Posterit yläkouluikäisten tupakoimattomuuden tukemiseen

Opinnäytetyön aiheena oli yläkouluikäisten nuorten tupakoimattomuuden edistäminen. Aihe on aina ajankohtainen ja tärkeä, koska tupakoinnilla on vaikutuksia niin kansanterveyteen kuin kansantalouteen. Tavoitteena oli yläkouluikäisten tupakoinnin aloittamisen ennaltaehkäisy, tupakoinnin vähentäminen sekä tupakoinnin lopettaminen Länsi-Porin yläkouluissa. Opinnäytetyön tarkoituksena oli tehdä viisi posteria, joiden aiheiksi valikoitui tupakoinnin vaikutukset ulkonäköön, terveyteen, henkilökohtaiseen talouteen ja seksuaalisuuteen sekä tupakoinnin lopettamisen hyödyt. Aiheiksi valittiin nuoria kiinnostavia aiheita. Postereiden tarkoituksena oli havainnollistaa nuorille tupakoimattomuuden hyötyjä sekä lisätä heidän tietouttaan tupakoinnin haitoista. Postereista oli tarkoitus tehdä parin kuukauden välein vaihtuvia tietoiskuja, jolloin aihe pysyisi esillä koko kouluvuoden ajan. Opinnäytetyö tehtiin yhteistyössä Porin perusturvakeskuksen kanssa ja tarkoituksena oli, että yläkoulujen terveydenhoitajat olisivat vastuussa postereiden vaihtamisesta esimerkiksi koulun ilmoitustaululle. Vastaavat posterit voisi tulevaisuudessa tehdä alkoholin ja huumausaineiden haitoista. Tällöin tupakka-, alkoholi- ja huumausaineposterit voisivat vaihdella yläkouluissa vuosittain, jolloin jokainen luokka näkisi kaikki posterit. Jatkotutkimusaiheena voisi tutkia, kumpi terveyden edistämisen toteutustapa, posterit vai teemapäivä, aiheesta on nuorten mielestä mielenkiintoisempi ja/tai parempi.The theme of this thesis was to facilitate non-smoking among the youth in upper comprehensive school. This theme is always present and important because it has influence in public health and in national economy. The aim of this thesis was to prevent youth from start smoking, decrease and quit smoking among youth in upper comprehensive school in West of Pori. The purpose of this thesis was to make five posters. The subjects of the posters are smoking’s effects on looks, health, personal economy, sexuality and the advantages of quitting smoking. The topics that interest the youth were chosen to be the themes of the posters. The purpose of the posters was to demonstrate the benefits of not smoking and to increase their knowledge of the disadvantages of smoking. The posters were supposed to be on sight throughout the school year. That’s why the posters are made to be changed every second month. The thesis was made in co-operation with Pori’s Social and Health Services and the purpose was that the public health nurse of the upper comprehensive school would be in charge of changing the posters. The disadvantages of alcohol and drugs could be the themes for similar posters in the future. These three themes could change annually so that every school class can see every poster. It would also be good to survey the opinion of youth whether post-ers or theme day is the most effective

Effect of Tactile Imitation Guidance on Imitation and Emotional Availability. A Case Report of a Mother and Her Child With Congenital Deafblindness

Interaction between parents and children with congenital deafblindness (CDB) is easily hampered due to dual sensory loss. This case report examines imitation and emotional availability in interaction between a mother and her 3-year-old child with CDB first in unguided play and then in three play sessions with tactile imitation guidance. The video recorded play sessions were analyzed for frequency, length, and modality of imitation. Emotional Availability Scales were used to code the emotional quality of interaction. The results showed that before the guidance the mother imitated the child mainly vocally. After the guidance, the use of tactility in imitations increased. Imitation exchanges lasted longest in the last session. The emotional availability between the mother and the child was higher after the guidance. Further research is needed to confirm the positive outcomes of this case study.Peer reviewe

Näyttää MS:ltä, kuulostaa MS:ltä, tuntuu MS:ltä - muttei ole MS : MS-taudin erotusdiagnostiikka

