Työterveyspalvelut asiakkaan tarpeeseen

TIIVISTELMÄ: Terveydenhuollossa on meneillään isoja muutoksia. Työterveyspalvelut edustavat terveydenhuollossa pääasiassa yksityisesti tuotettuja palveluita, joissa asiakasyrityksillä on isoja odotuksia palveluntuottajilleen. Kyseinen liiketoimintasektori on houkutellut alalle uusia toimijoita ja kilpailu asiakkaista on kovaa. Ei pelkästään lakisääteiset, vaan asiakkaan aitoihin tarpeisiin kohdentuvat palvelut ovat olleet alalla jo pitkään tavoitteena. Tähän tutkimukseen on innoittanut käytännöllinen tarve osuvien palveluiden tuottamiseen. Tutkimus toteutettiin työterveystoimijoiden verkkosivuillaan esittelemän tarjooman pohjalta. Tutkimuskysymyksinä olivat ”millaisia palveluita yritykset tarjoavat ja mitä asiakkaiden ongelmia niillä pyritään ratkaisemaan”. Kiinnostuksen kohteena olivat myös mahdolliset uudet innovaatiot alalla. Tutkimus pyrki löytämään ajankohtaisen katsauksen toimialan palveluihin asiakkaan ratkaisujen näkökulmasta. Tämän laadullisen tutkimuksen teoreettinen viitekehys rakentui palveluliiketoiminnan kehittämisen teorioista ja menetelmistä. Job To Be Done -teoria oli tutkimuksen lähtökohtana. Otanta koostui Pohjois-Pohjanmaalla toimivista työterveyspalveluiden tuottajista, joista osa oli pelkästään paikallisia ja osa valtakunnallisia. Materiaali kerättiin yritysten verkkosivuilta kuvakaappauksin ja aineiston käsittelyssä käytettiin sisällönanalyysiä. Tutkimuksessa haettiin kuvailevaa tilanneanalyysiä mahdollisen tulevan toiminnan kehittämisen pohjaksi. Tutkimuksen tuloksista voidaan todeta kaksi yleistettävää ilmiötä: työkyky nousi kaikkein olennaisimmaksi ongelmaksi ja palveluiden kohteeksi ja työterveyspalveluiden tuottajat ovat kehittäneet edistyksellisiä digitaalisia palvelumuotoja sekä työkyvyn että muiden palveluiden tueksi. Molemmat ilmiöt pyrkivät ratkaisemaan sekä yritys- että yksilöasiakkaiden ongelmia ja tarpeita. Vahvasti esille palveluiden tarjonnassa nousevat luonnollisesti työterveyshuollon lakisääteiset peruspalvelut sairaanhoitopalveluilla täydennettyinä sekä työhyvinvointipalvelut, joilla pyritään edistämään yksilöiden ja yhteisöjen hyvinvointia sekä työn tuottavuutta. Job To Be Done -ajattelua oli löydettävissä palveluratkaisuissa, joskin havainnot ovat viitteellisiä tarjooman perusteella tehdyistä tulkinnoista. Tutkimus on tuloksiltaan kuvaileva ja aikaan sidottu. Esitettyjä havaintoja ei voi yleistää tuloksiksi laajemmin

Introduction to Logophilosophy

Logophilosophy is based on the philosophical system of doctrines developed by Viennese psychiatrist and doctor of philosophy Viktor Frankl (1905-1997). The two consisting elements of this philosophical system of doctrines i.e. Logophilosophy, are Existential analysis and Logotherapy. Existential analysis aims to explore, understand and explain being-in-the-world concerning both humankind in general and each human individually. Logotherapy applies Existential analysis in practice. Logophilosophy is a purpose-centered philosophy, which includes basic pillars of the purposeful nature of life, the human will to find a purpose, and the freedom of human will. However, implementing purposes in everyone's own life is very different from creating meanings for one's life. Purposes are always outside of a human, in the world, to which we are related through and in accordance with our own existence. Purposes cannot be invented or created, but they are found. A purposeful life also always commits to values that are objective and the same for everyone. Together, purpose and values form the logophilosophical backbone of human activity in the world, which needs selflessness and joint efforts to become what it can be at its best. The authors of the book are professional logotherapists and logotherapy instructors with philosophical education. Their Institute for Purpose-centered Philosophy Finland is an accredited member of the International Association of Logotherapy and Existential Analysis at the Viktor Frankl Institute Vienna

