Practical nursing students' discursive practices on smoking in Finland

Peer reviewe

Usability issues in the operating room - Towards contextual design guidelines for medical device design

Most usability assessments of medical devices describe the problems of individual devices in detail, but few account for the real context of use or provide designers with actionable guidelines for improvement. To fill this gap, this paper reports the results of a case study on the usability of operating room technologies and documents the creation of contextual design guidelines for operating room device design. We spent 64 h in a gynecological operating unit conducting interviews with staff and observing device use during surgery. With qualitative analysis methods and based on existing usability principles, we created 21 design guidelines for the operating room context. The new guidelines highlight interactions between multiple devices, staff members, as well as other contextual factors. While the guidelines require further validation, they can potentially support the creation of more safe, ergonomic, and intuitive medical devices.Peer reviewe

Circadian preferences and sleep in 15- to 20-year old Finnish students

Purpose Despite progress in research concerning adolescent and young adult sleep and circadian preferences, several aspects have remained unexamined. This study explored gender and diurnal rhythms in relation to several sleep-related factors: sleep duration, bedtime, wake-up time, tiredness, sleepiness, and optimal subjective sleep duration Methods Circadian preferences and sleep were investigated in 555 (Females N=247) Finnish students aged 15–20. The self-report measures included a shortened version of the Horne-Östberg Morningness-Eveningness Scale, the Epworth Sleepiness Scale as well as items probing feelings of tiredness, optimal subjective sleep durations, and bedtime and wake-up time on the most recent day and a typical weekend. Data were collected from Tuesday to Thursday during an ordinary school week. Results and conclusion The most frequent chronotype was the intermediate type (54%), and compared to previous studies, the prevalence of evening-oriented individuals was high (37%), whereas only 9% of the participants were classified as morning oriented. No gender-specific or chronotype-specific differences in sleep durations were observed, but girls/women and evening-orientated individuals reported suffering more from sleepiness, compared to boys/men and more morning-typed participants, respectively. About 20% of the total sample indicated that their subjective need for sleep was not satisfied during the weekdays nor the weekend, indicating chronic sleep deprivation. Among girls/women and evening-oriented individuals, the subjective sleep need was greater for weekday nights.Peer reviewe

Persistent Seroconversion after Accidental Eye Exposure to Calcifying Nanoparticles

Biosafety of nanomaterials has attracted much attention recently. We report here a case where accidental human eye exposure to biogenic nanosized calcium phosphate in the form of calcifying nanoparticles (CNP) raised a strong IgG immune response against proteins carried by CNP. The antibody titer has persisted over ten years at the high level. The IgG was detected by ELISA using CNPs propagated in media containing bovine and human serum as antigen. The exposure incident occurred to a woman scientist (WS) at a research laboratory in Finland at 1993. CNP, also termed "nanobacteria", is a unique self-replicating agent that has not been fully characterized and no data on biohazards were available at that time. Before the accident, her serum samples were negative for both CNP antigen and anti-CNP antibody using specific ELISA tests (Nanobac Oy, Kuopio, Finland). The accident occurred while WS was harvesting CNP cultures. Due to a high pressure in pipetting, CNP pellet splashed into her right eye. Both eyes were immediately washed with water and saline. The following days there was irritation and redness in the right eye. These symptoms disappeared within two weeks without any treatment. Three months after the accident, blood and urine samples of WS were tested for CNP cultures (2), CNP-specific ELISA tests, and blood cell counts. Blood cell counts were normal, CNP antigen and culture tests were negative. A high IgG anti-CNP antibody titer was detected (see Figure). The antibodies of this person have been used thereafter as positive control and standard in ELISA manufacturing (Nano-Sero IgG ELISA, Nanobac Oy, Kuopio, Finland)

