Työyhteisön hyvinvointi hoitotyöntekijöiden kuvaamana : Mikkelin kaupungin terveyskeskussairaalan akuuttiosasto sekä osastot kaksi ja neljä

Valitsimme opinnäytetyömme aiheeksi työyhteisön hyvinvoinnin, koska aihe on mielenkiintoinen ja ajan-kohtainen. Tämän opinnäytetyön tarkoituksena oli selvittää Mikkelin kaupungin terveystoimen toimek-siantamana terveyskeskussairaalan akuuttiosaston sekä osastojen kaksi ja neljä hoitotyöntekijöiden työhy-vinvointia. Tavoitteena oli selvittää työyhteisön tämänhetkinen hyvinvoinnin tilanne. Opinnäytetyö toteutettiin kvan-titatiivisella tutkimusmenetelmällä. Aineisto koottiin kyselylomakkeella marraskuussa 2009. Tutkimuk-semme perusjoukko oli 56 ja otos 39. Kyselyyn vastasi 15 sairaanhoitajaa ja 24 perus- tai lähihoitajaa, joten vastausprosentti oli 70. Tulokset käsiteltiin Microsoft Excel- ohjelmalla. Tulosten mukaan hoitotyöntekijät kokivat työnsä merkityksellisenä ja tarkoituksellisena. Vastaajat olivat pääsääntöisesti tyytyväisiä työhönsä ja omaan elämäänsä. Työtä pidettiin mielenkiintoisena, missä omia tietoja ja taitoja voitiin hyödyntää. Esimiehen johtamistapaan oltiin tyytyväisiä. Työhyvinvointia huonon-taviksi tekijöiksi mainittiin hoitohenkilökunnan liian vähäinen määrä suhteessa työtehtäviin. Lisäksi hoi-totyöntekijät kokivat, että heillä ei ole riittävästi aikaa tehdä töitään niin hyvin ja huolellisesti kuin olisi haluttu. Myös töiden keskeytyminen usein erilaisten häiriötekijöiden takia ja työn tiukka aikataulutus huononsivat työhyvinvointia. Saatujen tulosten avulla osastot voivat jatkossa kehittää työyhteisöään ja sen toimintamalleja.Abstract We chose this diploma work because we are interested in work wellness. Also this subject was very cur-rent. Our work subject was to analysed work community wellness in Mikkeli city’s health central hospital. We distributed our questionnaire in different departments: two, four and the acute care department were those included in our analysis. Our aim was to investigate what level of work wellness presently exists in that working environment. Our analysis was carried out using the quantitative method. We distributed questionnaires to 56 employ-ees in the chosen departments and collected the final sample of 39 who answered in November 2009. Our questionnaire was answered by 15 registered nurses and 24 practical nurses. The percentage of received answers was 70%. We analysed the results with the Microsoft Excel program. According to the results the majority of the nurses felt that their work was meaningful and it had a purpose. The nurses were mainly satisfied at their work and with their own lives. They also felt that their work was interesting and they were able to utilize their knowledge and skills. Nurses were satisfied with their supervisor’s leading skills. In our respondents opinions there weren’t enough nurses to do the work, the schedule was too tight and there were many interruptions and disturbances. These were all factors that detracted from the quality of their work wellness. Also because of their tight schedule, they couldn’t do the work as well as they wanted. The results can be used in improving the work wellness. In the future they could use this diploma work when they are working their community skills. Also they should make better their work distribution

Greenhouse Gas Emission Reduction Potential of European Union’s Circularity Related Targets for Plastics

Current rising concerns about environmental and climate impacts in production, consumption and end-of-life of plastics have led to efforts to switch from linear to circular economy of plastics in Europe. Greenhouse gas emissions are likely to decrease with a transition to a circular system; however, a systematic and integrated perspective on plastics and the carbon cycle is currently missing in the debate on plastics. In this study, a model to estimate greenhouse gas emissions of the current mostly linear plastics value chain of the EU in 2018 and a future scenario, 2025 model, were created. By 2025 if current policy targets are reached, the plastic packaging recycling rate should be 50%, PET-based drinking bottles should include 25% recycled content, 77% collection target for plastic bottles, 10 Mt recyclates should enter the markets, uptake of bio-based plastics is estimated by European bioplastics to increase from current 1 to 1.32% and landfilling will continue to decrease according to the current trend at 3.85%. Total greenhouse gas emissions caused by the current plastics value chain are estimated at 208 million tonnes of CO2-eq. The 2025 model estimates that total plastics value chain emissions will be 182 Mt of CO2-eq. Reduction potential is approximately 26 Mt of CO2-eq or 13%

Accuracy of Finnish Cancer Registry colorectal cancer data : a comparison between registry data and clinical records

