Opettajien kertomuksia keinottomuudesta puuttua kiusaamiseen

Tiivistelmä. Tämän tutkimuksen tavoitteena on selvittää, millaisissa tilanteissa yläkoulun opettajat kokevat keinottomuutta puuttua kiusaamiseen työssään. Tarkastelemme tähän liittyviä tekijöitä niin opettajan työssä kuin koulun rakenteellisissa tasoissa. Tutkimuksemme on tehty osana SAFE-hanketta, jonka tavoitteena on laajentaa näkemystä kiusaamisen ilmiöstä ja miten oppilaiden vertaissuhteissa ilmeneviä haasteita voidaan ymmärtää aiempaa paremmin. Tutkimuksemme on laadullinen, narratiivinen tutkimus, jonka aineistona on käytetty SAFE-hankkeen valmista haastatteluaineistoa. Haastattelut on toteutettu yhden kysymyksen haastatteluina, joista valitsimme aineistoksi kolme yläkoulun opettajan haastattelua. Opettajat kertovat keinottomuuden kokemuksistaan kertomusten kautta, jolloin heidän äänensä tulevat hyvin esiin. Analysoinnissa on hyödynnetty aineistolähtöistä sisällönanalyysia. Tutkimustulosten mukaan opettajat kokevat keinottomuutta erityisesti eriarvoisuuden ja ennakkoluulojen kohtaamisesta, koulun rakenteista johtuvista paineista, ryhmänormien haasteista, nettikiusaamisesta, rasismin haasteista, sukupuolisuuteen ja puheen sensurointiin liittyvistä haasteista, työn paineista ja vaatimuksista sekä kollegan epäeettisestä toiminnasta. Tutkimuksemme osoittaa, että opettajat kohtaavat työssään rajoja, jotka vaikuttavat heidän keinoihinsa puuttua haastaviin tilanteisiin. Opettajat tarvitsevat kouluun avoimempaa ilmapiiriä, joka vähentää myös ennakkoluuloja ja haastavien tilanteiden muodostumista oppilaiden vertaissuhteissa. On tärkeää, että opettajat kertovat, että heidän keinonsa eivät riitä kiusaamiseen puuttumiseen, jolloin se antaa paremman mahdollisuuden tukea heitä.Teacher’s stories of their inability to intervene bullying. Abstract. The aim of this study is to find out in which situations secondary school teachers feel powerless to intervene in bullying. We look at factors related to this, both in the work of the teacher and at the structural levels of the school. Our research is part of the SAFE project, which aims to broaden our understanding of the phenomenon of bullying and how to better understand the challenges that students face in peer relationships. Our research is a qualitative narrative study, using interview data from the SAFE project. The interviews were conducted as one-question interviews, from which we selected three interviews with secondary school teachers as data. Teachers share their experiences of irrationality through narratives, allowing their voices to come through well. Data-driven content analysis has been used in the analysis. The findings suggest that teachers experience that there are not enough means particularly in relation to facing inequality and prejudice, pressures from school structures, challenges of group norms, cyberbullying, challenges of racism, challenges related to gender and speech censorship, work pressures and demands, and unethical behaviour by colleagues. Our research shows that teachers face boundaries in their work that affect their ability to address challenging situations. Teachers need a more open school climate, which will also reduce prejudice and challenging situations in students’ peer relationships. It is important for teachers to communicate that the means are not enough to tackle bullying, thus giving them a better chance to provide support

Geriatric pharmacotherapy : optimisation through integrated approach in the hospital setting

