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Kokemustieto yhteiskehittämisessä: hyppy asiakaslähtöisyyteen terveyspalveluissa

Kristina Grahn, Liisa Jussila, Kirsikka Kaipainen, Kirsti Kasila, Tarja Kettunen, Päivi Lappalainen, Raimo Lappalainen, Liisa Lumiaho, Heljä Lundgrén-Laine, Eeva Nykänen, Nina Peränen, Mari Punna (+5 others)
2021 JYU Reports  
Kirsti Kasila, Kristina Grahn, Liisa Lumiaho, Eeva Nykänen, Mari Punna, Päivi Lappalainen, Raimo Lappalainen, Kirsikka Kaipainen, Tarja Kettunen Tässä luvussa kuvaamme verkkopohjaisen elämäntaparyhmäohjausmallin  ...  Tarja Kettunen, Kirsti Kasila, Heljä Lundgrén-Laine Terveyden edistäminen on yhteistoimintaa kansalaisten kanssa.  ... 
doi:10.17011/jyureports/2021/1 fatcat:iaqox7php5fo5ojnjmvi645wne

Digital Coaching Motivating Young Elderly People towards Physical Activity

Eeva Kettunen, Tuomas Kari, Lauri Frank
2022 Sustainability  
The share of the elderly population is increasing globally, and it is important to help them to maintain their physical activity levels and ability to function to as late an age as possible. This qualitative intervention study focused on the experiences of young elderly on the ability of a sport and wellness technology digital coach to motivate them towards physical activity as well as on what needs and wishes this group has concerning digital coaching solutions. The findings of the study show
more » ... hat young elderly perceive digital coaching as potential in motivating them towards physical activity by providing instructive information and motivational feedback. It was also perceived to have positive influence on their exercise self-efficacy. However, it was also apparent that digital coaching devices should be tailored for this target group and be easy to learn in order to attract interest among them. Our findings provide insights for professionals and companies in sport technology field as well as to health professionals working in health promotion with young elderly people. Overall, this research aims to address social and economical sustainability of elderly people and their physical activity.
doi:10.3390/su14137718 fatcat:ieava2brejambh5ubnwtlupmry

CDKN2A copy number and p16 expression in malignant pleural mesothelioma in relation to asbestos exposure

Eeva Kettunen, Sauli Savukoski, Kaisa Salmenkivi, Tom Böhling, Esa Vanhala, Eeva Kuosma, Sisko Anttila, Henrik Wolff
2019 BMC Cancer  
Kettunen, the K. Albin Johansson Foundation to E. Kettunen, and the Finnish Work Environment Fund no. 109003 to Sisko Anttila.  ... 
doi:10.1186/s12885-019-5652-y pmid:31138176 pmcid:PMC6537412 fatcat:vqcgs7p36fbzdm7zc2fh2tafya

Accumulation of genomic alterations in 2p16, 9q33.1 and 19p13 in lung tumours of asbestos-exposed patients

Penny Nymark, Mervi Aavikko, Jussi Mäkilä, Salla Ruosaari, Tuija Hienonen-Kempas, Harriet Wikman, Kaisa Salmenkivi, Risto Pirinen, Antti Karjalainen, Esa Vanhala, Eeva Kuosma, Sisko Anttila (+1 others)
2012 Molecular Oncology  
A B S T R A C T We have previously demonstrated an association between genomic alterations in 19p13, 2p16, and 9q33.1 and asbestos exposure in patients' lung tumours. This study detected allelic imbalance (AI) in these regions in asbestos-exposed lung cancer (LC) patients' histologically normal pulmonary epithelium. We extended the analyses of tumour tissue to cover a large LC patient cohort and studied DNA copy number alteration (CNA) and AI in 19p13, 2p16, and 9q33.1 for the first time in
more » ... ination. We found both CNA and AI in !2/3 of the regions to be significantly and dose-dependently (P < 0.001) associated with pulmonary asbestos fibre count. Twenty percent of the exposed patients' LC showed CNA in !2/3 of the regions, whereas none of the non-exposed patients' LC showed CNA in more than one region. AI was evident in 89% of the exposed and in only 26% of the nonexposed patients' LC. The genomic alterations in 19p13, 2p16, and 9q33.1 in compilation identified asbestos-exposed patients' lung tumours better than each of the regions alone. These alterations form the basis for the development of a combinatorial molecular assay that could be used to identify asbestos-related LC.
doi:10.1016/j.molonc.2012.07.006 pmid:22901466 pmcid:PMC5528398 fatcat:p4f3b33lwzcyrfwrxfxp2i5dgq

