, surfaces and themselves. Tactile maps can be an excellent source of information for depicting space and environment. By means of tactile maps children can develop their spatial understanding more efficiently than through direct travel experiences supplemented with verbal explanations. Tactile maps can help children when they are learning to understand environmental, spatial, and directional concepts. The ability to read tactile maps is not self-evident; it is a skill, which must be learned. The main research question was: can children who are visually impaired learn to read tactile maps at the preschool age if they receive structural teaching? The purpose of this study was to develop an educational program for preschool children with visual impairment, the aim of which was to teach them to read tactile maps in order to strengthen their orientation skills and to encourage them to explore the world beyond their immediate experience. The study is a multiple case study describing the development of the map program consisting of eight learning tasks. The program was developed with one preschooler who was blind, and subsequently the program was implemented with three other children. Two of the children were blind from birth, one child had lost her vision at the age of two, and one child had low vision. The program was implemented in a normal preschool. Another objective of the pre-map program was to teach the preschooler with visual impairment to understand the concept of a map. The teaching tools were simple, map-like representations called pre-maps. Before a child with visual impairment can read a comprehensive tactile map, it is important to learn to understand map symbols, and how a three-dimensional model changes to a two-dimensional tactile map. All teaching sessions were videotaped; the results are based on the analysis of the videotapes. Two of the children completed the program successfully, and learned to read a tactile map. The two other children felt happy during the sessions, but it was problematic for them to engage fully in the instruction. One of the two eventually completed the program, while the other developed predominantly emerging skills. The results of the children's performances and the positive feedback from the teachers, assistants and the parents proved that this pre-map program is appropriate teaching material for preschool children who are visually impaired. The program does not demand high-level expertise; also parents, preschool teachers, and school assistants can carry out the program.

Lähi-itä - mielikuvat, media ja konflikti : Tutkimuskohteena opettajaopiskelijat

This study examines Finnish student teachers' images of The Middle East conflict and its parties and medias' influence on these images. The research problems are 1) how student teachers understand the Middle East as a geographical and a cultural area 2) what kind of conceptions they have of the Middle East conflict and its parties; Israelis, Palestinians and Arabs and societies and religions closely connected to them and 3) how the media has influenced on these conceptions. Theoretical background of this study concerns with different mental images, their construction and meaning, stereotypes, intercultural competence, media and its influence as well as media literacy. The methods used in this study were survey and theme interview. Also headlines of the news were analysed. The survey was directed at student teachers of the University of Helsinki (n = 75). Six of them were interviewed. The survey was conducted in February and interviews were made in the turn of May and June 2003. The headlines analysed dealt with the Middle East conflict in the newspaper "Helsingin Sanomat" in January, April and July 2003. Main results: Images of the Middle East area differed largely from respondent to another. Student teachers didn't know much about the Middle East conflict. Stereotypes occurred in the conceptions connected to the parties of the conflict. Stereotypes appeared especially in the negative conceptions of islam and muslims and one-sided conceptions of Arabs. The influence of the conflict was noticeable in conceptions related to Israelis, Israel and Palestinians. Palestinians were sympathized. Attitudes towards Israelis, Palestinians and Arabs were negative to some extend and their societies were not valued very equal, open or modern. On the basis of the research, student teachers' intercultural competence was not good enough. Media had influence on the conceptions. Also skills in critical use of media varied largely. Some trusted strongly in the objectivity of a picture and the news. It can be argued, on the grounds of the results, that teacher education should concentrate more on themes of intercultural competence and media literacy. These two are interrelated and are both needed in understanding and conceptualising the world.

Evaluation of a Drunk Driving Warning System

The Drunk Driving Warning System is an alcohol interlock based on performance of the Critical Tracking Task (CTT). An evaluation was undertaken to determine CTT sensitivity to blood alcohol concentration (BAC), particularly at .05 g/100 ml. Subjects were 36 males in 3 age groups (18, 21 to 25, 35 years and above) divided into 2 alcohol consumption categories ("light" and "heavy"), and scored on 4 training and 2 test days (one alcohol and one placebo). The CTT performance declined as BAC increased and was significantly impaired at .05 BAC. However, performance was too variable for in-vehicle use. Age and alcohol consumption pattern were without effect.

