Browsing by Title

Sort by: Order: Results:

Now showing items 62-81 of 418
  • Neittaanmäki-Perttu, Noora (Helsingin yliopisto, 2015)
    ABSTRACT Background and purpose: As the skin cancer burden continues to increase, there is an urgent need for novel methods for the early detection of skin cancers, and for new cost-effective treatments. The hyperspectral imaging system (HIS) is a novel technique which offers the dual advantages of allowing the imaging of large skin areas rapidly and non-invasively. Daylight photodynamic therapy (DL-PDT), with the advantages of excellent tolerability and convenience, is an attaractive therapy for actinic keratoses (AK) and field cancerization.This thesis aimed to enable early and effective treatment of common premalignancies of photo-damaged skin.The first purpose of this thesis was to evaluate the feasibility of HIS in the detection of field cancerized skin and in the detection of ill-defined borders of lentigo maligna (LM) and lentigo maligna melanoma (LMM). In addition, this thesis aimed to further develop the treatment of field cancerized skin with photodynamic therapy using a novel photosensitizer in combination with daylight (DL-PDT), and to evaluate the cost-effectiveness of DL-PDT. Methods: This thesis included four non-sponsored prospective clinical studies. The novel prototype HIS, used in studies I-II, was developed for the study at the VTT Technical Research Centre of Finland. The technique enabled in vivo imaging of the skin prior to surgical procedures and produced abundance maps of the affected skin areas. The results were verified by histopathology. Study III was randomized double-blinded intra-individual split-face trial comparing novel photosensitizer formulation, 5-aminolaevulinate nanoemulsion (BF-200 ALA) with methyl-5-aminolaevulinate (MAL) in DL-PDT of AKs. In addition to blinded clinical and histological treatment efficacy, tolerability of the treatment was assessed. Study IV evaluated the cost-effectiveness of MAL-DL-PDT compared to conventional MAL-LED-PDT. Results: In studies I-II HIS showed its feasibility in both the detection of subclinical borders of ill-defined lentigo malignas (LM) and lentigo maligna melanomas (LMM), and in the detection of early subclinical actinic keratoses (AK). In study I HIS accurately detected 20 of 23 (87%) of the LM/LMM borders as confirmed by histology. HIS was useful i.e. detected the lesion borders more accurately than a clinician using Wood s light in 11 of 23 (47.8%) cases. Six re-excisions could have been avoided with HIS. In 3/23 cases (13%) HIS was not in concordance with the histopathology, which in two cases HIS showed lesion extension which was not verified histologically (wrong positive) and in one case HIS missed the subclinical extension (wrong negative). In study II with 12 patients and 52 clinical AKs, HIS accurately detected all the clinical lesions in addition to numerous areas of subclinical damage. HIS findings matched the histopathological findings in all 33 biopsied areas (AK, n=28, photo-damaged skin, n=5), revealing 16 subclinical lesions of which 10 were not detected by fluorescence diagnosis. In study III (13 patients, 177 lesions) in a per patient (half-face) analysis BF-200 ALA cleared thin AKs more effectively than did MAL (p=0.027). In per lesion analysis the complete clearance rates were 84.5% for BF-200 ALA, and 74.2% for MAL (p=ns). The area response rates, including also the new appeared lesions (i.e.preventive effect), were 79.8% for BF-200 ALA and 65.6% for MAL, p=0.044. Histologically, DL-PDT effectively cleared all the signs of dysplasia in 61.5% lesions treated with BF-200 ALA and in 38.5% with MAL (p=ns). The mean decrease in p53 expression was 54.4% with BF-200 ALA, 34 % with MAL (p=ns). DL-treatment was nearly painless with both photosensitizers. BF-200 ALA and MAL DL-treatments were similarly tolerated as regards to adverse reactions. In study IV 70 patients (210 target lesions) randomized to receive DL-PDT or LED-PDT with MAL, at six months the patient complete response rates were 15 of 35 (42.9%) and 24 of 35 (68.6%), (p=0.030) and lesion clearance rates were 72.4% and 89.2%, respectively (p=0.0025). DL-PDT required significantly less time at the clinic (p less than 0.0001) and could be used with lower total costs ( 132) compared to conventional LED-PDT ( 170), p=0.022. However, in terms of cost-effectiveness MAL-DL-PDT was found to give less value for money compared to MAL-LED-PDT. The incrementl cost-effectiveness ratio (ICER) showed the monetary gain of 147 per unit of effectiveness lost. Thus, the use of DL-PDT instead of LED-PDT would decrease the healing probability but only low incremental cost savings would be achieved. The costs per complete responder were 308 for MAL DL-PDT and 248 for MAL LED-PDT, p= 0.004. Conclusions: The more accurate pre-surgical assessment of the subclinical borders of LM and LMM with HIS could lead to fewer re-excixions, which furthermore could reduce the burden to both patients and clinics. In addition, the early non-invasive detection of skin field cancerization could enhance the treatment process by revealing the as yet subclinical areas in need of treatment, and could possibly aid the monitoring of treatment efficacy. Even though HIS was found to be useful in these two indications, more studies are warranted to qualify the optimal mathematical algorithms for diagnostic use.The use of novel a photosensitizer formulation, BF-200 ALA, in DL-PDT could lead in lower costs and increase the efficacy. Interestingly, the efficacy of DL-PDT with BF-200 ALA was approaching the efficacy achieved with conventional LED-PDT. As field cancerized skin should be treated as a chronic disease requiring repeated treatments, DL-PDT offers a painless and convenient option for this purpose. However, DL-PDT with MAL provided less value for money compared to conventional MAL-PDT. The cost-effectiveness of BF-200 ALA in DL-PDT for AKs needs further studies.
