Käsihygienian toteuttaminen intraoperatiivisessa vaiheessa

Käsihygieniasta ja sen toteuttamisesta on olemassa runsaasti sekä oppimateriaalia että tutkimuksia. Useat tutkimukset todistavat, että käsihygienian toteuttamisessa leikkausosastoilla on merkittäviä puutteita. Vaasan keskussairaalan leikkaus- ja anestesiaosaston henkilökunnan kanssa keskusteltaessa ilmeni, että puutteita käsihygienian toteuttamisessa esiintyy myös kyseisellä osastolla. Keskustelun myötä esille tuli hoitohenkilökunnan henkilökohtaisten puhelimien käyttö leikkaussalissa sekä käsien desinfiointiin käytettävä aika ja tekniikka. Opinnäytetyön tarkoituksena oli tuottaa kirjallinen ohje selvittämään Vaasan keskussairaalan leikkaus- ja anestesiaosaston henkilökunnalle käsihygienian periaatteita ja merkitystä painottuen hoitotyön intraoperatiiviseen vaiheeseen. Opinnäytetyön teoreettisena viitekehyksenä on käytetty erilaisia oppikirjoja, näyttöön perustuvia tutkimuksia ja internet-lähteitä. Ohjeistus käsihygienian toteuttamiseen pohjautuu World Health Organization WHO:n kansainväliseen ohjeistukseen. Työn keskeisiä käsitteitä ovat intraoperatiivinen hoitotyö, käsihygienia, aseptiikka ja potilasturvallisuus. Muita keskeisiä käsitteitä ovat näyttöön perustuva tutkimus sekä käsien ihon terveys. Lähteistä yhteen koottu tieto toimii pohjana opinnäytetyön tuotoksille. Opinnäytetyön tuotoksille valmistui kirjallinen ohjelehtinen sekä PowerPoint-koulutusmateriaali, johon opinnäytetyön pääkohdat on esitetty. Työn pohjana toimivat näyttöön perustuvat tutkimukset todistavat käsihygienian toteuttamisessa leikkausosastolla olevan merkittäviä puutteita. Tutkimusten perusteella esimerkiksi ammattinimike sukupuoli ja henkilökohtaiset asenteet vaikuttavat käsihygienian toteutumiseen leikkausosastoilla. Käsihygieniasta ja sen vaikutuksesta esimerkiksi hoitokustannusten suuruuteen on kuitenkin olemassa huomattavan paljon oppimateriaalia, tutkimuksia ja kampanjoita. Tiedonpuute ei siis useinkaan ole syy käsihygienian toteutumisen puutteisiin.There is a lot of learning material and researches about hand hygiene and how to carry it out. Several researches prove the significant lack of implementation of hand hygiene in surgery units. When discussing with the personnel of Surgery and Anaesthesia Unit of Vaasa Central Hospital manifested that there are insufficiencies in the implementation of hand hygiene also in this unit. During the discussions with the personnel in the unit it came out that members of the nursing personnel use their personal mobile phone in the OR and also the time and technique used in the disinfection of the hands. The main purpose of this bachelor’s thesis was to produce written instructions to clarify the principles and meaning of hand hygiene in intraoperative phase to the personnel of Surgery and Anaesthesia Unit of Vaasa Central Hospital. Theoretical framework of bachelor’s thesis is based on different textbooks, evidence-based researches and internet sources. The instructions of proper hand hygiene are based on the international instructions of World Health Organization, WHO. The main concepts of thesis are intraoperative care, hand hygiene, aseptics and patient safety. Other key concepts are evidence-based research and health of the skin on hands. The information gathered from the sources works as a source for the outputs of thesis. The products of the thesis are written instructions and PowerPoint educational material. Evidence-based researches which show the insufficiencies in implementation of hand hygiene in surgery units are the base of this thesis. Based on the researches it can be said that for example title, genre and personal attitudes affect how hand hygiene is carried out in surgery units. Anyway, there is a lot of learning material and there are also many researches and campaigns related to hand hygiene and the effect of hand hygiene on for example the health care costs. Lack of knowledge is usually not the reason to insufficiencies in the implementation of hand hygiene

AvoHILMO - Anmälan om öppen primärvård 2013. Definitioner och anvisningar

Anmälan om öppen primärvård 2013 Definitioner och anvisningar Anmälningar om öppen primärvård ska inlämnas till Institutet för hälsa och välfärd. AvoHILMO-handboken redogör för informationsinnehållet och klassifikationerna i anmälan om öppenvård år 2013. Handboken innehåller också länkar till en datateknisk beskrivning av AvoHILMO och en beskrivning av den elektroniska dataöverföringen. Mer information: www.thl.fi/avohilmoTämän vanhan painoksen korvaa uusi, muutettu painos osoitteessa: http://urn.fi/URN:ISBN:978-952-302-335-2</a