Associations with low rates of postpartum glucose screening after gestational diabetes among Indigenous and non-Indigenous Australian women

OBJECTIVES To explore factors associated with postpartum glucose screening among women with Gestational Diabetes Mellitus (GDM). METHODS A retrospective study using linked records from women with GDM who gave birth at Cairns Hospital in Far North Queensland, Australia, from 1 January 2004 to 31 December 2010. RESULTS The rates of postpartum Oral Glucose Tolerance Test (OGTT) screening, while having increased significantly among both Indigenous* and non-Indigenous women from 2004 to 2010 (HR 1.15 per year, 95%CI 1.08-1.22, p<0.0001), remain low, particularly among Indigenous women (10% versus 27%, respectively at six months postpartum). Indigenous women in Cairns had a longer time to postpartum OGTT than Indigenous women in remote areas (HR 0.58, 0.38-0.71, p=0.01). Non-Indigenous women had a longer time to postpartum OGTT if they: were born in Australia (HR 0.76, 0.59-1.00, 0.05); were aged <25 years (HR 0.45, 0.23-0.89, p=0.02); had parity >5 (HR 0.33, 0.12-0.90, p=0.03); smoked (HR 0.48, 0.31-0.76, p=0.001); and did not breastfeed (HR 0.09, 0.01-0.64, p=0.02). CONCLUSIONS Postpartum diabetes screening rates following GDM in Far North Queensland are low, particularly among Indigenous women, with lower rates seen in the regional centre; and among non-Indigenous women with indicators of low socioeconomic status. IMPLICATIONS Strategies are urgently needed to improve postpartum diabetes screening after GDM that reach women most at risk.

Käsityötä, kotiteollisuutta ja sosiaalihuoltoa : Työtupa Aunuksessa 1941-1944

When Finland occupied East Karelian territories in Soviet Union during The Continuation War (1941 1944) Finnish people had also to take care of the inhabitants of the occupied East Karelia. For example there was a lack of clothes and shoes during the wartime. In order to facilitate clothing situation and to provide more opportunities to work for women, Finnish people founded some workshops in East Karelia. Workshops also helped to collect East Karelian craft products. One of the workshops was founded in the city of Olonets in October 1941 and it was in operation until June 1944. This workshop is the subject of this thesis. The aim of this thesis is to find out with the microhistorical approach what kind of functions the workshop of Olonets had during The Continuation War and who worked in the workshop. In this thesis I also examine women s crafts in the Olonets workshop and their meaning during the wartime. I collected the material of this thesis from different places. In February 2010 I interviewed Talvikki Lausala, the leader of the Olonets workshop, who worked in the Olonets from May 1942 to June 1944. From the Virkki Käsityömuseo I looked for objects which have been made in the workshop of Olonets. Tyyne-Kerttu Virkki collected crafts from the East Karelia when she was working in the area and in the workshop from 1941 to 1944. Archive material I found from the Finnish National archive and from the archive of the Tyyne-Kerttu Virkki -Foundation. East Karelian women and girls who were not able to do anything else came to work in the Olonets workshop. If women could not go to work outside of home, they had an option to do the same crafts at home. There were three Finnish women, Tyyne-Kerttu Virkki, Talvikki Lausala and Sofi Nyrkkö, who worked and led in the workshop of Olonets. In addition to the workshop, there was a dress maker s atelier in which clothes were made to order and soldiers uniforms were repaired, a small museum and a shop to sell products of the workshop. Craft products were also exported to Finland. Courses were organized in which Finnish women taught East Karelian crafts.

