Effect of Application of Subcutaneous Suction Drainage with Subcuticular Sutures for Wound Closure on the Incidence of Incisional Surgical Site Infection following Elective General Abdominal Surgery : A Randomized Controlled Trial

Article信州医学雑誌 63(2):91-101 (2015)journal articl

Laparoscopic Splenectomy Using a Low-pressure Pneumoperitoneum for the Treatment of Immune Thrombocytopenic Purpura During Pregnancy : A Case Report

Article信州医学雑誌 62(6):441-446(2014)journal articl

An Initial Case Report of a Laparoscopic Spleen-Preserving Distal Pancreatectomy for a Patent with a Pancreatic Metastasis of Malignant Melanoma

Article信州医学雑誌 63(1):19-24(2015)journal articl

Ikääntyneiden ravitsemuksen oppimateriaalin tuottaminen Eksoten henkilöstölle Moodleen

Tämän toiminnallisen opinnäytetyön aiheena oli ikääntyvien ravitsemus. Työn tavoitteena oli suunnitella ja toteuttaa ikääntyvien ravitsemuksen oppimateriaali Moodle verkko-oppimisalustalle Etelä-Karjalan sosiaali- ja terveyspiirin henkilöstön käyttöön. Lisäksi suunniteltiin ja valmistettiin intro-video, joka johdatteli ja herätti kiinnostuksen aiheeseen. Lisäksi tuotettiin tietovisa-tyyppinen kolmen vaihtoehdon kysymyssarja diojen aiheista. Kurssin sisältö koostui PowerPoint-esityksistä, joiden aiheet olivat: ravitsemus ja ikääntyminen, kuidut, D- vitamiinisuositukset, vitamiinit, muistisairaan ravitsemus,ikääntyneen ravitsemusongelmat, juominen ja nestetasapaino sekä Milloin syödään? – käytännönläheisiä vinkkejä muistisairaan kotihoitoon. Jatkossa voisi tutkia, kuinka sähköisen oppimisalustan saisi juurrutettua paremmin henkilöstön käyttöön sekä selvittää kurssin käytön esteet, jotta ne voitaisiin poistaaThe topic of this functional study was elderly nutrition. The objective of the thesis was to design and implement study material about nutrition for the elderly via Moodle eLearning environment for the use of the South Karelia Social and Health Care District staff. In addition an introductory video was designed and produced to spark interest in the topic. Also, a quiz consisting of three option questions based on topics presented in slides was produced. The course content consisted of powerPoint presentations with the following topics: nutrition and aging, fiber, vitamin D recommendations, vitamins,nutrition recommented for a person suffering from a memory disorder, problems with nutrition among the elderly, drinking and fluid balance, as well as When do we eat? - Practical tips for the home care of people suffering from a memory disorder. For further, study it could be recommented to examine how the e-learning platform could be anchored in better use for the staff, as well as to identify the obstacles to the use of the course, so that they could be removed