  • Saari, Kirsti (Helsingin yliopisto, 2009)
    The main focus of this research was to describe the educational purpose of Christian schools within their operation culture. The Christian schools founded in Finland can be seen as part of a greater movement in Europe. In this research the dialogue and encounter in the educational scheme of Finnish Christian schools were examined by asking three research questions: 1. What is the nature of the dialogue in education in Finnish Christian schools? 2. How do the teachers describe themselves as educators? 3. What are the special characteristics in the operation culture of a Christian school? The educational relationship was regarded as fundamental and in the background reflected the absolute value of each student. Communication skills were viewed as essential in the building of relationships, which also included emotion communication skills as a broader view. The teachers expressed their comprehension of the meaning of the dialogue in the building of a relationship with practical examples. Students learned to understand one another's experiences by discussion and listening to one another. The values that created a connection were mutual appreciation, honesty, taking the other one into account, and the ability for empathy. Caring was regarded as a relationship between people, as well as a genuine mutual encounter, in which all parties would listen to one another and be heard by others. The respondents thought that individual attention and time were the keys to reaching well-being and an encounter. Students' commitment to the community was supported by mutual agreements, identifying with the common world, and encounters. The appearance of Christian love agape was named as the basis for an educational relationship. The answers emphasised shared everyday life at school. According to the teachers, the willingness for personal growth enabled encounters, although growth as such was often regarded as difficult. Cognitive emphasising and emotional experiencing from a dynamic perspective, were the means by which students' ethical understanding was comprehended. The teachers named three key factors to create a confidential relationship: a respectful attitude, courage, and genuineness. Within the school operational environment, a sense of community was emphasised, in which each student was taken into account individually. The active role of parents was an essential part of the school culture. The administration of the schools appeared committed. The additional pressure in school work came from efforts to ensure the official status of the school, as well as the large amount of administrative work involved in a private school. According to the research data, there was no evidence to support any elitism that is often associated with private schools.
  • Nieminen, Juha (Helsingin yliopisto, 2011)
    Study orientations in higher education consist of various dimensions, such as approaches to learning, conceptions of learning and knowledge (i.e. epistemologies), self-regulation, and motivation. They have also been measured in different ways. The main orientations typically reported are reproducing and meaning orientations. The present study explored dimensions of study orientations, focusing in particular on pharmacy and medicine. New versions of self-report instruments were developed and tested in various contexts and in two countries. Furthermore, the linkages between study orientations and students epistemological development were explored. The context of problem-based (PBL) small groups was investigated in order to better understand how collaboration contributes to the quality of learning. The participants of Study I (n=66) were pharmacy students, who were followed during a three-year professionally oriented program in terms of their study orientations and epistemologies. A reproducing orientation to studying diminished during studying, whereas only a few students maintained their original level of meaning orientation. Dualism was found to be associated with a reproducing orientation. In Study II practices associated with deep and surface approaches to learning were measured in two differing ways, in order to better distinguish between what students believed to be useful in studying, and the extent to which they applied their beliefs to practice when preparing for examinations. Differences between domains were investigated by including a sample of Finnish and Swedish medical students (n=956) and a Finnish non-medical sample of university students (n=865). Memorizing and rote learning appeared as differing components of a surface approach to learning, while understanding, relating, and critical evaluation of knowledge emerged as aspects of a deep approach to learning. A structural model confirmed these results in both student samples. Study III explored a wide variety of dimensions of learning in medical education. Swedish medical students (n=280) answered the questionnaire. The deep approach to learning was strongly related to collaboration and reflective learning, whereas the surface approach was associated with novice-like views of knowledge and the valuing of certain and directly applicable knowledge. PBL students aimed at understanding, but also valued the role of memorization. Study IV investigated 12 PBL tutorial groups of students (n=116) studying microbiology and pharmacology in a medical school. The educational application was expected to support a deep approach to learning: Group members course grades in a final examination were related to the perceived functioning of the PBL tutorial groups. Further, the quality of cases that had been used as triggers for learning, was associated with the quality of small group functioning. New dimensions of study orientations were discovered. In particular, novel, finer distinctions were found within the deep approach component. In medicine, critical evaluation of knowledge appeared to be less valued than understanding and relating. Further, collaboration appeared to be closely related to the deep approach, and it was also important in terms of successful PBL studying. The results of the studies confirmed the previously found associations between approaches to learning and study success, but showed interesting context- and subgroup-related differences in this respect. Students ideas about the nature of knowledge and their approaches to learning were shown to be closely related. The present study expanded our understanding of the dimensions of study orientations, of their development, and their contextual variability in pharmacy and medicine.