Sleep deprivation and brain energy metabolism : in vivo studies in rats and humans

Sleep deprivation leads to increased subsequent sleep length and depth and to deficits in cognitive performance in humans. In animals extreme sleep deprivation is eventually fatal. The cellular and molecular mechanisms causing the symptoms of sleep deprivation are unclear. This thesis was inspired by the hypothesis that during wakefulness brain energy stores would be depleted, and they would be replenished during sleep. The aim of this thesis was to elucidate the energy metabolic processes taking place in the brain during sleep deprivation. Endogenous brain energy metabolite levels were assessed in vivo in rats and in humans in four separate studies (Studies I-IV). In the first part (Study I) the effects of local energy depletion on brain energy metabolism and sleep were studied in rats with the use of in vivo microdialysis combined with high performance liquid chromatography. Energy depletion induced by 2,4-dinitrophenol infusion into the basal forebrain was comparable to the effects of sleep deprivation: both increased extracellular concentrations of adenosine, lactate, and pyruvate, and elevated subsequent sleep. This result supports the hypothesis of a connection between brain energy metabolism and sleep. The second part involved healthy human subjects (Studies II-IV). Study II aimed to assess the feasibility of applying proton magnetic resonance spectroscopy (1H MRS) to study brain lactate levels during cognitive stimulation. Cognitive stimulation induced an increase in lactate levels in the left inferior frontal gyrus, showing that metabolic imaging of neuronal activity related to cognition is possible with 1H MRS. Study III examined the effects of sleep deprivation and aging on the brain lactate response to cognitive stimulation. No physiologic, cognitive stimulation-induced lactate response appeared in the sleep-deprived and in the aging subjects, which can be interpreted as a sign of malfunctioning of brain energy metabolism. This malfunctioning may contribute to the functional impairment of the frontal cortex both during aging and sleep deprivation. Finally (Study IV), 1H MRS major metabolite levels in the occipital cortex were assessed during sleep deprivation and during photic stimulation. N-acetyl-aspartate (NAA/H2O) decreased during sleep deprivation, supporting the hypothesis of sleep deprivation-induced disturbance in brain energy metabolism. Choline containing compounds (Cho/H2O) decreased during sleep deprivation and recovered to alert levels during photic stimulation, pointing towards changes in membrane metabolism, and giving support to earlier observations of altered brain response to stimulation during sleep deprivation. Based on these findings, it can be concluded that sleep deprivation alters brain energy metabolism. However, the effects of sleep deprivation on brain energy metabolism may vary from one brain area to another. Although an effect of sleep deprivation might not in all cases be detectable in the non-stimulated baseline state, a challenge imposed by cognitive or photic stimulation can reveal significant changes. It can be hypothesized that brain energy metabolism during sleep deprivation is more vulnerable than in the alert state. Changes in brain energy metabolism may participate in the homeostatic regulation of sleep and contribute to the deficits in cognitive performance during sleep deprivation.

Dietary elecrolytes and cyclosporine toxicity. Experimental studies in spontaneuosly hypertensive rats

Cyclosporine-A (CsA) is widely used after organ transplantation to prevent rejection and in the treatment of autoimmune diseases. Hypertension and nephrotoxicity are common side-effects of CsA. Studies in patients on the prevention of the side-effects of CsA are difficult to conduct because the patients often receive a combination of different drugs thus making study of the side-effects of a single drug impossible. A challenge in experimental studies has been the lack of an animal model in which the side-effects concomitantly occur. Epidemiological data show an association between sodium (Na) intake and blood pressure. There is also evidence on low dietary intake of magnesium (Mg) and potassium (K) and high blood pressure. Our study was designed to develop an experimental model to study the side-effects of CsA in spontaneously hypertensive rats (SHR). On high dietary sodium, CsA caused hypertension, left ventricular hypertrophy (LVH), narrowing of the coronary arteries, small myocardial infarctions, and proteinuria, reduced creatinine clearance and histopathological renal injury in SHR. Loss of Mg into the urine caused by CsA resulted in Mg depletion in the tissues. Renal excretion of dopamine was reduced and the renin-angiotensin-aldosterone system was activated. We investigated the effects of dietary Mg and/or K and the calcium antagonist drug, isradipine, on the prevention of CsA toxicity. Dietary supplementation of Mg alone or in combination with K prevented from the deleterious pathophysiological and histopathological changes in the kidneys and the heart. K alone had little effect. Isradipine protected better than Mg from LVH, but the combination of isradipine and Mg was the most effective. Isradipine did not, however, protect against Mg loss. In our animal model, the combination of high dietary Na and treatment with CsA accelerated the development of the cardiovascular and renal changes clinically known as the side-effects of CsA. Dietary supplementation of Mg and K and reduction of Na intake and the calcium antagonist drug isradipine prevent from the deleterious effects of CsA.

