Prerequisites for Retaining Expert Knowledge: Identifying Essential Knowledge and Know-how in Retirement Cases

Tässä diplomityössä tutkittiin eläköityvien asiantuntijoiden tiedon ja osaamisen tunnistamista suomalaisissa asiantuntijaorganisaatioissa. Olennaisen tiedon ja osaamisen tunnistaminen on edellytys arvokkaan asiantuntijaosaamisen säilyttämiselle organisaatiossa, kun osaamista hallussaan pitävät asiantuntijat siirtyvät eläkkeelle. Tutkimuksen tavoitteena oli eläköityvien asiantuntijoiden teemahaastattelujen (N=51) sisällönanalyysin avulla i) eritellä keinoja, joilla organisaatiot tunnistavat eläköityvien asiantuntijoiden tietoa ja osaamista, ii) tunnistaa haasteita, joita tiedon ja osaamisen tunnistamiseen liittyy sekä iii) tarkastella asiantuntijoiden itsensä oleelliseksi tunnistaman tiedon ja osaamisen luonnetta. Tutkimuksen tuloksina todettiin, että organisaatiot tunnistavat eläköityvien asiantuntijoiden tietoa ja osaamista monipuolisesti, mutta systemaattisemmalle ja tietoisemmalle toiminnalle on suuri tarve. Merkittävimmät haasteet tiedon ja osaamisen tunnistamisessa liittyvät tunnistamista koskeviin asenteisiin sekä puutteelliseen resursointiin, jotka ilmenevät välinpitämättömyytenä ja motivaation puutteena prosessia kohtaan. Asiantuntijat puolestaan kykenevät tunnistamaan ja erittelemään omaa tietoaan ja osaamistaan monipuolisesti, mutta tunnistamisessa olisi mahdollista hyötyä suuresti sitä tukevista malleista ja käsitteistöstä. Tulosten perusteella esitettiin asiantuntijaorganisaatiossa toimivan esimiehen tueksi muistilista tiedon ja osaamisen tunnistamisen vaaranpaikoista. Ratkaisuna näiden vaaranpaikkojen välttämiseksi tarjottiin tiedon ja osaamisen tunnistamista tukevan kulttuurin synnyttämistä. Tämän esitettiin olevan saavutettavissa synnyttämällä tiedon ja osaamisen ympärille rakennettuja epävirallisia yhteisöjä sekä jaettuja tiloja ja kehittämällä organisaation jäsenten kykyjä monipuoliseen kommunikaatioon.This master’s thesis studies identification of knowledge and know-how of retiring experts in Finnish expert organizations. Identification of essential knowledge is a necessary prerequisite for successful retention of valuable expert knowledge as aging experts retire. Via content analysis of theme interviews of retiring experts (N=51), the objective of the research was i) to analyze the ways in which organizations identify expert knowledge and know-how, ii) to recognize challenges associated with identification of expert knowledge and know-how, and iii) to analyze the nature of knowledge and know-how identified as essential by experts themselves. The results of the research showed that organizations identify expert knowledge and know-how in a myriad of ways, even if there exists a strong need for more systematic and conscious approaches. The most significant challenges associated with knowledge identification were related to attitudes and scarce resourcing, resulting in lack of motivation and neglect towards the identification process. Experts were also shown to be able to analyze their knowledge and know-how diversely, albeit special models and conceptual frameworks would further support the process. Based on the results, a checklist of possible risk factors associated with knowledge identification was presented to support the work of managers in expert organizations. Development of a culture that supports identification of knowledge and know-how was proposed as a solution to avoid the risks discussed. This was presented to be achievable by building informal communities and shared spaces around knowledge and know-how, and by cultivating organization’s members’ skills for versatile communication

Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: A randomized controlled trial