  • Castrén, Sari (Helsingin yliopisto, 2013)
    Disordered gambling is a multifaceted phenomenon, and consequently many factors have a role in its development and maintenance. Adverse consequences of disordered gambling can be mental, social and legal. Only a few epidemiological studies of disordered gambling have previously been conducted in Finland, and none of these studies have been published internationally. Gambling research in Finland has increased during the past years, especially the investigation of treatment options for disordered gambling. In this thesis, disordered gambling is approached from two angles: the epidemiological angle provides an overall picture of the current situation in Finland, and the treatment angle studies the phenomenon from an individual standpoint. In the epidemiological studies of this thesis, the prevalence, socio-demographic characteristics, comorbid substance use, perceived health and well-being and the type of gambling and its relations to the severity levels of gambling were measured. The data were derived from two samples, The Health Behaviour and Health among the Finnish Adult Population, Spring 2010, postal survey (N = 2826) and The Finnish Gambling 2011 (N = 3451), telephone interview. These studies used South Oaks Gambling Screen (SOGS) and Problem Gambling Severity Index as a measure of gambling severity. In the epidemiological studies the prevalence of disordered gambling was found to be about 3% (Finnish Gambling 2011). Disordered gambling was more common among males and the younger age group. Disordered gambling was generally associated with socio-economic disadvantages like being divorced, unemployed or having a low level of education. Comorbid alcohol use and nicotine dependency as well as low self-perceived mental health status were associated with disordered gambling. Lotto (Finnish lottery) was the most popular type of game gambled, but slot machine and internet gambling were found to be associated with disordered gambling. The two treatment studies of this thesis describe the socio-demographic characteristics (N = 471), the severity of disordered gambling, gambling urge, gambling-related erroneous thoughts and the level of control of gambling among the treatment-seeking gamblers. In the treatment studies, comorbid alcohol use and depression were also studied. Moreover, changes in the severity of gambling, gambling urge, gambling-related erroneous thoughts and control of gambling, as well as alcohol use and the level of depression at baseline, post-treatment and 6- and 12-month follow- up were studied. The data were derived from the Peli Poikki program which is an internet-based 8-week cognitive behavioural therapy for gamblers. This study used NORC DSM-IV Screen for Gambling Problems as a measure of gambling severity. Results revealed that 78.8% of the treatment-seeking participants were disordered gamblers. 224 participants completed the treatment and after 8 weeks of treatment a significant decline was seen in gambling-related problems and gambling urge, and an improvement in control of gambling. The mood of participants improved and alcohol use decreased during the treatment period, and participants reported improvements in their social situations after the treatment. In conclusion, the prevalence of disordered gambling has been more or less unchanged during the past years in Finland. A specific socio-demographic group of individuals seems to be at higher risk of having and developing disordered gambling, especially with the abundant gambling opportunities in Finland. The results of the Peli Poikki program encourages implementing more evidence-based treatment options for disordered gambling in Finland.
