Sydänterveyden edistäminen: elintapaohjausta mielenterveyskuntoutujille

Tämän opinnäytetyön tarkoituksena oli järjestää elintapaohjauskertojen sarja mielenterveyskuntoutujille Porin Hyvän Mielen Talolla. Tavoitteena oli havainnollistavan ja tietopohjaisen elintapaohjauksen keinoin motivoida osallistujia sydän- ja verisuonisairauksien ehkäisyyn ja siten myös yleisen terveyden edistämiseen noudattamalla hyviä elintapoja. Elintavat, joihin opinnäytetyössä on keskitytty ovat liikunta, tupakointi, ravitsemus, uni ja alkoholin käyttö. Myös stressin käsittelyn koimme oleelliseksi sen tiiviistä yhteydestä elintapoihin. Sydän- ja verisuonisairaudet ovat edelleen yleisin kuolinsyy Suomessa, huolimatta viime vuosikymmenien positiivisesta kehityksestä sairauksien hoidossa. Hyvien elintapojen noudattaminen on tärkein asia, miten yksilö voi omalta osaltaan vaikuttaa sairastumisriskiinsä. Mielenterveyshäiriötä sairastavilla on tässä suhteessa suurentunut elintapaohjauksen tarve, koska heillä on alentunut eliniän odote, osittain sydän- ja verisuonisairastavuuden ja niihin liittyvien huonojen elintapojen sekä liitännäissairauksien takia. Vaikuttavuus toimii myös toisin päin, sepelvaltimotautia sairastavilla on kohonnut riski sairastua masennukseen. Interventioiden sarja jakautui kolmeen kertaan, käsitellen eri elintapoja eri kerroilla. Jokaisella kerralla kävimme läpi terveysviestinnän periaatteiden mukaan laatimamme tietopohjaisen diaesityksen ja jaettavan materiaalin, jonka jälkeen oli vaihtuva toiminnallinen osio, kuten esimerkiksi ruokapakkausten tutkiminen. Interventiot pidettiin matalan kynnyksen tapahtumina, joihin kuka tahansa Hyvän Mielen Talon jäsen sai osallistua vapaaehtoisesti. Projektin lopputuloksena arvioimme sen pystyneen herättelemään osallistujia pohdiskelemaan elintapojensa vaikutuksia omaan terveyteensä. Interventioiden osallis-tujat pitivät tapahtumia kiinnostavina, selkeinä ja enemmistö tunsi saaneensa uutta tietoa. Kirjallisuushaun kautta huomasimme mielenterveyshäiriöiden ja elintapojen korreloivan vahvasti vain joissain tutkimuksissa. Mielenterveyshäiriöiden ja sydän- ja verisuonisairastavuuden yhteyttä selittävää tekijää ei siis vielä aukottomasti tiedetä. Aiheesta tarvitaan siis lisää tutkimusta. Kehittämisprojektina kohderyhmä voisi hyötyä tulevaisuudessa tiettyihin elintapoihin keskittyvistä interventioista, kuten ohjatuista liikuntatuokioista tai käytännön ohjeistuksesta terveellisestä ruoanlaitosta.The purpose of this thesis was to hold a series of lifestyle interventions about the prevention of cardiovascular diseases for mental rehabilitation patients. Those were conducted at Porin Hyvän Mielen Talo. In our thesis we aimed to motivate the participants to acquire better lifestyle habits to improve their overall, and specially, heart health. This was done through demonstrative group-based lifestyle counselling. The lifestyle habits we set our focus on were smoking, alcohol consumption, diet and sleep. We also included stress because of its direct relation to lifestyle habits. Cardiovascular diseases remain, despite beneficial development in their treatment, as the primary cause of death in Finland. Mental rehabilitation patients are no exception to this, in fact they have a greater need for lifestyle counselling when it comes to preventing cardiovascular diseases. People with severe mental illness have a reduced life expectancy and cardiovascular diseases plays a major role in this. Both mental and physical conditions feedback each other. For instance, depression increases the risk of developing heart disease and people suffering from coronary heart disease are more likely to develop depression. The interventions were divided in three events focusing on different lifestyle habits each time. The events were carried out adapting a group-based method of lifestyle counselling. We relied on slide presentations mostly followed by several activities, which were conducted in line with the principles of health communication. In our literary search we found data indicating both the possibility of mental health patients having worse lifestyle habits than those of the general population and studies that found this evidence inconclusive. The mechanism explaining the connection between heart diseases and mental disorders is not yet fully known. More studies are needed. We reckon the project to be successful in awakening a dialogue about lifestyle habits affecting heart health. Most of the participants found our interventions interesting, clear and informative. For future projects we believe the target group would benefit from long-term lifestyle counselling. We consider that setting focus on practical activities such as guided exercise and healthy cooking classes might be the next step to be taken in order to improve the heart health of the target group