Identification of differentially expressed genes in pulmonary adenocarcinoma by using cDNA array

Harriet Wikman, Eeva Kettunen, Jouni K Seppänen, Antti Karjalainen, Jaakko Hollmén, Sisko Anttila, Sakari Knuutila
2002 Oncogene  
., 2001; Kettunen et al., 2001) .  ... 
doi:10.1038/sj.onc.1205726 pmid:12173052 fatcat:ldynna2zzfbqfnlaj6t7r7auk4

Hot spot mutations in Finnish non-small cell lung cancers

Satu Mäki-Nevala, Virinder Kaur Sarhadi, Mikko Rönty, Eeva Kettunen, Kirsti Husgafvel-Pursiainen, Henrik Wolff, Aija Knuuttila, Sakari Knuutila
2016 Lung Cancer  
Objectives: Non-small cell lung cancer (NSCLC) is a common cancer with a poor prognosis. The aim of this study was to screen Finnish NSCLC tumor samples for common cancer-related mutations by targeted next generation sequencing and to determine their concurrences and associations with clinical features. Materials and methods: Sequencing libraries were prepared from DNA isolated from formalin-fixed, paraffin-embedded tumor material of 425 patients using the AmpliSeq Colon and Lung panel covering
more » ... mutational hot spot regions of 22 cancer genes. Sequencing was performed with the Ion Torrent Personal Genome Machine (PGM). Results: Data analysis of the hot spot mutations revealed mutations in 77% of the patients, with 7% having 3 or more mutations reported in the Catalogue of Somatic Mutations in Cancer (COSMIC) database. Two of the most frequently mutated genes were TP53 (46%) and KRAS (25%). KRAS codon 12 mutations were the most recurrently occurring mutations. EGFR mutations were significantly associated with adenocarcinoma, female gender and never/light-smoking history; CTNNB1 mutations with light ex-smokers, PIK3CA and TP53 mutations with squamous cell carcinoma, and KRAS with adenocarcinoma. TP53 mutations were most prevalent in current smokers and ERBB2, ERBB4, PIK3CA, NRAS, NOTCH1, FBWX7, PTEN and STK11 mutations occurred exclusively in a group of ever-smokers, however the association was not statistically significant. No mutation was found that associated with asbestos exposure. Conclusion: Finnish NSCLC patients have a similar mutation profile as other Western patients, however with a higher frequency of BRAF mutations but a lower frequency of STK11 and ERBB2 mutations. Moreover, TP53 mutations occurred frequently with other gene mutations, most commonly with KRAS, MET, EGFR and PIK3CA mutations.
doi:10.1016/j.lungcan.2016.06.024 pmid:27565922 fatcat:esf3dhxxurghjbnlwdbcct25ni

Frequent DNA methylation changes in cancerous and noncancerous lung tissues from smokers with non-small cell lung cancer