Microarrays in molecular profiling of cancer - focus on head and neck squamous cell carcinoma

Microarrays have a wide range of applications in the biomedical field. From the beginning, arrays have mostly been utilized in cancer research, including classification of tumors into different subgroups and identification of clinical associations. In the microarray format, a collection of small features, such as different oligonucleotides, is attached to a solid support. The advantage of microarray technology is the ability to simultaneously measure changes in the levels of multiple biomolecules. Because many diseases, including cancer, are complex, involving an interplay between various genes and environmental factors, the detection of only a single marker molecule is usually insufficient for determining disease status. Thus, a technique that simultaneously collects information on multiple molecules allows better insights into a complex disease. Since microarrays can be custom-manufactured or obtained from a number of commercial providers, understanding data quality and comparability between different platforms is important to enable the use of the technology to areas beyond basic research. When standardized, integrated array data could ultimately help to offer a complete profile of the disease, illuminating mechanisms and genes behind disorders as well as facilitating disease diagnostics. In the first part of this work, we aimed to elucidate the comparability of gene expression measurements from different oligonucleotide and cDNA microarray platforms. We compared three different gene expression microarrays; one was a commercial oligonucleotide microarray and the others commercial and custom-made cDNA microarrays. The filtered gene expression data from the commercial platforms correlated better across experiments (r=0.78-0.86) than the expression data between the custom-made and either of the two commercial platforms (r=0.62-0.76). Although the results from different platforms correlated reasonably well, combining and comparing the measurements were not straightforward. The clone errors on the custom-made array and annotation and technical differences between the platforms introduced variability in the data. In conclusion, the different gene expression microarray platforms provided results sufficiently concordant for the research setting, but the variability represents a challenge for developing diagnostic applications for the microarrays. In the second part of the work, we performed an integrated high-resolution microarray analysis of gene copy number and expression in 38 laryngeal and oral tongue squamous cell carcinoma cell lines and primary tumors. Our aim was to pinpoint genes for which expression was impacted by changes in copy number. The data revealed that especially amplifications had a clear impact on gene expression. Across the genome, 14-32% of genes in the highly amplified regions (copy number ratio >2.5) had associated overexpression. The impact of decreased copy number on gene underexpression was less clear. Using statistical analysis across the samples, we systematically identified hundreds of genes for which an increased copy number was associated with increased expression. For example, our data implied that FADD and PPFIA1 were frequently overexpressed at the 11q13 amplicon in HNSCC. The 11q13 amplicon, including known oncogenes such as CCND1 and CTTN, is well-characterized in different type of cancers, but the roles of FADD and PPFIA1 remain obscure. Taken together, the integrated microarray analysis revealed a number of known as well as novel target genes in altered regions in HNSCC. The identified genes provide a basis for functional validation and may eventually lead to the identification of novel candidates for targeted therapy in HNSCC.

Wedding portrait of Adolf Wolff and Eva Nathan with guests; Berlin, Germany.

