目次 : 『千葉医学雑誌 オープン・アクセス・ペーパー』 89E巻2号 2013年4月

Multivariate clustering. (DOCX 149 kb

Mix_sp_flocks_BDFFP

Tracking data for mixed species flocks at the Biological Dynamics of Forest Fragments Project in Brazil. Data is in GPX format. Each file is an aggregate of several days following flocks. Files with (...)_dry_2500(...) are a subsamples from flocks sampled for 100+ hours and only for the dry season. For a comprehensive list of sampling effort, check the supplementary material. Lidar data is split in Canopy height models (CHM) and Digital elevation models (DHM) all in TIF format

Mie aattelen niin, että siellä sitten neuvotaan, miten tässä toimitaan” ASIAKKAIDEN KOKEMUKSIA VANHUKSILLE TARKOITETUSTA PALVELUOHJAUKSESTA

Opinnäytetyön tarkoituksena oli selvittää Joensuun kaupungin seniorineuvonta Ankkurin asiakkaiden kokemuksia ikääntyneille tarkoitetusta palveluohjauksesta. Tavoitteena oli tuoda esiin asiakkaiden näkökulmia palveluohjauksesta. Palveluohjaus on sosiaalialan asiakaslähtöinen työskentelymenetelmä, jonka tarkoituksena on selvittää asiakkaan yksilölliset palveluntarpeet ja löytää hänen tarpeisiinsa sopivat palvelut. Tarve palveluohjaukselle on suuri, sillä vanhusten palvelujärjestelmä on laaja ja monitahoinen. Tämän vuoksi ikääntyneille voi olla vaikeaa hahmottaa omia oikeuksiaan ja heille kuuluvia palveluja. Opinnäytetyö on laadullinen tutkimus, jonka aineisto on kerätty teemahaastattelumenetelmää käyttäen. Yhteensä tutkimusta varten on haastateltu kuutta palveluohjausta saanutta asiakasta. Aineisto on analysoitu käyttäen aineistolähtöistä sisällönanalyysia. Tutkimuksessa ilmeni, että palveluohjauksen koettiin lisänneen tietoutta omista oikeuksista ja ikääntyneille palveluista. Tärkeänä koettiin se, että palveluohjaajilla olisi aikaa kuunnella asiakasta ja että asiakkaan tilanteen edistymistä seurattaisiin enemmän. Palveluohjaajilta kaivattaisiin myös ”asianajoa” eli tukea vaikuttamiseen yhteiskunnallisella ja yksilöllisellä tasolla. Opinnäytetyöprosessin aikana nousi esiin jatkotutkimusidea koskien vanhusten osallisuutta ja sitä, kuinka osallisuutta voisi edistää palveluohjauksen avulla.The aim of the thesis was to collect customers’ experiences about the case management aimed at the elderly people provided by the city of Joensuu. The purpose was to give a voice to the customers so they can express their own views in regard to the case management. Case management is a working method used in the social work. It is a customer-oriented method which is used to find out customer’s individual needs so they can be provided with appropriate services. The need for case management is high since the service system for elderly people is extensive and complex. Thus, it may be challenging for the elderly to find out the services they are entitled to. This research was done using qualitative methods. The data was gathered by using thematic interviews and altogether six customers were interviewed. The data was analyzed by using data-based content analysis. The results showed that the case management had increased the customers’ knowledge of their own rights and of the services for elderly people. It was considered important that the case management workers have enough time to listen and give attention to the customers. The results also show that the customers would like their situation to be followed more closely by the workers. Lastly, the customers hoped the case management workers would act as the customers’ advocate on societal and personal level. In the future, it would be interesting to research how the participation and engagement of elderly people could be supported

Non-viral liver disease burden in people living with HIV and elevated transaminases: a cross-sectional study