  • Vekkaila, Jenna (Helsingin yliopisto, 2014)
    This dissertation study explored students engagement in the doctoral process and factors associated with it. Doctoral students experiences of engagement were investigated in three studies, while the associated factors were analysed in a further two. The dissertation used a mixed-methods approach; accordingly, the data were collected through interviews and surveys, and were analysed by combining qualitative and quantitative methods. Study I investigated the key learning experiences that the students perceived to be either inspiring or challenging in their doctoral process. Altogether 19 natural sciences doctoral students were interviewed. The majority of the key learning experiences identified by the students were positive. Most of the experiences were related to the students participation in the scholarly community, developing as a scholar, and developing specific research competencies. The students situated such experiences typically in various scholarly activities including research work, courses, and academic meetings. Study II focused on analysing students engagement by exploring the main experiences and sources, as well as the qualitatively different forms of engagement in the doctoral process. Altogether 21 behavioural sciences doctoral students were interviewed. The students described their engagement in terms of experiences of dedication, efficiency, and sometimes absorption. They typically emphasised their sense of competence and relatedness as the main sources of engagement. In the students descriptions three qualitatively different forms of engagement in doctoral work were also identified: an adaptive form of engagement, an agentic form of engagement, and a work-life inspired form of engagement. Further, there was variation among the students in terms of what forms of engagement they emphasised in different phases of their doctoral studies. Study III focused on students disengagement by exploring the main experiences and sources of disengagement from the doctoral process. Also, the students perceptions of the dynamic interplay between themselves and their environments with respect to disengaging experiences were explored by analysing the perceived misfits between the students and their environments. Altogether 16 behavioural sciences doctoral students were interviewed. The students described their disengagement in terms of experiences of inefficacy, cynicism, and sometimes exhaustion. They typically emphasised their struggles and conflicts within the scholarly community as the main source of disengagement. The students typically attributed their disengagement to the perceived misfit between themselves and their environments, and in particular often associated the problem with the scholarly community rather than themselves. Study IV focused on the collective fit between doctoral students and their environments that had contributed to their engagement. Altogether 1 184 doctoral students and 431 supervisors from different disciplines participated in the surveys. The collective fit was explored at the faculty level in terms of similarities and differences in the students and supervisors perceptions of the main resources and challenges with respect to the doctoral process. The relation between the perceived fit and the doctoral students satisfaction with their study process and supervision was explored. The results showed that either a fit, a partial fit, or a misfit existed between the students and supervisors perceptions in the different faculties. A relation was also found between the collective fit and students satisfaction with their overall study process and supervisory support. This dissertation contributes to the literature on doctoral student engagement by breaking down the complexity of engagement; it does this by identifying the qualitatively different experiences, sources, and forms of engagement. Moreover, the study reveals the nature of engagement at the interface of study and work by shedding light on the dual role of doctoral students as both students and professional researchers. Further, the results provide a new understanding of the perceived student learning environment fit as a primary determinant of doctoral student engagement. The results encourage viewing doctoral student engagement as a complex, multidimensional phenomenon supported by the constructive interplay between doctoral students and their learning environments that fosters students meaningful participation and a sense of belonging in their scholarly communities. Keywords: doctoral education, doctoral process, doctoral student, engagement, disengagement, learning environment, scholarly community, student environment fit
  • Tanskanen, Topi (Helsingin yliopisto, 2008)
    The neural basis of visual perception can be understood only when the sequence of cortical activity underlying successful recognition is known. The early steps in this processing chain, from retina to the primary visual cortex, are highly local, and the perception of more complex shapes requires integration of the local information. In Study I of this thesis, the progression from local to global visual analysis was assessed by recording cortical magnetoencephalographic (MEG) responses to arrays of elements that either did or did not form global contours. The results demonstrated two spatially and temporally distinct stages of processing: The first, emerging 70 ms after stimulus onset around the calcarine sulcus, was sensitive to local features only, whereas the second, starting at 130 ms across the occipital and posterior parietal cortices, reflected the global configuration. To explore the links between cortical activity and visual recognition, Studies II III presented subjects with recognition tasks of varying levels of difficulty. The occipito-temporal responses from 150 ms onwards were closely linked to recognition performance, in contrast to the 100-ms mid-occipital responses. The averaged responses increased gradually as a function of recognition performance, and further analysis (Study III) showed the single response strengths to be graded as well. Study IV addressed the attention dependence of the different processing stages: Occipito-temporal responses peaking around 150 ms depended on the content of the visual field (faces vs. houses), whereas the later and more sustained activity was strongly modulated by the observers attention. Hemodynamic responses paralleled the pattern of the more sustained electrophysiological responses. Study V assessed the temporal processing capacity of the human object recognition system. Above sufficient luminance, contrast and size of the object, the processing speed was not limited by such low-level factors. Taken together, these studies demonstrate several distinct stages in the cortical activation sequence underlying the object recognition chain, reflecting the level of feature integration, difficulty of recognition, and direction of attention.