Perehdyttämisopas Yläristin Pysäkille

Opinnäytetyöni tarkoituksena oli suunnitella ja toteuttaa sähköisessä muodossa oleva perehdyttämisopas Yläristin pysäkin henkilökunnan ja opiskelijoiden käyttöön. Yläristin pysäkki on Pieksämäen kaupungin ylläpitämä 8-paikkainen päihdekuntoutus- ja asumispalveluyksikkö, jonka toiminta kuuluu mielenterveys- ja päihdepalveluiden piiriin. Toiminta perustuu tiimi- ja verkostoyhteistyöhön sekä yksilöhoitoon yhteisöhoidollisin menetelmin, ja sen tavoitteena on tukea asiakkaan päihteettömyyttä ja olla mukana muutosprosessin eri vaiheissa. Henkilökuntaan kuuluu yksi sairaanhoitaja ja kolme lähihoitajaa. Lisäksi Yläristin pysäkillä on vuosittain useita sairaanhoitaja-, sosionomi- ja lähihoitajaopiskelijoita suorittamassa opintoihin kuuluvia harjoittelujaksoja. Tavoitteena opinnäytetyölläni oli tukea työyhteisön hyvinvointia ja yhtenäisten toimintamallien toteutumista perehdyttämisoppaan avulla. Opinnäytetyön teoreettinen viitekehys käsittelee perehdyttämistä ja siihen liittyviä tekijöitä – perehdyttämisen sisältöä, perehdyttäjiä ja perehdyttämisprosessia kokonaisuutena. Aiempaa tutkimustietoa hoitoalan perehdyttämisestä ja sen hyödyistä löytyi suomen kielellä melko niukasti. Tutkimusten mukaan hyvällä perehdyttämisellä on merkittäviä vaikutuksia muun muassa työhön sitoutumiseen ja työssä viihtymiseen. Opinnäytetyöprosessi käynnistyi keväällä 2015 työharjoitteluni aikana ja eteni pääosin ennalta suunnitel-lun aikataulun mukaisesti. Toimeksiantajan edustajat olivat aktiivisesti mukana tuotteen kehittämisessä sekä koko opinnäytetyöprosessissa. Tuotteen kehitysvaiheessa toimeksiantajan edustajia haastateltiin tarpeista ja toiveista perehdyttämisoppaaseen liittyen, näin kokoon saatiin mahdollisimman kattava ja sisällöltään toimeksiantajan tarpeita vastaava tuote. Viimeistelyvaiheessa toteutettiin toinen haastattelu, jossa toimeksiantajan edustajat arvioivat tuotteen ja pohtivat sen jatkokehitysmahdollisuuksia. Valmis tuote, eli perehdyttämisopas on yhteisymmärryksessä toimeksiantajan ja koulun edustajien kanssa salattu sen sisältämien yksityiskohtaisten ja arkaluontoisten tietojen vuoksi.The purpose of this thesis was to design and create a digital orientation guide for the employees and students working at Yläristin Pysäkki. Yläristin Pysäkki is a rehabilitation and accommodation unit, which is maintained by the City of Pieksämäki. It has 8 places and operates under Pieksämäki mental and sub-stance abuse services. The operations are based on co-operation in teams and networks. Collaborative methods are used for supporting individual care. The aim in the unit is to support the clients’ abstinence and take part in the different stages of their change process. There a registered nurse and three practical nurses working in the unit. In addition, every year there are several registered and practical nurse students as well as students from social services programmes performing their practical training. The goal of the digital guide was to support the wellbeing of the personnell and harmonise and enable coherent procedures. The theoretical framework of the study discusses orientation and the factors related to it – the content of orientation, mentors and the orientation process as a whole. There were only a few previous studies avail-able on orientation in the Finnish language. According to the studies proper orientation has significant impact on employee commitment and satisfaction. The process of the thesis started in spring 2015 during my practical training and it progressed according to plan. The representatives of Yläristin Pysäkki took active part in the development phase as well as sup-ported me during the whole process. During the design phase the representatives of Yläristin Pysäkki were interviewed about their needs and hopes regarding the orientation guide. With this information it was possible to create a comprehensive product, which would fulfil their needs. During the finishing phase a second set of interviews was conducted for evaluation by the unit representatives. Further development possibilities were also considered. The final product itself, the digital orientation guide for Yläristin Pysäkki has been classified as Company Confidential due to its detailed and sensitive content.Opinnäytetyö sisältää perehdyttämisoppaan (30 sivua), josta julkaistu vain sisällysluettel

Subaru high-z exploration of low-luminosity quasars (SHELLQs). I. Discovery of 15 quasars and bright galaxies at 5.7 < z < 6.9