Background: The population-based Finnish Cancer Registry (FCR) is an important resource for research and healthcare politics in Finland. The aim of this study was to validate the accuracy of the colorectal cancer (CRC) data within the FCR. Material and methods: FCR data are based on independent cancer report forms (CRFs) from both clinicians and pathologists. Data from patients diagnosed with CRC during a randomized, population-based CRC screening program between 2004 and 2012 were extracted from the FCR and compared to data extracted from the original clinical patient records of these individuals by two gastrointestinal surgeons. The study focused on tumour characteristics and primary treatment. Accuracy was measured by calculating Cohen's kappa coefficient (kappa), which considers the possibility of agreement by chance. Results: Altogether, 1475 patients were studied. kappa was 0.74 for stage, 0.87 for tumour location (right/left), 0.78 for a more detailed location, 0.72 for tumour histology, 0.46 for surgical removal of the primary tumour, and 0.43 for chemotherapy. Among those who underwent surgery, the radicality of surgical treatment had a kappa of 0.24. In total, 173 (12%) patients were lacking a CRF from a clinician. Conclusion: The FCR data had good accuracy regarding tumour characteristics, but poor accuracy in treatment information. The main reason for this suboptimal accuracy was missing CRFs from treating clinicians. Awareness of these findings is crucial when research and decision making is based on FCR data. Measures have since been taken to improve the completeness of FCR recording.Peer reviewe

Accuracy of Finnish Cancer Registry colorectal cancer data : a comparison between registry data and clinical records

Background: The population-based Finnish Cancer Registry (FCR) is an important resource for research and healthcare politics in Finland. The aim of this study was to validate the accuracy of the colorectal cancer (CRC) data within the FCR. Material and methods: FCR data are based on independent cancer report forms (CRFs) from both clinicians and pathologists. Data from patients diagnosed with CRC during a randomized, population-based CRC screening program between 2004 and 2012 were extracted from the FCR and compared to data extracted from the original clinical patient records of these individuals by two gastrointestinal surgeons. The study focused on tumour characteristics and primary treatment. Accuracy was measured by calculating Cohen's kappa coefficient (kappa), which considers the possibility of agreement by chance. Results: Altogether, 1475 patients were studied. kappa was 0.74 for stage, 0.87 for tumour location (right/left), 0.78 for a more detailed location, 0.72 for tumour histology, 0.46 for surgical removal of the primary tumour, and 0.43 for chemotherapy. Among those who underwent surgery, the radicality of surgical treatment had a kappa of 0.24. In total, 173 (12%) patients were lacking a CRF from a clinician. Conclusion: The FCR data had good accuracy regarding tumour characteristics, but poor accuracy in treatment information. The main reason for this suboptimal accuracy was missing CRFs from treating clinicians. Awareness of these findings is crucial when research and decision making is based on FCR data. Measures have since been taken to improve the completeness of FCR recording.Peer reviewe

Last interglacial sea-level proxies in the glaciated Northern Hemisphere

Because global sea level during the last interglacial (LIG; 130–115 ka) was higher than today, the LIG is a useful approximate analogue for improving predictions of future sea-level rise. Here, we synthesize sea-level proxies for the LIG in the glaciated Northern Hemisphere for inclusion in the World Atlas of Last Interglacial Shorelines (WALIS) database. We describe 82 sites from Russia, northern Europe, Greenland and North America from a variety of settings, including boreholes, riverbank exposures and along coastal cliffs. Marine sediments at these sites were constrained to the LIG using a variety of radiometric methods (radiocarbon, uranium–thorium, potassium–argon), non-radiometric methods (amino acid dating, luminescence methods, electron spin resonance, tephrochronology) as well as various stratigraphic and palaeo-environmental approaches. In general, the sites reported in this paper do not offer constraint on the global LIG highstand, but rather evidence of glacial isostatic adjustment (GIA)-influenced sea-level positions following the Marine Isotope Stage 6 glaciation (MIS 6; 191–130 ka). Most of the proxies suggest that sea level was much higher during the LIG than at the present time. Moreover, many of the sites show evidence of regression due to sea-level fall (owing to glacial isostatic uplift), and some also show fluctuations that may reflect regrowth of continental ice or increased influence of the global sea-level signal. In addition to documenting LIG sea-level sites in a large swath of the Northern Hemisphere, this compilation is highly relevant for reconstructing the size of MIS 6 ice sheets through GIA modelling. The database is available at https://doi.org/10.5281/zenodo.5602212 (Dalton et al., 2021).publishedVersio

Mechanical bowel preparation and oral antibiotics versus mechanical bowel preparation only prior rectal surgery (MOBILE2) : a multicentre, double-blinded, randomised controlled trial-study protocol