  • Lahti, Marius (Helsingin yliopisto, 2012)
    Previous studies suggest that a suboptimal early life environment may predict an increased risk of adult personality disorders. However, most of this evidence is based on studies with retrospective accounts of early adversity. This retrospective design may induce a bias and hinder interpretation of the direction of causality. This thesis examines, in a longitudinal study setting, the developmental origins of personality disorders severe enough to justify hospitalisation. The focus is on pre- and postnatal growth and on parental separation in childhood due to temporary evacuations from Finland during World War II in the etiology of both any and dramatic personality disorders requiring hospitalisation. The study cohort is the Helsinki Birth Cohort Study, which comprises 13,345 individuals born 1934-1944. Data on early life growth, on childhood evacuations, and on the diagnoses of personality disorders were drawn from birth- and child welfare records and national registers. These objective record- and register-based data enabled the longitudinal design of the studies. In the current study cohort, there were 1,781 individuals who had been separated from their parents in childhood. There were 202 subjects who had been hospitalised for personality disorders, and 77 individuals with dramatic personality disorders. The results showed that a small head circumference and a small head-to-length ratio at birth predicted an increased risk of any severe personality disorder among men and a small placental surface area at birth predicted dramatic personality disorders among women. Slower gain in BMI between birth and six months of age, faster gains in weight and in BMI between six months and one year, and slower gains in weight and in BMI between seven and 11 years of age also predicted personality disorders among men. Slower height growth between two and seven years of age predicted an increased risk of personality disorders among women. The associations between infancy and childhood growth and severe personality disorders among men were especially characteristic of dramatic personality disorders, and were independent of comorbid mood disorders. Temporary separation from parents, particularly in the first five years of life, predicted an increased risk of severe personality disorders, and among men, of dramatic personality disorders. The effects of early parental separation were specific to personality disorders, since they emerged in comparisons to both healthy control participants and to individuals with other mental disorders. These longitudinal study findings strongly support an etiological role for early life, both pre- and postnatal, environmental adversity in the development of severe personality disorders, especially dramatic personality disorders. Vulnerability to severe personality disorders is developmentally programmed in early life.
  • Mononen, Riikka (Helsingin yliopisto, 2014)
    The purpose of this thesis was to investigate the effectiveness of early mathematics interventions for young children with low performance in mathematics. Previous research has indicated that early mathematics skills are a strong predictor of later mathematics performance. The goal of early mathematics support by means of interventions is to improve mathematics performance, and consequently, to diminish the possibility of mathematics learning disability emerging later on. This thesis sought to complement and extend previous research in the field of early mathematics interventions, by reviewing early mathematics interventions, and investigating the effectiveness of two early mathematics intervention programmes. Study I reviewed mathematics interventions (N = 19) aimed at 4–7-year-old children with low performance in mathematics. For each intervention, effect sizes were calculated for mathematics outcome measures, and the pedagogical implementation was described. The effectiveness of the RightStart Mathematics (RS) (Cotter, 2001) instruction was investigated in Studies II and III. In Study II, the instruction was provided for Finnish kindergartners (RS group: n = 38, comparison group: n = 32) in general education classrooms, with focus on low-performing children. In Study III, the RS instruction was provided in special education classrooms for children with a specific language impairment (SLI group: n = 9, comparison group: n = 32). In Study IV, a mathematics intervention programme Improving Mathematics Skills in the Second Grade (IMS-2) (Mononen & Aunio, 2012) was developed, and its effectiveness for second graders performing low in mathematics was examined (IMS-2 group: n = 11, low-performing controls: n = 13 and typically performing controls: n = 64). In Studies II-IV, quantitative methods were used for analysing the interventions’ effects. According to the results of the review, in the majority of the interventions, the mathematics skills of the participating children improved more than the skills of the children in control groups, with effect sizes varying from small to large. Progress in mathematics learning was evident when instruction included one or more of the following instructional features: explicit instruction, peer-assisted instruction, applying a concrete-representational-abstract sequence, computer assisted instruction, or games. Study II showed that the RS instruction was as effective as the typical Finnish kindergarten mathematics instruction. The counting skills of the initially low-performing children improved to the level of their typically performing peers. Follow-up in the first grade revealed performance differences between the initially low- and typically performing children, highlighting the importance of continuously monitoring progress, and providing intensified support. In Study III, children with a SLI receiving RS instruction improved their counting skills to the level of their peers. In the first grade follow-up, the children with SLI performed similarly to their peers in addition and subtraction skills (accuracy) and multi-digit number comparison. In Study IV, the mathematics skills of the second graders participating in the IMS-2 intervention did not improve more than the skills of the children in control groups. However, the study provided valuable information about the functionality of the IMS-2 programme’s intensity and content. To conclude, in general, the results indicate that rather than waiting for children to fail, mathematics interventions can be used successfully to promote the early mathematics skills of children with low performance in mathematics, already before the onset of formal schooling and in the early grades. Therefore, identifying low performance in mathematics and providing sufficient support should be emphasised already in early childhood education, in accordance with the Finnish three-tiered educational support system. Keywords: early mathematics skills, low performance in mathematics, mathematics learning disability, mathematics intervention, review, specific language impairment, educational support
  • Jauhiainen, Johanna (Helsingin yliopisto, 2013)
    Within the framework of a national science and mathematics education development program a long-term physics teachers training program was organized. The aim of the program was to enhance teachers pedagogical content knowledge, especially regarding the role of experiments in physics education. The role of experiments was discussed based on a practical teaching philosophy called perceptional approach. The research aimed at exploring teachers experience of the training program, as well as the effect it had on their beliefs about the role of experiments and the concept of interaction (interacting bodies) in teaching Newtonian mechanics. Moreover, the goal was to examine the influence of teachers' beliefs about interaction on students conceptual understanding of force. The model of pedagogical content knowledge and the model of practical conceptual change formed the frameworks for the research. The results of the teacher survey showed that teachers considered the training valuable for their daily teaching practice. The laboratory course was regarded to be most valuable. The course dealing with theoretical principles of the perceptional approach was less advantageous. Approximately 20% of the teachers had changed their beliefs in the use of experiments after the ideas represented in the training program. There were no significant differences between the experimental and control groups in the views regarding the reasons for using experiments in teaching physics. The most important objective for practical work was to enhance students learning of concepts. According to teacher interviews, some teachers were influenced by the program and the way experiments could be used in supporting the creation of meanings for concepts. However, some teachers strongly held to their previous beliefs. The effect of the training program on teachers beliefs about the concept of interaction as an organizing principle in teaching mechanics was examined using teacher interviews. The results showed no remarkable effects. However, the explicit use of interaction as a guiding principle in teaching Newtonian mechanics enhanced students conceptual understanding of force as measured with the Force Concept Inventory, which was translated into Finnish.
