Lääkehoidon osaamisen kehittyminen Sairaanhoitajan lääkkeenmäärääminen -koulutuksessa

Artikkelissa kuvataan sairaanhoitajan lääkkeenmäärääminen koulutuksessa vuonna 2016 olleiden opiskelijoiden (n=20) lääkehoidon osaamisen kehittymistä opintojen aikana. Opiskelijat kirjoittivat opintojen lopussa esseen otsikolla ”Oman osaamisen kehittyminen”. Aineiston analyysissa käytettiin induktiivista sisällönanalyysia ja abdutiivista päättelyä. Lääkehoidon osaaminen kehittyi opiskelun aikana tiedon lisääntymisen ja ymmärtämisen kautta soveltamiseen, analysointiin ja tiedon synteesiin

Haavahoidon erikoistumiskoulutuksella asiantuntijuuteen

Erikoistumiskoulutus on uusi koulutusmuoto, joka edellyttää ammattikorkeakoulujen ja työelämän yhteistyötä koulutuksen suunnittelussa, toteutuksessa sekä arvioinnissa. Haavahoidon erikoistumiskoulutus on 30 opintopisteen kokonaisuus, joka toteutetaan monimuoto-opiskeluna. Opiskelijalähtöisyys ja näyttöön perustuvuus ovat keskeisiä periaatteita koulutuksessa. Tarkoituksena on, että opiskelija pystyy opintojen avulla kehittämään oman työyhteisönsä haavahoitoa. Haavahoidon erikoistumiskoulutuksen tavoitteena on laaja-alainen haavahoidon erikoisosaaminen. Koulutuksen jälkeen opiskelijalla on valmiudet toimia haavahoidon asiantuntijana. Asiantuntijuuden kehittyminen vaatii pitkää kokemusta sekä tietoista, tavoitteellista ja reflektiivistä toimintaa vuorovaikutuksessa muiden asiantuntijoiden kanssa

Species sorting drives variation of boreal lake and river macrophyte communities

Metacommunity paradigms are increasingly studied to explain how environmental control and spatial patterns determine variation in community composition. However, the relative importance of these patterns on biological assemblages among different habitats is not well known. We investigated the relative roles of local, catchment and spatial variables based on overland and watercourse distances in explaining the variation of community structure of lake and river macrophytes in two large river basins at two spatial extents (within and across river basins). Partial redundancy analysis was used to explore the share of variability in macrophyte communities attributable to local environmental conditions, catchment land cover and space (generated with Principle Coordinates of Neighbour Matrices). We found that local variables had the highest effect on both lake and river macrophyte communities, followed by catchment variables. Space had no or only marginal influence on the community structure regardless of used distance measure. Total phosphorus, conductivity and turbidity of the local variables contributed most for lake macrophytes, whereas pH and color had largest independent contribution for variation in river macrophytes. Size of catchment area and proportion of lakes and agriculture were the most important catchment variables in both habitats. The strong importance of environmental control suggests that both lake and river macrophyte communities are structured by species sorting. This finding gives support to the validity of assessment systems based on the European Water Framework Directive

