Kohti parempaa elämän loppuvaiheen hoitoa

”Yllättyisinkö, jos potilaani kuolisi puolen vuoden sisällä?” Jos vastaus on kielteinen, on aika käynnistää elämän loppuvaiheen hoitosuunnitelma. Keskustelu elämän loppuvaiheen hoidosta koetaan vaikeaksi. Harva potilas tohtii ottaa asiaa puheeksi lääkärinsä kanssa.</p

Tilitoimistopalvelut asiakkaan näkökulmasta : case: Tilipalvelu Irja Malin

Tämän opinnäytetyön tavoitteena oli selvittää Tilipalvelu Irja Malinin asiakkaiden tyytyväisyys käyttämiensä palveluiden laatuun. Lisäksi kartoitettiin asiakkaiden tarvetta saada sellaisia lisäpalveluita, joita heillä ei vielä ollut käytössään. Vastausten avulla on tarkoitus kehittää tilitoimiston palvelun laatua ja palveluvalikoimaa. Opinnäytetyön teoriaosuuden ensimmäisessä osassa käsitellään taloushallintoalaa, sen nykypäivää ja tulevaisuutta. Lisäksi käydään läpi tilitoimistoalaa sekä sen palveluiden laatua. Toisessa osassa perehdytään palveluun ja sen laatuun sekä asiakastyytyväisyyteen. Tutkimuksen empiriaosuus toteutettiin kvantitatiivisena eli määrällisenä tutkimuksena. Tutkimuksen aineiston hankkimiseen käytettiin asiakastyytyväisyyskyselylomaketta. Lomake lähetettiin postitse neljällekymmenelle Tilipalvelu Irja Malinin asiakkaalle. Tutkimustulosten perusteella voidaan päätellä, että Tilipalvelu Irja Malinin asiakkaat ovat pääsääntöisesti erittäin tyytyväisiä saamiinsa palveluihin. Tarvetta lisäpalveluille ei ole tällä hetkellä, vaan asiakkaat ovat tyytyväisiä nykyiseen palveluvalikoimaan.The objective of this thesis was to explore the satisfaction of the quality of service the customers of Tilipalvelu Irja Malin have when using the case company’s services. Furthermore, the study charted customer needs for additional services which were not yet utilized. The aim of study, through received responses, was to develop the quality of an accounting firm’s services and its range of services offered. The first part of the theoretical section of the study deals with the financial management industry, its present situation and future. It also goes through the accounting firm industry and the quality of its services. The second part focuses on the service and the quality of service and customer satisfaction. The empirical section of this thesis was executed as a quantitative study. The data was obtained by a questionnaire of customer satisfaction. The questionnaire was sent by post to the forty customers of Tilipalvelu Irja Malin. Based on the results of this study, it seems that the customers of Tilipalvelu Irja Malin are generally very satisfied with their services. At this moment there is no need for additional services. The customers are satisfied with the present range of services.Key words: financial management industry, service, service quality, customer satisfactio

Competence-Based Pharmacy Education in the University of Helsinki

In order to meet the expectations to act as an expert in the health care profession, it is of utmost importance that pharmacy education creates knowledge and skills needed in today’s working life. Thus, the planning of the curriculum should be based on relevant and up-to-date learning outcomes. In the University of Helsinki, a university wide curriculum reform called ‘the Big Wheel’ was launched in 2015. After the reform, the basic degrees of the university are two-cycle (Bachelor–Master) and competence-based, where the learning outcomes form a solid basis for the curriculum goals and implementation. In the Faculty of Pharmacy, this curriculum reform was conducted in two phases during 2012–2016. The construction of the curriculum was based on the most relevant learning outcomes concerning working life via high quality first (Bachelor of Science in Pharmacy) and second (Master of Science in Pharmacy) cycle degree programs. The reform was kicked off by interviewing all the relevant stakeholders: students, teachers, and pharmacists/experts in all the working life sectors of pharmacy. Based on these interviews, the intended learning outcomes of the Pharmacy degree programs were defined including both subject/contents-related and generic skills. The curriculum design was based on the principles of constructive alignment and new structures and methods were applied in order to foster the implementation of the learning outcomes. During the process, it became evident that a competence-based curriculum can be created only in close co-operation with the stakeholders, including teachers and students. Well-structured and facilitated co-operation amongst the teachers enabled the development of many new and innovative teaching practices. The European Union funded PHAR-QA project provided, at the same time, a highly relevant framework to compare the curriculum development in Helsinki against Europe-wide definitions of competences and learning outcomes in pharmacy education.Peer reviewe