  • Ahveninen, Jyrki (Helsingin yliopisto, 2000)
  • Kivikangas, J Matias (Helsingin yliopisto, 2015)
    Arguably, the emotions elicited by playing are the reason why people play digital games. Social interaction is an important source of emotion during game play, but research on it is rather sparse. In this dissertation I briefly review the emotion-theoretic literature in order to better understand what emotion means in the context of games, and how this should be taken into account when measuring emotions related to a game experience. Study I presents a review of the use of psychophysiological methods in game research. I show that the theoretical background behind these methods generally tends to be neglected. This could be remedied by a theoretical framework that integrates the understanding of emotions and explicitly describes the links between different emotion measures and the theoretical concepts they are professed to reflect. I present my proposition for the first step towards such a framework in Study II. I employ the sociality characteristics framework by de Kort and IJsselsteijn (2008) and my interpretation of the social factors in order to study the effect of the central social context factors on the emotional game experience. Study III presents evidence that in addition to tonic physiological levels, the relationship between the participants also affects the momentary, phasic responses to the key game events victory and defeat. In particular, although physiological signals can, to a certain extent, be used to assess emotional experiences (such as positive responses to a victory), in some cases the typical psychophysiological mappings may even be completely opposite. Interpreting these signals requires a broader theoretical understanding than what is typically acknowledged. Study IV supports the earlier findings that competition is experienced more positively than cooperation but that the effect is dependent on gender, as this was found only in males. For females, there was no difference between the two modes, and no difference in negative activation. In addition, self-reports concerning social presence suggested that this concept is not always associated with higher positive emotions, while a form of friendly rivalry (associated with lower social presence) might be experienced positively a finding apparently new in existing literature. Finally, Study V provides insight into the practical significance of the measurements with a predictive validity study, showing practical effects how the certain kinds of game experiences may lead to greater game use and preference, but that these links are not as simple as previously suggested. In sum, this work offers new knowledge on how social context factors are generally related to the game experience, on how emotions can be studied in game research and what theoretical considerations should be taken into account, and on the emotional effects of particular social context factors during play. The results are mainly useful for further basic game research, but they have also potential implications for general emotion research, the game industry, and in the long run, society at large.
  • Kelo, Marjatta (Helsingin yliopisto, 2013)
    The aim of the research, conducted between 2008 and 2011, was to obtain knowledge of patient education, to enable the development of empowering patient education, and promote nurses competence of diabetes education. To achieve this goal, an educational intervention for school-age children s diabetes education was developed and the implementation of the intervention was evaluated. The approach chosen was design-based research including preparing for, implementing and evaluating the intervention. To serve as the basis for the intervention development in the preparation phase, data concerning patient education were collected from nurses (n = 45) working in paediatric units, school-age children with a chronic illness (N = 12) and their parents (N = 19). In addition, an integrative review including 22 research articles of self-care for school-age children with diabetes was conducted and utilized. The intervention was developed as a collaborative effort by a team comprising research (N = 2), patient education (N = 2), paediatric nursing (N = 5) and diabetes management (N = 2) experts and the parents of children with a chronic illness (N = 2). The intervention ward was consulted during the design process. In the implementation phase, the nurses were instructed how to use the intervention and the intervention was applied to nursing practice for about one year. In the evaluation phase, nurses descriptions (n = 11) were collected with semi-structured interviews. In nurses patient education descriptions, their empowering behaviour consisted of a process based on the holistically assessed educational needs. The objectives were based on the patient s needs and nurses were prepared for the patient education. Patient education was implemented by interactive child- and family-centred counselling. The learning achievements were verified using several methods promoting patient participation. The elements of traditional behaviour were deficient needs assessment, deficient planning of objectives and preparation, nurse-oriented implementation and deficient evaluation of learning achievements. In the school-age children s and their parents descriptions, nursing competence consisted of knowledge and the ability to care for children and families as well as knowledge of the disease and its management. Didactic competence comprised practical examples of knowledge of teaching children and parents as well as the ability to implement the patient education process. Interpersonal competence manifested itself in the ability to have a dialogue with children and their parents. Self-care of school-age children with diabetes was formed in a learning process involving the objectives of normality, being able to cope and independence. The content of self-care was a combination of knowledge and skills. The factors related to self-care comprised the characteristics of the child; the nature of the illness and care; and support from the parents, school environment, peers and health care team. In the intervention, blood glucose monitoring education was described as a process including the assessment of learning needs, planning, implementation and evaluation. The intervention contained instructions on how to implement the process taking into account school-age children s developmental stage, the principles of teaching them and empowering patient education methods. After implementing the intervention, nurses described the successful management of the empowering patient education process that was consistent with the intervention. Three types of challenges were encountered in applying the intervention. The challenges were related to management and leadership, ambivalence with traditional and empowering patient education, and client s situation. The research produced new information to be used in patient education development. The intervention can be utilized to standardize patient education and promote empowering patient education, but more research is needed to evaluate the intervention comprehensively.
