Vammapotilaan hoidon osaamista arvioivan mittarin edelleen kehittäminen : Kuosce-hanke

Ensihoitaja Metropolia ammattikorkeakoulun -tutkintoon kuuluva opinnäytetyömme on osa KUOSCE- hanketta, joka tehdään yhteistyössä Keski-Uudenmaan pelastuslaitoksen (KUP) kanssa. Hankkeen tarkoituksena on luoda ensihoidon koulutusohjelmaan ja KUP:lle perustason sairaankuljetuksen osaamisen kehittymisen malli. Tässä opinnäytetyössä edelleen kehitämme KUOSCE- hankkeen osana aikaisemmin kehitettyä ja testattua vammapotilaan hoidon osaamista arvioivaa mittaria. Opinnäytetyön tarkoituksena on edelleen kehittää Romppasen ja Sarkkisen vuonna 2007 kehittämää ja testattua sekä Laineen ja Piiraisen vuonna 2008 testaamaa vammapotilaan hoidon osaamisen arvioivaa mittaria. Alkuperäinen mittari sisälsi paljon väittämiä, jotka perustuivat kirjallisuuteen vammapotilaan hoidossa tarvittavasta osaamisesta. Alkuperäisen mittarin seitsemästäkymmenestäkolmesta (73) väittämästä poistimme ja yhdistimme väittämiä niin, että kehittämäämme mittariin väittämiä jäi kolmekymmentäyksi (31). Mittarin edelleen kehittäminen toteutettiin kehittämällä sen ulkoasua, ohjeita, loogisuutta ja realistisuutta. Mittarin muutosehdotukset hyväksytettiin työelämän edustajan kanssa. Lopputuloksena mittarista on jäljelle jääneissä väittämissä pyritty työelämälähtöisesti käytännöllisyyteen ja simulaatiotilanteen järjestämisen realistisuuteen. Mittarin väittämiä karsittiin ajatuksella, että arvioitsijoina toimivat kokeneet ensihoitajat, jotka ilman kysymysten pilkkomista osaavat oikeat hoidolliset tekniikat. Mittarin väittämät sijoiteltiin ABCDE- mallin mukaisesti kuitenkin niin, että lopullisten painotusalueiden tulkinta jää arvioitsijoille.Our thesis in the degree programme for paramedics at the Metropolia polytechnic is a part of the KUOSCE project being carried out in cooperation with the Central Uusimaa rescue service (KUP). The project aims to create a basic level model for patient transportation for the degree programme of Emergency First Response and the KUP. In the thesis we develop further the measurement of competence in treating a trauma patient, which was earlier developed and tested as a part of the KUOSCE project. The goal of the thesis is to develop further the measurement of competence in treating a trauma patient developed and tested by Romppanen and Sarkkinen in 2007 and tested in 2008 by Laine and Piirainen. Originally, the measurement of competence included a number of statements based on the literature with regard to the competence needed in treating a trauma patient. Out of the original number of 73 statements we developed by removing and putting together statements to the extent that there were 31 statements left in our measurement of competence. Furthermore, we developed the visual appearance, instructions, logic and real-life aspects of the measurement of competence. The changes were approved by a representative of work life. The statements left in the measurement of competence are now work-life oriented and strive for practical and realistic aspects in arranging a simulation situation. The basic idea with the elimination process of excess statements was that the evaluators will be experienced paramedics who know the correct treatment procedures without dividing the questions further. The statements of the measurement of competence were arranged according to the ABCDE model so that the evaluation of the final areas of emphasis will be left to the evaluator

The Toxicity of Wiped Dust and Airborne Microbes in Individual Classrooms Increase the Risk of Teachers' Work-Related Symptoms : A Cross-Sectional Study

Background: The causes and pathophysiological mechanisms of building-related symptoms (BRS) remain open. Objective: We aimed to investigate the association between teachers' individual work-related symptoms and intrinsic in vitro toxicity in classrooms. This is a further analysis of a previously published dataset. Methods: Teachers from 15 Finnish schools in Helsinki responded to the symptom survey. The boar sperm motility inhibition assay, a sensitive indicator of mitochondrial dysfunction, was used to measure the toxicity of wiped dust and cultured microbial fallout samples collected from the teachers' classrooms. Results: 231 teachers whose classroom toxicity data had been collected responded to the questionnaire. Logistic regression analysis adjusted for age, gender, smoking, and atopy showed that classroom dust intrinsic toxicity was statistically significantly associated with the following 12 symptoms reported by teachers (adjusted ORs in parentheses): nose stuffiness (4.1), runny nose (6.9), hoarseness (6.4), globus sensation (9.0), throat mucus (7.6), throat itching (4.4), shortness of breath (12.2), dry cough (4.7), wet eyes (12.7), hypersensitivity to sound (7.9), difficulty falling asleep (7.6), and increased need for sleep (7.7). Toxicity of cultured microbes was found to be associated with nine symptoms (adjusted ORs in parentheses): headache (2.3), nose stuffiness (2.2), nose dryness (2.2), mouth dryness (2.8), hoarseness (2.2), sore throat (2.8), throat mucus (2.3), eye discharge (10.2), and increased need for sleep (3.5). Conclusions: The toxicity of classroom dust and airborne microbes in boar sperm motility inhibition assay significantly increased teachers' risk of work-related respiratory and ocular symptoms. Potential pathophysiological mechanisms of BRS are discussed.Peer reviewe