Pharmacy Practice and Education in Finland

The Pharmacy Education in Europe (PHARMINE) project studies pharmacy practice and education in the European Union (EU) member states. The work was carried out using an electronic survey sent to chosen pharmacy representatives. The surveys of the individual member states are now being published as reference documents for students and staff interested in research on pharmacy education in the EU, and in mobility. This paper presents the results of the PHARMINE survey on pharmacy practice and education in Finland. Pharmacies have a monopoly on the dispensation of medicines. They can also provide diagnostic services. Proviisori act as pharmacy owners and managers. They follow a five-year (M.Sc. Pharm.) degree course with a six-month traineeship. Farmaseutti, who follow a three-year (B.Sc. Pharm.) degree course (also with a six-month traineeship), can dispense medicines and counsel patients in Finland. The B.Sc. and the first three years of the M.Sc. involve the same course. The current pharmacy curriculum (revised in 2014) is based on five strands: (1) pharmacy as a multidisciplinary science with numerous opportunities in the working life, (2) basics of pharmaceutical sciences, (3) patient and medication, (4) optional studies and selected study paths, and (5) drug development and use. The learning outcomes of the pharmacy graduates include (1) basics of natural sciences: chemistry, physics, technology, biosciences required for all the students (B.Sc. and M.Sc.), (2) medicine and medication: compounding of medicines, holism of medication, pharmacology and biopharmaceutics (side-effects and interactions), patient counseling, efficacy and safety of medicines and medication, (3) comprehensive and supportive interactions of the various disciplines of pharmacy education and research: the role and significance of pharmacy as a discipline in society, the necessary skills and knowledge in scientific thinking and pharmaceutical research, and (4) basics of economics and management, multidisciplinarity, hospital pharmacy, scientific writing skills, management skills. In addition, teaching and learning of “general skills”, such as the pharmacist’s professional identity and the role in society as a part of the healthcare system, critical and creative thinking, problem-solving skills, personal learning skills and life-long learning, attitude and sense of responsibility, and communication skills are developed in direct association with subject-specific courses. Professional specialization studies in industrial pharmacy, and community and hospital pharmacy are given at the post-graduate level at the University of Helsinki

Whole-exome sequencing identifies novel candidate predisposition genes for familial polycythemia vera

Background: Polycythemia vera (PV), characterized by massive production of erythrocytes, is one of the myeloproliferative neoplasms. Most patients carry a somatic gain-of-function mutation in JAK2, c.1849G > T (p.Val617Phe), leading to constitutive activation of JAK-STAT signaling pathway. Familial clustering is also observed occasionally, but high-penetrance predisposition genes to PV have remained unidentified. Results: We studied the predisposition to PV by exome sequencing (three cases) in a Finnish PV family with four patients. The 12 shared variants (maximum allowed minor allele frequency G (p.Phe418Leu) in ZXDC, c.1931C > G (p.Pro644Arg) in ATN1, and c.701G > A (p.Arg234Gln) in LRRC3. We also observed a rare, predicted benign germline variant c.2912C > G (p.Ala971Gly) in BCORL1 in all four patients. Somatic mutations in BCORL1 have been reported in myeloid malignancies. We further screened the variants in eight PV patients in six other Finnish families, but no other carriers were found. Conclusions: Exome sequencing provides a powerful tool for the identification of novel variants, and understanding the familial predisposition of diseases. This is the first report on Finnish familial PV cases, and we identified three novel candidate variants that may predispose to the disease.Peer reviewe