  • Kangas, Jonna (Helsingin yliopisto, 2016)
    Children's participation in early childhood education has raised concern and discussion in the international researches lately. Young children have been considered to have lack of participation experiences in early education settings because of institutional policies, social understanding about childhood and perspectives of educators (Bae, 2009; Emilson and Folkesson, 2006; Smith, 2002). Focus of children as active agents of their own development through sociocultural learning paradigm the approach of participatory learning has been considered important in early childhood education and research (Berthelsen, Brownlee and Johansson, 2009). This approach of children's learning views participation as a developing and dynamic cultural phenomenon. This research is focusing on the educators' perspectives and the conceptions of children's participation in everyday pedagogic practices and is based on a survey conducted in early childhood education in Metropolitan area of Helsinki in 2010. The survey was realized in the VKK-Metro development and research project funded by the Ministry of Social and Health affairs. The participants represented 1114 working teams from 350 kindergartens. The working teams included 3721 educators taking care of 19 907 children. The analytical framework of research is based on an abductive approach conducted with mixed methods. The findings indicate that children's voice was considered important by educators. Also opportunities to make independent initiatives and choices were considered as a right and an item of learning and of developing of skills of participation. However children's chances to participate in decision making process and pedagogical processes were weak because of challenges of children's participation experienced by educators. These challenges were connected to both institutional issues, such as routines and adult-child-ratios, and professional skills and beliefs about children's competence. According to findings of this research children's participation is understood to include such aspects as having opportunities to have an influence in their learning and the culture of kindergartens, becoming respected and listened to by educators and having chances to practice responsibility and self-regulation. The role of educators as facilitators of children's participation is found essential and the research builds knowledge of children's participation through framework of participatory pedagogy in early education context. Through this framework the challenges of children's participation could be reflected and a culture of developing participation built in co-operation between educators, children and political and social environment of early childhood education.
  • Loukomies, Anni (Helsingin yliopisto, 2013)
    An inquiry-based site visit teaching sequence for school science was designed in co-operation with researchers and science teachers, according to the principles of Design Based Research (DBR). Out-of-school industry site visits were central in the design. Theory-based conjectures arising from the literature on motivation, interest and inquiry-based science teaching (IBST) were embodied in the design solution, and these embodied conjectures were studied in order to uncover the aspects of the design related to students motivation and interest. The design solution was researched throughout the process. The aim of the design was to generate a phenomenon to be investigated in the research stage. The aim of the research was to clarify which particular aspects of the design have appealed particular students and enhanced their motivation and interest, and what scientific content students have learnt within the project. In this research report, the iterative design process with several implementations of the site visit teaching sequence, research methodology and the results that emerged, are considered. The design process took place in the years 2007 2009. A pilot cycle, two implementation-refinement cycles and a final trial were conducted. Lower secondary school students (age 14 15) participated in the cycles. Data were collected using a mixed-methods approach. The students experiences of school science were mapped with the Evaluation of Science Inquiry Activities Questionnaire (ESIAQ) before and after the implementations. The students Self-determination theory (SDT) based motivation orientations were examined using the Academic Motivation Questionnaire (AMQ) before the implementations. Both questionnaires are based on SDT. Students with different motivational profiles and their teachers were interviewed using a semi-structured interview protocol. The interviews were analysed by employing a theory-driven content analysis approach. The students representations of the scientific content of the sequence were examined by comparing the informal mind maps they constructed before and after the sequence, and with interviews. The results of the research reveal that a teaching sequence that combines inquiry activities, industry site visits and writing tasks contains the potential to enhance students feeling of relevance of their science studies and promote motivation and interest in school science. When asked about the most motivating aspects of the teaching sequence, students emphasised different aspects depending on their motivational profile. Students with an autonomous motivation orientation emphasised the support for their independent planning and decision making and support for their personal interest, whereas amotivated students reported an increase in their feeling of the relevance of studying. The results show that students in science classes value different aspects of science learning based on their motivational profile. The site visit teaching sequence offers science teachers an appropriate way of differentiating teaching according to students different needs. Because the research problems of this research project are multifaceted, concerning the design process, students motivation and students learning of the scientific content of the sequence, the problems of design, motivation and learning are reported in three different sub-studies, each containing specific research questions, data analysis and discussion. Keywords: motivation orientation, industry site visit, design-based research, inquiry-based science teaching
