Johtajien näkemyksiä RAI-tiedon hyödyntämisestä ikääntyneiden kotihoidossa vuosina 2013 ja 2022

RAI-järjestelmää (Resident Assessment Instrument) ja sen tuottamaa tietoa voidaan hyödyntää ikääntyneiden kotihoidon johtamisessa ja päätöksenteon tukena. Poikkileikkausasetelmassa toteutetussa kyselytutkimuksessa kuvattiin johtajien näkemyksiä yksikkönsä hoitajien RAI-osaamisesta, RAI-arvioinnin tekemiseen liittyvistä käytänteistä sekä toiminnan seurannasta ja arvioinnista ikääntyneiden kotihoidossa vuosina 2013 ja 2022. Tutkimusaineisto kerättiin syksyllä 2022 ikääntyneiden kotihoidon johtajilta eri puolilta Suomea hyödyntäen RAIHYJ-mittaria (RAI-järjestelmän hyödyntäminen johtamisessa). Tuloksia vertailtiin vuonna 2013 toteutetun kyselyn tuloksiin, jossa käytettiin samaa mittaria. Aineisto analysoitiin tilastollisin menetelmin. Johtajien näkemyksien mukaan yksiköiden hoitajien RAI-osaamisessa, RAI-arvioinnin tekemiseen liittyvissä käytänteissä sekä toiminnan seurannassa ja arvioinnissa oli kehitettävää. Parhaiten toteutui hoitajien RAI-osaaminen, eniten kehitettävää taas oli toiminnan seurannassa ja arvioinnissa. Johtajien itsearvioidussa RAI-järjestelmään liittyvässä johtamisosaamisessa havaittiin merkittäviä puutteita. Johtajien näkemykset vuosina 2013 ja 2022 olivat samansuuntaisia, mutta myönteistä kehitystä oli havaittavissa kaikilla sisältöalueilla. Tulokset osoittavat, että henkilöstöä ja johtajia tulee ikääntyneiden kotihoidon organisaatioissa kouluttaa systemaattisesti ja koulutus tulee kohdentaa oikein. Lisäksi on tärkeää varmistaa RAI-arviointiprosessin toteutuminen. Managers’ perceptions on the utilization of Resident Assessment Instrument system in home-care services for the older persons in 2013 and 2022  The RAI system (Resident Assessment Instrument) and the information it produces can be used in the management and decision-making of home care services for older people. The aim of this cross-sectional survey was to describe managers’ perceptions of the RAI competence of nurses in their unit, practices related to RAI assessments, and monitoring and evaluation in home care services for older persons. In addition, the study aimed to compare the differences in managers’ perceptions between 2013 and 2022. The data were collected in autumn 2022 from managers of home care services in different parts of Finland using the RAIHYJ (Utilization of the Resident Assessment Instrument in Management) scale. The results of the study were compared to the results of a survey conducted in 2013 in a project concerning the development of elderly care resources and quality of care, in which the data were collected using the same RAIHYJ scale. The data were analyzed using statistical methods. According to the managers’ perceptions, there is a need for improvement in their unit’s nurses’ RAI competence, practices related to RAI assessment, and monitoring and evaluation. RAI competence was rated at the highest level, while monitoring and evaluation were perceived as needing the most improvement. Significant deficiencies were found in the managers’ self-assessed RAI-related management competency. The managers’ perceptions appeared to be approximately similar in 2013 and 2022, but positive developments were noted in every content area. The results of the study emphasize the need for systematic properly targeted training of the entire staff and for ensuring the implementation of the RAI assessment process in home care organizations for older people

Linking vgll3 genotype and aggressive behaviour in juvenile Atlantic salmon (Salmo salar)

We tested the possibility that vgll3, a gene linked with maturation age in Atlantic salmon (Salmo salar), may be associated with behaviour by measuring aggressiveness and feeding activity in 380 juveniles with different vgll3 genotypes. Contrary to our prediction, individuals with the genotype associated with later maturation (vgll3*LL) were significantly more aggressive than individuals with the genotype associated with earlier maturation (vgll3*EE). Individuals with higher aggression were also significantly lighter in colour and had higher feeding activity. Although higher aggression was associated with higher feeding activity, there was no association between feeding activity and vgll3 genotype. Increased aggression of vgll3*LL individuals was independent of their sex and size, and genotypes did not differ in their condition factor. These results imply that aggressive behaviour may have an energetic cost impairing growth and condition, especially when food cannot be monopolized. This may have implications for individual fitness and aquaculture practices.Peer reviewe

