94 research outputs found
Participative Facility Planning for Obstetrical and Neonatal Care Processes: Beginning of Life Process
Introduction. Old hospitals may promote inefficient patient care processes and safety. A new, functionally planned hospital presents a chance to create an environment that supports streamlined, patient-centered healthcare processes and adapts to users' needs. This study depicts the phases of a facility planning project for pregnant women and newborn care processes (beginning of life process) at Turku University Hospital. Materials and Methods. Project design reports and meeting documents were utilized to assess the beginning of life process as well as the work processes of the Women's and Children's Hospital. Results. The main elements of the facility design (FD) project included rigorous preparation for the FD phase, functional planning throughout the FD process, and setting key values: (1) family-centered care, (2) Lean thinking and Lean tools as the framework for the FD process, (3) safety, and (4) cooperation. Conclusions. A well-prepared FD project with sufficient insight into functional planning, Lean thinking, and user-centricity seemed to facilitate the actual FD process. Although challenges occurred, the key values were not forgone and were successfully incorporated into the new hospital building
Tutkijan vapaus institutionaalisen tietoteorian nÀkökulmasta
Institutionaalinen tietoteoria tutkii erilaisten institutionaalisten jaÌrjestelyjen (kaÌytaÌnnoÌt, sosiaaliset normit, kannustimet jne.) tiedollisia seurauksia, kuten tutkimuksen aiheiden valikoitumista, tietoon mahdollisesti syntyviaÌ vinoumia ja tiedollisia aukkoja. Institutionaalisen tietoteorian naÌkoÌkulmasta tutkijan vapaudessa ei ole kysymys vain yksiloÌn ilmaisuvapaudesta vaan myoÌs julkisen ja tieteellisen keskustelun taustaedellytyksistaÌ ja tiedollisista seurauksista. Tutkijoiden vapaus asettaa kysymyksiaÌ ja tehdaÌ todistusaineistosta itsenaÌisiaÌ paÌaÌtelmiaÌ on olennainen osa luotettavan tiedon tuottamisen prosessia. TaÌmaÌn vuoksi tutkijan vapaus tulee ymmaÌrtaÌaÌ laajemmin kuin vain ulkoisten esteiden puuttumisena. Tutkijalla taÌytyy olla todellinen mahdollisuus seurata, mihin tutkimus johtaa. Ilman taÌllaista mahdollisuutta ajatus tieteen itsekorjaavuudesta ja luotettavuudesta on vain toiveajattelua. Vastaavasti, jos tieteen toivotaan toteuttavan yhteiskunnallista tehtaÌvaÌaÌ demokratiassa, tutkijoilla ei tulisi olla vain vapaus esittaÌaÌ tutkimuksensa tuloksia julkisesti vaan taÌhaÌn viestintaÌaÌn tulee olla institutionaaliset edellytykset ja kannustimet. Vaikka tutkijan vapaus on olennainen osa luotettavaa tietoa tuottavaa tieteellistaÌ tutkimusprosessia, ei se kuitenkaan ole riittaÌvaÌ ehto luotettavan tiedon tuottamiselle. Tutkimuksen vapauden institutionaalisten ennakkoedellytysten lisaÌksi on syytaÌ tarkastella myoÌs tilanteita, joissa tutkijoiden vapaus tuottaa ei-toivottuja seurauksia. Tarkastelemme kirjoituksessa kahta esimerkkiaÌ taÌllaisista tilanteista. EnsimmaÌinen esimerkkimme on niin kutsuttu toistettavuuskriisi, joka osoittaa, ettaÌ vaikka tutkijoiden valinnat ovat vapaita, voivat vaÌaÌraÌnlaiset kannustimet ja institutionaaliset jaÌrjestelyt johtaa tilanteeseen, jossa tiedeyhteisoÌ tuottaa suuren maÌaÌraÌn epaÌluotettavaa tietoa. Toinen esimerkkimme on laÌaÌketutkimuksessa yleistynyt laÌaÌketehtaiden organisoima julkaisusuunnittelu ja haamukirjoitta- minen. SiinaÌ missaÌ toistettavuuskriisi on periaatteessa hyvaÌaÌ tarkoittavien tutkijoiden toiminnan tahaton seuraus, on taÌssaÌ esimerkissaÌ kysymys tutkimusjaÌrjestelmaÌn heikkouksien tarkoituksellisesta hyvaÌksikaÌytoÌstaÌ.Peer reviewe
Different Types of Door-Opening Motions as Contributing Factors to Containment Failures in Hospital Isolation Rooms
10.1371/journal.pone.0066663PLoS ONE86-POLN
Healthy people in healthy premises: the Finnish Indoor Air and Health Programme 2018-2028