Freshwater ecosystem services in Finland

Ecosystem services have become a significant multidisciplinary research agenda in the world. Man-made activities both at global and local scales deteriorate biodiversity and ecosystem functioning, which are essential also to human welfare. Ecosystem services are material and immaterial benefits and services provided by nature. Ecosystem services can be divided to the following main categories: provisioning, regulating, cultural and sustaining services. Different ecosystems provide various services depending also on their geographical location. For example, boreal ecosystems differ ecologically from tropical ones, for which the services they provide also vary. Boreal region is generally known for its high abundance of freshwaters. Quantity of freshwaters is rarely a problem in boreal region, but quality of inland waters is decreased in many places due to anthropogenic pressures. Freshwaters have received less attention than other ecosystems in ecosystem services research, because direct link between inland waters and terrestrial ecosystems makes evaluation of freshwater ecosystem services challenging. Purpose of this report is to identity and classify freshwater ecosystem services in Finland. The report consists of two parts: 1) historical review of freshwater ecosystem services in Finland, and 2) identification and classification of current ecosystem services in Finnish freshwaters. In historical review, we roughly evaluate how identification and appreciation of freshwater ecosystem services have varied temporally. In the second part, we identify and classify current freshwater ecosystem services in Finland based on two classification criteria, which complement each other. This report is part of project ”Integrated and policy relevant valuation of forest, agro, peatland and aquatic ecosystem services in Finland”, which is funded by Maj and Tor Nessling Foundation and coordinated by University of Eastern Finland. Appreciation of freshwater ecosystem services has varied over the decades. In the beginning of 20th century, inland waters were important source of nutriment and way of transportation. Increased pollution of water bodies awaked society to appreciate other services provided by freshwaters in turn of 1970s-80s. Nowadays, freshwaters have a major role among others in flood protection, climate regulation, primary production and recreation. However, identification of many freshwater services is still superficial or deficient. For example, genetic and biochemical resources, control of invasive species and diseases, aesthetic and religious services, and formation of soil and water cycling are generally poorly known in Finland. In addition, large scale studies of freshwater ecosystem services are rarely done in Finland and knowledge on how services interact with each other is inadequate

“This used to be a children’s app” - Media ideologies and social life in Finnish TikTok

This thesis examines the social interaction and media ideologies of Finnish TikTok users and how they are different from the discourses about TikTok in Finnish news media. My aim is to understand how TikTok is seen as a social media platform and what kind of social interaction and face-work users do when encountered with differing views of their media ideologies. I use Gershon’s framework of media ideologies to understand the implied and explicit opinions of Finnish TikTok users of the proper ways of using the medium and to compare those views to Finnish news media’s representations of the app and its use. By analysing discourses of the online news of Finnish Public Broadcasting Company (YLE) and the online news of Finland’s biggest newspaper Helsingin Sanomat (HS), I identify main categories of discourse about TikTok and its use. To understand the users’ perspective, I have conducted online ethnography in TikTok with two separate user accounts to collect data from videos, comments and video replies. From this data, I identify multiple media ideologies voiced out among the users of TikTok. Lastly, I compare these two data sets to see where they overlap and where they live separate lives. In order to understand the social phenomena related to the debates over different media ideologies, I utilise Erving Goffman’s concept of face and face-work. By exploring these questions with these methods and theoretical frameworks I wish to contribute to the discussion of how young users might adopt new ways of interacting and expressing themselves within a new medium, and how that might be different from the views of the people outside that medium. The goal of my thesis is to create an analytical overview on social interaction and media ideologies in TikTok, especially among Finnish TikTokers and how that differs from the discourses represented in Finnish news medi

Organotypic three-dimensional assays based on human leiomyoma-derived matrices

Alongside cancer cells, tumours exhibit a complex stroma containing a repertoire of cells, matrix molecules and soluble factors that actively crosstalk between each other. Recognition of this multifaceted concept of the tumour microenvironment (TME) calls for authentic TME mimetics to study cancer in vitro. Traditionally, tumourigenesis has been investigated in non-human, three-dimensional rat type I collagen containing organotypic discs or by means of mouse sarcoma-derived gel, such as Matrigel (R). However, the molecular compositions of these simplified assays do not properly simulate human TME. Here, we review the main properties and benefits of using human leiomyoma discs and their matrix Myogel for in vitro assays. Myoma discs are practical for investigating the invasion of cancer cells, as are cocultures of cancer and stromal cells in a stiff, hypoxic TME mimetic. Myoma discs contain soluble factors and matrix molecules commonly present in neoplastic stroma. In Transwell, IncuCyte, spheroid and sandwich assays, cancer cells move faster and form larger colonies in Myogel than in Matrigel (R). Additionally, Myogel can replace Matrigel (R) in hanging-drop and tube-formation assays. Myogel also suits three-dimensional drug testing and extracellular vesicle interactions. To conclude, we describe the application of our myoma-derived matrices in 3D in vitro cancer assays. This article is part of the discussion meeting issue 'Extracellular vesicles and the tumour microenvironment'.Peer reviewe