Främjandet av mannens hälsa och välbefinnande med hjälp av mångprofessionalitet : Sociala medier som verktyg

Arbetet är en del av den sista fasen av projektet Mannens hälsa och välbefinnande. Ett gemensamt resultat för de tidigare faserna är att mannen borde tas mera i beaktande som en individ och det borde användas mera samarbete för att kunna hjälpa mannen med psykiska problem. Syftet med arbetet är att, med fokus på mannen, utreda mångprofessionella arbetsmetoder för personal inom mental- och missbrukarvård. En frågeställning som utreds är hur mångprofessionellt arbete för män inom mental- och missbrukarvården kan främjas genom social media. Arbetet resulterar i att ett mångprofessionellt arbetssätt kan vara till stor hjälp eftersom expertisen i en mångprofessionell arbetsgrupp behövs för att stödja mannen och hans näromgivning under en svår process. Resultatet har uppnåtts med hjälp av latent innehållsanalys. För kommande och nuvarande personal inom vården och det sociala området har en hemsida producerats. Hemsidans uppgift är att väcka tankar och stöda personalen i mångprofessionellt arbete med män.This Bachelor’s thesis is part of the last phase in the project Men’s Health and Well-being. A common result of the previous phases concludes that the man should be taken more into account as an individual, and there should be more co-operation to help the man with mental health problems. The aim of this thesis is, focusing on the man, to study interprofessional working methods for staff within mental health and substance abuse. An issue under investigation is how interprofessional work for men in mental health and substance abuse services can be promoted through social media. The thesis results in that an interprofessional approach can be very helpful, because the expertise within an interprofessional working team is needed to support the man and his immediate environment during a difficult process. The result has been achieved by using latent content analysis. A website has been produced for current and future professionals within health and social work. The website is to provoke thoughts and support staff in interprofessional work with men

The hidden image of mobile apps : geographic, demographic, and cultural factors in mobile usage

Peer reviewe

Particle telescope aboard FORESAIL-1 : Simulated performance

The Particle Telescope (PATE) of FORESAIL-1 mission is described. FORESAIL-1 is a CubeSat mission to polar Low Earth Orbit. Its scientific objectives are to characterize electron precipitation from the radiation belts and to observe energetic neutral atoms (ENAs) originating from the Sun during the strongest solar flares. For that purpose, the 3-unit CubeSat carries a particle telescope that measures energetic electrons in the nominal energy range of 80–800 keV in seven energy channels and energetic protons at 0.3–10 MeV in ten channels. In addition, particles penetrating the whole telescope at higher energies will be measured in three channels: one >800 keV electron channel, two integral proton channels at >10 MeV energies. The instrument contains two telescopes at right angles to each other, one measuring along the spin axis of the spacecraft and one perpendicular to it. During a spin period (nominally 15 s), the rotating telescope will, thus, deliver angular distributions of protons and electrons, at 11.25-degree clock-angle resolution, which enables one to accurately determine the pitch-angle distribution and separate the trapped and precipitating particles. During the last part of the mission, the rotation axis will be accurately pointed toward the Sun, enabling the measurement of the energetic hydrogen from that direction. Using the geomagnetic field as a filter and comparing the rates observed by the two telescopes, the instrument can observe the solar ENA flux for events similar to the only one so far observed in December 2006. We present the Geant4-simulated energy and angular response functions of the telescope and assess its sensitivity showing that they are adequate to address the scientific objectives of the mission.The Particle Telescope (PATE) of FORESAIL-1 mission is described. FORESAIL-1 is a CubeSat mission to polar Low Earth Orbit. Its scientific objectives are to characterize electron precipitation from the radiation belts and to observe energetic neutral atoms (ENAs) originating from the Sun during the strongest solar flares. For that purpose, the 3-unit CubeSat carries a particle telescope that measures energetic electrons in the nominal energy range of 80-800 keV in seven energy channels and energetic protons at 0.3-10 MeV in ten channels. In addition, particles penetrating the whole telescope at higher energies will be measured in three channels: one >800 keV electron channel, two integral proton channels at >10 MeV energies. The instrument contains two telescopes at right angles to each other, one measuring along the spin axis of the spacecraft and one perpendicular to it. During a spin period (nominally 15 s), the rotating telescope will, thus, deliver angular distributions of protons and electrons, at 11.25-degree clock-angle resolution, which enables one to accurately determine the pitch-angle distribution and separate the trapped and precipitating particles. During the last part of the mission, the rotation axis will be accurately pointed toward the Sun, enabling the measurement of the energetic hydrogen from that direction. Using the geomagnetic field as a filter and comparing the rates observed by the two telescopes, the instrument can observe the solar ENA flux for events similar to the only one so far observed in December 2006. We present the Geant4-simulated energy and angular response functions of the telescope and assess its sensitivity showing that they are adequate to address the scientific objectives of the mission. (C) 2019 COSPAR. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)