Since older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate prescribing in these patients in order to prevent misuse, overuse and underuse of drugs. Different tools and strategies have been developed to reduce inappropriate prescribing; the available measures can be divided into medication assessment tools, and specific interventions to reduce inappropriate prescribing. Implicit criteria of inappropriate prescribing focus on appropriate dosing, search for drug-drug interactions, and increase adherence. Explicit criteria are consensus-based standards focusing on drugs and diseases and include lists of drugs to avoid in general or lists combining drugs with clinical data. These criteria take into consideration differences between patients, and stand for a medication review, by using a systematic approach. Different types of interventions exist in order to reduce inappropriate prescribing in older patients, such as: educational interventions, computerized decision support systems, pharmacist-based interventions, and geriatric assessment. The effects of these interventions have been studied, sometimes in a multifaceted approach combining different techniques, and all types seem to have positive effects on appropriateness of prescribing. Interdisciplinary teamwork within the integrative pharmaceutical care is important for improving of outcomes and safety of drug therapy. The pharmaceutical care process consists offour steps, which are cyclic for an individual patient. These steps are pharmaceutical anamnesis, medication review, design and follow-up of a pharmaceutical care plan. A standardized approach is necessary for the adequate detection and evaluation of drug-related problems. Furthermore, it is clear that drug therapy should be reviewed in-depth, by having full access to medical records, laboratory values and nursing notes. Although clinical pharmacists perform the pharmaceutical care process to manage the patient’s drug therapy in every day clinical practice, the physician takes the ultimate responsibility for the care of the patient in close collaboration with nurses

Clinical practice selectively follows acute appendicitis guidelines

Peer reviewe

Tropical Peatland Hydrology Simulated With a Global Land Surface Model

Tropical peatlands are among the most carbon-dense ecosystems on Earth, and their water storage dynamics strongly control these carbon stocks. The hydrological functioning of tropical peatlands differs from that of northern peatlands, which has not yet been accounted for in global land surface models (LSMs). Here, we integrated tropical peat-specific hydrology modules into a global LSM for the first time, by utilizing the peatland-specific model structure adaptation (PEATCLSM) of the NASA Catchment Land Surface Model (CLSM). We developed literature-based parameter sets for natural (PEATCLSM(Trop,Nat)) and drained (PEATCLSM(Trop,Drain)) tropical peatlands. Simulations with PEATCLSM(Trop,Nat) were compared against those with the default CLSM version and the northern version of PEATCLSM (PEATCLSM(North,Nat)) with tropical vegetation input. All simulations were forced with global meteorological reanalysis input data for the major tropical peatland regions in Central and South America, the Congo Basin, and Southeast Asia. The evaluation against a unique and extensive data set of in situ water level and eddy covariance-derived evapotranspiration showed an overall improvement in bias and correlation compared to the default CLSM version. Over Southeast Asia, an additional simulation with PEATCLSM(Trop,Drain) was run to address the large fraction of drained tropical peatlands in this region. PEATCLSM(Trop,Drain) outperformed CLSM, PEATCLSM(North,Nat), and PEATCLSM(Trop,Nat) over drained sites. Despite the overall improvements of PEATCLSM(Trop,Nat) over CLSM, there are strong differences in performance between the three study regions. We attribute these performance differences to regional differences in accuracy of meteorological forcing data, and differences in peatland hydrologic response that are not yet captured by our model.Peer reviewe

Pharmacotherapy-Based Problems in the Management of Diabetes Mellitus: Needs Much More to be Done!

A total of 856 diabetic patients were evaluated for pharmacotherapy-based problems like for possible drug interactions, adverse drug reactions, and other mismatches, if any. Poor correlation between the advised insulin therapy and patients’ fasting blood glucose levels (12%, n=103) was observed. To most of the patients (41.66%, n= 357), insulin therapy was advised in combination with glucocorticoides, thiazides diuretics, and propranolol. Prescribing beta blocker (propranolol) with insulin is contraindicated. The higher incidence of diabetic foot patients was in the mean age of 57±3.4 years that was controlled with combination therapy of insulin and oral antidiabetics (63.0%, n=516). 11.1% of the treated patients could not take the prescribed therapy due to poor acceptance of insulin therapy due to its syringe needle prick. 41.66% risks of potential drug interactions, 7.93% adverse drug reactions, and 6.6% mismatches were recorded, as per the international approved algorithm, for managing a diabetes mellitus that reflects poor health care system. All these events necessitate for coordinating with other health professionals to make the therapy safer in the better interest of the patients. It is concluded that in practice prescribing pattern carries more risks for patients. It is imperative to improve the practice of pharmacotherapeutics rather than to practice in routine