Association between Randall's Plaque and Calcifying Nanoparticles

Randall's plaques, first described by Alexander Randall in the 1930s, are small subepithelial calcifications in the renal papillae (RP) that also extend deeply into the renal medulla. Despite the strong correlation between the presence of these plaques and the formation of renal stones, the precise origin and pathogenesis of Randall s plaque formation remain elusive. The discovery of calcifying nanoparticles (CNP) and their detection in many calcifying processes of human tissues has raised hypotheses about their possible involvement in renal stone formation. We collected RP and blood samples from 17 human patients who had undergone laparoscopic nephrectomy due to neoplasia. Homogenized RP tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis were performed on fixed RP samples. Immunohistochemical staining (IHS) was applied on the tissue samples using CNP-specific monoclonal antibody (mAb). Randall s plaques were visible on gross inspection in 11 out of 17 collected samples. Cultures of all serum samples and 13 tissue homogenates had CNP growth within 4 weeks. SEM revealed spherical apatite formations in 14 samples, with calcium and phosphate peaks detected by EDS analysis. IHS was positive in 9 out of 17 samples. A strong link was found between the presence of Randall s plaques and the detection of CNP, also referred to as nanobacteria. These results suggest new insights into the etiology of Randall's plaque formation, and will help us understand the pathogenesis of stone formation. Further studies on this topic may lead us to new approaches on early diagnosis and novel medical therapies of kidney stone formation

Riskitekijät hoitotyössä : Riskinarviointi Mäntyharjun terveyskeskuksen hoitohenkilöstölle

Työturvallisuuslaki (738/2002) velvoittaa työnantajan huolehtimaan työntekijöiden työturvallisuudesta ja työterveydestä. Käytännössä työnantajan vastuulla on löytää työhön liittyvät haitta- ja vaaratekijät, sekä pyrkiä ehkäisemään niitä. Työturvallisuutta ja työterveyttä uhkaavien tekijöiden löytämiseksi työpaikalla on tehtävä riskinarviointi. Opinnäytetyön tarkoituksena oli suorittaa Mäntyharjun terveyskeskuksessa riskinarviointi, eli selvitys työntekijöiden työssään kokemista riskitekijöistä. Opinnäytetyön tavoitteena oli parantaa kyselyn tulosten avulla työturvallisuutta Mäntyharjun terveyskeskuksessa. Kysely toteutettiin määrällisenä tutkimuksena, johon sisältyi myös laadullinen osuus avoimien kysymysten kautta. Kyselylomakkeena käytettiin Kaste-hankeen (2009–2011) sisällä VeTe-hankkeessa terveydenhuollon käyttöön kehitettyä Riskinarvioinnin apulomaketta. Lomakkeessa riskitekijät on jaoteltu viiteen eri luokkaan. Niitä ovat kemialliset ja biologiset riskitekijät, tapaturman vaara, psykososiaalinen kuormittuminen, ergonomia sekä fysikaaliset vaaratekijät. Kemiallisten ja biologisten riskitekijöiden osalta työturvallisuus oli suurelta osin kunnossa, mutta es imerkiksi neulojen hylsytyskiellon noudattamisessa löytyi parantamisen varaa . Tapaturman vaaraa aiheutti liukastumisen vaara ja potilaan aggressiivinen käytös hoitajaa kohtaan. Psykososiaalista kuormittumista lisäsi kouluttautumisen ja suunnittelun vähäinen osuus työssä, sekä kokemus sujuvan perehdytyksen puuttumisesta. Sen sijaan työilmapiiri koettiin hyväksi. Ergonomian osa-alueen riskitekijöistä vuorotyön terveyshaitat tunnettiin, mutta vuorotyön ergonomisen suunnittelun ei koettu olevan yhtä sujuvaa. Ongelmatekijöinä fysikaalisten vaaratekijöiden osa-alueelta nostettiin esille muun muassa riittämätön ilmanvaihto sekä lämpötilan epätasainen jakautuminen. Positiivisena asiana koettiin riittävä valaistus sekä työn matala melutaso. Riskinarviointi on helposti toistettavissa. Jatkossa kysely olisi järkevää toteuttaa sähköisenä kyselynä aineiston analyysivaiheen yksinkertaistamiseksi ja työmäärän vähentämiseksi.The law regarding work safety (738/2002) defines the employers ’ responsibility to take care of employees work safety and work health. That means that it is the employers ’ assignment to find out the safety hazards in work, and try to prevent them. For finding the issues that threat work safety and health a risk evaluation needs to be done in all workplaces. The purpose for our bachelor thesis was to accomplish a risk evaluation in Mäntyharju health care center, which means a research about the safety hazards the employees experience in work. The goal for the bachelor thesis was to enhance the work safety in Mäntyharju health care center, based on the results of the survey. The survey was done as a quantitative research, which included also a qualitative part by the open questions. The form we used in the survey was produced by a scheme called Kaste (2009-2011), and the form was meant for health care use. In the form the safety hazards are categorized in to five categories. Those are chemical and biological risks, the risk of a casualty, psychosocial load, ergonomics and physical risks. In the area of chemical and biological risks the basics were in good terms, but for example the handling of used needles was something that needs to be improved. The risk of a casualty was caused by the danger or slipping and by the aggressive behaviour by a patient towards the nurse. The lack of education and planing the work were experienced as things that add the psychosocial load in work, and also the lack of training the new employees in the workplace. On the other hand the working environment was experienced good. In the area of ergonomics the dangers regarding shift work are known, but the ergonomic planing of shifts was experienced less smooth. The problems that were experienced in the area of physical hazards were the unsufficient ventilation and the unsteady dividing of temperature in the workplace. The positive things that were brought up in the survey were for example the sufficient lighting and the low level of noise at work. The risk evaluation is easy to remake. It would be reasonable to use a computer-assisted questionnaire to decrease the amount of work with the analysis of material