OCR Quality Affects Perceived Usefulness of Historical Newspaper Clippings. A User Study

Publisher Copyright: © 2022 Copyright for this paper by its authors.Effects of Optical Character Recognition (OCR) quality on historical information retrieval have so far been studied in data-oriented scenarios regarding the effectiveness of retrieval results. Such studies have either focused on the effects of artificially degraded OCR quality (see, e.g., [1-2]) or utilized test collections containing texts based on authentic low quality OCR data (see, e.g., [3]). In this paper the effects of OCR quality are studied in a user-oriented information retrieval setting. Thirty-two users evaluated subjectively query results of six topics each (out of 30 topics) based on pre-formulated queries using a simulated work task setting. To the best of our knowledge our simulated work task experiment is the first one showing empirically that users' subjective relevance assessments of retrieved documents are affected by a change in the quality of optically read text. Users of historical newspaper collections have so far commented effects of OCR'ed data quality mainly in impressionistic ways, and controlled user environments for studying effects of OCR quality on users' relevance assessments of the retrieval results have so far been missing. To remedy this The National Library of Finland (NLF) set up an experimental query environment for the contents of one Finnish historical newspaper, Uusi Suometar 1869-1918, to be able to compare users' evaluation of search results of two different OCR qualities for digitized newspaper articles. The query interface was able to present the same underlying document for the user based on two alternatives: either based on the lower OCR quality, or based on the higher OCR quality, and the choice was randomized. The users did not know about quality differences in the article texts they evaluated. The main result of the study is that improved optical character recognition quality affects perceived usefulness of historical newspaper articles significantly. The mean average evaluation score for the improved OCR results was 7.94% higher than the mean average evaluation score of the old OCR results.Peer reviewe

High relative density of lymphatic vessels predicts poor survival in tongue squamous cell carcinoma

Tongue cancer has a poor prognosis due to its early metastasis via lymphatic vessels. The present study aimed at evaluating lymphatic vessel density, relative density of lymphatic vessel, and diameter of lymphatic vessels and its predictive role in tongue cancer. Paraffin-embedded tongue and lymph node specimens (n = 113) were stained immunohistochemically with a polyclonal antibody von Willebrand factor, recognizing blood and lymphatic endothelium and with a monoclonal antibody podoplanin, recognizing lymphatic endothelium. The relative density of lymphatic vessels was counted by dividing the mean number of lymphatic vessels per microscopic field (podoplanin) by the mean number of all vessels (vWf) per microscopic field. The high relative density of lymphatic vessels (aeyen80 %) was associated with poor prognosis in tongue cancer. The relative density of lymphatic vessels predicted poor prognosis in the group of primary tumor size T1-T2 and in the group of non-metastatic cancer. The lymphatic vessel density and diameter of lymphatic vessels were not associated with tongue cancer survival. The relative density of lymphatic vessels might have clinically relevant prognostic impact. Further studies with increased number of patients are needed.Peer reviewe

Factors Affecting Revision Rate of Chronic Rhinosinusitis

Peer reviewe

Radiological score of computed tomography scans predicts revision surgery for chronic rhinosinusitis

Objective. Evaluate computed tomography (CT) signs that predict need for revision endoscopic sinus surgery (ESS) of chronic rhinosinusitis (CRS). Methods. CRS patients (n = 48) underwent routine sinus CT scans and baseline ESS in 2006-2011. Lund-Mackay (LM) scores and 43 other CT signs were analysed blinded from both sides. Patients filled in a questionnaire during the day of CT scanning. Follow-up data were collected from hospital records until January 2018. Associations were analysed by Fisher's exact, Mann Whitney U, Kaplan-Meier method with logrank test and Cox's proportional hazard model. Results. Total LM score was not significantly associated with the need for revision ESS. The best predictive model was a sum of CT signs of non-detectable anatomy of inferior/middle turbinates, obstructed frontal recess, and previous sinus surgery. Using these CT findings, we formed a Radiological Score (RS) (min-max, 0-3 points). Having at least one RS point was significantly associated with the need for revision ESS during the average follow-up of 10.7 years (p = 0.008, Logrank test). Conclusion. We identified a radiologic score that was able to predict the need for revision ESS, which is probably useful in predicting CRS outcomes.Peer reviewe

The expression and prognostic relevance of CDH3 in tongue squamous cell carcinoma

