Psykoosipotilas ensihoitotilanteessa : Simulaatioharjoitukseen valmistavaa videomateriaalia sairaanhoitajaopiskelijoille

Psykoosista kärsivien kohtaaminen on lisääntynyt ensihoitotyössä sairaalapaikkojen vähentämisen ja hoitoaikojen pienentämisen johdosta. Psykoosi on vakava mielenterveydenhäiriö, joka heikentää merkittävästi todellisuudentajua. Simulaatio-oppiminen mahdollistaa vaikeiden tilanteiden harjoittelun niin, että virheitä pystyy tekemään ilman jälkiseuraamuksia ja ottamaan ne oppimiskokemuksena. Se perustuu tekemisen kautta oppimiseen ja kokemuksen kautta syntyneisiin toimintoihin ja kokemukseen. Opinnäytetyön tarkoituksena oli valmistaa opiskelijoita kohtaamaan psykoosipotilas ja antaa heille perustiedot tilanteessa toimimista varten. Opinnäytetyön tehtävä on tuottaa opetuksessa käytettävää videomateriaalia psykoosipotilaan kohtaamisesta ensihoidossa ammattikorkeakoulun simulaatio-oppimisympäristöön. Opinnäytetyön toimeksiantajana toimi Karelia-ammattikorkeakoulu. Simula on pääasiassa sosiaali- ja terveysalan oppimisympäristö, jossa simulaatiopedagogiikan keinoja käyttäen opitaan monipuolisesti käytännön hoitotaitoja. Simulan harjoituksissa toimitaan oikeaa elämää simuloivissa tilanteissa ja siellä voidaan harjoitella käytännön taitoja hoitotyössä, kuten myös vuorovaikutusta, tiimityötä, johtamista, tilanteen haltuunottoa ja päätöksentekoa. Opinnäytetyön jatkokehitysideana toimii opetusvideoiden laajentaminen psykoosin hoitamisen muihin osa-alueisiin, kuten hoidon jatkumiseen ensihoidon jälkeen.Due to the reduction in the number of hospital beds and shortened treatment periods, it has become more common to encounter psychotic patients in emergency care. Psychosis is a serious mental disorder that significantly reduces the sense of reality. Simulation-based learning enables the training of difficult situations so one can safely make mistakes without consequences and then learn from those mistakes. This is based on learning-by-doing and on the skills that develop from experience. The purpose of this thesis was to prepare students for encountering psychotic patients and to give them basic information on how to act during such an encounter. The goal is to produce video material for the simulated learning environment at the Karelia University of Applied Sciences. This video will be used for educational purposes. The thesis was commissioned by the Karelia University of Applied Sciences. Simula is a learning environment mainly for Social Services and Health Care which utilises simulation pedagogy for learning practical skills. The simulations imitate real life situations and are a great way to learn practical skills as well as interpersonal skills, teamwork, leadership, taking over a situation, and decision-making. An idea for further development is to make videos presenting other aspects on the treatment of psychosis, for example how to continue treatment after emergency care

No difference in implant survival between 28-mm M2a RingLoc metal-on-metal and metal-on-polyethylene total hip arthroplasty : results from the Finnish Arthroplasty Register

Publisher Copyright: © 2022 The Author(s).Background and purpose — Long-term outcome of small head (28 mm) metal-on-metal (MoM) total hip arthroplasty (THA) is available mainly for Metasul devices (Sulzer Medica, Winterthur, Switzerland). Biomet MoM THA was frequently used in Finland. Therefore, we assessed long-term survivorship of the M2a 28-mm RingLoc MoM THA (Biomet, Warsaw, IN, USA) and compared it with the metal-on-polyethylene (MoP) RingLoc THA from the same manufacturer. Patients and methods — We conducted a register study based on THAs from the Finnish Arthroplasty Register performed between January 1, 2000 and December 31, 2007. 290 28-mm head M2a MoM THAs and 1,647 28-mm head MoP THAs (reference group) were included. The endpoint was revision for any reason, or revision for aseptic loosening, osteolysis, liner wear, or metallosis as one group. Kaplan– Meier survival estimates were calculated, and revision risks were assessed using a Cox multiple regression model, both with 95% confidence intervals (CI). Results — No difference was found in the 15-year Kaplan–Meier survivorship between the 28-mm head M2a RingLoc MoM THA and the reference group for any reason for revision (87.7% [82.9–92.1] and 83.3% [81.0–85.3], respectively). The adjusted hazard ratio (HR) for any reason for revision for the MoM THA group compared with the reference group was at least equal or better (0.70 [0.48–1.02]). Both groups presented similar survival for revision for aseptic loosening of the cup, osteolysis, liner wear, or metallosis, at 96.2% (92.7–98.0) and 95.4% (93.9–96.5), respectively. Interpretation — In the long-term survival there was no difference between the M2a 28-mm RingLoc MoM THA and 28-mm MoP THA. Further follow-up regimens for M2a 28-mm RingLoc THA patients may be unnecessary, but long-term metal ion and radiological data is needed before any formal suggestions.Peer reviewe