KARVAKAMU-TOIMINTAVIHKO VARHAISKASVATUKSESSA : Koiramaista toimintaa erityistä tukea tarvitseville lapsille

Opinnäytetyömme tarkoituksena oli kehittää koirien käyttöä osana varhaiskasvatusta. Opinnäytetyö on luonteeltaan toiminnallinen ja sen konkreettisena tuotoksena teimme Karvakamutoimintavihkon. Toimintavihkon tarkoituksena on tutustuttaa lapsia koiriin sekä nähdä koirien käytön mahdollisuudet varhaiskasvatuksessa. Tavoitteena oli myös tuottaa lapsille kokemuksia koirista ja niiden kanssa toimimisesta erilaisten harjoitusten avulla. Lisäksi pyrimme madaltamaan kasvattajien kynnystä käyttää koiria osana varhaiskasvatusta. Tuotos suunniteltiin ja testattiin erityistä tukea tarvitsevien lasten pienryhmälle. Toimintavihko toteutettiin yhteistyössä toimeksiantajien, Joensuun kaupungin päiväkodin sekä Pohjois-Karjalan Kaverikoirien, kanssa. Karvakamu-toimintavihko sisältää viisi harjoituskokonaisuutta, jotka on suunnattu 4–6-vuotiaille lapsille. Jokaisella harjoituskokonaisuudella on oma teema ja tavoitteet. Harjoitusten yhteisenä tavoitteena on lapsen kasvun ja kehityksen kokonaisvaltainen tukeminen. Opinnäytetyön keskeisinä menetelminä olivat kokeileva toiminta sekä havainnointi. Toiminnan havainnot liitettiin osaksi laajempaa kerättyä tietoperustaa. Kerätty tietoperusta suuntasi havainnoinnin keskittymään erityisesti koirien käytön merkityksiin lapsen sosiaalisen ja emotionaalisen kehityksen näkökulmasta. Jatkossa Karvakamu-toimintavihkoa voisi soveltaa eri asiakasryhmiin sekä laajentaa muihin eläimiin.The objective of this thesis was to develop practices for using dogs as a part of early childhood education. The thesis is functional, and as an output, we submitted an exercise leaflet called ”Karvakamu”. The purpose of the leaflet is to familiarize children to dogs and to explore the opportunities for the use of dogs in education. Another target was to create experiences for children by cooperating with dogs in various exercises. We aim to ease the use of dogs as a part of early childhood education. The leaflet was planned for a small group of children with special needs and was tested in practice with the group. The functional leaflet was elaborated in cooperation with the assignment of the Municipal Daycare Centre of the city of Joensuu and with the North Karelian Friend-dog Association. The leaflet ”Karvakamu” contains five units of exercises for children within age of 4–6 years. Each unit of exercises has a specific theme and objectives. The general purpose of these exercises is to support the child’s overall growth and development. The primary methods in preparing the thesis were experimental practice and observation. The findings of the observation were combined with the larger knowledge base of fact-findings. The discovered fact-findings focused our attention on the significance of using dogs especially while viewing the aspects of social and emotional development of a child. In the future, the leaflet ”Karvakamu” could be implemented with other client groups and expanded to be utilized with some other animals