Kokemuksia tietojen vaihdosta työterveysyhteistyössä: terveystarkastuksessa kirjattavat tiedot

TiivistelmäTyöterveyshuollon terveystarkastuksissa kertyy tietoa työntekijöiden terveydentilasta, työ- ja toimintakyvystä sekä työolosuhteista. Halusimme kartoittaa, mitkä terveystarkastuksessa kirjattavat tiedot ovat asiantuntijoiden mielestä oleellisia työterveyshuollon tietojen vaihdossa työntekijän, työnantajan, muun terveydenhuollon ja sosiaalivakuutuksen kanssa.Tutkimuksessa käytettiin Delphi-menetelmää. Kysyimme asiaa työterveyslääkäreiltä, työterveyshoitajilta, työfysioterapeuteilta ja työterveyspsykologeilta (n=40). Tutkimusaineisto kerättiin kolmella sähköisellä kyselyllä, joista ensimmäisen vastausprosentti oli 76 %, toisen 73 % ja kolmannen 73 %. Tutkimusaineisto analysoitiin sisällön analyysilla. Tärkeimmät työterveyshuollon tietojenvaihdon kannalta terveystarkastuksessa potilaskertomukseen kirjattavat tiedot olivat sairaudet ja oireilu (erityisesti työperäiset), jatkotoimenpiteet, -suunnitelma ja seuranta sekä työntekijän oma arvio työkyvystä ja työssä selviytymisestä.Tutkimus tuotti uutta tietoa työterveyshuollon kirjaamisesta terveystarkastusten näkökulmasta. Tuloksia voidaan hyödyntää työterveyshuollon tietojärjestelmien ja terveystarkastusten tietorakenteen ja -sisältöjen kehittämisessä työterveysyhteistyötä tukeviksi. AbstractInformation about employees' health, work ability and functional capacity, as well as working conditions is collected in occupational health checkups. We wanted to find out, which data in occupational health checkups is regarded by the experts in occupational health services (OHS) relevant for the exchange of information between OHS and the employee, employer, other health services and social security system.The research used the Delphi method. We asked about the relevant data for the information exchange from the OH physicians, OH nurses, OH physiotherapists and OH psychologists (n = 40) with three electronic questionnaires. The response rate was 76%, 73% and 73%, respectively. The data was analyzed with content analysis.The most relevant data for the exchange of information to be documented in electronic health records in health checkups were work-related diseases and symptoms, action plan and follow-up, as well as the employee's own assessment of work ability and coping at work.The research produced new information that can be used in the development of health information systems in OHS and the data structure and contents of occupational health checkups to serve better information exchange between OHS and the employee, employer, other health services and social security system

Tutkimusmenetelmäopintoja tohtorikoulutettaville – terveiset Hong Kongin kevään kurssilta

Kiinalaiset ja suomalaiset tohtoriopiskelijat vahvistavat tutkimusmenetelmäosaamistaan CIMOn rahoittamassa yhteistyöhankkeessa. Syksyllä 2016 alkaneen opintokokonaisuuden suunnittelun tavoitteena on pilotoida kahta opetusteemaa- Hoitosuositusten kehittäminen ja Big Data. Verkko-opetusta hyödyntävän hankkeen ensimmäinen lähiopetusjakso toteutettiin Hong Kongissa maaliskuussa 2017. Ajankohta tarjosi tohtoriopiskelijoille mahdollisuuden esittää myös omaa tutkimusta kansainvälisessä EAFONS-konferenssissa

Fruit, Vegetable, and Fibre Intake among Finnish Preschoolers in Relation to Preschool-Level Facilitators and Barriers to Healthy Nutrition

Preschool is a major factor affecting food consumption among young children in Finland, given that most preschoolers eat three meals a day in that setting. Thus, it is important to recognise the determinants of dietary intake at preschool. The aim of this study was to examine food-related factors at the preschool and manager level, and their association with the dietary intake of children in childcare. The study was a part of the cross-sectional DAGIS survey conducted in 2015 to 2016 in Finland. The managers of 58 preschools filled in a questionnaire related to food and nutrition at their preschools. Preschool personnel kept food records for the children (n = 585) on two preschool days. Multilevel linear and logistic regression analyses were conducted with age, gender, and municipality as covariates, preschool-level factors as independent variables, and children’s vegetable (g/day) and fruit (yes vs. no) consumption and fibre intake (g/MJ) as outcome variables. Having many written food policies in the preschool was associated with a higher intake of vegetables (p = 0.01) and fibre (p = 0.03) among the children. Having at least two out of three cooperation-related challenges with the catering service was associated with a higher intake of fibre (p = 0.03) and lower odds of eating fruit (p = 0.01). Factors that are relatively distal from meal situations may have an effect, and should be taken into account in the promotion of healthy eating at preschool, but more studies are needed