Introduction: Due to improved life expectancy in people living with HIV (PLWH), liver disease is increasingly being recognised. We assessed non-viral chronic liver disease (CLD) burden in PLWH. Methods: The HeAL (HIV non-virAL liver disease) study (2014-2021) prospectively recruited PLWH with elevated serum alanine aminotransferase (ALT) levels and negative hepatitis serology. Clinically significant hepatic fibrosis (CSHF) was defined as liver stiffness measurement (LSM) of >7.1 kPa and hazardous alcohol use as AUDIT score > 8. Primary outcome was prevalence/predictors of CSHF. Results: Total recruited were n=274, 92% male, median age 52 (45-59) years, 96% having undetectable HIV viral load. Overall, n=97 (35%) had hazardous alcohol use, n=72 (26%) had metabolic syndrome (MS) and 17%-27% had exposure to hepatotoxic antiretrovirals (ARV). Prevalence of CSHF was 20% (n=54), prevalence of cirrhosis (LSM >12.5 kPa) being 7% (19/274). Risk factors for CSHF were hazardous alcohol use in 44% (n=24), MS in 46% (n=25) and hepatotoxic ARV in 56% (n=30), majority having more than one risk factor. Independent predictors of CSHF were serum HDL (OR 0.220; 95% CI 0.061-0.790, p=0.020) (inverse relationship); serum AST (OR 1.033, 95% CI 1.001-1.067, p=0.045) and didanosine use (OR 2.878, 95% CI 1.228-6.774, p=0.015). Moderate-severe hepatic steatosis was identified in 52%(n=142). Both FIB-4 and APRI performed poorly in predicting CSHF (PPV 27.3% and 30.6% respectively) and advanced fibrosis(>F3) (PPV 17.6% and 5.9% respectively). Conclusion: In this study, 20% of PLWH had CSHF associated with high prevalence of hazardous alcohol use/MS/potentially hepatotoxic ARV. These potentially modifiable risk factors need addressing.</p

Non-viral liver disease burden in people living with HIV and elevated transaminases: a cross-sectional study

Introduction: Due to improved life expectancy in people living with HIV (PLWH), liver disease is increasingly being recognised. We assessed non-viral chronic liver disease (CLD) burden in PLWH. Methods: The HeAL (HIV non-virAL liver disease) study (2014-2021) prospectively recruited PLWH with elevated serum alanine aminotransferase (ALT) levels and negative hepatitis serology. Clinically significant hepatic fibrosis (CSHF) was defined as liver stiffness measurement (LSM) of >7.1 kPa and hazardous alcohol use as AUDIT score > 8. Primary outcome was prevalence/predictors of CSHF. Results: Total recruited were n=274, 92% male, median age 52 (45-59) years, 96% having undetectable HIV viral load. Overall, n=97 (35%) had hazardous alcohol use, n=72 (26%) had metabolic syndrome (MS) and 17%-27% had exposure to hepatotoxic antiretrovirals (ARV). Prevalence of CSHF was 20% (n=54), prevalence of cirrhosis (LSM >12.5 kPa) being 7% (19/274). Risk factors for CSHF were hazardous alcohol use in 44% (n=24), MS in 46% (n=25) and hepatotoxic ARV in 56% (n=30), majority having more than one risk factor. Independent predictors of CSHF were serum HDL (OR 0.220; 95% CI 0.061-0.790, p=0.020) (inverse relationship); serum AST (OR 1.033, 95% CI 1.001-1.067, p=0.045) and didanosine use (OR 2.878, 95% CI 1.228-6.774, p=0.015). Moderate-severe hepatic steatosis was identified in 52%(n=142). Both FIB-4 and APRI performed poorly in predicting CSHF (PPV 27.3% and 30.6% respectively) and advanced fibrosis(>F3) (PPV 17.6% and 5.9% respectively). Conclusion: In this study, 20% of PLWH had CSHF associated with high prevalence of hazardous alcohol use/MS/potentially hepatotoxic ARV. These potentially modifiable risk factors need addressing.</p