Real-time monitoring of human blood-brain barrier disruption

Chemotherapy aided by opening of the blood-brain barrier with intra-arterial infusion of hyperosmolar mannitol improves the outcome in primary central nervous system lymphoma. Proper opening of the blood-brain barrier is crucial for the treatment, yet there are no means available for its real-time monitoring. The intact blood-brain barrier maintains a mV-level electrical potential difference between blood and brain tissue, giving rise to a measurable electrical signal at the scalp. Therefore, we used direct-current electroencephalography ( DC-EEG) to characterize the spatiotemporal behavior of scalp-recorded slow electrical signals during blood-brain barrier opening. Nine anesthetized patients receiving chemotherapy were monitored continuously during 47 blood-brain barrier openings induced by carotid or vertebral artery mannitol infusion. Left or right carotid artery mannitol infusion generated a strongly lateralized DC-EEG response that began with a 2 min negative shift of up to 2000 mu V followed by a positive shift lasting up to 20 min above the infused carotid artery territory, whereas contralateral responses were of opposite polarity. Vertebral artery mannitol infusion gave rise to a minimally lateralized and more uniformly distributed slow negative response with a posterior-frontal gradient. Simultaneously performed near-infrared spectroscopy detected a multiphasic response beginning with mannitol-bolus induced dilution of blood and ending in a prolonged increase in the oxy/deoxyhemoglobin ratio. The pronounced DC-EEG shifts are readily accounted for by opening and sealing of the blood-brain barrier. These data show that DC-EEG is a promising real-time monitoring tool for bloodbrain barrier disruption augmented drug delivery.Peer reviewe

Patterns and mechanisms underlying ecoregion delineation in North American freshwater plants

AbstractAim: The regionalized patterns of biodiversity distributions are actively studied in terrestrial and marine ecosystems, but much less is known on the geographical patterns of ecoregions founded on freshwater taxa. Here, we studied, for the first time, how well existing freshwater ecoregions describe the geographical distribution of inland water plants.Location: Greenland, continental Canada and USA.Taxon: Freshwater vascular plants of all taxa and multiple functional groups (i.e. growth forms).Methods: Using newly available fine-grained data on freshwater plant distributions, we studied how ecoregions founded on fish are suitable for freshwater plant regionalization across North America. Specifically, we calculated internal homogeneity and distinctness among neighbouring ecoregions in relation to species replacements and richness differences. We also explored how a complex suite of ecogeographical characteristics affect ecoregion delineation of freshwater plants using spatially explicit regression routines.Results: We found a clear geographical patterning of ecoregion robustness for North American freshwater plants, with communities being more internally homogeneous and more similar to one another in Polar and Subtropical inland waters. The degree of internal homogeneity and ecoregion distinctness were almost equally driven by species replacements and richness differences. Considering different life-forms, ecoregion delineation performed best for emergent and floating-leaved plants. Finally, within-ecoregion homogeneity and distinctness were best explained by annual mean temperature and terrain ruggedness, respectively, with mean water alkalinity, ecoregion area and late Quaternary glacial legacies having supplementary effects.Main conclusions: Our findings suggest that selection through climate filtering (e.g. mean annual temperature) is likely the main mechanistic driver of freshwater plant ecoregions. Geographical regionalizations founded on a particular organismal group may not be directly applicable for all taxa but can be a good basis for further adjustments. Our study is a promising starting point for further investigations of geographical delineations for freshwater taxa other than fish.Abstract Aim: The regionalized patterns of biodiversity distributions are actively studied in terrestrial and marine ecosystems, but much less is known on the geographical patterns of ecoregions founded on freshwater taxa. Here, we studied, for the first time, how well existing freshwater ecoregions describe the geographical distribution of inland water plants. Location: Greenland, continental Canada and USA. Taxon: Freshwater vascular plants of all taxa and multiple functional groups (i.e. growth forms). Methods: Using newly available fine-grained data on freshwater plant distributions, we studied how ecoregions founded on fish are suitable for freshwater plant regionalization across North America. Specifically, we calculated internal homogeneity and distinctness among neighbouring ecoregions in relation to species replacements and richness differences. We also explored how a complex suite of ecogeographical characteristics affect ecoregion delineation of freshwater plants using spatially explicit regression routines. Results: We found a clear geographical patterning of ecoregion robustness for North American freshwater plants, with communities being more internally homogeneous and more similar to one another in Polar and Subtropical inland waters. The degree of internal homogeneity and ecoregion distinctness were almost equally driven by species replacements and richness differences. Considering different life-forms, ecoregion delineation performed best for emergent and floating-leaved plants. Finally, within-ecoregion homogeneity and distinctness were best explained by annual mean temperature and terrain ruggedness, respectively, with mean water alkalinity, ecoregion area and late Quaternary glacial legacies having supplementary effects. Main conclusions: Our findings suggest that selection through climate filtering (e.g. mean annual temperature) is likely the main mechanistic driver of freshwater plant ecoregions. Geographical regionalizations founded on a particular organismal group may not be directly applicable for all taxa but can be a good basis for further adjustments. Our study is a promising starting point for further investigations of geographical delineations for freshwater taxa other than fish