Effect of Palliative Care Decision on Use of Hospital Services in Pancreatic Cancer Patients : A Retrospective Study

Peer reviewe

Nordic Specialist Course in Palliative Medicine: Evaluation and Impact on the Development of Palliative Medicine in the Nordic Countries: A Survey among Participants from Seven Courses 2003-2017

Background: The five Nordic Associations for palliative medicine (PM) have since 2003 organized a common specialist course for six weeks in two years. Aim: To describe the course: participants, evaluations, impact on participants' careers, and on the development of PM in the Nordic countries. Methods: Information on participants taken from the course archive and national registries. A web survey sent to graduates from the courses 2003–2013 (n = 150) and 2013–2017 (n = 72). Results: Mean age at course start was 46.9 years; 66% were women. Mean overall evaluation score 5.7 (range 5.4–6.0, max 7.0). Survey response rate 84% (n = 186); 80% of respondents were working in PM, the majority as leaders, >90% engaged in teaching PM. About 40% were active in PM associations, lobbying, and guideline development. Conclusion: The Nordic Specialist Course in PM has had a profound impact on the participants' postcourse careers, influencing the development of PM in the Nordic countries.publishedVersio

Palliatiivisen lääketieteen opetus lääketieteen kandidaattien arvioimana

Lähtökohdat Palliatiivinen lääketiede on lääkärin ydinosaamista, mutta alan professuuri ja opetussuunnitelma ovat vain Helsingin ja Tampereen yliopistoissa. Menetelmät Lukuvuonna 2018–2019 kaikissa Suomen lääketieteellisissä tiedekunnissa kysyttiin kysely­lomakkeella valmistuvien kandidaattien näkemyksiä palliatiivisen lääketieteen opetuksesta. Tulokset Vastaajista (n = 502) lähes kaikki (98 %) pitivät palliatiivisen lääketieteen opetusta hyödyllisenä. Opetus oli kattanut parhaiten kivun hoidon, heikoimmin psyykkiset oireet ja psykososiaalisen tuen. Lisäopetusta olisi kaivattu eniten hoitolinjauksista ja psykososiaalisista seikoista. Tampereen ja Helsingin yliopistojen vastaajat kokivat opetuksen kattaneen paremmin lähes kaikki osa-alueet verrattuna muiden yliopistojen vastaajiin. Helsingin ja Tampereen opiskelijoista 80–90 % kertoi kohdanneensa saattohoitopotilaan opetuksessa, kun muista näin arvioi noin kolmannes. Avoimissa vastauksissa korostui tarve opetukseen ennen ensimmäisiä lääkärin työtehtäviä. Päätelmät Kokemukset palliatiivisen lääketieteen opetuksesta vaihtelivat yliopistojen välillä. Valtakunnallisen palliatiivisen lääketieteen opetussuunnitelman käyttöönotto on tarpeen.</p

Nordic Specialist Course in Palliative Medicine: Evaluation and Impact on the Development of Palliative Medicine in the Nordic Countries: A Survey among Participants from Seven Courses 2003-2017.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: The five Nordic Associations for palliative medicine (PM) have since 2003 organized a common specialist course for six weeks in two years. Aim: To describe the course: participants, evaluations, impact on participants' careers, and on the development of PM in the Nordic countries. Methods: Information on participants taken from the course archive and national registries. A web survey sent to graduates from the courses 2003-2013 (n = 150) and 2013-2017 (n = 72). Results: Mean age at course start was 46.9 years; 66% were women. Mean overall evaluation score 5.7 (range 5.4-6.0, max 7.0). Survey response rate 84% (n = 186); 80% of respondents were working in PM, the majority as leaders, >90% engaged in teaching PM. About 40% were active in PM associations, lobbying, and guideline development. Conclusion: The Nordic Specialist Course in PM has had a profound impact on the participants' postcourse careers, influencing the development of PM in the Nordic countries