Perhehoitotyön hyödyt ja aloittamisen haasteet

Perhehoitotyö on yksilön ja perheen sekä terveyden että sairauden välisten yhteyksien huomioonottamista hoitosuunnitelmassa ja hoitoa arvioitaessa. Perhehoitotyön tärkeimmät tavoitteet ovat perheen tukeminen ja tiedon lisääminen sekä hoidon jatkuvuuden turvaaminen. Tutkimuksen tarkoituksena oli selvittää, millä eri tavoin työskennellään potilaan perheen kanssa, hoitajien kokemuksia perhehoitotyön hyödyistä ja perhehoitotyön aloittamisen haasteista uuden potilaan kanssa, sekä tarvittavan tuen tarpeesta omalta työyhteisöltään. Tutkimuksen tavoitteena oli, että saatua tietoa voidaan hyödyntää perhehoitotyön toimintamallin edelleen kehittämisessä psykiatrisella osastolla. Lähestymistapa tässä tutkimuksessa oli kvalitatiivinen. Tutkimusmenetelmänä käytettiin kyselyä avoimin kysymyksin. Tutkimusaineisto kerättiin psykiatrisen osaston perhehoitotyötä tekeviltä hoitajilta. Saatu aineisto analysoitiin induktiivisella sisällön analyysillä. Tulosten mukaan perhehoitotyö koettiin erittäin tärkeäksi. Suurimpana hyötynä oli tiedon antaminen ja saaminen. Haasteina koettiin perheiden erilaisuuden ja yksilöllisyyden huomioiminen sekä käytännön tuomat ongelmat. Koulutus ja käytännön harjoittelu kokeneemman hoitajan kanssa koettiin tärkeimmiksi työyhteisön antamaksi tueksi. Osastolla vallitseva perhehoitomyönteisyys antoi myös merkityksellistä tukea. Jatkotutkimusaiheena voitaisiin selvittää perhehoitotyön hyödyt, haasteet ja odotukset perheen näkökulmasta.Family nursing means taking into account the connections between an individual and family and between health and illness when planning and assessing nursing care. The main goals of family nursing are to support the family, to increase knowledge, and to secure the continuity of nursing care. The aim of the study was to find out the different ways that work is carried out with the patient's family, and nurses' experiences of the benefits of family nursing, the initial challenges of family nursing with a new patient and the need for support from their own work community. The goal of the study was to be able to utilize the obtained information in the further development of an operational model of family nursing on a psychiatric ward. The approach in this study was qualitative. A questionnaire with open-ended questions was used to gather data. The material for the study was collected from nurses involved in family nursing on a psychiatric ward. The material obtained was processed using inductive analysis of the contents. According to the results, family nursing was considered to be very important. The greatest benefit was the giving and receiving of information. Taking into account the differences between families and individuality and problems that came up in practice were seen as challenges. Education and practical training with a more experienced nurse were regarded as the most important support given by the work community. The positive attitude towards family nursing prevailing on the ward also provided significant support. A subject for a further study would be to find out the benefits and challenges of, and the expectations for, family nursing from the family's point of view

X-Linked Lymphoproliferative Disease Type 1: A Clinical and Molecular Perspective

X-linked lymphoproliferative disease (XLP) was first described in the 1970s as a fatal lymphoproliferative syndrome associated with infection with Epstein–Barr virus (EBV). Features include hemophagocytic lymphohistiocytosis (HLH), lymphomas, and dysgammaglobulinemias. Molecular cloning of the causative gene, SH2D1A, has provided insight into the nature of disease, as well as helped characterize multiple features of normal immune cell function. Although XLP type 1 (XLP1) provides an example of a primary immunodeficiency in which patients have problems clearing primarily one infectious agent, it is clear that XLP1 is also a disease of severe immune dysregulation, even independent of EBV infection. Here, we describe clinical features of XLP1, how molecular and biological studies of the gene product, SAP, and the associated signaling lymphocyte activation molecule family receptors have provided insight into disease pathogenesis including specific immune cell defects, and current therapeutic approaches including the potential use of gene therapy. Together, these studies have helped change the outcome of this once almost uniformly fatal disease

The Epstein-Barr Virus G-Protein-Coupled Receptor Contributes to Immune Evasion by Targeting MHC Class I Molecules for Degradation

