Tulohaastattelulomake potilaan hoidon suunnitteluun Pohjois-Satakunnan peruspalvelu-liikelaitoskuntayhtymä Kankaanpään vuodeosasto kahdelle

Tämän projektiluontoisen opinnäytetyön tarkoituksena oli kehittää potilaan hoitoprosessia kokonaisuudessaan PoSa Kankaanpään sairaalan vuodeosasto kahdella. Tulohaastattelu toimii hoitotyön prosessin perustekijänä ja sillä on suuri merkitys hoitoprosessin sisältöön. Aluksi keskityttiin potilaan tulotilanteeseen, jonka pohjalta laadittiin lomake potilaan hoidon suunnitteluun. Henkilöstö kokeili ensimmäistä versiota lomakkeesta. Lomakkeen arviointi tapahtui kyselylomakkeiden avulla. Kyselyyn vastasi yhdeksän henkilöstöön kuuluvaa sairaanhoitajaa. Kyselylomakkeiden vastausten perusteella ulkoasu ja luettavuus pysyivät alkuperäisen tulohaastattelulomakkeen muodossa. Lomakkeesta poistettiin potilaan lääkelista ja pituus mitatuista arvoista. Yhteisen potilastietorekisterin käyttöön liittyvä kysymys sekä e-resepti kysymysten asettelua tarkennettiin. Lomakkeeseen lisättiin yhteyshenkilö, lähettävän laitoksen yhteystiedot, kotihoidon asiakasalueisiin puuttuvat kunnat Pomarkku ja Lavia, lääkitys kohtaan luontaistuotteiden käyttö, aistitoiminnot ja kommunikaatio sekä erillinen tarkistuslista haastattelijalle, johon kuuluvat potilasrannekkeen vieminen, ruokakortin tekeminen, informaation antaminen vierailuajoista, lääkelistan ajantasaisuuden tarkistaminen ja puhelimen sekä hälytyskellon käyttöopastuksen antaminen. Potilaan ravitsemus tietoihin lisättiin haastattelijan arvioitavaksi onko potilaalle tarvetta tehdä ravitsemuskartoitus. Palautteen myötä lomake muutettiin mahdollisimman hyvän lopputuloksen aikaansaamiseksi. Yhteistyötahon kanssa työskentely oli vaivatonta ja johdonmukaista. Lomakkeen tuottaminen osastolle oli ajankohtaista, koska osastolla ei ollut aikaisempaa tulohaastattelulomaketta. Tulevaisuudessa lomakkeen voisi tehdä sähköiseen muotoon ja monipuolistaa sen sisältöä. Lomakkeen toimivuutta voisi selvittää kysymällä henkilöstön ja potilaiden mielipiteitä lomakkeen sisällöstä.ENTRANCE INTERVIEW FORM FOR PLANNING PATIEN’S CARE IN POHJOIS-SATAKUNTA BASIC SERVICE PUBLIC UTILITY FEDERATION MUNICIPALITIES KANKAANPÄÄ HOSPITAL INPATIENT WARD TWO Kauramäki, Päivi Satakunnan ammattikorkeakoulu, Satakunta University of Applied Sciences Degree Programme in Nursing November 2013 This project natured thesis was to develop a patient nursing process as a whole PoSa Kankaanpää hospital inpatient ward two. Entrance interview form is a basic component of the nursing process and it is important for the process of content management. In the beginning focused on the patient's income situation, which form the basis for the patient's care planning. Officials tested the first version of the form. Form to the investigating assessment was by questionnaire. Questionnaire was answered by nine members of staff nurses. Questionnaires and the responses to the appearance and readability of the original remained entrance interview form. The patient's medication-form and the length of the measured values were removed from the form. A common patient data registry related to the use, as well as e-prescription questions arrangement was clarified. Form was added to the contact person, sending Institute contact information, home health care client areas are missing municipalities Pomarkku and Lavia, medication point to the use of natural products, sensory functions and communication and A separate checklist for the interviewer including exporting patient wristband, making food card, giving information of visiting hours, checking the timeliness of medication list, giving instruction phone and alarm bell use. The patient's nutritional information was added to the interviewer assessed whether patients need to make nutrition survey. The feedback form was changed as a good end result to obtain. Working with the cooperative partner was easy and consistent. Production of the form to ward was timely, because the ward did not have an earlier entrance interview form. In the future, the form could be made in electronic form and to diversify its content. Form functionality to find out by asking the staff and the patients' opinions the contents of form

