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Tiivistelmä. Tukea tarvitsevien korkeakouluopiskelijoiden määrä on kasvussa kansainvälisesti, ja yhä useampi opiskelija tarvitsee tukea jossain vaiheessa opintojaan. Vaikka tuen tarvitsijoiden määrä korkeakouluissa on kasvussa, on opiskelijoiden tuen tarpeista saatavilla vain vähän tietoa. Yhdenvertaisuuslain (1325/2014) nojalla korkeakoulut ovat velvoitettuja tarjoamaan tukea opiskelijoille. Tutkielman tavoitteena on selvittää, millaisia konkreettisia tukikeinoja opiskelijat ovat saaneet opettajaopinnoissaan ja millaisista tukikeinoista he ovat kokeneet hyötyneensä eniten. Lisäksi selvitetään saavutettavuuden eri osa-alueiden toteutumisen riittävyyttä, sekä pandemian vaikutuksia saavutettavuuteen. Tutkielmassa selvitetään myös opiskelijoiden ideoita opettajankoulutuksen saavutettavuuden kehittämiseksi. Tutkielman kohdejoukkona on yhden Suomen yliopiston vähintään toisen vuosikurssin opettajaopiskelijat. Tutkielma on toteutettu yhteistyössä Opetus- ja kulttuuriministeriön rahoittaman Hohto-hankkeen kanssa. Tutkielma on toteutettu fenomenologisena monimenetelmätutkimuksena. Teoreettinen viitekehys pohjautuu saavutettavuuden ja yhdenvertaisuuden käsitteille ja tuen tarpeen taustatekijöiden sekä saavutettavuuden eri osa-alueiden toteutumisen tarkastelulle. Saavutettavuudella tarkoitetaan korkeakoulussa yhdenvertaisten mahdollisuuksien tarjoamista kaikille opiskelijoille. Saavutettavuus sisältää fyysisen, psyykkisen ja sosiaalisen ulottuvuuden. Tutkielman aineisto on kerätty kyselylomakkeella. Laadullinen aineisto on analysoitu aineistolähtöisellä sisällönanalyysillä ja määrällisestä aineistosta on laskettu keskiarvot, keskihajonnat ja frekvenssit. Tutkielman tuloksista käy ilmi, että opiskelijat ovat kokeneet saaneensa eniten sosiaaliseen saavutettavuuteen liittyviä tukikeinoja, kuten lisäaikaa tentteihin. Opiskelijoiden hyödylliseksi kokemia tukikeinoja ovat esimerkiksi luentotallenteet sekä vaihtoehtoiset kurssisuoritustavat. Kaikilla saavutettavuuden osa-alueilla on vielä kehitettävää erityisesti tukea tarvitsevien opiskelijoiden mukaan. Tukikeinot hyödyttävät kaikkia opiskelijoita, eikä pelkästään tuen tarvitsijoita. Pandemian koetaan lisänneen tarvetta tuelle, vaikka osa opiskelijoista kokee etäopetuksen olevan hyödyllistä. Opiskelijoiden kokemuksista käy myös ilmi ideoita opettajankoulutuksen saavutettavuuden kehittämiseksi. Tutkielma antaa tietoa opiskelijoiden saamista tukikeinoista ja saavutettavuuden toteutumisesta opettajaopinnoissa. Tätä tietoa voidaan käyttää apuna opettajankoulutuksen kehittämistyössä.Students’ experiences of accessibility in pedagogical studies. Abstract. The number of higher education students that need support is growing internationally, and more and more students need support at some point in their studies. Even though the number of people needing support is growing, there is very little information available about students’ need for support. Higher education institutions are required by the Non-Discrimination Act (1325/2014) to offer support for their students. The aim of this thesis is to find out what kind of concrete means of support students have been offered in their pedagogical studies and which kind they have found the most helpful. Additionally, the sufficiency of the realization of the different parts of accessibility are established, as well as the effects of the pandemic on accessibility. Students’ ideas on improving the accessibility in pedagogical studies are also established. The target group of the thesis is at least second year teacher students of one university in Finland. The thesis has been implemented in cooperation with the Hohto project that is funded by the Ministry of Education and Culture. The thesis has been carried out as a phenomenological mixed method study. The theoretical framewok of the study is based on the concepts of accessibility and equality, as well as the examination of the realization of the different parts of accessibility. Accessibility stands for the providement of equal possibilities for all higher education students. Accessibility includes a physical, psychological and a social dimension. The data of the thesis has been collected through a questionnaire. The qualitative data has been analyzed with a data-based content analysis and averages, standard deviations and frequencies have been calculated from the quantitative data. The results of the thesis show that based on the students’ experiences, they have mostly gotten support means of social accessibility, such as additional time in exams. Support means that students find helpful are for example lecture recordings and alternative ways to complete a course. There is space for improvement on all parts of accessibility, especially according to students in need of support. Support means benefit all students, not only those in need of support. Students have experienced that their need for support has grown due to the pandemic, though some students find online education helpful. Students’ experiences also reveal ideas for the improvement of accessibility in pedagogical studies. The thesis provides information about the support means that students are offered, and the realization of accessibility in pedagogical studies. This information can be used as an aid in the development of teacher training.