Clean and fresh indoor air supports health and well-being. However, indoor air can contain pollutants that can cause a variety of symptoms and reduce well-being. Individual exposure agents can also increase the risk of certain diseases. Finns have taken major steps to improve the quality of indoor air for several decades. The primary focus of these activities has been the prevention and reduction of exposure to poor indoor air quality through guidance and regulation directing remediation of damaged buildings. Nevertheless, reported symptoms related to poor indoor air quality are common in Finland. In addition to exposure to indoor air pollutants, this may be partly due to the lively public discussion on the health risks caused by poor indoor air quality, conflicting views between experts, and mistrust towards public authorities, building owners and builders. Because of the scale of the indoor air problems in Finland, people's needs for reliable information and support, and the major costs involved, there is a call for new evidence-based methods, perspectives and solutions. Therefore, the Finnish Institute for Health and Welfare initiated the Finnish Indoor Air and Health Programme 2018-2028 together with a number of collaborators and stakeholders. The primary, long-term objective of the programme is to reduce hazards to health and well-being linked to indoor environments in Finland. To fulfill this objective, the programme will focus on the promotion of human health and well-being, the prevention of hazards, improved communication and engage the whole health-care sector to manage better patients ' symptoms and complaints. The 10-year Finnish Indoor Air and Health Programme consists of four areas that aim (1) to increase understanding of the effects of indoor environments on health and well-being; (2) to develop the management of problems linked to indoor environments; (3) to improve the treatment and working and functional capacity of people with symptoms and illnesses; and (4) to strengthen the competence in matters related to indoor environments. The progress of the programme and reaching the predefined, quantitative goals will be monitored throughout the programme
Testing for cattle allergy: modified diagnostic cutoff levels improve sensitivity in symptomatic claw trimmers
Test-retest repeatability of child's respiratory symptoms and perceived indoor air quality - comparing self-and parent-administered questionnaires
Background: Questionnaires can be used to assess perceived indoor air quality and symptoms in schools. Questionnaires for primary school aged children have traditionally been parent-administered, but self-administered questionnaires would be easier to administer and may yield as good, if not better, information. Our aim was to compare the repeatability of self- and parent-administered indoor air questionnaires designed for primary school aged pupils. Methods: Indoor air questionnaire with questions on child's symptoms and perceived indoor air quality in schools was sent to parents of pupils aged 7-12 years in two schools and again after two weeks. Slightly modified version of the questionnaire was administered to pupils aged 9-12 years in another two schools and repeated after a week. 351 (52%) parents and 319 pupils (86%) answered both the first and the second questionnaire. Test-retest repeatability was assessed with intra-class correlation (ICC) and Cohen's kappa coefficients (k). Results: Test-retest repeatability was generally between 0.4-0.7 (ICC; k) in both self-and parent-administered questionnaire. In majority of the questions on symptoms and perceived indoor air quality test-retest repeatability was at the same level or slightly better in self-administered compared to parent-administered questionnaire. Agreement of self-and parent administered questionnaires was generally <0.4 (ICC; k) in reported symptoms and 0.4-0.6 (ICC; k) in perceived indoor air quality. Conclusions: Children aged 9-12 years can give as, or even more, repeatable information about their respiratory symptoms and perceived indoor air quality than their parents. Therefore, it may be possible to use self-administered questionnaires in future studies also with children.Peer reviewe
Antigenic Proteins Involved in Occupational Rhinitis 1 and Asthma Caused by Obeche Wood (Triplochiton Scleroxylon)
Background
Obeche wood dust is a known cause of occupational asthma where an IgE-mediated mechanism has been demonstrated.
Objective
To characterize the allergenic profile of obeche wood dust and evaluate the reactivity of the proteins by in vitro, ex vivo and in vivo assays in carpenters with confirmed rhinitis and/or asthma
Materials and methods
An in-house obeche extract was obtained, and two IgE binding bands were purified (24 and 12 kDa) and sequenced by N-terminal identity. Specific IgE and IgG, basophil activation tests and skin prick tests (SPTs) were performed with whole extract and purified proteins. CCD binding was analyzed by ELISA inhibition studies.