Evaluation of High-Throughput PCR and Microarray-Based Assay in Conjunction with Automated DNA Extraction Instruments for Diagnosis of Sepsis

BACKGROUND: High incidence of septic patients increases the pressure of faster and more reliable bacterial identification methods to adapt patient management towards focused and effective treatment options. The aim of this study was to assess two automated DNA extraction solutions with the PCR and microarray-based assay to enable rapid and reliable detection and speciation of causative agents in the diagnosis of sepsis. METHODOLOGY/PRINCIPAL FINDINGS: We evaluated two automated DNA instruments NucliSENS® easyMAG® and NorDiag Arrow for the preparation of blood culture samples. A set of 91 samples flagged as positive during incubation was analyzed prospectively with the high-throughput generation of Prove-it™ Sepsis assay designed to identify over 60 gram-negative and gram-positive bacterial species as well as methicillin resistance marker from a blood culture. Bacterial findings were accurately reported from 77 blood culture samples, whereas 14 samples were reported as negative, containing bacteria not belonging to the pathogen panel of the assay. No difference was observed between the performance of NorDiag Arrow or NucliSENS® easyMAG® with regard to the result reporting of Prove-it™ Sepsis. In addition, we also assessed the quality and quantity of DNA extracted from the clinical Escherichia coli isolate with DNA extraction instruments. We observed only minor differences between the two instruments. CONCLUSIONS: Use of automated and standardized sample preparation methods together with rapid, multiplex pathogen detection offers a strategy to speed up reliably the diagnostics of septic patients. Both tested DNA extraction devices were shown to be feasible for blood culture samples and the Prove-it™ Sepsis assay, providing an accurate identification of pathogen within 4.5 hours when the detected pathogen was in the repertoire of the test

Introduction to Logophilosophy

Logophilosophy is based on the philosophical system of doctrines developed by Viennese psychiatrist and doctor of philosophy Viktor Frankl (1905-1997). The two consisting elements of this philosophical system of doctrines i.e. Logophilosophy, are Existential analysis and Logotherapy. Existential analysis aims to explore, understand and explain being-in-the-world concerning both humankind in general and each human individually. Logotherapy applies Existential analysis in practice. Logophilosophy is a purpose-centered philosophy, which includes basic pillars of the purposeful nature of life, the human will to find a purpose, and the freedom of human will. However, implementing purposes in everyone's own life is very different from creating meanings for one's life. Purposes are always outside of a human, in the world, to which we are related through and in accordance with our own existence. Purposes cannot be invented or created, but they are found. A purposeful life also always commits to values that are objective and the same for everyone. Together, purpose and values form the logophilosophical backbone of human activity in the world, which needs selflessness and joint efforts to become what it can be at its best

Leuconostoc Strains Unable to Split a Lactose Analogue Revealed by Characterisation of Mesophilic Dairy Starters

Mesophilic starter cultures used in dairy industry have been traditionally characterised by metabolic and biochemical methods. As closely related species of lactic acid bacteria have often only minor differences in phenotypic traits, which may also be variable within certain species, clear identification is often complicated. Therefore, techniques of molecular biology have been applied for rapid detection and differentiation of lactic acid bacteria. In this work, some bacterial clones isolated from mesophilic starters, which were preliminary identified as lactococci by phenotypic methods, were found to be Leuconostoc strains by both PCR and PFGE. According to the results, genotypic differentiation methods used in combination with phenotypic tests provide a fast and convenient way to reliably identify lactic acid bacteria displaying atypical metabolic characteristics