Implant survival of 2,723 vitamin E-infused highly crosslinked polyethylene liners in total hip arthroplasty: data from the Finnish Arthroplasty Register

Background and purpose - The use of crosslinked polyethylene in total hip arthroplasty (THA) has decreased wear remarkably. It has been suggested that the antioxidative effects of vitamin E may enhance the wear properties of polyethylene even further. This study evaluates revision rates between vitamin E-infused polyethylene liners (E1 and E-poly, ZimmerBiomet, Warsaw, IN, USA) versus moderately crosslinked polyethylene (ModXLPE) liners from the same manufacturer used in primary THA.Patients and methods - We conducted a study based on data from the Finnish Arthroplasty Register. The study group consisted of 2,723 THAs with a vitamin E-infused liner and a reference group of 2,707 THAs with a moderately crosslinked polyethylene liner. Survivorship, revision risk, and re-revision causes were compared between groups.Results - The 7-year survival of the vitamin E-infused polyethylene liner group and of the reference group with revision for any reason as the endpoint was comparable (94% [95% CI 92.9-94.9] and 93% [CI 91.9-93.9], respectively). The adjusted hazard ratio (HR) for any revision was similar between the groups (0.7 [CI 0.4-1.1]). When revision for aseptic loosening was studied as the endpoint, the survival for the study group was 99% (CI 98.6-99.4) and for the reference group 99% (CI 98.7-99.5), and the risk of revision was comparable between the study groups (HR 1.3 [CI 0.7-2.5]).Interpretation - After an observation period of 7 years vitamin E-infused liners shows results equal to results obtained with crosslinked polyethylene liners

Implant Survival of 6,080 Tritanium Cups in Primary Total Hip Arthroplasty Data from the Finnish Arthroplasty Register from 2009 to 2017

Background: To enhance osseointegration in total hip arthroplasty (THA), ultraporous or highly porous-coated cups were introduced. Implant survival data on these new devices have been scarce. The aim of our study was to assess the survivorship of ultraporous Tritanium cups (Stryker) in a population-based register study.Methods: In this study, we collected data on 6,080 primary THAs using a Tritanium cup and 25,670 THAs using a conventional cup (control group) from the Finnish Arthroplasty Register; these procedures were performed from January 1, 2009, to December 31, 2017. We calculated the Kaplan-Meier survival estimates with 95% confidence intervals (CIs). The end point was revision for any reason or for aseptic loosening of the cup. The revision risks were assessed with use of the Cox multiple regression model. The variables assessed in the Cox model were femoral head size, age group, involved side, operation year, sex, diagnosis, and fixation of the stem. The proportional hazards assumption of the Cox model was not fulfilled, so the follow-up time was divided into 3 time periods: 0 to 2 years, >2 to 4 years, and >4 years.Results: When comparing the 2 groups with regard to revision for any reason, the 5-year Kaplan-Meier survivorship of the Tritanium group (94.7% [95% CI, 94.0% to 95.4%]) was inferior to that of the control group (96.0% [95% CI, 95.7% to 96.3%]). In the Cox regression analysis of the 2 groups for the time period of >4 years, the Tritanium group had an increased risk of revision for any reason compared with the control group (hazard ratio [HR], 3.12 [95% CI, 1.82 to 5.35]; p 2 to 4 years (HR, 11.2 [95% CI, 3.28 to 38.0]; p Conclusions: There was no advantage to using the ultraporous-coated Tritanium cup for primary THA compared with conventional uncemented cups. However, wide CIs for some HR estimates may point to a lack of precision. Therefore, further research on subject is needed.</div

Suppression of RNAi by dsRNA-Degrading RNaseIII Enzymes of Viruses in Animals and Plants