Kristina Daniunaite, Agne Sestokaite, Raimonda Kubiliute, Kristina Stuopelyte, Eeva Kettunen, Kirsti Husgafvel-Pursiainen, Sonata Jarmalaite
2020 Mutagenesis  
Cancer deaths account for nearly 10 million deaths worldwide each year, with lung cancer (LCa) as the leading cause of cancer-related death. Smoking is one of the major LCa risk factors, and tobacco-related carcinogens are potent mutagens and epi-mutagens. In the present study, we aimed to analyse smoking-related epigenetic changes in lung tissues from LCa cases. The study cohort consisted of paired LCa and noncancerous lung tissues (NLT) from 104 patients, 90 of whom were smokers or ex-smokers
more » ... (i.e. ever smokers) at the time of diagnosis. DNA methylation status of tumour suppressor genes DAPK1, MGMT, p16, RASSF1 and RARB was screened by means of methylation-specific PCR (MSP) and further analysed quantitatively by pyrosequencing. Methylation of at least one gene was detected in 59% (61 of 104) of LCa samples and in 39% (41 of 104) of NLT. DAPK1 and RASSF1 were more frequently methylated in LCa than in NLT (P = 0.022 and P = 0.041, respectively). The levels of DNA methylation were higher in LCa than NLT at most of the analysed CpG positions. More frequent methylation of at least one gene was observed in LCa samples of ever smokers (63%, 57 of 90) as compared with never smokers (36%, 5 of 14; P = 0.019). In the ever smokers group, methylation of the genes also occurred in NLT, but was rare or absent in the samples of never smokers. Among the current smokers, RASSF1 methylation in LCa showed association with the number of cigarettes smoked per day (P = 0.017), whereas in NLT it was positively associated with the duration of smoking (P = 0.039). Similarly, p16 methylation in LCa of current smokers correlated with the larger number of cigarettes smoked per day (P = 0.047). Overall, DNA methylation changes were present in both cancerous and noncancerous tissues of LCa patients and showed associations with smoking-related parameters.
doi:10.1093/mutage/geaa022 pmid:32914849 fatcat:smxjo6m23fhbvncmdd527duplq

Stromal Caveolin-1 and Caveolin-2 Expression in Primary Tumors and Lymph Node Metastases

Wladimir Gerstenberger, Michaela Wrage, Eeva Kettunen, Klaus Pantel, Sisko Anttila, Stefan Steurer, Harriet Wikman
2018 Analytical Cellular Pathology  
The expression of caveolin-1 (CAV1) in both tumor cell and cancer-associated fibroblasts (CAFs) has been found to correlate with tumor aggressiveness in different epithelial tumor entities, whereas less is known for caveolin-2 (CAV2). The aim of this study was to investigate the clinicopathological significance and prognostic value of stromal CAV1 and CAV2 expression in lung cancer. The expression of these two genes was investigated at protein level on a tissue microarray (TMA) consisting of
more » ... primary tumor samples. 50.7% of squamous cell lung cancer (SCC) tumors showed strong expression of CAV1 in the tumor-associated stromal cells, whereas only 15.1% of adenocarcinomas (AC) showed a strong CAV1 expression (p<0.01). A strong CAV2 stromal expression was found in 46.0% of the lung tumor specimens, with no significant difference between the subtypes. Neither CAV1 nor CAV2 stromal expression was associated with any other clinicopathological factor including survival. When the stromal expression in matched primary tumors and lymph node metastases was compared, both CAV1 and CAV2 expressions were frequently found lost in the corresponding stroma of the lymph node metastasis (40.6%, p=0.003 and 38.4%, p=0.001, resp.). Loss of stromal CAV2 in the lymph node metastases was also significantly associated with earlier death (p=0.011). In conclusion, in contrast to the expression patterns in the tumor tissue of lung cancer, stromal expression of CAV1 in primary tumors was not associated with clinical outcome whereas the stromal expression of especially CAV2 in the metastatic lymph nodes could be associated with lung cancer pathogenesis.
doi:10.1155/2018/8651790 pmid:29850392 pmcid:PMC5914130 fatcat:rocoozjsnfeenpidgrgw7ipuhq

