PAB-V -tutkimukset 1995

320035

Patterns of paediatric end-of-life care: a chart review across different care settings in Switzerland

BACKGROUND: Paediatric end-of-life care is challenging and requires a high level of professional expertise. It is important that healthcare teams have a thorough understanding of paediatric subspecialties and related knowledge of disease-specific aspects of paediatric end-of-life care. The aim of this study was to comprehensively describe, explore and compare current practices in paediatric end-of-life care in four distinct diagnostic groups across healthcare settings including all relevant levels of healthcare providers in Switzerland. METHODS: In this nationwide retrospective chart review study, data from paediatric patients who died in the years 2011 or 2012 due to a cardiac, neurological or oncological condition, or during the neonatal period were collected in 13 hospitals, two long-term institutions and 10 community-based healthcare service providers throughout Switzerland. RESULTS: Ninety-three (62%) of the 149 reviewed patients died in intensive care units, 78 (84%) of them following withdrawal of life-sustaining treatment. Reliance on invasive medical interventions was prevalent, and the use of medication was high, with a median count of 12 different drugs during the last week of life. Patients experienced an average number of 6.42 symptoms. The prevalence of various types of symptoms differed significantly among the four diagnostic groups. Overall, our study patients stayed in the hospital for a median of six days during their last four weeks of life. Seventy-two patients (48%) stayed at home for at least one day and only half of those received community-based healthcare. CONCLUSIONS: The study provides a wide-ranging overview of current end-of-life care practices in a real-life setting of different healthcare providers. The inclusion of patients with all major diagnoses leading to disease- and prematurity-related childhood deaths, as well as comparisons across the diagnostic groups, provides additional insight and understanding for healthcare professionals. The provision of specialised palliative and end-of-life care services in Switzerland, including the capacity of community healthcare services, need to be expanded to meet the specific needs of seriously ill children and their families

Uusiopäällystetutkimukset 1998

320055

PAB-V-päällysteiden suunnittelu

320049

Pehmeän bitumin kokeilut 1994

320028

Maintaining family life balance while facing a child's imminent death-A mixed methods study

AIM: To understand parents' experiences and needs during a child's end-of-life care at home and to identify systemic factors that influence its provision. BACKGROUND: A child's end-of-life phase is an extremely difficult time for the whole family. Parents have specific needs, especially when they care for a dying child at home. DESIGN: Concurrent embedded mixed methods design. METHODS: This sub-study of the nationwide survey, 'Paediatric End-of-Life Care Needs in Switzerland' (2012-2015) included 47 children who received EOL care at home from 2011-2012. We extracted quantitative data from patients' medical charts and obtained information via parental questionnaire and then compared parents whose child died at home or in hospital by computing generalized estimation equations. We thematically analysed interviews with parents who provided EOL care at home. RESULTS: Parents created an intimate lifeworld and a sense of normality for the child at home. They constantly balanced the family's lifeworld with the requirements and challenges posed by the outside world. This work exhausted parents. Parental 'readiness' and social support drove EOL care for children at home. Parents needed practical help with housekeeping and had negative experiences when dealing with insurance. In only 34.8% of cases was a child's EOL home care supported by paediatric palliative care team. CONCLUSION: Paediatric end-of-life care at home is only feasible if parents make extraordinary efforts. If family-centred end-of-life home care is provided by a hospital-based paediatric palliative home care team, which includes paid housekeeping help and psychological support, parents' needs could be better met

The Bitumen Related Problems Observed on Soft Asphalt Concrete Pavements : Case Study

Publisher Copyright: © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.Four roads paved with soft asphalt concrete during the autumn of 2017 by one contractor in a Nordic country, damaged during the following winter. The road users reported that bitumen detached from the surface and was sticking to the fur of pet animals, as well as to the surfaces of the vehicles. The article discusses aspects connected with production and paving, which may have affected the performance. In addition, the material analysis of the samples collected from the field was performed. The core samples were tested by Indirect Tensile Strength (ITS). Because of the low strength of the soft asphalt concrete the ITS is not routinely performed for this material. Therefore, the results of ITS were inconclusive due to the lack of reliable references. The gradation was analyzed after the bitumen extraction and recovery, and no abnormalities were discovered. The Zero Shear Viscosity at multiple temperatures and fractional composition was performed on both extracted and reference binders type V1500 and 650/900 (EN 12591) after evaluation of bitumen purity with infrared spectroscopy. The bitumen extracted from the most questionable pavement expressed comparable rheological behavior to references, but was characterized by the exceptionally high content of saturates. The short research project was unable to determine if the damage was a result or the reason for the altered binder composition. Nevertheless, the link between abnormal performance observed in the field and abnormal chemical characteristic of bitumen is reported.Peer reviewe

Nykyisen oppimiskäsityksen mukaisen matematiikan formatiivisen arvioinnin kohteet oppilaiden ja opettajien näkökulmasta

TIIVISTELMÄ Eskola, Annamaija ja Kumpulainen, Katri. 2017. Nykyisen oppimiskäsityksen mukaisen matematiikan formatiivisen arvioinnin kohteet oppilaiden ja opettajien näkökulmasta. Erityispedagogiikan pro gradu -tutkielma. Jyväskylän yliopisto. Kasvatustieteiden tiedekunta. 64 sivua. Tässä pro gradu -tutkielmassa selvitettiin nykyisen oppimiskäsityksen mukaisia matematiikan formatiivisen arvioinnin kohteita oppilaiden ja opettajien näkökulmasta. Lisäksi tutkittiin, millaisia yhtäläisyyksiä ja eroavaisuuksia oppilas- ja opettajanäkökulmista voidaan löytää sen suhteen. Tutkimus toteutettiin ja analysoitiin kvalitatiivisin menetelmin. Sähköisen Google forms -työkalun avulla tehtyyn kyselyyn vastasi 26 oppilasta ja yhdeksän opettajaa eteläsuomalaisessa alakoulussa helmikuussa 2017. Tulokset analysoitiin fenomenografisesti. Tutkimuksessa selvisi, etteivät opettajien ja oppilaiden vastaukset juurikaan poikenneet toisistaan, vaan heidän käsityksensä formatiivisen arvioinnin kohteista olivat hyvin samansuuntaiset. Opettajien määritelmissä oli pidemmälle vietyjä ja yksityiskohtaisempia ilmaisuja samasta asiasta. Oppilaat pitävät arvioinnin kohteina matemaattista prosessia (esimerkiksi “Miten yksilö on miettinyt tehtävän laskemisen?”) ja lopputuloksen oikeellisuutta ja opettajat mm. matemaattisten käsitteiden hallintaa, havainnollistamisen kykyä, päättelykykyä ja opiskelustrategioita. Vastauksissa tuli esiin myös runsaasti ryhmädynamiikkaan, toisen huomioon ottamiseen, vastuun ottamiseen ja kommunikatiivisiin taitoihin liittyviä mainintoja