Publisher's version (útgefin grein)Background: Preterm infants are especially vulnerable to pain. The intensive treatment often necessary for their survival unfortunately includes many painful interventions and procedures. Untreated pain can lead to both shortand long-term negative effects. The challenge of accurately detecting pain has been cited as a major reason for lack of pain management in these non-verbal patients. The Premature Infant Pain Profile (PIPP) is one of the most extensively validated measures for assessing procedural pain in premature infants. A revised version, PIPP-R, was recently published and is reported to be more user-friendly and precise than the original version. The aims of the study were to develop translated versions of the PIPP-R in Finnish, Icelandic, Norwegian, and Swedish languages, and to establish their content validity through a cultural adaptation process using cognitive interviews. Methods: PIPP-R was translated using the recommendations from the International Society for Pharmacoeconomics and Outcomes Research and enhanced with cognitive interviews. The respondent nurse was given a copy of the translated, national version of the measure and used this together with a text describing the infant in the film to assess the pain of an infant in a short film. During the assessment the nurse was asked to verbalize her thought process (thinking aloud) and upon completion the interviewer administered probing questions (verbal probing) from a structured interview guide. The interviews were recorded, transcribed, and analyzed using a structured matrix approach. Results: The systematic approach resulted in translated and culturally adapted versions of PIPP-R in the Finnish, Icelandic, Norwegian and Swedish languages. During the cultural adaptation process several problems were discovered regarding how the respondent understood and utilized the measure. The problems were either measure problems or other problems. Measure problems were solved by a change in the translated versions of the measure, while for other problems different solutions such as education or training were suggested. Conclusions: This study have resulted in translations of the PIPP-R that have content validity, high degree of clinical utility and displayed beginning equivalence with each other and the original version of the measure.Not applicable.Peer Reviewe

Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)

BackgroundPreterm infants are especially vulnerable to pain. The intensive treatment often necessary for their survival unfortunately includes many painful interventions and procedures. Untreated pain can lead to both short- and long-term negative effects. The challenge of accurately detecting pain has been cited as a major reason for lack of pain management in these non-verbal patients. The Premature Infant Pain Profile (PIPP) is one of the most extensively validated measures for assessing procedural pain in premature infants. A revised version, PIPP-R, was recently published and is reported to be more user-friendly and precise than the original version. The aims of the study were to develop translated versions of the PIPP-R in Finnish, Icelandic, Norwegian, and Swedish languages, and to establish their content validity through a cultural adaptation process using cognitive interviews.MethodsPIPP-R was translated using the recommendations from the International Society for Pharmacoeconomics and Outcomes Research and enhanced with cognitive interviews. The respondent nurse was given a copy of the translated, national version of the measure and used this together with a text describing the infant in the film to assess the pain of an infant in a short film. During the assessment the nurse was asked to verbalize her thought process (thinking aloud) and upon completion the interviewer administered probing questions (verbal probing) from a structured interview guide. The interviews were recorded, transcribed, and analyzed using a structured matrix approach.ResultsThe systematic approach resulted in translated and culturally adapted versions of PIPP-R in the Finnish, Icelandic, Norwegian and Swedish languages. During the cultural adaptation process several problems were discovered regarding how the respondent understood and utilized the measure. The problems were either measure problems or other problems. Measure problems were solved by a change in the translated versions of the measure, while for other problems different solutions such as education or training were suggested.ConclusionsThis study have resulted in translations of the PIPP-R that have content validity, high degree of clinical utility and displayed beginning equivalence with each other and the original version of the measure.</p