Vertaisarvioitu. Teema : neuroimmunologia.MS-taudin diagnoosi pyritään varmentamaan jo ensioireiden jälkeen, jotta hoito päästään aloittamaan aikaisin. Diagnoosin on oltava täsmällinen, koska virhediagnoosi kuormittaa potilasta ja terveydenhuoltoa, ja sen perusteella aloitettu hoito voi huonontaa tilannetta. Keskeistä MS-taudin tunnistamisessa on luottaa anamneesin ja kliinisen tutkimuksen merkitykseen ja peilata näitä magneettikuvauksen ja aivo-selkäydinnestenäytteen tulehduksellisiin löydöksiin. Tyypillinen aaltomaisen MS-taudin oirejakso on toispuolinen näköhermotulehdus, aivorunko-oireisto tai osittainen selkäydinoireyhtymä. Oirejakso tulee tunneissa tai päivissä voimistuen, esiintyy jatkuvana ja lievittyy muutamissa viikoissa. Aaltomaisen MS-taudin erotusdiagnostiikassa tärkeitä ovat muut autoimmuunisairaudet, tulehdukset, syöpäsairaudet sekä geneettiset sairaudet. Suoraan etenevän MS-taudin tyyppioire puolestaan on etenevä kävelyvaikeus, jonka tutkimuksissa etsitään tulehduksellisen demyelinoivan sairauden piirteitä ja suljetaan pois erityisesti selkäydinsairauksia.Peer reviewe

COVID-19-infektion neurologiset ilmentymät

Vertaisarvioitu.COVID-19-infektion neurologisista ilmentymistä kertynyt tieto on tapausselostusten ja -sarjojen hallitsemaa. Yleisimmät neurologiset ilmentymät ovat olleet haju- ja makuaistin muutokset. Aivoverenkiertohäiriöt, enkefalopatia ja immuunivälitteiset keskushermoston sairaudet tulevat usein esiin COVID-19-infektion komplikaatioina, mutta toisaalta Guillain-Barrén oireyhtymän osalta yhteys tähän infektioon kumottiin laajemmassa epidemiologisessa kohorttitutkimuksessa. Myös enkefaliitin, epileptisten kohtauksien, ääreishermoston sairauksien ja lihassairauksien on kuvattu liittyvän tähän infektioon. Neuropatologisissa tutkimuksissa tärkeimmät löydökset ovat olleet hypoksis-iskeeminen vaurio, verenvuodot ja epäspesifiset tulehdusmuutokset. Vielä odotellaan varmuutta siitä, aiheutuvatko kudosmuutokset viruksen invaasiosta aivoihin vai onko kyse epäsuorista muutoksista. Mekanismi SARS-CoV2-viruksen pääsylle aivokudokseen näyttäisi olevan olemassa. COVID-19-infektion jälkeisestä pitkittyneestä neurologisesta oireilusta tarvitaan lisää tutkimustietoa.Peer reviewe

Early clinical features of new-onset refractory status epilepticus (NORSE) in adults

Peer reviewe

Effect of Tactile Imitation Guidance on Imitation and Emotional Availability. A Case Report of a Mother and Her Child With Congenital Deafblindness

Interaction between parents and children with congenital deafblindness (CDB) is easily hampered due to dual sensory loss. This case report examines imitation and emotional availability in interaction between a mother and her 3-year-old child with CDB first in unguided play and then in three play sessions with tactile imitation guidance. The video recorded play sessions were analyzed for frequency, length, and modality of imitation. Emotional Availability Scales were used to code the emotional quality of interaction. The results showed that before the guidance the mother imitated the child mainly vocally. After the guidance, the use of tactility in imitations increased. Imitation exchanges lasted longest in the last session. The emotional availability between the mother and the child was higher after the guidance. Further research is needed to confirm the positive outcomes of this case study.</p

Ectopic germinal centers in the thymus accurately predict prognosis of myasthenia gravis after thymectomy