Background: Clinical guidelines recommend research on sub-groups of patients with low back pain (LBP) but, to date, only few studies have been published. One sub-group of LBP is movement control impairment (MCI) and clinical tests to identify this sub-group have been developed. Also, exercises appear to be beneficial for the management of chronic LBP (CLBP), but very little is known about the management of sub-acute LBP. Methods: A randomized controlled trial (RCT) was conducted to compare the effects of general exercise versus specific movement control exercise (SMCE) on disability and function in patients with MCI within the recurrent sub-acute LBP group. Participants having a MCI attended five treatment sessions of either specific or general exercises. In both groups a short application of manual therapy was applied. The primary outcome was disability, assessed by the Roland-Morris Disability Questionnaire (RMDQ). The measurements were taken at baseline, immediately after the three months intervention and at twelve-month follow-up. Results: Seventy patients met the inclusion criteria and were eligible for the trial. Measurements of 61 patients (SMCE n = 30 and general exercise n = 31) were completed at twelve months. (Drop-out rate 12.9 %). Patients in both groups reported significantly less disability (RMDQ) at twelve months follow-up. However, the mean Change on the RMDQ between baseline and the twelve-month measurement showed statistically significantly superior improvement for the SMCE group -1.9 points (-3.9 to -0.5) 95 % (CI). The result did not reach the clinically significant three point difference. There was no statistical difference between the groups measured with Oswestry Disability Index (ODI). Conclusion: For subjects with non-specific recurrent sub-acute LBP and MCI an intervention consisting of SMCE and manual therapy combined may be superior to general exercise combined with manual therapy. Trial registration: The study protocol registration number is ISRCTN48684087. It was registered retrospectively 18th Jan 2012

Comparison of sleep between youth elite amateur athletes and professional athletes

Publisher Copyright: © 2021, The Author(s).Recent studies suggest that professional athletes seem to experience significant sleeping problems. However, little is still known about the occurrence of sleeping challenges at different stages of an athletic career. This descriptive study aimed to compare the sleep of professional athletes with younger elite amateur athletes. A total of 401 sportsmen, 173 youth elite amateur athletes and 228 professional athletes fulfilled a validated questionnaire. The self-estimated quality of sleep (on a linear scale 0–10) was significantly better in youth, being 7.9 compared to 7.4 (p < 0.001). The professional athletes had a significantly higher risk for sleeping problems, especially during the competitive season (OR = 7.3, 95% confidence interval 4.1–12.9) and they also used significantly more sleep medications (OR = 8.3, 95% confidence interval 1.7–4.1). Interestingly, majority of youth athletes (85.4%) had received adequate sleep counselling compared with professional athletes (58.1%), (p < 0.001). Furthermore, 75.8% of professional athletes considered that additional sleep counselling would improve their performance compared with only 45.6% of youth athletes (p < 0.001). Our study demonstrates that compared with the younger counterparts, professional athletes experience impaired sleep quality and significantly more sleeping problems. There may be various underlying factors to induce the problems. The early intervention with sleep counselling may play an important role in preventing these problems and, therefore, it is recommended to be integrated in athletes’ overall training process.Peer reviewe

Biokaasulaitoksen käsittelyjäännöksen, lannoituksen ja puna-apilapitoisuuden vaikutus nurmen satoon ja metaanintuottopotentiaaliin

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Biokaasulaitoksen käsittelyjäännöksen, lannoituksen ja puna-apilapitoisuuden vaikutus nurmen satoon ja metaanintuottopotentiaaliin

201

Association of CHA2DS2-VASc Score with Long-Term Incidence of New-Onset Atrial Fibrillation and Ischemic Stroke after Myocardial Infarction

The CHA2DS2-VASc score is a reliable tool used to estimate the risk of ischemic stroke (IS) in patients with atrial fibrillation (AF). Few tools exist for the prediction of new-onset AF (NOAF) after myocardial infarction (MI) and its relation to IS. We studied the usefulness of CHA2DS2-VASc in predicting NOAF and IS in a long-term follow-up after MI. Consecutive MI patients without baseline AF (n = 70,922; mean age: 68.2 years), discharged from 20 hospitals in Finland during 2005-2018, were retrospectively studied using national registries. The outcomes of interest after discharge were NOAF- and IS-assessed with competing risk analyses at one and ten years. The median follow-up was 4.2 years. The median baseline CHA2DS2-VASc score was 3 (IQR 2-5). The likelihood of both NOAF and NOAF-related IS increased stepwise with this score at one and ten years (all p 2DS2-VASc scores ≥6 points. The cumulative incidence of IS was 15.2% in patients with NOAF vs. 6.2% in patients without AF at 10 years after MI (adj. sHR 2.12; CI 1.98-2.28; p p 2DS2-VASc score is a simple tool used to estimate the long-term risk of NOAF and IS after MI in patients without baseline AF. Coronary bypass surgery is associated with an increased NOAF incidence after MI.</p

Cross-cultural adaptation and validation of the Finnish version of the central sensitization inventory and its relationship with dizziness and postural control