We report the discovery of 15 quasars and bright galaxies at 5.7 < z < 6.9. This is the initial result from the Subaru High-z Exploration of Low-Luminosity Quasars (SHELLQs) project, which exploits the exquisite multiband imaging data produced by the Subaru Hyper Suprime-Cam (HSC) Strategic Program survey. The candidate selection is performed by combining several photometric approaches including a Bayesian probabilistic algorithm to reject stars and dwarfs. The spectroscopic identification was carried out with the Gran Telescopio Canarias and the Subaru Telescope for the first 80 deg2 of the survey footprint. The success rate of our photometric selection is quite high, approaching 100 % at the brighter magnitudes (zAB < 23.5 mag). Our selection also recovered all the known high-z quasars on the HSC images. Among the 15 discovered objects, six are likely quasars, while the other six with interstellar absorption lines and in some cases narrow emission lines are likely bright Lyman-break galaxies. The remaining three objects have weak continua and very strong and narrow Ly alpha lines, which may be excited by ultraviolet light from both young stars and quasars. These results indicate that we are starting to see the steep rise of the luminosity function of z > 6 galaxies, compared with that of quasars, at magnitudes fainter than M1450 ~ -22 mag or zAB ~24 mag. Follow-up studies of the discovered objects as well as further survey observations are ongoing.Comment: Published in ApJ (828:26, 2016

Discovery of the First Low-Luminosity Quasar at z > 7

We report the discovery of a quasar at z = 7.07, which was selected from the deep multi-band imaging data collected by the Hyper Suprime-Cam (HSC) Subaru Strategic Program survey. This quasar, HSC J124353.93+010038.5, has an order of magnitude lower luminosity than do the other known quasars at z > 7. The rest-frame ultraviolet absolute magnitude is M1450 = -24.13 +/- 0.08 mag and the bolometric luminosity is Lbol = (1.4 +/- 0.1) x 10^{46} erg/s. Its spectrum in the optical to near-infrared shows strong emission lines, and shows evidence for a fast gas outflow, as the C IV line is blueshifted and there is indication of broad absorption lines. The Mg II-based black hole mass is Mbh = (3.3 +/- 2.0) x 10^8 Msun, thus indicating a moderate mass accretion rate with an Eddington ratio 0.34 +/- 0.20. It is the first z > 7 quasar with sub-Eddington accretion, besides being the third most distant quasar, known to date. The luminosity and black hole mass are comparable to, or even lower than, those measured for the majority of low-z quasars discovered by the Sloan Digital Sky Survey, and thus this quasar likely represents a z > 7 counterpart to quasars commonly observed in the low-z universe.Comment: Accepted for publication in ApJ Letter

First Data Release of the Hyper Suprime-Cam Subaru Strategic Program

The Hyper Suprime-Cam Subaru Strategic Program (HSC-SSP) is a three-layered imaging survey aimed at addressing some of the most outstanding questions in astronomy today, including the nature of dark matter and dark energy. The survey has been awarded 300 nights of observing time at the Subaru Telescope and it started in March 2014. This paper presents the first public data release of HSC-SSP. This release includes data taken in the first 1.7 years of observations (61.5 nights) and each of the Wide, Deep, and UltraDeep layers covers about 108, 26, and 4 square degrees down to depths of i~26.4, ~26.5, and ~27.0 mag, respectively (5sigma for point sources). All the layers are observed in five broad bands (grizy), and the Deep and UltraDeep layers are observed in narrow bands as well. We achieve an impressive image quality of 0.6 arcsec in the i-band in the Wide layer. We show that we achieve 1-2 per cent PSF photometry (rms) both internally and externally (against Pan-STARRS1), and ~10 mas and 40 mas internal and external astrometric accuracy, respectively. Both the calibrated images and catalogs are made available to the community through dedicated user interfaces and database servers. In addition to the pipeline products, we also provide value-added products such as photometric redshifts and a collection of public spectroscopic redshifts. Detailed descriptions of all the data can be found online. The data release website is https://hsc-release.mtk.nao.ac.jp/.Comment: 34 pages, 20 figures, 7 tables, moderate revision, accepted for publication in PAS