Perhetyökansio

Ajatus opinnäytetyöhön saatiin työelämästä ja omista työelämän kiinnostuksen kohteista. Toiminnallinen opinnäytetyömme käsittelee korjaavan perhetyön kehittämistä. Opinnäytetyön produktin taustalla on työelämälähtöinen tarve kehittää työväline tukemaan perhetyötä. Produkti on suunnattu käytettäväksi kaikille korjaavan perhetyön toimijoille. Tämä opinnäytetyö toteutettiin vuosina 2012-2013. Opinnäytetyön tarkoituksena oli kehittää apuväline korjaavan perhetyön suunnitteluun ja kirjaamiseen. Perheelle annetaan kansion kautta mahdollisuus ymmärtää perhetyön tarkoitusperiä, miksi asetetaan jokin tavoite ja miten tavoite saavutetaan. Produktin avulla perhetyön piirin asiakkaille luodaan kokemus tavoitteellisesta perhetyöstä. Perheen tuen tarpeita kartoitetaan kansion eri osa-alueilla, jonka ansiosta tuki voidaan kohdentaa oikeisiin ongelmakohtiin. Perhetyökansion toteutuksessa on käytetty haastatteluja, keskusteluita eri ammattilaisten kanssa sekä käytännön testaamista. Tuotokseksi saatiin vanhoja sekä uusia menetelmiä hyödyntävä työväline, jota voidaan kehittää niissä instansseissa joissa työvälinettä tullaan käyttämään. Raportissa käydään läpi perhetyökansion osioita ja niiden taustalla olevaa teoriapohjaa. Raportissa käsitellään perhetyötä, menetelmiä ja produktin valmistamisen vaiheita.The idea of thesis is based on our work and on our intrests in work. Thesis handles development of reconstructive family work. Product of thesis is based on work life and the need to develop tools for support of family work. Product is aimed for all the workers around family work. This thesis was produced during years 2012-2013. The main purpose of our thesis was to develope a tool for planning and registering of correcting family work. Our product gives family an opportunity to understand the main reasons of family work, why is there a goal and how to achieve it. Product creates the experience of purpose for the customers around family work. The needs of support is charted with different sections of the product, which creates an opportunity to focus on family's real problems. The product was made by using interviews, practical testing and conversations with dfferent professionals around family work. Final product utilizes old and new methods, which can be recreated by workers around reconstructive family work. Report explains the sections of our product and the basic theory of these sections. Report also includes family work, methods and phases of creating the product