  • Niemi, Anna-Maija (Helsingin yliopisto, 2015)
    The study focuses on special needs education after basic education, particularly in the context of pre-vocational and vocational education and training. It analyses the positions of young people and the formation of their educational paths and choice-making. The starting point of the study is to consider the definitions given to the concepts of special and special educational needs . I ask, 1) how are special educational needs and students positions defined in pre-vocational and vocational education and training; 2) how are young people s educational paths, choices and subjectivities constructed in the practices of special needs education; and 3) how do different pedagogical practices restrict or enable participation in learning and studies of students regarded as having special educational needs? The study is positioned in the fields of sociology of education, disability studies, youth studies and gender studies. It includes five articles and a summary chapter. Methodologically, the study is multi-sited ethnographic research, contextualised in current education policy. The research data derives from two institutes of vocational education and training, while observing Metalwork and Machinery classes and Preparatory Training classes for disabled students over a six-month period. The data consist of interviews, field notes and education policy documents. In addition, the data also include life-historical interviews with 27 young adults as part of the Equality is Priority research project. My analytical approach is ethnographic and discursive. The practices of vocational education were found to be balanced between an inclusive education discourse and an individual, medical orientation that focuses on the identification of (special) needs. Visible both in the everyday life of vocational education and in education policy documents were, on the one hand, support for inclusive education, and on the other, a tendency to seek assurance from special needs statements and diagnoses. Many of the young people and professionals interviewed in the study interpreted the segregated arrangements of special needs education and the definition of special needs itself as stigmatizing. Combining the support needed by each student with general teaching was suggested as a pedagogic practice to combat stigmatization. Structural factors associated with the education system such as study field-specific entrance requirements, educational content, pedagogical practices and available support in each field influence how students regarded as having special educational needs are admitted and become attached to vocational education. For many young people applying and being accepted into upper secondary education seems to be complex and challenging. When addressing their own educational hopes and negotiating the options offered in study counselling, many did so in various roundabout ways. I propose that educational choices be seen as processes where young people shape their subjectivities and create spaces for their agency while negotiating the guidance offered by professional adults. The study suggests that in order to develop education in line with the objectives of an inclusive education policy, stereotypical definitions and meanings of special needs and disability should be constantly re-considered and questioned.
  • Suhonen, Eira (Helsingin yliopisto, 2009)
    How toddlers with special needs adjust to the daycare setting A multiple case study of how the relationships with adults and children are built The aim in this study is to describe how toddlers with special needs adjust to daycare. The emotional well-being and involvement in daycare activities of toddlers are especially investigated in this study. The relationship and how it is built between an adult and a child, a child and a child is examined. The daycare is examined through the socio-cultural theory as a pedagogical institution, where the child adapts by participating in social and cultural activities with the others. The development of the child is the result of the experiences that are gained through the constant relationship between the child, the family and social context. By the attachment theory the inner self-regulation, that allows the child safely adapt to new situations, develops most in the relationship between the child under 3years of age and the attending adult. The relationships between toddlers in daycare are usually built by the coincidental encounters in play and daily activities. In these relationships, the toddler gets the information of themselves and the other children. The complexity of the rules in the setting that organize the social action is challenging for the children and they need constant support from the adults. The participants of the study were five toddlers with special needs. When applying to daycare they were less than three years old and they got the specialist statement for their special needs, and the reference for daycare. The children were observed by recording their attending in the daycare once in the 3-4 months from the first day in daycare. Approximately 15 hours of material that was analysed with the Transana-program. The qualitative material was analysed by first collecting a descriptive model that explains and theorises the phenomenon. By the summery of the narrative it is placed a hypothesis that is tested by quantitative methods using correlations and variance analyses and general linear modeling that is used to count the differences between repeated measures and connections between different variables. The results of the study are built theoretically for the consistent conception between the theory and the findings in research. The toddlers in the study were all dependent on the support given by the adults in all the situations in the daycare. They could not associate with the other children without the support of the adults and their involvement in activities was low. The engagement of an adult in interaction was necessary for the children’s involvement in activities, and the co-operation with the other children. The engagement of teachers was statistically significantly higher than the engagement of other professions.