Introduction Mechanical bowel preparation (MBP) prior to rectal surgery is widely used. Based on retrospective data many guidelines recommend mechanical and oral antibiotic bowel preparation (MOABP) to reduce postoperative complications and specifically surgical site infections (SSIs). The primary aim of this study is to examine whether MOABP reduces complications of rectal surgery. Methods and analysis The MOBILE2 (Mechanical Bowel Preparation and Oral Antibiotics vs Mechanical Bowel Preparation Only Prior Rectal Surgery) trial is a multicentre, double-blinded, parallel group, superiority, randomised controlled trial comparing MOABP to MBP among patients scheduled for rectal surgery with colorectal or coloanal anastomosis. The patients randomised to the MOABP group receive 1 g neomycin and 1 g metronidazole two times on a day prior to surgery and patients randomised to the MBP group receive identical placebo. Based on power calculations, 604 patients will be enrolled in the study. The primary outcome is Comprehensive Complication Index within 30 days after surgery. Secondary outcomes are SSIs within 30 days after surgery, the number and classification of anastomosis dehiscences, the length of hospital stay, mortality within 90 days after surgery and the number of patients who received adjuvant treatment if needed. Tertiary outcomes are overall survival, disease-specific survival, recurrence-free survival and difference in quality-of-life before and 1 year after surgery. In addition, the microbiota differences in colon mucosa are analysed. Ethics and dissemination The Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.Peer reviewe

Levät ja biotalous biotekniikan näkökulmasta

Biotalous tarjoaa vaihtoehdon fossiilisiin polttoaineisiin perustuvalle taloudelle ja sen avulla luonnonvaroja hyödynnetään kestävällä, liiketaloudellisesti kannattavalla tavalla. Biotalous voi osaltaan olla ratkaisu luonnonvarojen ehtymisen ja ilmastonmuutoksen aiheuttamiin globaaleihin haasteisiin. Bioteknologia puolestaan tarjoaa biotaloudelle monia mahdollisuuksia teollisuusprosesseissa, lääketieteessä, elintarvike- ja energiantuotannossa, maa- ja metsätaloudessa sekä ympäristönsuojelussa. Biotalous on käsitteenä laaja ja kehittyy nopeasti. Levät ovat esimerkki nopeasti kasvavasta biomassasta, joka on herättänyt paljon kiinnostusta sen monista sovellusmahdollisuuksista johtuen. Levät voivat tulevaisuudessa olla merkittävä biomassan lähde ja niitä hyödyntämällä voidaan tuottaa sähkö- ja lämmitysenergiaa sekä erilaisia biopolttoaineita liikenteen ja teollisuuden käyttöön. Leväbiomassasta voidaan myös saada monia erilaisia kaupallistettavia sivutuotteita biopolttoainetuotannon ohessa. Biomassan tuotanto polttoaineiksi painottuu tällä hetkellä ns. energiakasvien viljelyyn. Ollakseen kestävää energiabiomassan tuotanto ei saisi kuitenkaan perustua ravinnoksi kelpaaviin kasveihin tai viedä tilaa niiden viljelyltä. Levät tarvitsevat kasvaakseen vettä, auringon valoa, hiilidioksidia ja ravinteita. Leviä voidaan kasvattaa ruoantuotantoon kelpaamattomalla maalla ja ne kasvavat nopeammin kuin maalla elävät kasvit. Ne voivat lisäksi saada tarvitsemiaan ravinteita jätevesistä ja niiden hiilenlähteenä voidaan käyttää tehdastuotannon savukaasuja. Leväkasvatuksen avulla voitaisiinkin tulevaisuudessa mahdollisesti puhdistaa jätevesiä sekä pienentää hiilidioksidipäästöjä biopolttoainetuotannon yhteydessä. Tässä selvityksessä kartoitettiin levätutkimuksen kansallista ja kansainvälistä tilannetta ja toimintaympäristöä sekä pyrittiin laajentamaan ymmärrystä biotalouden mahdollisuuksista ja haasteista

Land-ocean changes on orbital and millennial time scales and the penultimate glaciation

Past glacials can be thought of as natural experiments in which variations in boundary conditions influenced the character of climate change. However, beyond the last glacial, an integrated view of orbital- and millennial-scale changes and their relation to the record of glaciation has been lacking. Here, we present a detailed record of variations in the land-ocean system from the Portuguese margin during the penultimate glacial and place it within the framework of ice-volume changes, with particular reference to European ice-sheet dynamics. The interaction of orbital- and millennial-scale variability divides the glacial into an early part with warmer and wetter overall conditions and prominent climate oscillations, a transitional mid-part, and a late part with more subdued changes as the system entered a maximum glacial state. The most extreme event occurred in the mid-part and was associated with melting of the extensive European ice sheet and maximum discharge from the Fleuve Manche river. This led to disruption of the meridional overturning circulation, but not a major activation of the bipolar seesaw. In addition to stadial duration, magnitude of freshwater forcing, and background climate, the evidence also points to the influence of the location of freshwater discharges on the extent of interhemispheric heat transport