Creating an operational framework for digital multi-disciplinary oral health promotion in children - the ODA pilot in Kuopio public oral health care

Health care professionals are in the front line to identify signals of life issues. In Finnish school healthcare 25% of the children are raising concern from the professional’s perspective. In oral health care, ill oral health may be an indicator of issues and vice versa. However, the early inter-professional cross-talk is minimal. The aim of this project was to recognize the patients that would raise concern among oral health care professionals. Holistic interventions of these patients would secondarily improve oral health. Targeting the group with heaviest disease and social burden, the morbidity would cease in the total population. The staff of Kuopio public oral health care was trained for early patient recognition and referral to an oral health intervention clinic. The clinic focused on speaking out the patient’s life situation and individual oral health education. If needed, a multi-professional primary healthcare support team was gathered. With the most complex problems, the family services and child protection services were consulted. In 2017 and 2018 there were 264 and 344 recognized concerning individuals. Through tailored intervention strategies, the target group was able to increase brushing, lower the plague index and improve self-reported oral health (SOH). Total population indicators (decayed-missing-filled index, DMFT and invasive treatment) showed decreasing trends but have too many background variables for reliable effect assessment. Oral health can play an integral role in recognizing compromised individuals. The operational changes created during the project will act as platform for future digital tools

Introduction and Rapid Spread of SARS-CoV-2 Omicron Variant and Dynamics of BA.1 and BA.1.1 Sublineages, Finland, December 2021

Multiple introductions of SARS-COV-2 Omicron variant BA.1 and BA.1.1. lineages to Finland were detected in early December 2021. Within 3 weeks, Omicron overtook Delta as the most common variant in the capital region. Sequence analysis demonstrated the emergence and spread through community transmission of a large cluster of BA.1.1 virus.Peer reviewe

Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial

We report the first long-term follow-up of a randomized trial (NCT04978259) addressing the effects of remdesivir on recovery (primary outcome) and other patient-important outcomes one year after hospitalization resulting from COVID-19. Of the 208 patients recruited from 11 Finnish hospitals, 198 survived, of whom 181 (92%) completed follow-up. At one year, self-reported recovery occurred in 85% in remdesivir and 86% in standard of care (SoC) (RR 0.94, 95% CI 0.47-1.90). We infer no convincing difference between remdesivir and SoC in quality of life or symptom outcomes (p > 0.05). Of the 21 potential long-COVID symptoms, patients reported moderate/major bother from fatigue (26%), joint pain (22%), and problems with memory (19%) and attention/concentration (18%). In conclusion, after a one-year follow-up of hospitalized patients, one in six reported they had not recovered well from COVID-19. Our results provide no convincing evidence of remdesivir benefit, but wide confidence intervals included possible benefit and harm.Peer reviewe

"Jos sä kerrot, niin me tapetaan sut" : Kehitysvammaisten kokemuksia kiusaamisesta

Opinnäytetyön tarkoituksena oli tutkia kehitysvammaisten henkilöiden kokemuksia ja ajatuksia kiusaamisesta. Tutkimuksella haluttiin selvittää, miten kehitysvammaiset määrittelevät kiusaamisen, millaisia omia kokemuksia heillä on siitä sekä ajatukset siihen puuttumisesta ja vähentämisestä. Teoreettinen viitekehys käsittelee kehitysvammaisuutta, kehitysvammaisten erityishuoltoa sekä kiusaamista. Tutkimus toteutettiin kvalitatiivisena eli laadullisena tutkimuksena. Tutkimusaineisto kerättiin teemahaastattelemalla kymmentä kehitysvammaista päivä- ja työtoiminnan asiakasta. Aineisto analysoitiin aineistolähtöisellä sisällönanalyysilla. Tutkimuksessa kävi ilmi, että kiusaamisen määritelmä ei ollut täysin selkeä kaikkien tutkittavien kohdalla. Kiusaamisen määritelmää olisikin hyvä käydä tarkemmin läpi kehitysvammaisten kanssa. Kaikki tutkimuksen kymmenen haastateltavaa olivat kokeneet kiusaamista jossakin vaiheessa elämäänsä. Kiusaaminen oli esiintynyt suurimmalla osalla sanallisen ja fyysisen kiusaamisen keinoin. Seitsemän haastateltavaa oli kokenut kiusaamista kouluiässä ja puolet aikuisiällä. Tutkimuksessa kävi ilmi, että kiusaamiseen ei ollut osattu puuttua oikeilla keinoilla. Tästä huolimatta kiusaamisesta uskallettaisiin kertoa tänä päivänä toisin kuin lapsuusiässä.The purpose of this bachelor’s thesis was to study the experiences and thoughts of intellectually disabled people about bullying. The research was conducted in order to find out how these people define bullying, what kind of own experiences they have and if they have any ideas on how to intervene and reduce it. The theoretical framework of the study deals with intellectual disability, special care and bullying. The research was conducted qualitatively. The research material was collected with theme interviews with ten intellectually disabled persons who are clients of day- and work activity. The research material was analysed using material-based content analysis. The results show that the definition of bullying is not clear to everyone of the respondents. Thus it would be good to go through the definition of bullying with intellectually disabled people. All of the respondents had experienced bullying in their life. In most cases the bullying had manifested itself in verbal and physical forms. Of the respondents seven had experienced bullying in school age and a half of the respondents in adulthood. The study discovered that the bullying had not been intervened in with proper measures. However, the respondents think that they nowadays have the courage to tell about bullying contrary to their childhood