Certain RNA and DNA viruses that infect plants, insects, fish or poikilothermic animals encode Class 1 RNaseIII endoribonuclease-like proteins. dsRNA-specific endoribonuclease activity of the RNaseIII of rock bream iridovirus infecting fish and Sweet potato chlorotic stunt crinivirus (SPCSV) infecting plants has been shown. Suppression of the host antiviral RNA interference (RNAi) pathway has been documented with the RNaseIII of SPCSV and Heliothis virescens ascovirus infecting insects. Suppression of RNAi by the viral RNaseIIIs in non-host organisms of different kingdoms is not known. Here we expressed PPR3, the RNaseIII of Pike-perch iridovirus, in the non-hosts Nicotiana benthamiana (plant) and Caenorhabditis elegans (nematode) and found that it cleaves double-stranded small interfering RNA (ds-siRNA) molecules that are pivotal in the host RNA interference (RNAi) pathway and thereby suppresses RNAi in non-host tissues. In N. benthamiana, PPR3 enhanced accumulation of Tobacco rattle tobravirus RNA1 replicon lacking the 16K RNAi suppressor. Furthermore, PPR3 suppressed single-stranded RNA (ssRNA)–mediated RNAi and rescued replication of Flock House virus RNA1 replicon lacking the B2 RNAi suppressor in C. elegans. Suppression of RNAi was debilitated with the catalytically compromised mutant PPR3-Ala. However, the RNaseIII (CSR3) produced by SPCSV, which cleaves ds-siRNA and counteracts antiviral RNAi in plants, failed to suppress ssRNA-mediated RNAi in C. elegans. In leaves of N. benthamiana, PPR3 suppressed RNAi induced by ssRNA and dsRNA and reversed silencing; CSR3, however, suppressed only RNAi induced by ssRNA and was unable to reverse silencing. Neither PPR3 nor CSR3 suppressed antisense-mediated RNAi in Drosophila melanogaster. These results show that the RNaseIII enzymes of RNA and DNA viruses suppress RNAi, which requires catalytic activities of RNaseIII. In contrast to other viral silencing suppression proteins, the RNaseIII enzymes are homologous in unrelated RNA and DNA viruses and can be detected in viral genomes using gene modeling and protein structure prediction programs.Peer reviewe

No difference in implant survival between 28-mm M2a RingLoc metal-on-metal and metal-on-polyethylene total hip arthroplasty: results from the Finnish Arthroplasty Register

Background and purpose:Long-term outcome of small head (28 mm) metal-on-metal (MoM) total hip arthroplasty (THA) is available mainly for Metasul devices (Sulzer Medica, Winterthur, Switzerland). Biomet MoM THA was frequently used in Finland. Therefore, we assessed long-term survivorship of the M2a 28-mm RingLoc MoM THA (Biomet, Warsaw, IN, USA) and compared it with the metal-on-polyethylene (MoP) RingLoc THA from the same manufacturer.Patients and methods:We conducted a register study based on THAs from the Finnish Arthroplasty Register performed between January 1, 2000 and December 31, 2007. 290 28-mm head M2a MoM THAs and 1,647 28-mm head MoP THAs (reference group) were included. The endpoint was revision for any reason, or revision for aseptic loosening, osteolysis, liner wear, or metallosis as one group. Kaplan–Meier survival estimates were calculated, and revision risks were assessed using a Cox multiple regression model, both with 95% confidence intervals (CI).Results:No difference was found in the 15-year Kaplan–Meier survivorship between the 28-mm head M2a RingLoc MoM THA and the reference group for any reason for revision (87.7% [82.9–92.1] and 83.3% [81.0–85.3], respectively). The adjusted hazard ratio (HR) for any reason for revision for the MoM THA group compared with the reference group was at least equal or better (0.70 [0.48–1.02]). Both groups presented similar survival for revision for aseptic loosening of the cup, osteolysis, liner wear, or metallosis, at 96.2% (92.7–98.0) and 95.4% (93.9–96.5), respectively.Interpretation:In the long-term survival there was no difference between the M2a 28-mm RingLoc MoM THA and 28-mm MoP THA. Further follow-up regimens for M2a 28-mm RingLoc THA patients may be unnecessary, but long-term metal ion and radiological data is needed before any formal suggestions. </p

Reconstruction and Validation of RefRec: A Global Model for the Yeast Molecular Interaction Network

Molecular interaction networks establish all cell biological processes. The networks are under intensive research that is facilitated by new high-throughput measurement techniques for the detection, quantification, and characterization of molecules and their physical interactions. For the common model organism yeast Saccharomyces cerevisiae, public databases store a significant part of the accumulated information and, on the way to better understanding of the cellular processes, there is a need to integrate this information into a consistent reconstruction of the molecular interaction network. This work presents and validates RefRec, the most comprehensive molecular interaction network reconstruction currently available for yeast. The reconstruction integrates protein synthesis pathways, a metabolic network, and a protein-protein interaction network from major biological databases. The core of the reconstruction is based on a reference object approach in which genes, transcripts, and proteins are identified using their primary sequences. This enables their unambiguous identification and non-redundant integration. The obtained total number of different molecular species and their connecting interactions is ∼67,000. In order to demonstrate the capacity of RefRec for functional predictions, it was used for simulating the gene knockout damage propagation in the molecular interaction network in ∼590,000 experimentally validated mutant strains. Based on the simulation results, a statistical classifier was subsequently able to correctly predict the viability of most of the strains. The results also showed that the usage of different types of molecular species in the reconstruction is important for accurate phenotype prediction. In general, the findings demonstrate the benefits of global reconstructions of molecular interaction networks. With all the molecular species and their physical interactions explicitly modeled, our reconstruction is able to serve as a valuable resource in additional analyses involving objects from multiple molecular -omes. For that purpose, RefRec is freely available in the Systems Biology Markup Language format