Viability of Lactobacillus paraplantarum DSM 14485 in human gastrointestinal tract and its molecular and biochemical identification after fermented vegetable consumption

Abstract In this study the viability of a potentially probiotic Lactobacillus paraplantarum DSM 14485 in the intestinal tract of 22 healthy test subjects was qualitatively assessed in a randomised double blinded cross-over study design lasting 2 x 4 weeks (interventions I and II) with a 4-week washout period. The subjects were given in their diet either spontaneously fermented vegetables (SF) or vegetables fermented by starter bacteria which contained  Lb. paraplantarum DSM 14485 (P). The numbers of lactic acid bacteria (LAB) in fecal samples were at the level of 105 cfu g-1 in both groups. The presence of Lb. paraplantarum DSM 14485 was confirmed by biochemical and molecular methods. We were able to show that Lb. paraplantarum DSM 14485, isolated from spontaneously fermented cucumbers, was viable in the intestine of ten test subjects after taking P-diet when the numbers of LAB were sufficiently high in the product

Kanta-arkiston käyttökokemuksia työterveyshuollossa

The purpose of the eHealth and eSocial Strategy 2020 by the Finnish Ministry of Social Affairs and Health is to provide health care professionals with access to up-to-date patient data and information systems that support their work. Patient data are exchanged between organizations using the national Patient Data Repository (Kanta repository). The repository is increasingly used by the health care professionals as well as citizens. Presently, patient data of nearly every Finn are stored in it. The purpose of this study was to determine the use of the Kanta repository in Occupational Health Services using an electronic questionnaire in summer 2017. The survey targeted occupational health physicians, nurses, physiotherapists, and psychologists. There was a total of 359 respondents. The results indicate that the Kanta repository is positively viewed but not used extensively. Respondents say that patient data retrieval is slow, the required data cannot be found with certainty and occasionally, there are some delays with saving patient data in the Kanta repository. Furthermore, the dates of patient visits showed in the Kanta repository do not always correspond to the actual dates of the visits. Occupational health professionals believe that other professionals utilize patient data generated in occupational health services. However, they feel that getting an overall status of a patient’s care is not easy with the Kanta repository. Documenting and archiving patient data without delay in the Kanta repository provides patients with the best care possible, as professionals can access the patient’s entire medical history if necessary. Although using the Kanta repository is still somewhat cumbersome and there are difficulties with finding patient data, it fulfils its purpose and supports the occupational health professionals’ work. In the future, the situation will hopefully improve. The national patient data management service of the Kanta repository will start providing professionals with the summaries of patient’s key structural health information.Sosiaali- ja terveysministeriön laatiman Sote-tieto hyötykäyttöön -strategian tarkoituksena on mahdollistaa, että terveydenhuollon ammattilaisella on käytössään ajantasainen potilastieto ja työtä tukevat tietojärjestelmät. Tietojen vaihto yli organisaatiorajojen toteutetaan valtakunnallisen Potilastiedon arkiston (Kanta-arkiston) avulla. Arkistoon on tallennettu tietoja lähes kaikista suomalaisista ja sen käyttö lisääntyy terveydenhuollon ammattilaisten keskuudessa koko ajan. Tutkimuksen tarkoituksena oli selvittää Kanta-arkiston käyttöä työterveyshuollossa. Sähköinen kysely lähetettiin työterveyslääkäreille, työterveyshoitajille, työfysioterapeuteille ja työterveyspsykologeille kesällä 2017 ja siihen vastasi yhteensä 359 henkilöä. Tulokset osoittavat, että Kanta-arkistoa pidetään hyvänä ideana, mutta sitä käytetään vielä vähän. Vastaajat kokevat, että tietojen haku on hidasta, tarvittavan tiedon löytäminen hankalaa ja potilastietojen tallentumisessa Kanta-arkistoon on ajoittain viivettä. Lisäksi Kanta-arkistossa näkyvät potilaskäyntien päivämäärät eivät aina välttämättä vastaa käynnin todellista ajankohtaa. Työterveyshuollon ammattilaiset uskovat muiden ammattilaisten hyödyntävän työterveyshuollossa syntyneitä tietoja, vaikka kokevatkin, että Kanta-arkiston avulla kokonaiskuvan saaminen potilaan hoidon tilanteesta ei onnistu helposti. Tietojen ajantasainen kirjaaminen ja niiden tallentuminen Kanta-arkistoon mahdollistaa potilaalle parhaan mahdollisen hoidon, kun ammattilaiset saavat tarvittaessa esille potilaan koko terveys- ja sairaushistorian. Vaikka Kanta-arkiston käyttö on vielä osin hankalaa ja tietojen löytämisessä on vaikeutta, voidaan kuitenkin sanoa sen täyttävän tarkoituksensa ja hyödyttävän työterveyshuollon ammattilaisen työtä. Tulevaisuudessa tilanne tulee paranemaan, kun Kanta-arkistoon toteutettavan tiedonhallintapalvelun kautta saadaan ammattilaisille käyttöön kooste potilasta koskevista keskeisistä terveystiedoista