Risk factors for bit-related lesions in Finnish trotting horses

Background Bit-related lesions in competition horses have been documented, but little evidence exists concerning their potential risk factors. Objectives To explore potential risk factors for oral lesions in Finnish trotters. Study design Cross-sectional study. Methods The rostral part of the mouth of 261 horses (151 Standardbreds, 78 Finnhorses and 32 ponies) was examined after a harness race. Information on bit type, equipment and race performance was collected. Results A multivariable logistic regression model of Standardbreds and Finnhorses showed a higher risk of moderate or severe oral lesion status associated with horses wearing a Crescendo bit (n = 38, OR 3.6, CI 1.4–8.9), a mullen mouth regulator bit (n = 25, OR 9.9, CI 2.2-45) or a straight plastic bit (n = 14, OR 13.7, CI 1.75-110) compared with horses wearing a snaffle trotting bit (n = 98, P = .002). Bar lesions (67 horses) were more common in horses wearing unjointed bits than in horses wearing jointed bits (Fisher's exact test P < .001). Lesions in the buccal area and the inner lip commissures were not associated with bit type. Using a tongue-tie or an overcheck, galloping, placement in the top three or money earned in the race were not associated with lesion risk. Main limitations The sample size for certain bit types was insufficient for statistical analysis. Conclusions Moderate and severe oral lesion status was more common in horses wearing a Crescendo bit, a mullen mouth regulator bit or a straight plastic bit than in horses wearing a single-jointed snaffle trotting bit. However, lesions were observed regardless of bit type. Further studies on rein tension, the interaction between bit type and rein tension and prevention of mouth lesions in trotters are warranted.Peer reviewe

Development and evaluation of a rapid nucleic acid amplification method to detect influenza A and B viruses in human respiratory specimens

Isothermal nucleic acid amplification methods can potentially shorten the amount of time required to diagnose influenza. We developed and evaluated a novel isothermal nucleic acid amplification method, RT-SIBA to rapidly detect and differentiate between influenza A and B viruses in a single reaction tube. The performance of the RT-SIBA Influenza assay was compared with two established RT-PCR methods. The sensitivities of the RT-SIBA, RealStar RT-PCR, and CDC RT-PCR assays for the detection of influenza A and B viruses in the clinical specimens were 98.8%, 100%, and 89.3%, respectively. All three assays demonstrated a specificity of 100%. The average time to positive result was significantly shorter with the RT-SIBA Influenza assay (90 min). The method can be run using battery-operated, portable devices with a small footprint and therefore has potential applications in both laboratory and near-patient settings. (C) 2018 Elsevier Inc. All rights reserved.Peer reviewe

Overlooked organic vapor emissions from thawing Arctic permafrost

Volatile organic compounds (VOCs) play an essential role in climate change and air pollution by modulating tropospheric oxidation capacity and providing precursors for ozone and aerosol formation. Arctic permafrost buries large quantities of frozen soil carbon, which could be released as VOCs with permafrost thawing or collapsing as a consequence of global warming. However, due to the lack of reported studies in this field and the limited capability of the conventional measurement techniques, it is poorly understood how much VOCs could be emitted from thawing permafrost and the chemical speciation of the released VOCs. Here we apply a Vocus proton-transfer-reaction time-of-flight mass spectrometer (PTR-TOF) in laboratory incubations for the first time to examine the release of VOCs from thawing permafrost peatland soils sampled from Finnish Lapland. The warming-induced rapid VOC emissions from the thawing soils were mainly attributed to the direct release of old, trapped gases from the permafrost. The average VOC fluxes from thawing permafrost were four times as high as those from the active layer (the top layer of soil in permafrost terrain). The emissions of less volatile compounds, i.e. sesquiterpenes and diterpenes, increased substantially with rising temperatures. Results in this study demonstrate the potential for substantive VOC releases from thawing permafrost. We anticipate that future global warming could stimulate VOC emissions from the Arctic permafrost, which may significantly influence the Arctic atmospheric chemistry and climate change.Peer reviewe