Vuorotyöunihäiriön seulonta- ja diagnoosimenetelmien kehittäminen työterveyshuoltoon

Tämän tutkimuksen tavoitteena oli tuottaa tietoa epäsäännöllisiin työaikoihin liittyvien uni- ja vireyshäiriöiden diagnosoinnin edistämiseksi ja kehittää seulontamenetelmiä siten, että vireystilaongelmat voitaisiin entistä paremmin tunnistaa työterveyshuollossa. Henkilöt, joilla seulontamenetelmän perusteella arvioitiin olevan vuorotyöunihäiriö, eivät kärsineet merkittävästä univajeesta, mutta arvioivat unen tarpeensa suuremmaksi ja unen laadun heikommaksi kuin oireettomat vuorotyöntekijät. Tutkimuksen tulokset osoittivat, että vuorotyöhön liittyvien uni- ja vireystilaongelmien seulontaan voidaan käyttää kyselymenetelmää

Contrasting microbiotas between Finnish and Estonian infants : exposure to Acinetobacter may contribute to the allergy gap

Background Allergic diseases are more common in Finland than in Estonia, which-according to the biodiversity hypothesis-could relate to differences in early microbial exposures. Methods We aimed at defining possible microbial perturbations preceding early atopic sensitization. Stool, nasal and skin samples of 6-month-old DIABIMMUNE study participants with HLA susceptibility to type 1 diabetes were collected. We compared microbiotas of sensitized (determined by specific IgE results at 18 months of age) and unsensitized Estonian and Finnish children. Results Sensitization was differentially targeted between populations, as egg-specific and birch pollen-specific IgE was more common in Finland. Microbial diversity and community composition also differed; the genusAcinetobacterwas more abundant in Estonian skin and nasal samples. Particularly, the strain-level profile ofAcinetobacter lwoffiiwas more diverse in Estonian samples. Early microbiota was not generally associated with later sensitization. Microbial composition tended to differ between children with or without IgE-related sensitization, but only in Finland. While land-use pattern (ie green areas vs. urban landscapes around the children's homes) was not associated with microbiota as a whole, it associated with the composition of the genusAcinetobacter. Breastfeeding affected gut microbial composition and seemed to protect from sensitization. Conclusions In accordance with the biodiversity hypothesis, our results support disparate early exposure to environmental microbes between Finnish and Estonian children and suggest a significant role of the genusAcinetobacterin the allergy gap between the two populations. The significance of the observed differences for later allergic sensitization remains open.Peer reviewe

Rhinoviruses in infancy and risk of immunoglobulin E sensitization

Previous data about the role of viruses in the development of allergic immunoglobulin E (IgE) sensitization are contradictory. The aim of this study was to determine the possible associations between exposure to different viruses (rhinovirus, enterovirus, norovirus, and parechovirus) during the first year of life and IgE sensitization. Viruses were analyzed from stool samples collected monthly from infants participating in a prospective birth cohort study. From that study, 244 IgE sensitized case children and 244 nonsensitized control children were identified based on their allergen-specific IgE antibody levels at the age of 6, 18, and 36 months. Stool samples (n = 4576) from the case and control children were screened for the presence of rhinovirus, enterovirus, norovirus, and parechovirus RNA by reverse transcription quantitative polymerase chain reaction. The study showed that rhinovirus was the most prevalent virus detected, present in 921 (20%) samples. None of the viruses were associated with IgE sensitization in the full cohort but after stratifying by sex, the number of rhinovirus positive samples was inversely associated with IgE sensitization in boys (odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.69-0.94; P = 0.006). There was also a temporal relation between rhinoviruses and IgE sensitization, as rhinovirus exposure during the first 6 months of life was associated with a reduced risk of subsequent IgE sensitization in boys (OR: 0.76; 95% CI: 0.6-0.94; P = 0.016). In conclusion, early exposure to rhinoviruses was inversely associated with IgE sensitization but this protective association was restricted to boys.Peer reviewe