Toivoton tapaus? - osa 1

Miten sinä hoitaisit.60-vuotiaalle miehelle varattiin lääkärin vastaanotto psykiatrian poliklinikalle vaativan lääkinnällisen kuntoutuksen jatkoarviota varten

A Two-Week Vacation in the Tropics and Psychological Well-Being—An Observational Follow-Up Study

Despite the vast annual number of international visitors to the tropics, surprisingly little data are available on the psychological well-being associated with the travels or with travelers’ diarrhoea (TD). We herein recruited participants of a vaccination trial, OEV-123, before their 12-day holiday in Benin, West Africa. We assessed the travelers’ psychological distress with a general health questionnaire (GHQ-12) and retrieved data on TD from the trial database. The GHQ-12 was completed before (wave 0), at return (wave 1), and 1-month after (wave 2) the trip. Of the 174 participants, 73% were women, with a mean age 40 years. Moreover, 24% reported psychological distress before traveling, 10% immediately after, and 16% 1-month after the trip (GHQ-12, 3 or more; 0–12 scoring). The findings showed that psychological well-being increased after the tropical holiday. The GHQ-12 middle wave sum score differed from the wave 0 (p < 0.001) and wave 2 (p = 0.008) sum scores, with travelers reporting highest levels of well-being on their return, with evidence of a lasting improvement. TD was experienced by 71%, and it had a negative impact on psychological well-being only if experienced after travel

A Two-Week Vacation in the Tropics and Psychological Well-Being—An Observational Follow-Up Study

Despite the vast annual number of international visitors to the tropics, surprisingly little data are available on the psychological well-being associated with the travels or with travelers’ diarrhoea (TD). We herein recruited participants of a vaccination trial, OEV-123, before their 12-day holiday in Benin, West Africa. We assessed the travelers’ psychological distress with a general health questionnaire (GHQ-12) and retrieved data on TD from the trial database. The GHQ-12 was completed before (wave 0), at return (wave 1), and 1-month after (wave 2) the trip. Of the 174 participants, 73% were women, with a mean age 40 years. Moreover, 24% reported psychological distress before traveling, 10% immediately after, and 16% 1-month after the trip (GHQ-12, 3 or more; 0–12 scoring). The findings showed that psychological well-being increased after the tropical holiday. The GHQ-12 middle wave sum score differed from the wave 0 (p < 0.001) and wave 2 (p = 0.008) sum scores, with travelers reporting highest levels of well-being on their return, with evidence of a lasting improvement. TD was experienced by 71%, and it had a negative impact on psychological well-being only if experienced after travel

Sosiaalinen osallisuus etsivän nuorisotyön asiakkaiden koulukokemuksissa

Tämän tutkimuksen tarkoituksena oli tutkia etsivän nuorisotyön asiakkaiden koulukokemuksia sosiaalisen osallisuuden näkökulmasta keskittyen opettaja–oppilassuhteeseen sekä vertaissuhteisiin. Tutkimustehtävänä oli selvittää, millaisia sosiaalisen osallisuuden ja osattomuuden koulukokemuksia etsivän nuorisotyön asiakkailla oli ollut. Sosiaalisen osallisuuden tutkiminen on tärkeää, sillä osallisuutta korostetaan vuonna 2016 voimaan tulleessa perusopetuksen opetussuunnitelman perusteissa aiempia opetussuunnitelmia enemmän. Tämä velvoittaa myös kasvatus- ja opetushenkilöstöä sen edistämiseen kouluyhteisössä. Sosiaalinen osallisuus on osa koulua muun muassa kuulumisen, arvostuksen, toimivien suhteiden sekä turvallisuuden ja hyvinvoinnin kautta. Sosiaalista osallisuutta tukemalla edistetään myös oikeudenmukaisuutta, yhdenvertaisuutta ja tasa-arvoa. Tämä tutkimus on luonteeltaan laadullinen tutkimus. Tutkimuksen metodologisena viitekehyksenä toimi fenomenologia, joka keskittyy kokemuksen tutkimiseen. Tutkimuksen aineisto kerättiin teemahaastatteluina keväällä 2018 neljästä eri Suomen kaupungista. Tutkimukseen haastateltiin 13 etsivän nuorisotyön asiakasta, jotka olivat 17–29-vuotiaita. Aineisto analysoitiin teoriaohjaavalla sisällönanalyysilla luokittelua apuna käyttäen. Tutkimuksesta ilmeni, että etsivän nuorisotyön asiakkailla oli sekä sosiaalisen osallisuuden että osattomuuden koulukokemuksia. Sosiaalisen osattomuuden kokemuksia olivat ulkopuolisuus vertaisryhmässä, epäoikeudenmukaisuus ja välinpitämättömyys opettajan toiminnassa sekä fyysinen turvattomuus opettajan ja vertaisten toiminnan seurauksena. Sosiaalisen osallisuuden kokemuksia olivat opettajalta saatu arvostus ja kuulluksi tuleminen sekä yhteisöllisyyden kokemus vertaissuhteissa. Tutkimustulokset osoittivat, että hyvät vuorovaikutussuhteet vertaisten kanssa ja hyvä opettaja– oppilassuhde olivat avainasemassa sosiaalisen osallisuuden kokemuksien muodostumisessa. Opettajalta vaadittiin enemmän aikaa ja ymmärrystä kohdata nuori. Lisäksi etenkin yläkouluaikana vertaissuhteiden ja sosiaalisen osallisuuden kokemuksien merkitys korostui. Mikäli sosiaalisen osallisuuden kokemuksia ei saavutettu, syntyi negatiivista yhteisöllisyyttä, jolloin kapinoitiin vahvasti koulun arvoja vastaan. Negatiivinen yhteisöllisyys vahvisti oman porukan yhteisöllisyyttä, mutta heikensi sitä koko luokan tasolla. Tutkimuksen tulokset ja erityisesti osattomuuden kokemukset ohjaavat tulkintaa siihen suuntaan, ettei nuoria kuulla ja kohdata kouluarjessa tarpeeksi heille merkityksellisissä asioissa. Yhteiskunnallisesti tarkasteltuna opettajalta vaaditun huomion taakse kytkeytyy pohdinta koulun riittämättömistä resursseista ja opettajan kykyjen riittämättömyydestä tukea sosiaalista osallisuutta. Lisäksi tutkimustulokset perustelevat sosiaalisen osallisuuden käsitteen kytkemistä osaksi perusopetuksen opetussuunnitelman perusteita