Tilaaja - tuottajamallin soveltaminen yliopistojen palvelukeskuksessa

Yliopistojen talous- ja henkilöstöhallinnon palvelukeskusreformin taustalla on Suomessa jo jonkin aikaa yleisesti käynnissä olut julkisen sektorin toiminnan määrätietoinen tehostaminen ja uudelleen organisointi. Tätä on toteutettu ottamalla käyttöön erilaisia markkinaohjautuvia toimintamuotoja julkisessa palvelutuotannossa. Tässä tutkimuksessa paneudutaan tilaaja - tuottajamallin käyttöönottoon ja prosessien johtamiseen tilaaja – tuottajamallia kehitettäessä. Tutkimuksessa haetaan vastausta siihen onko yliopistojen palvelukeskusreformissa syntymässä tilaaja – tuottajamalli ja jos on, niin millainen. Tarkastelua täydentävinä kysymyksinä on: Millaisia muutoksia asiakasorganisaation prosesseissa tapahtuu sen siirtyessä tilaaja - tuottajamallin mukaiseksi tilaaja organisaatioiksi ja miten tuottajaorganisaatio organisoidaan siten, että se pystyy vastaamaan asiakkaiden tarpeisiin. Tutkimuksessa on tehty kvalitatiivinen dokumenttianalyysi yliopistojen palvelukeskusta perustettaessa syntyneeseen valmistelumateriaaliin sekä osin aiheeseen liittyvään laajempaan dokumenttiaineistoon. Dokumenttianalyysiä on lisäksi tuettu ja täydennetty tutkijan suorittaman havainnoinnin avulla. Yliopistojen palvelukeskusreformissa perustettavan palvelukeskuksen toiminta tulee perustumaan markkinaohjautuvuudesta johdettavaan tilaaja – tuottajamalliin. Reformissa kehitettävä malli sisältää kuitenkin monia markkinaehtoisuutta rajoittavia tekijöitä, minkä vuoksi se jää kauas puhtaasti markkinoiden ehdoilla toimivasta tilaaja – tuottajamallista. Keskeisimpiä palvelukeskuksen toimintamallin markkinaohjautuvuutta rajoittavia piirteitä on varsinaisen tilaajan ja tuottajan välisen palvelusopimuksen ulkopuolinen vahva ohjausrooli, toiminnan perustuminen näennäismarkkinoille, aidon kilpailun puute sekä se, että palvelukeskus ei itse ensi sijassa hyödy oman toimintansa kannattavuudesta. Palvelukeskuksen valmistelutyössä on toiminnan kehittämisen apuna käytetty myös prosessien johtamisen teoriaa, jonka avulla on pyritty löytämään keinoja toiminnan tehostamiseksi. Näin on pystytty yhdenmukaistamaan ja virtaviivaistamaan yliopistojen talous- ja henkilöstöhallinnon prosesseja sekä määrittelemään tarkasti palvelukeskukselle siirtyvät tehtävät. Asiakkaiden tarpeet on otettu huomioon palvelukeskuksen valmistelun alusta lähtien ottamalla tulevat asiakasorganisaatiot tiiviisti mukaan valmistelutyöhön ja perustamalla koko palvelukeskuksen organisointi asiakaslähtöisiin tiimeihin. Nyt perustettava palvelukeskusmalli on hyvä alku markkinaehtoisten toimintatapojen käyttöönotolle organisoitaessa yliopistojen tukitoimintoja uudelleen. Mielenkiintoista onkin nähdä miten asiassa edetään tulevaisuudessa.fi=Opinnäytetyö kokotekstinä PDF-muodossa.|en=Thesis fulltext in PDF format.|sv=Lärdomsprov tillgängligt som fulltext i PDF-format

High-Performance Digital Hydraulic Tracking Control of a Mobile Boom Mockup

The automation of hydraulic mobile machinery, such as excavators, requires high performance control solutions. In hydraulics, this means fast and accurate force, velocity and position control of hydraulic cylinder. Especially the force control is known to be difficult with traditional servo valves. Fast digital hydraulic valves together with modern control solutions can overcome this problem. This paper uses a new force control solution, which is based on the fast digital hydraulic valves and model based control principle. The control solution is applied in a heavy axis mimicking dynamics of mobile machine booms. Experimental results show good force, velocity and position tracking performance with varying load masses. The slow velocity performance is also much improved when compared to the earlier results

Spatial Visualization Skills of Student Teacher Applicants : A pilot Study in the Finnish CDT Teacher Education Admissions

Problem-solving is a key element in design and engineering processes for finding answers to challenges and open problems. The use of spatial visualization skills is part of problem-solving in terms of transforming ideas into 2D or 3D form and transferring this thinking into practice in a practical hands-on process. Spatial visualization seems to play a key role in the design, engineering and production processes as well as in various professions. Spatial visualization skills can be considered as an important part of teachers’ multidimensional professional competence as they teach students and guide and tutor their hands-on projects. While educating teachers, it would be important to know the levels of the student teachers’ spatial visualization skills to consider its role in courses and even in admissions. However, there are no existing studies on spatial visualization skills of student teacher applicants. To address this research gap, we pose the following research question: What is the level of spatial visualization skills of student teacher applicants in craft, design and technology teacher education admissions? The data, analyzed with document analysis, includes student teacher applicants' performance in a spatial visualization test (N=89, three tasks) as part of Finnish craft, design and technology teacher education admissions. According to the results, four of the five applicants performed on a good level whilst only four per cent of applicants performed weakly. Since spatial visualization skills can be trained, it is important to recognize student teachers’ weak performance so that it can be enhanced in various courses. This study is part of a larger problem-solving skills evaluation project in CDT teacher education admissions</p

Novel electrocardiographic features in carriers of hypertrophic cardiomyopathy causing sarcomeric mutations