Oliko EMU virhe? Euroalue optimaalisen valuutta-alueen teorian näkökulmasta

EMUn eli Euroopan rahaliiton perustaminen aiheutti keskustelua rahaliiton toimivuudesta ja järkevyydestä. Erityisesti yhdysvaltalaiset taloustieteilijät olivat skeptisiä euron suhteen. Euroaluetta verrattiin paljon Yhdysvaltoihin, jossa työvoimanliikkuvuus on korkeampaa ja liittovaltioon budjetti tasaa suhdanne-eroja osavaltioiden välillä. Keskustelu yhteisvaluutan järkevyydestä heräsi uudelleen eurokriisin myötä. Eräät taloustieteilijät nimittivät euroa talouspoliittiseksi virheeksi. Eurokriisin aikana alettiin myös puhua euroalueen mahdollisesta hajoamisesta. Tässä tutkielmassa tarkastellaan euroaluetta optimaalisen valuutta-alueen teorian näkökulmasta. Tarkoituksena on selvittää, oliko EMU virhe taloustieteen näkökulmasta. Tämä tutkielma on muodoltaan kirjallisuuskatsaus. Tutkielmassa tutustutaan optimaalisen valuutta-alueen teoriaan ja sen keskeisiin kriteereihin. Optimaalisen valuutta-alueen teoria on pysynyt melko muuttumattomana sen kehittymisestä asti. Lisäksi tutkielmassa tutustutaan empiirisiin tutkimuksiin siitä, kuinka hyvin euroalue täyttää näitä kriteerejä. Keskeisessä osassa on myös näkökulma voiko Eurooppa yhdentymisen myötä lähentyä entistä enemmän optimaalista valuutta-aluetta

Auditory affective processing requires awareness

Recent work has challenged the previously widely accepted belief that affective processing does not require awareness and can be carried out with more limited resources than semantic processing. This debate has focused exclusively on visual perception, even though evidence from both human and animal studies suggests that existence for nonconscious affective processing would be physiologically more feasible in the auditory system. Here we contrast affective and semantic processing of nonverbal emotional vocalizations under different levels of awareness in three experiments, using explicit (two-alternative forced choice masked affective and semantic categorization tasks, Experiments 1 and 2) and implicit (masked affective and semantic priming, Experiment 3) measures. Identical stimuli and design were used in the semantic and affective tasks. Awareness was manipulated by altering stimulus-mask signal-to-noise ratio during continuous auditory masking. Stimulus awareness was measured on each trial using a four-point perceptual awareness scale. In explicit tasks, neither affective nor semantic categorization could be performed in the complete absence of awareness, while both tasks could be performed above chance level when stimuli were consciously perceived. Semantic categorization was faster than affective evaluation. When the stimuli were partially perceived, semantic categorization accuracy exceeded affective evaluation accuracy. In implicit tasks neither affective nor semantic priming occurred in the complete absence of awareness, whereas both affective and semantic priming emerged when participants were aware of the primes. We conclude that auditory semantic processing is faster than affective processing, and that both affective and semantic auditory processing are dependent on awareness

Haptic recognition memory and lateralisation for verbal and nonverbal shapes

Laterality effects generally refer to an advantage for verbal processing in the left hemisphere and for non-verbal processing in the right hemisphere, and are often demonstrated in memory tasks in vision and audition. In contrast, their role in haptic memory is less understood. In this study, we examined haptic recognition memory and laterality for letters and nonsense shapes. We used both upper and lower case letters, with the latter designed as more complex in shape. Participants performed a recognition memory task with the left and right hand separately. Recognition memory performance (capacity and bias-free d') was higher and response times were faster for upper case letters than for lower case letters and nonsense shapes. The right hand performed best for upper case letters when it performed the task after the left hand. This right hand/left hemisphere advantage appeared for upper case letters, but not lower case letters, which also had a lower memory capacity, probably due to their more complex spatial shape. These findings suggest that verbal laterality effects in haptic memory are not very prominent, which may be due to the haptic verbal stimuli being processed mainly as spatial objects without reaching robust verbal coding into memory.Peer reviewe

Self-Conscious Affect Is Modulated by Rapid Eye Movement Sleep but Not by Targeted Memory Reactivation–A Pilot Study

The neurophysiological properties of rapid eye movement sleep (REMS) are believed to tune down stressor-related emotional responses. While prior experimental findings are controversial, evidence suggests that affective habituation is hindered if REMS is fragmented. To elucidate the topic, we evoked self-conscious negative affect in the participants (N = 32) by exposing them to their own out-of-tune singing in the evening. Affective response to the stressor was measured with skin conductance response and subjectively reported embarrassment. To address possible inter-individual variance toward the stressor, we measured the shame-proneness of participants with an established questionnaire. The stressor was paired with a sound cue to pilot a targeted memory reactivation (TMR) protocol during the subsequent night's sleep. The sample was divided into three conditions: control (no TMR), TMR during slow-wave sleep, and TMR during REMS. We found that pre- to post-sleep change in affective response was not influenced by TMR. However, REMS percentage was associated negatively with overnight skin conductance response habituation, especially in those individuals whose REMS was fragmented. Moreover, shame-proneness interacted with REM fragmentation such that the higher the shame-proneness, the more the affective habituation was dependent on non-fragmented REMS. In summary, the potential of REMS in affective processing may depend on the quality of REMS as well as on individual vulnerability toward the stressor type.Peer reviewe

Endogenous circadian temperature rhythms relate to adolescents' daytime physical activity