The ability of thymic histopathology to predict the long-term impact of thymectomy in non-thymomatous myasthenia gravis (NTMG) is mainly uncharted. We applied digital pathology to quantitatively characterize differences of thymic histology between early-onset (EOMG) and late-onset MG (LOMG) and to investigate the role of thymic changes for thymectomy outcomes in MG. We analyzed 83 thymic H&E slides from thymectomized NTMG patients, of which 69 had EOMG and 14 LOMG, using digital pathology open-access software QuPath. We compared the results to the retrospectively assessed clinical outcome at two years after thymectomy and at the last follow-up visit where complete stable remission and minimal use of medication were primary outcomes. The automated annotation pipeline was an effective and reliable way to analyze thymic H&E samples compared to manual annotation with mean intraclass correlation of 0.80. The ratio of thymic tissue to stroma and fat was increased in EOMG compared to LOMG (p = 8.7e-07), whereas no difference was observed in the ratio of medulla to cortex between these subtypes. AChRAb seropositivity correlated with the number of ectopic germinal centers (eGC; p = 0.00067) but not with other histological areas. Patients with an increased number of eGCs had better post-thymectomy outcomes at two years after thymectomy (p = 0.0035) and at the last follow-up (p = 0.0267). ROC analysis showed that eGC area predicts thymectomy outcome in EOMG with an AUC of 0.79. Digital pathology can thus help in providing a predictive tool to the clinician, the eGC number, to guide the post-thymectomy treatment decisions in EOMG patients.Peer reviewe

Multiple sclerosis in Finland 2018-Data from the national register

Objectives Finland is a high-risk multiple sclerosis (MS) region, but a national MS register has not existed until 2014. In this paper, we present the Finnish MS register variables and data collected by 31 December 2018. Materials and Methods Numbers and data counts of MS patients in the register (ICD-10 code G35) are presented. The disease types and proportion of patients receiving disease-modifying treatments (DMTs) were analysed in five hospital districts with most complete data sets. MS prevalence in Finland was estimated using administrative hospital discharge data as an additional resource. Results There were a total of 8722 MS patients in the Finnish MS register by 31 December 2018 (71.5% females). Mean age at MS diagnosis was 38.7 years and peak prevalence was at age 50-54 years. Disease course was relapsing remitting (RRMS) in 66.7%, secondary progressive (SPMS) in 13.5%, and primary progressive (PPMS) in 7.9% of the 5365 MS patients in the selected districts with most complete data. A total of 66.0% of RRMS patients, 19.6% of SPMS patients and 9.9% of PPMS patients were receiving DMTs. By combining MS register data with databases of those hospitals that had not joined the register, the nationwide prevalence estimate was between 10 and 11 thousand patients (corresponding to crude prevalence 180-200/100 000). Conclusions The Finnish MS register is currently used in 15/21 Finnish hospital districts. By register integration into the electronic patient files, the coverage of the register has increased to approximately 80% of the estimated Finnish MS population.Peer reviewe

Bodily-tactile early intervention for a mother and her child with visual impairment and additional disabilities: a case study

Purpose Congenital visual impairment and additional disabilities (VIAD) may hamper the development of a child's communication skills and the quality of overall emotional availability between a child and his/her parents. This study investigated the effects of bodily-tactile intervention on a Finnish 26-year-old mother's use of the bodily-tactile modality, the gestural and vocal expressions of her one-year-old child with VIAD, and emotional availability between the dyad. Materials and methods Mixed methods were used in the video analysis. The child's and his mother's bodily-tactile and gestural expressions were analyzed using a coding procedure. Applied conversation analysis was used to further analyse the child's emerging gestural expressions in their sequential interactive context. Emotional availability scales were used to analyze the emotional quality of the interaction. Results The results showed that the mother increased her use of the bodily-tactile modality during the intervention, especially in play and tactile signing. The child imitated new signs and developed new gestural expressions based on his bodily-tactile experiences during the intervention sessions. His vocalizations did not change. Emotional availability remained stable. Conclusions The case study approach allowed the in-depth investigation of the components contributing to the emergence of gestural expressions in children with VIAD