Back row against wall, left to right: Josef Molling, Margaret Molling nee Benjamin, Werner Wolff, Miss Hermann (called "Ferna", Peter Molling's governess), " Selma" (partially hidden, Anna Marianne/Berthold Nathan's cook), "Lisbeth" (Anna Marianne/Berthold's maid), Ilse Joachim, Ernst Joachim, Annemarie Nathan (3rd wife of Julius Nathan), Julius Nathan (brother of Berthold Nathan), Ernst Kallmes (son of Ceilchen nee Wolff, Helene's sister). Very tall against the wall: Max Benjamin (son of Helene). Third row, left to right: Mathilde Kaufmann nee Benjamin, Adolf Molling, Paul Nathan (son of Anna Marianne/Berthold), Marianne Rasmussen (daughter of Waldemar), Hildegard Weinberger (friend of bride), Herta Albrecht (friend of bride), Dr. Franz Gruenberg (friend of groom), Leonie Wolff nee Simon (wife of Werner Wolff), Lina Molling nee Marx (wife of Richard), Waldemar Benjamin-Rasmussen (son of Helene/David), Luzi's Husband, Minka Bernard nee Nathan (sister of Berthold Nathan), Richard Molling (brother of Claerchen), Albert Wolff (brothter of Moritz Wolff). Second row, seated, left to right: Helene Benjamin nee Wolff, Berthold Nathan, Anna Marianne Nathan nee Benjamin, bride Eva Wolff nee Nathan, groom Adolf Wolff, Claerchen Wolff nee Molling, Moritz Wolff, standing Luzi Rasmussen nee Gruen (wife of Waldemar). Front row, children on floor, left to right: Peter Molling, Elizabeth Benjamin-Rasmussen mar. Engel, Louis Peter Wolff, Helmut Benjamin Rasmussen (became Henry)

Family portrait of the Gottschalk family; Hannover, Germany.

Front Row (l-r): Frau Steinfeld (mother of Elizabeth Gottschalk nee Steinfeld and Hela Steinfeld), Fritz Gottschalk, Karl Gottschalk, Henrietta Gottschalk nee Rothschild (mother of Fritz, Karl, Anna and Ernst), Anna Catsenstein nee Gottschalk (twin of Karl Gottschalk), and Elizabeth Gottschalk; Back Row (l-r): Hela Steinfeld (sister of Elizabeth Gottschalk nee Steinfeld), Therese Gottschalk nee Molling (wife of Fritz), Leo Catsenstein (husband of Anna), Elizabeth Gottschalk nee Steinfeld (wife of Karl), Ernst Gottschalk, and Henny Molling nee Meyerhof (mother of Therese Gottschalk nee Molling)

Genetic studies of body mass index yield new insights for obesity biology

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10−8), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ~2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

Algorithm of medication review in frail older people: Focus on minimizing the use of high-risk medications

Aim Frail older people typically suffer several chronic diseases, receive multiple medications and are more likely to be institutionalized in residential aged care facilities. In such patients, optimizing prescribing and avoiding use of high-risk medications might prevent adverse events. The present study aimed to develop a pragmatic, easily applied algorithm for medication review to help clinicians identify and discontinue potentially inappropriate high-risk medications. Methods The literature was searched for robust evidence of the association of adverse effects related to potentially inappropriate medications in older patients to identify high-risk medications. Prior research into the cessation of potentially inappropriate medications in older patients in different settings was synthesized into a four-step algorithm for incorporation into clinical assessment protocols for patients, particularly those in residential aged care facilities. Results The algorithm comprises several steps leading to individualized prescribing recommendations: (i) identify a high-risk medication; (ii) ascertain the current indications for the medication and assess their validity; (iii) assess if the drug is providing ongoing symptomatic benefit; and (iv) consider withdrawing, altering or continuing medications. Decision support resources were developed to complement the algorithm in ensuring a systematic and patient-centered approach to medication discontinuation. These include a comprehensive list of high-risk medications and the reasons for inappropriateness, lists of alternative treatments, and suggested medication withdrawal protocols. Conclusions The algorithm captures a range of different clinical scenarios in relation to potentially inappropriate medications, and offers an evidence-based approach to identifying and, if appropriate, discontinuing such medications. Studies are required to evaluate algorithm effects on prescribing decisions and patient outcomes.