Pyroligneous Acids of Differently Pretreated Hybrid Aspen Biomass : Herbicide and Fungicide Performance

The pyroligneous acids (PAs) of woody biomass produced by torrefaction have pesticidal properties. Thus, PAs are potential alternatives to synthetic plant protection chemicals. Although woody biomass is a renewable feedstock, its use must be efficient. The efficiency of biomass utilization can be improved by applying a cascading use principle. This study is novel because we evaluate for the first time the pesticidal potential of PAs derived from the bark of hybrid aspen (Populus tremula L. x Populus tremuloides Michx.) and examine simultaneously how the production of the PAs can be interlinked with the cascade processing of hybrid aspen biomass. Hybrid aspen bark contains valuable extractives that can be separated before the hemicellulose is thermochemically converted into plant protection chemicals. We developed a cascade processing scheme, where these extractives were first extracted from the bark with hot water (HWE) or with hot water and alkaline alcohol (HWE+AAE) prior to their conversion into PAs by torrefaction. The herbicidal performance of PAs was tested using Brassica rapa as the test species, and the fungicidal performance was proven using Fusarium culmorum. The pesticidal activities were compared to those of the PAs of debarked wood and of commercial pesticides. According to the results, extractives can be separated from the bark without overtly diminishing the weed and fungal growth inhibitor performance of the produced PAs. The HWE of the bark before its conversion into PAs appeared to have an enhancing effect on the herbicidal activity. In contrast, HWE+AAE lowered the growth inhibition performance of PAs against both the weeds and fungi. This study shows that hybrid aspen is a viable feedstock for the production of herbicidal and fungicidal active chemicals, and it is possible to utilize biomass according to the cascading use principle.Peer reviewe

Effects of site preparation and reindeer grazing on the early-stage success of Scots pine regeneration from seeds in northern Finland and Sweden

The importance of sufficient soil scarification to ensure the regeneration of Scots pine on sub-dry and more fertile sites has been emphasized in many studies. Here we aimed to study, how site preparation intensity affects the early success of natural regeneration and sowing (bare seeds and seed pellets) of Scots pine with or without the reindeer grazing. The study area was located in northern Finland and Sweden where five site preparation methods were compared: unprepared control, logging machine tracks, Huminmix (mixing the mineral soil and organic layer), disc trenching and intensive disc trenching. In each of these we used direct seeding, seed pellets and natural regeneration. Results revealed that even the lightest site preparation methods can provide sufficient regeneration results while the reindeer grazing limits the optimal regeneration result. Huminmix and even the track of the logging machine could provide satisfactory regeneration results both in direct seeding and natural regeneration. This could facilitate the coexistence of forest management, reindeer herding and other land use forms in the same stands and area. The use of seed pellets needs further research, but it may have potential due to lower consumption of seeds and less need for site preparation

Colonialism as Context in Diversity Research

Diversity management practice and research are both direct responses to the conditions that European colonialism of other parts of the world has produced. We argue that diversity research thus functions within a colonial episteme, a way of thinking and producing knowledge about the world that is structured by colonial logic. Taking colonialism seriously as a context is not only about acknowledging culturally different ways of knowing, but also about recognizing and undoing the authority of the West to determine what diversity is around the world and what constitutes diversity research. We propose there may be other ways to conceptualize the relationship between difference and diversity, and offer some provisional ideas about how we can begin to do this in our research

EEG-Based Brain-Computer Interface for Tetraplegics

Movement-disabled persons typically require a long practice time to learn how to use a brain-computer interface (BCI). Our aim was to develop a BCI which tetraplegic subjects could control only in 30 minutes. Six such subjects (level of injury C4-C5) operated a 6-channel EEG BCI. The task was to move a circle from the centre of the computer screen to its right or left side by attempting visually triggered right- or left-hand movements. During the training periods, the classifier was adapted to the user's EEG activity after each movement attempt in a supervised manner. Feedback of the performance was given immediately after starting the BCI use. Within the time limit, three subjects learned to control the BCI. We believe that fast initial learning is an important factor that increases motivation and willingness to use BCIs. We have previously tested a similar single-trial classification approach in healthy subjects. Our new results show that methods developed and tested with healthy subjects do not necessarily work as well as with motor-disabled patients. Therefore, it is important to use motor-disabled persons as subjects in BCI development