Results
Sixty-two subjects participated: 12 with confirmed occupational asthma/rhinitis (ORA+), 40 asymptomatic exposed (ORAâ), and 10 controls. Of the confirmed subjects, 83% had a positive SPT to obeche. There was a 100% recognition by ELISA in symptomatic subjects vs. 30% and 10% in asymptomatic exposed subjects and controls respectively (p<0.05). Two new proteins were purified, a 24 kDa protein identified as a putative thaumatin-like protein and a 12 kDa gamma-expansin. Both showed allergenic activity in vitro, with the putative thaumatin being the most active, with 92% recognition by ELISA and 100% by basophil activation test in ORA+ subjects. Cross-reactivity due to CCD was ruled out in 82% of cases.
Conclusions
Two proteins of obeche wood were identified and were recognized by a high percentage of symptomatic subjects and by a small proportion of asymptomatic exposed subjects. Further studies are required to evaluate cross reactivity with other plant allergens
Assessment of burnout in veterinary medical students using the Maslach Burnout Inventory-Educational Survey: a survey during two semesters
BACKGROUND: Burnout among veterinary students can result from known stressors in the absence of a support system. The objectives of this study were to evaluate use of the Maslach Burnout Inventory-Educator Survey (MBI-ES) to assess burnout in veterinary students and evaluate the factors that predict the MBI-ES scores. METHODS: The MBI-ES was administered to first (Class of 2016) and second year (Class of 2015) veterinary medical students during the 2012-2013 academic year in the fall and spring semesters. Factor analysis and test reliability for the survey were determined. Mean scores for the subscales determining burnout namely emotional exhaustion (EE), depersonalization (DP) and lack of personal accomplishment (PA) were calculated for both classes in the 2 semesters. Multiple regression analysis was performed to evaluate other factors that predict the MBI-ES scores. RESULTS: A non-probability sampling method was implemented consisting of a voluntary sample of 170 and 123 students in the fall and spring semesters, respectively. Scores for EE, DP and PA were not different between the 2 classes within the same semester. Meanâ±âSD scores for EE, DP and PA for the fall semester were 22.9â±â9.6, 5.0â±â4.8 and 32.3â±â6.7, respectively. Meanâ±âSD scores for EE, DP and PA the spring semester were 27.8â±â10.7, 6.5â±â6.1and 31.7â±â6.8, respectively. The EE score was higher in spring compared to fall while DP and PA scores were not different between the 2 semesters. Living arrangements specifically as to whether or not a student lived with another veterinary medical students was the only variable significantly associated with the MBI-ES scores. Students in this study had moderate levels of burnout based on the MBI-ES scores. CONCLUSIONS: The MBI-ES was an acceptable instrument for assessing burnout in veterinary medical students. The EE scores were higher in the spring semester as compared to the fall semester. Thus students in the first and second years of veterinary school under the current curriculum experience the greatest levels of emotional exhaustion during the spring semester. This has administrative implications for the school, when considering the allocation and use of resources for student support systems during each semester
Asthma caused by occupational exposures is common â A systematic analysis of estimates of the population-attributable fraction
<p>Abstract</p> <p>Background</p> <p>The aim of this paper is to highlight emerging data on occupational attributable risk in asthma. Despite well documented outbreaks of disease and the recognition of numerous specific causal agents, occupational exposures previously had been relegated a fairly minor role relative to other causes of adult onset asthma. In recent years there has been a growing recognition of the potential importance of asthma induced by work-related exposures</p> <p>Methods</p> <p>We searched Pub Med from June 1999 through December 2007. We identified six longitudinal general population-based studies; three case-control studies and eight cross-sectional analyses from seven general population-based samples. For an integrated analysis we added ten estimates prior to 1999 included in a previous review.</p> <p>Results</p> <p>The longitudinal studies indicate that 16.3% of all adult-onset asthma is caused by occupational exposures. In an overall synthesis of all included studies the overall median PAR value was 17.6%.</p> <p>Conclusion</p> <p>Clinicians should consider the occupational history when evaluating patients in working age who have asthma. At a societal level, these findings underscore the need for further preventive action to reduce the occupational exposures to asthma-causing agents.</p
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