Biodiversity conservation across scales: lessons from a science–policy dialogue

Riikka Paloniemi, Evangelia Apostolopoulou, Eeva Primmer, Malgorzata Grodzinska-Jurcak, Klaus Henle, Irene Ring, Marianne Kettunen, Joseph Tzanopoulos, Simon Potts, Sybille van den Hove, Pascal Marty, Andrew McConville (+1 others)
2012 Nature Conservation  
One of the core challenges of biodiversity conservation is to better understand the interconnectedness and interactions of scales in ecological and governance processes. These interrelationships constitute not only a complex analytical challenge but they also open up a channel for deliberative discussions and knowledge exchange between and among various societal actors which may themselves be operating at various scales, such as policy makers, land use planners, members of NGOs, and
more » ... In this paper, we discuss and integrate the perspectives of various disciplines academics and stakeholders who participated in a workshop on scales of European biodiversity governance organised in Brussels in the autumn of 2010. The 23 participants represented various governmental agencies and NGOs from the European, national, and sub-national levels. The data from the focus group discussions of the workshop were analysed using qualitative content analysis. The core scale-related challenges of biodiversity policy identified by the
doi:10.3897/natureconservation.2.3144 fatcat:ocxiuyysprcfzegx7c2b5wgkju

Is postpartum depression a homogenous disorder: time of onset, severity, symptoms and hopelessness in relation to the course of depression

Pirjo Kettunen, Eeva Koistinen, Jukka Hintikka
2014 BMC Pregnancy and Childbirth  
Postpartum depression (PPD) is a common illness, but due to the underlying processes and the diversity of symptoms, some variability is exhibited. The risk of postpartum depression is great if the mother has previously suffered from depression, but there is some evidence that a certain subgroup of women only experience depression during the postpartum period. Methods: The study group consisted of 104 mothers with postpartum major depression and a control group of 104 postpartum mothers without
more » ... epression. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for data collection. The severity of depression and other mental symptoms were assessed using several validated rating scales. Results: A history of past depression (82%), including depression during pregnancy (42%) and during the postpartum period (53%), was very common in those with current PPD. Eighteen per cent of mothers with current PPD had previously not had any depressive episodes and four per cent had experienced depression only during the postpartum period. Therefore, pure PPD was rare. The onset of PPD was usually (84%) within six weeks of childbirth. Obsessive-compulsive symptoms, phobic anxiety, paranoid ideation, depressed mood, diminished pleasure/ interest, decreased energy, and psychomotor agitation/retardation were common with all kinds of depression histories. Pure PPD was the most similar to the first depressive episode. Nevertheless, the severity of depression, the level of hopelessness, somatisation, interpersonal sensitivity, anxiety, hostility, psychoticism, sleep disturbance, and suicidal ideation were lower, appetite changed less, and concentration was better than in other recurrent depressions. Conclusions: According to this study, PPD is not a homogenous disorder. The time of onset, severity, symptoms, level of hopelessness, and the course of depression vary. Recurrent depression is common. All mothers must be screened during the sixth week postpartum at the latest. Screening alone is not effective; it is also important to give mothers information about PPD and to discuss the symptoms with them in order for them to recognise this disorder and possible new episodes in the future.
doi:10.1186/s12884-014-0402-2 pmid:25491477 pmcid:PMC4279462 fatcat:hlmjvkbl6jfx3atrkxfuidjoaa

Is postpartum depression a homogenous disorder: time of onset, severity, symptoms and hopelessness in relation to the course of depression

Pirjo Kettunen, Eeva Koistinen, Jukka Hintikka
2014 BMC Pregnancy and Childbirth  
Postpartum depression (PPD) is a common illness, but due to the underlying processes and the diversity of symptoms, some variability is exhibited. The risk of postpartum depression is great if the mother has previously suffered from depression, but there is some evidence that a certain subgroup of women only experience depression during the postpartum period. Methods: The study group consisted of 104 mothers with postpartum major depression and a control group of 104 postpartum mothers without
more » ... epression. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used for data collection. The severity of depression and other mental symptoms were assessed using several validated rating scales. Results: A history of past depression (82%), including depression during pregnancy (42%) and during the postpartum period (53%), was very common in those with current PPD. Eighteen per cent of mothers with current PPD had previously not had any depressive episodes and four per cent had experienced depression only during the postpartum period. Therefore, pure PPD was rare. The onset of PPD was usually (84%) within six weeks of childbirth. Obsessive-compulsive symptoms, phobic anxiety, paranoid ideation, depressed mood, diminished pleasure/ interest, decreased energy, and psychomotor agitation/retardation were common with all kinds of depression histories. Pure PPD was the most similar to the first depressive episode. Nevertheless, the severity of depression, the level of hopelessness, somatisation, interpersonal sensitivity, anxiety, hostility, psychoticism, sleep disturbance, and suicidal ideation were lower, appetite changed less, and concentration was better than in other recurrent depressions. Conclusions: According to this study, PPD is not a homogenous disorder. The time of onset, severity, symptoms, level of hopelessness, and the course of depression vary. Recurrent depression is common. All mothers must be screened during the sixth week postpartum at the latest. Screening alone is not effective; it is also important to give mothers information about PPD and to discuss the symptoms with them in order for them to recognise this disorder and possible new episodes in the future.
doi:10.1186/preaccept-1301881224127235 pmid:25491477 pmcid:PMC4279462 fatcat:vcr7cfdrtvbhbiwlnkftlnvgs4