Background: The Prospective Lynch Syndrome Database (PLSD) collates information on carriers of pathogenic or likely pathogenic MMR variants (path_MMR) who are receiving medical follow-up, including colonoscopy surveillance, which aims to the achieve early diagnosis and treatment of cancers. Here we use the most recent PLSD cohort that is larger and has wider geographical representation than previous versions, allowing us to present mortality as an outcome, and median ages at cancer diagnoses for the first time.Methods: The PLSD is a prospective observational study without a control group that was designed in 2012 and updated up to October 2022. Data for 8500 carriers of path_MMR variants from 25 countries were included, providing 71,713 years of follow up. Cumulative cancer incidences at 65 years of age were combined with 10-year crude survival following cancer, to derive estimates of mortality up to 75 years of age by organ, gene, and gender.Findings: Gynaecological cancers were more frequent than colorectal cancers in path_MSH2, path_MSH6 and path_PMS2 carriers [cumulative incidence: 53.3%, 49.6% and 23.3% at 75 years, respectively]. Endometrial, colon and ovarian cancer had low mortality [8%, 13% and 15%, respectively] and prostate cancers were frequent in male path_MSH2 carriers [cumulative incidence: 39.7% at 75 years]. Pancreatic, brain, biliary tract and ureter and kidney and urinary bladder cancers were associated with high mortality [83%, 66%, 58%, 27%, and 29%, respectively]. Among path_MMR carriers undergoing colonoscopy surveillance, particularly path_MSH2 carriers, more deaths followed non-colorectal Lynch syndrome cancers than colorectal cancers.Interpretation: In path_MMR carriers undergoing colonoscopy surveillance, non-colorectal Lynch syndrome cancers were associated with more deaths than were colorectal cancers. Reducing deaths from non-colorectal cancers presents a key challenge in contemporary medical care in Lynch syndrome. Background: The Prospective Lynch Syndrome Database (PLSD) collates information on carriers of pathogenic or likely pathogenic MMR variants (path_MMR) who are receiving medical follow-up, including colonoscopy surveillance, which aims to the achieve early diagnosis and treatment of cancers. Here we use the most recent PLSD cohort that is larger and has wider geographical representation than previous versions, allowing us to present mortality as an outcome, and median ages at cancer diagnoses for the first time. Methods: The PLSD is a prospective observational study without a control group that was designed in 2012 and updated up to October 2022. Data for 8500 carriers of path_MMR variants from 25 countries were included, providing 71,713 years of follow up. Cumulative cancer incidences at 65 years of age were combined with 10-year crude survival following cancer, to derive estimates of mortality up to 75 years of age by organ, gene, and gender. Findings: Gynaecological cancers were more frequent than colorectal cancers in path_MSH2, path_MSH6 and path_PMS2 carriers [cumulative incidence: 53.3%, 49.6% and 23.3% at 75 years, respectively]. Endometrial, colon and ovarian cancer had low mortality [8%, 13% and 15%, respectively] and prostate cancers were frequent in male path_MSH2 carriers [cumulative incidence: 39.7% at 75 years]. Pancreatic, brain, biliary tract and ureter and kidney and urinary bladder cancers were associated with high mortality [83%, 66%, 58%, 27%, and 29%, respectively]. Among path_MMR carriers undergoing colonoscopy surveillance, particularly path_MSH2 carriers, more deaths followed non-colorectal Lynch syndrome cancers than colorectal cancers. Interpretation: In path_MMR carriers undergoing colonoscopy surveillance, non-colorectal Lynch syndrome cancers were associated with more deaths than were colorectal cancers. Reducing deaths from non-colorectal cancers presents a key challenge in contemporary medical care in Lynch syndrome. Funding: We acknowledge funding from the Norwegian Cancer Society, contract 194751-2017.