A cross-sectional study of children's temperament, food consumption and the role of food-related parenting practices

Although evidence exists of the association between children's temperament and weight, only few studies have examined how temperament is associated with actual food consumption among preschoolers. We examined concurrent associations between children's temperament and the consumption of different foods, and investigated whether the association between children's temperament and vegetable consumption is mediated by vegetable-related parenting practices. We utilized the data from the cross-sectional DAGIS study of 864 preschool children aged between three to six and their families, conducted between 2015 and 2016 in Finland. The parents reported their children's temperament, food consumption, and their vegetable-related parenting practices. Adjusted logistic regression analyses found positive associations between surgency and vegetable consumption as well as between effortful control and vegetable consumption. Both associations were mediated by one examined vegetable-related parenting practice: enhanced availability and autonomy support. No associations were found between children's negative affectivity and food consumption or vegetable-related parenting practices. In conclusion, children's temperament may be an important factor behind food-related parenting practices and children's diet. However, further longitudinal research and research covering different food-related parenting practices and home environment factors is necessary to better understand the complex associations between temperament and food consumption among young children.Peer reviewe

The Contribution of Preschool Meals to the Diet of Finnish Preschoolers

Preschool meals may influence the formation of children’s dietary habits and health. We assessed the contribution of preschool meals to the diet of Finnish children. We used food record data from the cross-sectional DAGIS survey and selected recording days which included all three meals (breakfast, lunch, afternoon snack) at preschool. We analyzed the diet of three- to four-year-olds (n = 324) and five- to six-year-olds (n = 233). Preschool meals accounted for 54% of the weekday’s energy intake in both age groups, and provided ≥60% of total fiber, polyunsaturated fatty acids, and vitamins D and E. More than 60% of fish dishes but only one third of total daily fresh fruit were consumed at preschool. The mean (SD) percentages of energy from protein and fat at preschool were 17% (3%) and 30% (7%) in the younger and 17% (3%) and 31% (6%) in the older age group, respectively. The mean proportions of energy from added sugar at preschool were below 5% in both age groups. On average, salt intake exceeded recommendations and 60% of salt came from preschool food. Tackling high salt intake should be a future goal of guidance for early childhood education and care food services

Sustainability analysis of Finnish pre-schoolers' diet based on targets of the EAT-Lancet reference diet

Purpose The EAT-Lancet reference diet is a healthy plant-based diet produced within planetary boundaries. To inform the food system transformation, we compared Finnish pre-schoolers' food consumption with the reference diet's food group targets. Methods Food record data for 3- to 6-year-old pre-schoolers were collected in the cross-sectional DAGIS survey. Ingredients of composite dishes were available in the data. In addition, we manually decomposed industrial products such as sausages and biscuits by estimating the shares of ingredients. We also estimated the consumption of added sugars and converted the consumption of dairy products into milk equivalents. We used usual intake modelling to estimate the mean consumption and the proportion of children who met the reference diet's targets. We set the target amounts separately for 3- to 4-year-olds and 5- to 6-year-olds in grams by proportioning the published target amounts (assuming a 2500 kcal diet) to the children's mean reported energy intake. Results For both age groups (3- to 4-year-olds, n = 460; 5- to 6-year-olds, n = 402), the daily mean consumption of whole grains, vegetables, legumes, nuts, and unsaturated oils was below targets, whereas the consumption of red meat, dairy foods, tubers, and added sugars was above targets. The consumption of fruit and fish was in line with targets. Conclusion To comply with the reference diet's targets, major changes in the diets of Finnish children are needed. The key food groups targeted for higher consumption are whole grains and legumes and targeted for lower consumption red meat and dairy products.Peer reviewe