Background: Central Sensitization (CS) involves dysfunction in neurophysiological mechanisms that increase neuronal responses to both noxious and non-noxious stimuli in the central nervous system. The Central Sensitization Inventory (CSI) is considered the leading patient-reported outcome measure for assessing CS-related symptoms. The aim of this study was to translate and cross-culturally adapt the CSI into Finnish (CSI-FI) and to evaluate its psychometric properties. Methods: Translation and cross-cultural validation of the CSI was conducted according to established guidelines. The validation sample was 229 subjects, including 42 pain free controls and 187 subjects with chronic musculoskeletal pain. The CSI-FI was evaluated for internal consistency, test-retest reliability, exploratory factor analysis with maximum likelihood extraction, relationship with subject-reported outcome measures [Tampa scale of kinesiophobia (TSK), the Depression scale (DEPS), 5-level EQ-5D version (EQ-5 L-5D), Roland-Morris Disability Questionnaire (RMDQ), and Pain and Sleep Questionnaire Three-Item Index (PSQ-3)], pain history, subjective symptoms of dizziness, and CS-related diagnoses on CSI part B. Furthermore, we studied the ability of the CSI-FI to distinguish pain free controls, subjects with chronic pain in a single body area, and subjects with multisite chronic pain. In addition, we studied the relationship of CSI-FI scores with postural control on a force plate. Results: The CSI-FI demonstrated good internal consistency (0.884) and excellent test-retest reliability (0.933) with a 7 ± 1 day gap between test administrations. Exploratory factor analysis with maximum likelihood extraction yielded a one factor solution. Fair to good correlations were found between the CSI-FI and the TSK, DEPS, EQ-5 L-5D, RMDQ, and PSQ-3. Subjective symptoms of dizziness correlated better with CSI-FI scores than any of the CS-related diagnoses on CSI part B. Total CSI-FI scores successfully distinguished between pain free controls, subjects with chronic pain in a single body area, and subjects with multisite chronic pain. The multisite pain group reported significantly more dizziness symptoms than the other two groups. Force plate measurements showed no relationship between postural control and CSI-FI scores. Conclusion: The CSI-FI translation was successfully cross-culturally adapted and validated into Finnish. CSI-FI psychometric properties and scores were all in acceptable levels and in line with previous CSI validations. The CSI-FI appears to be a valid and reliable instrument for assessing CS-related symptomology in Finnish-speaking populations

Occurrence of Postpericardiotomy Syndrome: Association With Operation Type and Postoperative Mortality After Open-Heart Operations

BackgroundPostpericardiotomy syndrome (PPS) is a common complication after cardiac surgery. However, large‐scale epidemiological studies about the effect of procedure type on the occurrence of PPS and mortality of patients with PPS have not yet been performed.Methods and ResultsWe studied the association of PPS occurrence with operation type and postoperative mortality in a nationwide follow‐up analysis of 28 761 consecutive patients entering coronary artery bypass grafting, aortic valve replacement, mitral valve replacement, or ascending aortic surgery. Only PPS episodes severe enough to result in hospital admission or to contribute as a cause of death were included. Data were collected from mandatory Finnish national registries between 2005 and 2014. Of all the patients included, 493 developed PPS during the study period. The occurrence of PPS was significantly higher after aortic valve replacement (hazard ratio, 1.97; 95% confidence interval, 1.58–2.46; PPPPP=0.014).ConclusionsThe occurrence of PPS was higher after aortic valve replacement, mitral valve replacement, and aortic surgery when compared with the coronary artery bypass grafting procedure. Aging decreased the risk of PPS. The development of PPS was associated with higher mortality within the first year after cardiac or ascending aortic surgery.</p

Verihiutaleiden estäjähoito toteutuu vajavaisesti sepelvaltimotautikohtauksen jälkeen

Lähtökohdat Sepelvaltimotautikohtauksen hoidoksi suositellaan tehokasta ja taukoamatonta verihiutaleiden kaksoisestohoitoa.Menetelmät Selvitimme rekisteriaineistoista kaikkien Suomessa v. 2009–13 sepelvaltimotautikohtauksen vuoksi hoidettujen yli 18-vuotiaiden potilaiden (n = 54 416) kaksoisestohoidon toteutumista.Tulokset Potilaista 49 % lunasti lääkityksen viikon kuluessa kotiutumisesta. Potilasvolyymi oli suurin keskussairaaloissa. Niissä lääkitys aloitettiin 50,8 %:lle. Yliopistosairaaloiden potilaista 57,4 % sai lääkitystä asian­mukaisesti, mutta aluesairaaloissa vain 31,3 %. Yleisimmin käytössä oli klopidogreeli. Uudempia valmisteita käytettiin enenevästi jakson loppupuolella.Päätelmät Antitromboottinen hoito toteutui suosituksiin nähden vajavaisesti. Hoidossa oli ongelmia etenkin, kun potilas kotiutettiin aluesairaalasta.</p