Four selves of a student - a case report of dissociative identity disorder

English abstract.Peer reviewe

Challenges in investigation of diabetes-related aviation fatalitiesan analysis of 1491 subsequent aviation fatalities in USA during 2011-2016

Diabetes mellitus (DM) could cause pilot incapacitation and result in aviation fatalities. The mechanisms could be directly as a consequence of acute hypoglycemia/subacute diabetic ketoacidosis (DKA) or indirectly as an acute cardiovascular event by contributing to the development of atherosclerosis in coronary or carotid and cerebral arteries. In this study, DM-related fatal flight accidents in the US National Transport Bureau's database between years 2011-2016 were analyzed with special emphasis on postmortem (PM) glucose levels and correlation of toxicological reports with anamnestic information on DM. Additionally, autopsy results on coronary arteries were reviewed. In 43 out of 1491 (similar to 3%) fatal accidents pilots had DM. Postmortem glucose or glycated hemoglobin percentage (Hb1Ac) was measured in 12 of the 43 cases; while antidiabetic medication was found in 14 of the cases (only two of the cases had both glucose measurements and medication). With the increasing prevalence of DM, a possibility of pilot incapacitation due to DM or complications of DM should be actively studied, even if no anamnestic information of DM was available. While PM hypoglycemia is difficult to assess, we propose a systematic investigation based on measurement of glucose, Hb1Ac%, and ketone bodies, and documentation of atherosclerotic lesions in major arteries to identify or rule out DM as a cause of pilot incapacitation.Peer reviewe

Subjective and objective measures of function and return to work : an observational study with a clinical psychiatric cohort

To evaluate the association between two measurement tools (Social and Occupational Functioning Assessment Scale, SOFAS and Sheehan Disability Scale, SDS), returning to work (RTW) and their inter-correlation. 132 psychiatric patients referred to assessment of work ability participated. The association between SOFAS and SDS Work to RTW were assessed by logistic regression. Inter-correlations between SOFAS and SDS were assessed with the Spearman's rho correlation coefficient. SOFAS and SDS Work scores were associated with a 1-year RTW and SOFAS and SDS were inter-correlated. When assigning the ability to work, both subjective and objective measures of function predict RTW.Peer reviewe

PREVIOUS MILITARY PILOTS AND THEIR LATER FATAL CIVIL AVIATION ACCIDENTS

Military pilots undergo rigorous selection compared with civilian professional pilots because of different operational requirements. There are no studies of military pilots' subsequent civil aviation careers and fatal pilot aviation accidents. This study focuses on Vietnam War (VW) pilots and subsequent fatal aviation accidents in the U.S from 1965 to 2018. In total nine aviation accidents met the inclusion criteria and are described in detail, including the pilots' previous civil aviation incidents. The VW pilots were healthy, had valid Medicals and continued to fly in demanding pilot positions after their military careers. Although the data are limited, this study suggests that previous military pilots may differ slightly from other pilots in their subsequent civil aviation careers.Peer reviewe

Duty of Notification and Aviation SafetyA Study of Fatal Aviation Accidents in the United States in 2015

After the Germanwings accident, the French Safety Investigation Authority (BEA) recommended that the World Health Organization (WHO) and European Community (EC) develop clear rules for the duty of notification process. Aeromedical practitioners (AMEs) face a dilemma when considering the duty of notification and conflicts between pilot privacy and public and third-party safety. When balancing accountability, knowledge of the duty of notification process, legislation and the clarification of a doctor's own set of values should be assessed a priori. Relatively little is known of the magnitude of this problem in aviation safety. To address this, the National Transportation Safety Board (NTSB) database was searched to identify fatal accidents during 2015 in the United States in which a deceased pilot used a prescribed medication or had a disease that potentially reduced pilot performance and was not reported to the AME. Altogether, 202 finalized accident reports with toxicology were available from (the year) 2015. In 5% (10/202) of these reports, the pilot had either a medication or a disease not reported to an AME which according to the accident investigation was causal to the fatal accident. In addition, the various approaches to duty of notification in aviation in New Zealand, Finland and Norway are discussed. The process of notification of authorities without a pilot's express permission needs to be carried out by using a guidance protocol that works within legislation and professional responsibilities to address the pilot and the public, as well as the healthcare provider. Professional guidance defining this duty of notification is urgently needed.Peer reviewe