Histopathological features of epithelioid malignant pleural mesotheliomas in patients with extended survival

Juuso Paajanen, Sanna Laaksonen, Eeva Kettunen, Ilkka Ilonen, Tapio Vehmas, Jarmo Salo, Jari Räsänen, Eva Sutinen BHc, Hely Ollila BHc, Mikko I. Mäyränpää, Marjukka Myllärniemi, Henrik Wolff
2020 Human Pathology  
Diffuse malignant mesothelioma (DMM) of the pleura is a rare and aggressive disease, where the long-term survival (LTS) rate is low. The epithelioid subtype is the most prevalent form of DMM with the best prognosis. In order to study prognostic histopathologic factors associated with extended survival in epithelioid DMM, we examined 43 tumors from patients with survival over five years (long-term survivals [LTS]) and compared the findings with 84 tumors from a reference group with average
more » ... al (RG). We analyzed the tumors considering previously published histopathological prognostic features and attempted to identify additional morphological features predictive of extended survival. Most of the LTS tumors presented with nuclear grade I (n = 34,90%) and a tubulopapillary growth pattern (n = 30,70%). One LTS tumor had necrosis. In contrast, nuclear grade II (n = 49,61%) and solid growth pattern (n = 59,70%) were more frequent in RG, and necrosis was present in 16 (19%) tumors. We also evaluated the association of asbestos lung tissue fiber burden quantified from autopsy samples with histopathological features and found that elevated asbestos fiber was associated with higher nuclear grade (p < 0.001) and the presence of necrosis (p = 0.021). In univariate survival analysis, we identified the following three novel morphological features associated with survival: exophytic polypoid growth pattern, tumor density, and single mesothelium layered tubular structures. After adjustments, low nuclear grade (p < 0.001) and presence of exophytic polypoid growth (p = 0.024) were associated with prolonged survival. These results may aid in estimating DMM prognosis.
doi:10.1016/j.humpath.2020.02.007 pmid:32142836 fatcat:52oihcijfzdnfaecu3olyykey4

Leveraging Northern European population history; novel low frequency variants for polycystic ovary syndrome [article]