HOITAJAN TOIMINTA EPILEPSIAKOHTAUKSESSA : Epilepsiaopas Kangaspirtin henkilökunnalle

Opinnäytetyön tarkoituksena oli tuottaa selkeä, yksinkertainen ohjevihko epilepsiasta sekä epilepsiakohtauksessa toimimisesta kehitysvammaisyksikön henkilökunnalle. Opinnäytetyömme tavoite oli kehittää hoitotyötä sekä henkilökunnan osaamista epilepsiakohtauksessa toimimisessa. Opinnäytetyömme on tehty yhteistyössä Attendo Kangaspirtin henkilökunnan kanssa. Opinnäytetyömme on toiminnallinen opinnäytetyö. Opinnäytetyö on tehty tuotteistamisen menetelmää käyttäen. Ohjevihko sisältää hoitajalle toimintaohjeet epilepsiakohtauksen tullessa. Ohjevihossa on kerrottu myös yleisesti epilepsiasta sekä sen hoidosta

Luokkatandemilla vauhtia ammattikorkeakoulun toisen kotimaisen kielen opiskeluun

Artikkeli kertoo Insinööriopiskelijoiden korkeakoulutandem -hankkeesta, jossa Vaasan ammattikorkeakoulun ja Yrkeshögskolan Novian insinööriopiskelijat harjoittelivat yhdessä suomea/ruotsia toisen kotimaisen kielen opintojakson puitteissa. Menetelmäksi valittiin luokkatandem. Tavoitteena oli, että opiskelijat saisivat harjoitella ennen kaikkea suullista kielitaitoa mielekkäiden tehtävien parissa sosiaalisessa vuorovaikutuksessa. Sekä opettajien että opiskelijoiden kokemukset olivat erittäin myönteisiä ja kannustavat jatkamaan luokkatandemin käyttöä jatkossakin toisen kotimaisen kielen opetuksessa.nonPeerReviewe

Impact of RYGB surgery on plasma immunoglobulins : association between blood pressure and glucose levels six months after surgery

We aimed to study levels of natural antibodies in plasma, and their associations to clinical and fecal biomarkers, before and 6 months after Roux-en-Y gastric bypass (RYGB) surgery. Thirty individuals with obesity [16 type 2 diabetic, 14 non-diabetic (ND)] had RYGB surgery. Total plasma IgA, IgG and IgM antibody levels and specific antibodies to oxidized low-density lipoprotein (oxLDL), malondialdehyde-acetaldehyde adducts, Porphyromonas gingivalis gingipain A hemagglutinin domain (Rgp44), and phosphocholine were measured using chemiluminescence immunoassay. Associations between plasma and fecal antibodies as well as clinical markers were analyzed. RYGB surgery reduced blood pressure, and the glycemic state was improved. A higher level of diastolic blood pressure was associated with lower plasma antibodies to oxLDL after surgery. Also, lower level of glucose markers associated with lower level of plasma antibodies to bacterial virulence factors. Antibodies to oxLDL decreased after surgery, and positive association between active serum lipopolysaccharide and specific oxLDL antibodies was detected. Total IgG levels decreased after surgery, but only in ND individuals. Reduced level of total plasma IgG, improved state of hypertension and hyperglycemia and their associations with decreased levels of specific antibodies in plasma, suggest an improved state of systemic inflammation after RYGB surgery.Peer reviewe

Susceptibility of low-density lipoprotein particles to aggregate depends on particle lipidome, is modifiable, and associates with future cardiovascular deaths

Abstract Aims: Low-density lipoprotein (LDL) particles cause atherosclerotic cardiovascular disease (ASCVD) through their retention, modification, and accumulation within the arterial intima. High plasma concentrations of LDL drive this disease, but LDL quality may also contribute. Here, we focused on the intrinsic propensity of LDL to aggregate upon modification. We examined whether inter-individual differences in this quality are linked with LDL lipid composition and coronary artery disease (CAD) death, and basic mechanisms for plaque growth and destabilization. Methods and results: We developed a novel, reproducible method to assess the susceptibility of LDL particles to aggregate during lipolysis induced ex vivo by human recombinant secretory sphingomyelinase. Among patients with an established CAD, we found that the presence of aggregation-prone LDL was predictive of future cardiovascular deaths, independently of conventional risk factors. Aggregation-prone LDL contained more sphingolipids and less phosphatidylcholines than did aggregation-resistant LDL. Three interventions in animal models to rationally alter LDL composition lowered its susceptibility to aggregate and slowed atherosclerosis. Similar compositional changes induced in humans by PCSK9 inhibition or healthy diet also lowered LDL aggregation susceptibility. Aggregated LDL in vitro activated macrophages and T cells, two key cell types involved in plaque progression and rupture. Conclusion: Our results identify the susceptibility of LDL to aggregate as a novel measurable and modifiable factor in the progression of human ASCVD