Circadian rhythms relate to multiple aspects of health and wellbeing, including physical activity patterns. Susceptible circadian regulation predisposes to circadian misalignment, poor sleep, sleep deprivation, increased sleepiness, and thereby sedentary behavior. Adolescents' circadian regulation is particularly vulnerable, and may lead to sedentary behavior. To investigate which factors associate strongest between physical activity (PA) and circadian behavior, we conducted multimodal circadian rhythm analyses. We investigate how individual characteristics of habitual circadian patterns associate with objectively measured PA. We studied 312 adolescents [70% females) (56% with delayed sleep phase (DSP)], mean age 16.9 years. Circadian period length, temperature mesor (estimated 24 h midline) and amplitude (difference between mesor and peak) were measured using distally attached thermologgers (ibutton 1922L, 3-day-measurement). We additionally utilized algorithm-formed clusters of circadian rhythmicity. Sleep duration, timing, DSP, and PA were measured using actigraphs (GeneActiv Original, 10-day-measurement). We found that continuous circadian period length was not associated with PA, but lower mesor and higher amplitude were consistently associated with higher levels of PA as indicated by mean Metabolic Equivalent (METmean) and moderate-to-vigorous PA (MVPA), even when controlling for sleep duration. Separate circadian clusters formed by an algorithm also reflected distinct patterns of PA accordingly. Late sleepers and those with DSP were less likely to engage in MVPA compared to non-DSP and had more sedentary behavior. Adolescents who engage in higher levels or high-intensity PA have better circadian regulation, as measured by different objective methods including distal temperature measurements as well as actigraphy-measured sleep-wake behavior.Peer reviewe

Inter-Subject Synchronization of Prefrontal Cortex Hemodynamic Activity During Natural Viewing

Hemodynamic activity in occipital, temporal, and parietal cortical areas were recently shown to correlate across subjects during viewing of a 30-minute movie clip. However, most of the frontal cortex lacked between-subject correlations. Here we presented 12 healthy naïve volunteers with the first 72 minutes of a movie (“Crash”, 2005, Lions Gate Films) outside of the fMRI scanner to involve the subjects in the plot of the movie, followed by presentation of the last 36 minutes during fMRI scanning. We observed significant between-subjects correlation of fMRI activity in especially right hemisphere frontal cortical areas, in addition to the correlation of activity in temporal, occipital, and parietal areas. It is possible that this resulted from the subjects following the plot of the movie and being emotionally engaged in the movie during fMRI scanning. We further show that probabilistic independent component analysis (ICA) reveals meaningful activations in individual subjects during natural viewing

Imaging Real-Time Tactile Interaction With Two-Person Dual-Coil fMRI

Studies of brain mechanisms supporting social interaction are demanding because real interaction only occurs when persons are in contact. Instead, most brain imaging studies scan subjects individually. Here we present a proof-of-concept demonstration of two-person blood oxygenation dependent (BOLD) imaging of brain activity from two individuals interacting inside the bore of a single MRI scanner. We developed a custom 16-channel (8 + 8 channels) two-helmet coil with two separate receiver-coil pairs providing whole-brain coverage, while bringing participants into a shared physical space and realistic face-to-face contact. Ten subject pairs were scanned with the setup. During the experiment, subjects took turns in tapping each other's lip versus observing and feeling the taps timed by auditory instructions. Networks of sensorimotor brain areas were engaged alternatingly in the subjects during executing motor actions as well as observing and feeling them; these responses were clearly distinguishable from the auditory responses occurring similarly in both participants. Even though the signal-to-noise ratio of our coil system was compromised compared with standard 32-channel head coils, our results show that the two-person fMRI scanning is feasible for studying the brain basis of social interaction

Differential effects of ageing on the neural processing of speech and singing production

BackgroundUnderstanding healthy brain ageing has become vital as populations are ageing rapidly and age-related brain diseases are becoming more common. In normal brain ageing, speech processing undergoes functional reorganisation involving reductions of hemispheric asymmetry and overactivation in the prefrontal regions. However, little is known about how these changes generalise to other vocal production, such as singing, and how they are affected by associated cognitive demands.MethodsThe present cross-sectional fMRI study systematically maps the neural correlates of vocal production across adulthood (N=100, age 21–88 years) using a balanced 2x3 design where tasks varied in modality (speech: proverbs / singing: song phrases) and cognitive demand (repetition / completion from memory / improvisation).ResultsIn speech production, ageing was associated with decreased left pre- and postcentral activation across tasks and increased bilateral angular and right inferior temporal and fusiform activation in the improvisation task. In singing production, ageing was associated with increased activation in medial and bilateral prefrontal and parietal regions in the completion task, whereas other tasks showed no ageing effects. Direct comparisons between the modalities showed larger age-related activation changes in speech than singing across tasks, including a larger left-to-right shift in lateral prefrontal regions in the improvisation task.ConclusionThe present results suggest that the brains’ singing network undergoes differential functional reorganisation in normal ageing compared to the speech network, particularly during a task with high executive demand. These findings are relevant for understanding the effects of ageing on vocal production as well as how singing can support communication in healthy ageing and neurological rehabilitation