Particle telescope aboard FORESAIL-1: Simulated performance

The Particle Telescope (PATE) of FORESAIL-1 mission is described. FORESAIL-1 is a CubeSat mission to polar Low Earth Orbit. Its scientific objectives are to characterize electron precipitation from the radiation belts and to observe energetic neutral atoms (ENAs) originating from the Sun during the strongest solar flares. For that purpose, the 3-unit CubeSat carries a particle telescope that measures energetic electrons in the nominal energy range of 80–800 keV in seven energy channels and energetic protons at 0.3–10 MeV in ten channels. In addition, particles penetrating the whole telescope at higher energies will be measured in three channels: one >800 keV electron channel, two integral proton channels at >10 MeV energies. The instrument contains two telescopes at right angles to each other, one measuring along the spin axis of the spacecraft and one perpendicular to it. During a spin period (nominally 15 s), the rotating telescope will, thus, deliver angular distributions of protons and electrons, at 11.25-degree clock-angle resolution, which enables one to accurately determine the pitch-angle distribution and separate the trapped and precipitating particles. During the last part of the mission, the rotation axis will be accurately pointed toward the Sun, enabling the measurement of the energetic hydrogen from that direction. Using the geomagnetic field as a filter and comparing the rates observed by the two telescopes, the instrument can observe the solar ENA flux for events similar to the only one so far observed in December 2006. We present the Geant4-simulated energy and angular response functions of the telescope and assess its sensitivity showing that they are adequate to address the scientific objectives of the mission

Huumenäytteiden manipulointiyritykset ja niiden estäminen näytteenottajan työssä

Nykyisin huumeiden käytöllä on aiempaa huomattavasti vahvempi asema. Huumeiden kokeilu ja käyttö on yleistynyt merkittävästi etenkin nuorten aikuisten keskuudessa, mikä on johtanut mielipiteiden ja asenteiden lieventymiseen huumeita kohtaan. Myös huumetestaukset ovat voimakkaasti lisääntyneet viime vuosina, mutta niiden merkitys on vähentynyt muun muassa manipuloinnista johtuen. Opinnäytetyön tarkoituksen oli selvittää, minkälaisia huumenäytteiden manipulointikeinoja Suomessa käytetään ja miten näytteenottaja voisi näitä havaita ja estää. Tavoitteena oli, että näytteenottaja pystyy havaitsemaan ja estämään erilaisia huumenäytteiden manipulointikeinoja. Näin voitaisiin varmistaa, että näyte on laadullisesti otettu oikein ja huumetestien tutkimustulokset ovat luotettavia. Tutkimusmenetelmänä käytettiin laadullista eli kvalitatiivista tutkimusta ja aineistonkeruumenetelmänä teemahaastattelua. Tutkimusaineisto koostui viidestä haastattelusta. Haastateltavat olivat entisiä huumeidenkäyttäjiä, joilla oli kokemusta huumenäytteiden manipuloinnista. Haastattelut toteutettiin syksyllä 2016 ja keväällä 2017. Tutkimustulosten perusteella jokaisella haastateltavalla oli kokemusta huumenäytteiden manipulointiyrityksistä. Tutkimusaineiston perusteella esille tulleet manipulointiyritykset jakautuivat ennen näytteenantoa ja näytteenannon aikana tapahtuvaan manipulointiin, joista ennen näytteenantoa tapahtuva manipulointi osoittautui huomattavasti yleisemmäksi tavaksi. Tulosten mukaan näytteenottajan on hankala estää huumenäytteiden manipulointia, sillä se tapahtuu pääasiassa ennen näytteenantotilannetta. Kuitenkin näytteenottajan toimintaan, näytteenottotilaan ja näytteenantajan toimintaan tulisi kiinnittää huomiota, jotta manipulointi pystyttäisiin estämään ja havaitsemaan. Tulosten perusteella voidaan todeta, että huumenäytteitä manipuloidaan ja siihen tulee kiinnittää enemmän huomiota. Jatkotutkimuksena voisi olla hyödyllistä selvittää, kuinka paljon manipulointia tapahtuu ja kuinka luotettavia huumetestit ovat manipuloinnista johtuen. Myös eri laboratorioissa työskentelevien näytteenottajien ohjeiden noudattamisesta olisi tarpeellista tehdä jatkotutkimusta.Drug use and experimentation with drugs has grown exponentially among young adults, which has changed opinions towards drugs. Attitudes towards drug use have become more liberal, resulting in the number of drug tests needed having grown significantly. However, drug testing has become less useful due to the manipulation of test results. The purpose of this study was to find out manipulation methods used in drug urine sampling by interviewing former drug users. The objective of this study was to help sample takers notice and stop attempts to manipulate the results. The data were analysed using qualitative content analysis. The research material consisted of five interviews with former drug addicts. They all had experiences in drug test manipulation. Based on the research data, the manipulation attempts were divided into those before giving the sample and those during giving the sample, with the former being more common. Because the majority of the manipulation attempts were made before the sample giving, it is difficult for a sample taker to prevent such attempts. However, paying closer attention to the sample taking process may help to prevent manipulation attempts. Based on the results, it can be concluded that drug samples are manipulated and more attention should be focused on the subject. As further research it would be useful to find out to what extent drug tests are manipulated, and how reliable drug testing is due to manipulation