Deciphering land-use influences on boreal lakes to guide landscape planning

Abstract1. Changes in natural land cover have been pronounced in the last 12,000 years, and land use has intensified in the last century owing to anthropogenic pressures on landscapes. This trend has led to concomitant changes in the abiotic templates and biotic communities of different ecosystems embedded in a landscape.2. Deciphering the role of land use is key to understand ecological change in boreal landscapes. These landscapes are characterized by large numbers of lakes that have been affected by various anthropogenic factors, of which land use has considerable direct and indirect effects on lakes.3. In this review, we focus on land use impacts on boreal lakes in a historical perspective. We will consider lake features related to abiotic conditions, biological communities and ecosystem services, and provide potential solutions for planning lake management and conservation in a landscape setting. More specifically, we propose a novel way to characterize lake abiotic, biotic and ecosystem service features by applying the alpha, beta and gamma concept used widely in ecological research.4. Finally, we highlight situations where this approach could be a valuable addition to existing means to identify lakes that should be reserved for ecosystem services (‘lake-sharing’) and those that are vital for protecting aquatic biodiversity (‘lake-sparing’).Abstract 1. Changes in natural land cover have been pronounced in the last 12,000 years, and land use has intensified in the last century owing to anthropogenic pressures on landscapes. This trend has led to concomitant changes in the abiotic templates and biotic communities of different ecosystems embedded in a landscape. 2. Deciphering the role of land use is key to understand ecological change in boreal landscapes. These landscapes are characterized by large numbers of lakes that have been affected by various anthropogenic factors, of which land use has considerable direct and indirect effects on lakes. 3. In this review, we focus on land use impacts on boreal lakes in a historical perspective. We will consider lake features related to abiotic conditions, biological communities and ecosystem services, and provide potential solutions for planning lake management and conservation in a landscape setting. More specifically, we propose a novel way to characterize lake abiotic, biotic and ecosystem service features by applying the alpha, beta and gamma concept used widely in ecological research. 4. Finally, we highlight situations where this approach could be a valuable addition to existing means to identify lakes that should be reserved for ecosystem services (‘lake-sharing’) and those that are vital for protecting aquatic biodiversity (‘lake-sparing’)