Epstein-Barr virus (EBV) is a human herpesvirus that persists as a largely subclinical infection in the vast majority of adults worldwide. Recent evidence indicates that an important component of the persistence strategy involves active interference with the MHC class I antigen processing pathway during the lytic replication cycle. We have now identified a novel role for the lytic cycle gene, BILF1, which encodes a glycoprotein with the properties of a constitutive signaling G-protein-coupled receptor (GPCR). BILF1 reduced the levels of MHC class I at the cell surface and inhibited CD8+ T cell recognition of endogenous target antigens. The underlying mechanism involves physical association of BILF1 with MHC class I molecules, an increased turnover from the cell surface, and enhanced degradation via lysosomal proteases. The BILF1 protein of the closely related CeHV15 c1-herpesvirus of the Rhesus Old World primate (80% amino acid sequence identity) downregulated surface MHC class I similarly to EBV BILF1. Amongst the human herpesviruses, the GPCR encoded by the ORF74 of the KSHV c2-herpesvirus is most closely related to EBV BILF1 (15% amino acid sequence identity) but did not affect levels of surface MHC class I. An engineered mutant of BILF1 that was unable to activate G protein signaling pathways retained the ability to downregulate MHC class I, indicating that the immune-modulating and GPCR-signaling properties are two distinct functions of BILF1. These findings extend our understanding of the normal biology of an important human pathogen. The discovery of a third EBV lytic cycle gene that cooperates to interfere with MHC class I antigen processing underscores the importance of the need for EBV to be able to evade CD8+ T cell responses during the lytic replication cycle, at a time when such a large number of potential viral targets are expressed

Finnish vocational education and training (VET) students’ perceptions of the joy of studying in an online learning environment

We examined the perceptions of students in Finnish vocational education and training (VET) institutions about the joy of studying in online learning environments. The data consisted of 290 students’ answers to a survey and a thematic interview with eight students. The phenomenographic analysis revealed students’ experiences of joy in practical learning using digital programmes, independent learning online, collaborative learning online, and working life-oriented online learning. Students experienced the joy of studying when the teacher was positive, supportive, and interested in the subject being taught and treated all students equally. Some students experienced the joy of studying when they could study with others, while others experienced joy alone, regardless of time and place. The research contributed a profound understanding of the joy of learning in different online learning environments, which helps develop teaching and learning in VET in a student-centred manne

Students\u27 thriving and well-being in online learning environments in vocational education and training

Context: Recent research on students\u27 experiences with the quality of online learning during the COVID-19 pandemic has increased the challenge to the development of online learning. During the pandemic, anxiety, depression, and fatigue occurred in online studies, which also weakened students\u27 well-being. In this quantitative study, we examined how students thrive in synchronous and asynchronous online implementations. The goal of the research was to support students\u27 well-being in online studies; therefore, the study uses the PERMA well-being theory. Approach: Finnish vocational education and training students (N = 363) participated in the study and answered the questions on positive emotions, engagement, relationships, meaning, and accomplishment from both asynchronous and synchronous online delivery perspectives using a questionnaire. Findings: This study highlighted the importance of the teacher\u27s online learning facilitation skills and task design skills, and the emotions generated in an online course. Based on the results, the respondents were divided into three student profiles: (1) Students thriving in online courses in general; (2) Students thriving, especially in asynchronous online courses; and (3) Students not thriving in online courses in general. Conclusions: According to the findings, students need different options for completing online courses. The role of the teacher in creating a positive and supportive atmosphere, fostering relationships, and creating clear work-related and versatile tasks is of great importance in the generation of emotions, whether it is an asynchronous or synchronous online implementation. (DIPF/Orig.

Enveloping Sophisticated Tools into Process-Centered Environments

We present a tool integration strategy based on enveloping pre-existing tools without source code modifications or recompilation, and without assuming an extension language, application programming interface, or any other special capabilities on the part of the tool. This Black Box enveloping (or wrapping) idea has existed for a long time, but was previously restricted to relatively simple tools. We describe the design and implementation of, and experimentation with, a new Black Box enveloping facility intended for sophisticated tools --- with particular concern for the emerging class of groupware applications