Jaakko S Tyrmi, Riikka K Arffman, Nàtalia Pujol-Gualdo, Venla Kurra, Laure Morin-Papunen, Eeva Sliz, Terhi T Piltonen, Triin S Laisk, Johannes Kettunen, Hannele Laivuori, FinnGen, Estonian Biobank Research Team
2021 medRxiv   pre-print
Polycystic ovary syndrome (PCOS) is a common, complex disorder, which should be recognized as a prominent health concern also outside the context of fertility. Although PCOS affects up to 18% of women worldwide, its etiology remains poorly understood. It is likely that a combination of genetic and environmental factors contributes to the risk of PCOS development. Whilst previous genome-wide association studies have mapped several loci associated with PCOS, analysis of populations with unique
more » ... ulation history and genetic makeup has the potential to uncover new low frequency variants with larger effects. In this study, we leverage genetic information of two neighboring and well-characterized populations in Europe - Finnish and Estonian - to provide a basis for a new understanding of the genetic determinants of PCOS. Methods and Findings: We conducted a three-stage case-control genome-wide association study (GWAS). In the discovery phase, we performed a GWAS comprising of a total of 797 cases and 140,558 controls from the FinnGen study. For validation, we used an independent dataset from the Estonian Biobank, including 2,812 cases and 89,230 controls. Finally, we conducted a joint meta-analysis of 3,609 cases and 229,788 controls from both cohorts. In total, we identified three novel genome-wide significant variants associating with PCOS. Two of these novel variants, rs145598156 (p=3.6 x 10-8, OR=3.01 [2.02-4.50] MAF=0.005) and rs182075939 (p=1.9 x 10-16, OR= 1.69 [1.49-1.91], MAF=0.04), were found to be enriched in the Finnish and Estonian populations and are tightly linked to a deletion c.1100delC (r2= 0.95) and a missense I157T (r2=0.83) in CHEK2. The third novel association is a common variant near MYO10 (rs9312937, p= 1.7 x 10-8, OR=1.16 (1.10-1.23), MAF=0.44). We also replicated four previous reported associations near the genes ERBB4, DENND1A, FSHB and ZBTB16. Conclusions: We identified three novel variants for PCOS in a Finnish-Estonian GWAS. Using isolated populations to perform genetic association studies provides a useful resource to identify rare variants contributing to the genetic landscape of complex diseases such as PCOS.
doi:10.1101/2021.05.20.21257510 fatcat:xtsqp7ijxvavnocpwnzgkmxnji

Psychometric properties and factor structure of the Finnish version of the Health Care Providers' Pain and Impairment Relationship Scale

Jolanda Ehrström, Reino Pöyhiä, Jyrki Kettunen, Nina Santavirta, Eeva Pyörälä
2021 Musculoskeletal Science and Practice  
Health care providers' beliefs influence the outcomes of low back pain patients care. The aim of this study was to translate and cross-culturally adapt the Health Care Providers' Pain and Impairment Relationship Scale into Finnish (HC-PAIRS-FI) and to evaluate its psychometric properties and factor structure in a sample of Finnish physiotherapists and physiotherapy students. The translation was performed using established guidelines. Participants answered an online survey consisting of
more » ... FI and the Finnish Tampa Scale of Kinesiophobia adapted for health care providers (TSK-HC-FI). Internal consistency was assessed using Cronbach's alpha. Intraclass correlation coefficient (ICC) was used to determine test-retest reliability. A second round of analysis, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed as the fit indices of the initial CFA were not satisfactory. A sample of 202 physiotherapists and 97 physiotherapy students completed the survey. The second round of analysis EFA and CFA, conducted on a randomly split subsample, revealed and confirmed a three-factor, 11-item HC-PAIRS-FI scale with satisfactory model fit indices. Cronbach's alpha 0.79 and ICC = 0.82 (p < 0.001) indicate good internal consistency and test-retest reliability. The standard error of measurement was 2.12. HC-PAIRS-FI scores correlated moderately with TSK-HC-FI (r = 0.69, p < 0.001). The 11 items HC-PAIRS-FI appears to be a valid and reliable questionnaire to evaluate Finnish physiotherapists' and physiotherapy students' attitudes and beliefs about the relationship between chronic low back pain and impairment. Future studies are required to validate this scale for other health care providers.
doi:10.1016/j.msksp.2021.102471 pmid:34740150 fatcat:5pl7teou5bferbnjnxmbxsi6jy

Integrative analysis of microRNA, mRNA and aCGH data reveals asbestos- and histology-related changes in lung cancer

Penny Nymark, Mohamed Guled, Ioana Borze, Ali Faisal, Leo Lahti, Kaisa Salmenkivi, Eeva Kettunen, Sisko Anttila, Sakari Knuutila
2011 Genes, Chromosomes and Cancer  
., 2008; Kettunen et al., 2009; Nymark et al., 2009) . In this study, we have profiled the miRNAome of the same samples and integrated the data with earlier mRNA and aCGH results.  ... 
doi:10.1002/gcc.20880 pmid:21563230 fatcat:3ned4lp3r5bdpaxkor2paf6diy
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