Objectives: The sensitivity and specificity of the conventional 12-lead ECG to identify carriers of hypertrophic cardiomyopathy (HCM) - causing mutations without left ventricular hypertrophy (LVH) has been limited. We assessed the ability of novel electrocardiographic parameters to improve the detection of HCM mutation carriers. Methods: We studied 140 carriers (G+) of the TPM7-Asp175Asn or MYBPC3-Glnl 061X pathogenic variants for HCM: The G+/LVH+ group (n = 98) consisted of mutation carriers with LVH and the G+/LVH- group (n = 42) without LVH. The control group consisted of 30 subjects. The standard 12-lead ECG was comprehensively analyzed and two novel ECG variables were introduced: RVlRV3 and septal remodeling. A subset of 65 individuals underwent cardiac magnetic resonance imaging and 2D strain echocardiography. Results: Conventional major ECG criteria were sensitive (90%) and specific (97%) in identifying G+/LVH+ subjects. RV1RV3 and septal remodeling were more prevalent in the G+/LVH- subjects compared to the control group (33% vs 3%, p = 0.005 and 45% vs 3%, p <0.001, respectively). The combination of RVlRV3 and Q waves and repolarization abnormalities (QR) differentiated between the G+/LVH- subjects and the control group with a sensitivity of 52% and specificity of 97%. The combination of septa] remodeling and QR differentiated between G+/LVH- subjects and the control group with a sensitivity of 64% and specificity of 97%. Conclusions: The novel ECG-parameters RVlRV3 and septal remodeling were effective in identifying G+/LVH-subjects and could be useful in the diagnostics of new suspected HCM patients and in the screening and follow-up of HCM families. (C) 2018 Elsevier Inc. All rights reserved.Peer reviewe

Cluster Analysis of Finnish Population-Based Adult-Onset Asthma Patients

Background: Phenotypes of adult asthma have been identified in previous studies but rarely in population-based settings. Objective: To identify clusters of adult-onset asthma in a Finnish population-based study on subjects born before 1967. Methods: We used population-based data from 1350 asthmatics with adult-onset asthma (Adult Asthma in Finland) from Finnish national registers. Twenty-eight covariates were selected based on literature. The number of covariates was reduced by using factor analysis before cluster analysis. Results: Five clusters (CLU1-CLU5) were identified, 3 clusters with late-onset adult asthma (onset ≥40 years) and 2 clusters with onset at earlier adulthood (<40 years). Subjects in CLU1 (n = 666) had late-onset asthma and were nonobese, symptomatic, and predominantly female with few respiratory infections during childhood. CLU2 (n = 36) consisted of subjects who had earlier-onset asthma, were predominantly female, obese with allergic asthma, and had recurrent respiratory infections. Subjects in CLU3 (n = 75) were nonobese, older, and predominantly men with late-onset asthma, smoking history, comorbidities, severe asthma, least allergic diseases, low education, many siblings, and childhood in rural areas. CLU4 (n = 218) was a late-onset cluster consisting of obese females with comorbidities, asthma symptoms, and low education level. Subjects in CLU5 (n = 260) had earlier onset asthma, were nonobese, and predominantly allergic females. Conclusions: Our population-based adult-onset asthma clusters take into account several critical factors such as obesity and smoking, and identified clusters that partially overlap with clusters identified in clinical settings. Results give us a more profound understanding of adult-onset asthma phenotypes and support personalized management.publishedVersionPeer reviewe

Fatal Outcome in Bacteremia is Characterized by High Plasma Cell Free DNA Concentration and Apoptotic DNA Fragmentation: A Prospective Cohort Study