Publisher Copyright: © 2021 Scandinavian Societies for Medical Microbiology and Pathology.P-cadherin (CDH3) is a cell-to-cell adhesion molecule that regulates several cellular homeostatic processes in normal tissues. Lack of CDH3 expression is associated with aggressive behavior in oral squamous cell carcinoma (OSCC). Previous studies have shown that CDH3 is downregulated in high-grade OSCC and its reduced expression is predictive for poorer survival. The aim of this study was to evaluate the expression and prognostic relevance of CDH3 in tongue squamous cell carcinoma (TSCC). A retrospective series of 211 TSCC and 50 lymph node samples were stained immunohistochemically with polyclonal antibody (anti-CDH3). CDH3 expression was assessed semi-quantitatively with light microscopy. Fisher’s exact test was used to compare patient and tumor characteristics, and the correlations were tested by Spearman correlation. Survival curves were drawn by the Kaplan–Meier method and analyzed by the log-rank test. Univariate and multivariate Cox regression was used to estimate the association between CDH3 expression and survival. CDH3 expression did not affect TSCC patient’s disease-specific survival or overall survival. Strong CDH3 expression in the primary tumor predicted poor disease-specific and overall survival in patients with recurrent disease. CDH3 expression in lymph nodes without metastasis was negative in all cases. CDH3 expression was positive in all lymph node metastases with extranodal extension. In contrast to previous report about the prognostic value of CDH3 in OSCC, we were not able to validate the result in TSCC.Peer reviewe

The expression and prognostic relevance of CDH3 in tongue squamous cell carcinoma

Publisher Copyright: © 2021 Scandinavian Societies for Medical Microbiology and Pathology.P-cadherin (CDH3) is a cell-to-cell adhesion molecule that regulates several cellular homeostatic processes in normal tissues. Lack of CDH3 expression is associated with aggressive behavior in oral squamous cell carcinoma (OSCC). Previous studies have shown that CDH3 is downregulated in high-grade OSCC and its reduced expression is predictive for poorer survival. The aim of this study was to evaluate the expression and prognostic relevance of CDH3 in tongue squamous cell carcinoma (TSCC). A retrospective series of 211 TSCC and 50 lymph node samples were stained immunohistochemically with polyclonal antibody (anti-CDH3). CDH3 expression was assessed semi-quantitatively with light microscopy. Fisher’s exact test was used to compare patient and tumor characteristics, and the correlations were tested by Spearman correlation. Survival curves were drawn by the Kaplan–Meier method and analyzed by the log-rank test. Univariate and multivariate Cox regression was used to estimate the association between CDH3 expression and survival. CDH3 expression did not affect TSCC patient’s disease-specific survival or overall survival. Strong CDH3 expression in the primary tumor predicted poor disease-specific and overall survival in patients with recurrent disease. CDH3 expression in lymph nodes without metastasis was negative in all cases. CDH3 expression was positive in all lymph node metastases with extranodal extension. In contrast to previous report about the prognostic value of CDH3 in OSCC, we were not able to validate the result in TSCC.Peer reviewe

Factors Affecting the Control of Chronic Rhinosinusitis With Nasal Polyps : A Comparison in Patients With or Without NERD

Objectives: The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing: A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting: Tertiary rhinology centers. Methods: Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001-17 were studied. Mean follow-up time was 9.9 years (range 1.1-15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results: Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean +/- SD of 4.3 +/- 2.8 and 3.7 +/- 2.6 years, respectively (p = .013, by Logrank test). In Cox ' s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions: Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.Peer reviewe

The efficacy of Equine Assisted Therapy intervention in gross motor function, performance, and spasticity in children with Cerebral Palsy

PurposeTo evaluate the efficacy of Equine Assisted Therapy in children with Cerebral Palsy, in terms of gross motor function, performance, and spasticity as well as whether this improvement can be maintained for 2 months after the end of the intervention.MethodsChildren with Cerebral Palsy participated in this prospective cohort study. The study lasted for 28 weeks, of which the equine assisted therapy lasted 12 weeks taking place once a week for 30 min. Repeated measures within the subject design were used for the evaluation of each child’s physical performance and mental capacity consisting of six measurements: Gross Motor Function Measure-88 (GMFM-88), Gross Motor Performance Measure (GMPM), Gross Motor Function Classification System (GMFCS), Modified Ashworth Scale (MAS) and Wechsler Intelligence Scale for Children (WISC III).ResultsStatistically significant improvements were achieved for 31 children in Gross Motor Function Measure and all its subcategories (p &lt; 0.005), also in total Gross Motor Performance Measure and all subcategories (p &lt; 0.005). These Gross Motor Function Measure results remained consistent for 2 months after the last session of the intervention. Regarding spasticity, although an improving trend was seen, this was not found to be statistically significant.Conclusion and implicationsEquine Assisted Therapy improves motor ability (qualitatively and quantitatively) in children with Cerebral Palsy, with clinical significance in gross motor function