Flying solo or working together? How are the media professionals managed? : perceptions of heads of PR-agencies and editors-in-chief

Tämä tutkimus tutkii viestintätoimistojen ja sanomalehtien johtamista. Tutkimuksen aihe on haasteellinen, sillä aikaisemmat tutkimukset eivät tutki johtamista viestintäyrityksissä vaan keskittyvät mm. suhdetoiminnan (PR) integroimiseen osaksi viestintäyritysten asiakasorganisaatioiden johtamista. Sanomalehdissä johtamistutkimukset viime aikoina ovat taas jääneet vähemmälle, kun tutkimukset ovat kohdistuneet lähinnä mediamuutoksen vaikutukseen ja printtimedian tulevaisuusnäkymien arviointiin. Tutkimuksen teoreettinen tausta yhdisteltiin muun muassa käsitteistä huomiotyö ja push ja pull –prosessit, jotta voitiin painottaa media-alojen toiminnan muuttumista perinteisistä push-prosesseista pull-prosesseihin. Kohdeorganisaatioina tutkimuksessa oli 7 viestinnän konsulttitoimistoa ja 7 erikokoista sanomalehteä. Viestintäyrityksistä haastateltiin toimitusjohtajia ja sanomalehdistä päätoimittajia. Haastateltavien johtamiskäytänteitä analysoitiin fenomenografisella tutkimusotteella luomalla johtamisprofiileista kuvauskategorioita. Lisäksi tutkittiin, onko viestintäyritysten johtamiskäytänteillä ja mediamuutoksella yhteys. Tutkimuksessa nousi esille, ettei viestintäyritysten johtaminen puhtaasti edusta enää teollisista organisaatioista periytyviä johtamismalleja vaan yleisesti ottaen vastuu oli jaettu tasaisesti organisaation työntekijöille; suoraa käskemistä ja valvontaa ei esiintynyt ja alaiset olivat autonomisia. Tulosten perusteella viestintäorganisaatiot muistuttivat vapaan tiedonjaon organisaatioita (eng. shared-access system; ks. Ehin 2008) ja useiden johtajien profiili oli valmentajamainen. Tämä edellyttää johtajilta vastuunjakoa ja neuvonantoa tarvittaessa. Johtajat myös puhuivat mieluummin yhteistyöstä kuin johtamisesta, sillä ilmapiiri viestintäyrityksissä oli kollegiaalinen. Johtajilla viestintäyrityksissä korostuu taloudellinen vastuu ja päätoimittajilla vastuu lehden sisällöstä. Mediamuutos taas on vaikuttanut viestintäyritysten toimintaan, mutta vaikutus johtamiseen on vähäisempi

Probabilistinen mallinnustyökalu systeemibiologista ohjelmistoalustaa varten

Viime vuosina systeemibiologian nousu keskeiseksi paradigmaksi on muuttanut biologista tutkimusta. Biologit ja bioinformaatikot turvautuvat yhä useammin laskennallisiin menetelmiin pystyäkseen tulkitsemaan havaintoja ja kokeellista aineistoa. Ohjelmistojen tarjoama tuki on olennaisessa roolissa tutkimustyössä. Niin sanottuja workflow- ohjelmistoja voidaan hyödyntää laskennallisen biologian data-analyysivaiheiden suunnitteluun, dokumentointiin ja suoritukseen. Sekä kvalitatiivisia että kvantitatiivisia malleja tarvitaan biologisten järjestelmien toiminnan ymmärtämiseen. Biologian monimutkainen maailma on erityisen haastava mallinnettava, sillä siihen liittyy monia epävarmuuden lähteitä. Probabilistiset mallit ovat osoittautuneet erittäin sopiviksi tämäntyyppisten järjestelmien mallintamiseen. Bayes- verkot ovat nousseet erittäin suosituksi probabilististen graafimallien perheeksi laskennallisen biologisen tutkimuksen apuvälineinä. Tässä diplomityössä suunnitellaan probablistinen mallinnuskirjasto Medical Oy:n workflow-ohjelmistojärjestelmälle. Työssä toteutetaan kirjastoon eräs keskeinen osa, ohjelmistotyökalu, joka suorittaa päättelyä käyttäjän määrittelemällä Bayes-verkolla. Lisäksi työssä suunnitellaan Bayes-verkoille tietomalli ja tiedostoformaatti, joita mallinnuskirjasto ja toteutettu työkalu hyödyntävät