INTRODUCTION: Recent studies have shown that apoptosis plays a critical role in the pathogenesis of sepsis. High plasma cell free DNA (cf-DNA) concentrations have been shown to be associated with sepsis outcome. The origin of cf-DNA is unclear. METHODS: Total plasma cf-DNA was quantified directly in plasma and the amplifiable cf-DNA assessed using quantitative PCR in 132 patients with bacteremia caused by Staphylococcus aureus, Streptococcus pneumoniae, ß-hemolytic streptococcae or Escherichia coli. The quality of cf-DNA was analyzed with a DNA Chip assay performed on 8 survivors and 8 nonsurvivors. Values were measured on days 1-4 after positive blood culture, on day 5-17 and on recovery. RESULTS: The maximum cf-DNA values on days 1-4 (n = 132) were markedly higher in nonsurvivors compared to survivors (2.03 vs 1.26 ug/ml, p<0.001) and the AUCROC in the prediction of case fatality was 0.81 (95% CI 0.69-0.94). cf-DNA at a cut-off level of 1.52 ug/ml showed 83% sensitivity and 79% specificity for fatal disease. High cf-DNA (>1.52 ug/ml) remained an independent risk factor for case fatality in a logistic regression model. Qualitative analysis of cf-DNA showed that cf-DNA displayed a predominating low-molecular-weight cf-DNA band (150-200 bp) in nonsurvivors, corresponding to the size of the apoptotic nucleosomal DNA. cf-DNA concentration showed a significant positive correlation with visually graded apoptotic band intensity (R = 0.822, p<0.001). CONCLUSIONS: Plasma cf-DNA concentration proved to be a specific independent prognostic biomarker in bacteremia. cf-DNA displayed a predominating low-molecular-weight cf-DNA band in nonsurvivors corresponding to the size of apoptotic nucleosomal DNA

DUX4 is a multifunctional factor priming human embryonic genome activation

Double homeobox 4 (DUX4) is expressed at the early pre-implantation stage in human embryos. Here we show that induced human DUX4 expression substantially alters the chromatin accessibility of non-coding DNA and activates thousands of newly identified transcribed enhance-like regions, preferentially located within ERVL-MaLR repeat elements. CRISPR activation of transcribed enhancers by C-terminal DUX4 motifs results in the increased expression of target embryonic genome activation (EGA) genes ZSCAN4 and KHDC1P1. We show that DUX4 is markedly enriched in human zygotes, followed by intense nuclear DUX4 localization preceding and coinciding Kith minor EGA. DUX4 knockdown in human zygotes led to changes in the EGA transcriptome but did not terminate the embryos. We also show that the DUX4 protein interacts with the Mediator complex via the C-terminal KIX binding motif. Our findings contribute to the understanding of DUX4 as a regulator of the non-coding genome.Peer reviewe

The severity of Puumala hantavirus induced nephropathia epidemica can be better evaluated using plasma interleukin-6 than C-reactive protein determinations

<p>Abstract</p> <p>Background</p> <p>Nephropathia epidemica (NE) is a Scandinavian type of hemorrhagic fever with renal syndrome caused by Puumala hantavirus. The clinical course of the disease varies greatly in severity. The aim of the present study was to evaluate whether plasma C-reactive protein (CRP) and interleukin (IL)-6 levels associate with the severity of NE.</p> <p>Methods</p> <p>A prospectively collected cohort of 118 consecutive hospital-treated patients with acute serologically confirmed NE was examined. Plasma IL-6, CRP, and creatinine, as well as blood cell count and daily urinary protein excretion were measured on three consecutive days after admission. Plasma IL-6 and CRP levels higher than the median were considered high.</p> <p>Results</p> <p>We found that high IL-6 associated with most variables reflecting the severity of the disease. When compared to patients with low IL-6, patients with high IL-6 had higher maximum blood leukocyte count (11.9 <it>vs </it>9.0 × 10⁹/l, <it>P </it>= 0.001) and urinary protein excretion (2.51 <it>vs </it>1.68 g/day, <it>P </it>= 0.017), as well as a lower minimum blood platelet count (55 <it>vs </it>80 × 10⁹/l, <it>P </it>< 0.001), hematocrit (0.34 <it>vs </it>0.38, <it>P </it>= 0.001), and urinary output (1040 <it>vs </it>2180 ml/day, <it>P </it>< 0.001). They also stayed longer in hospital than patients with low IL-6 (8 <it>vs </it>6 days, <it>P </it>< 0.001). In contrast, high CRP did not associate with severe disease.</p> <p>Conclusions</p> <p>High plasma IL-6 concentrations associate with a clinically severe acute Puumala hantavirus infection, whereas high plasma CRP as such does not reflect the severity of the disease.</p