Jäsenten kuuntelu järjestöjen nuorisotoiminnan kehittämisessä : Case Suomen Nuorisoseurat

Opinnäytetyössä tarkastelen järjestöjen kehittämistä nuorten osallisuuden edistämisen ja jäsenten kuulemisen näkökulmista. Työntekijöiden teemahaastatteluissa selvitän, mitä ajatuksia, ideoita ja mahdollisia toimenpiteitä Suomen Nuorisoseurat saa kehittämistyöhön Allianssi ry:n Vetovoima-hankkeen valmennusmenetelmien tuloksena. Tutkimus painottuu laadulliseen ja tapaustutkimukseen. Nuorisoseurat toteutti hankkeen valmennuksessa saadun idean valtuustokokouksen muuttamisesta osallistaviksi haastatteluiksi, jotka jatkoivat järjestössä tehtävää kehittämistyötä jäsentenkuuntelun teemalla. Opinnäytetyössä analysoin valtuustohaastattelujen vastauksia taulukoissa ja kuvioissa, joihin purin vastaukset teemoittamalla ja osittain koodaamalla. Menetelmillä tuon esille toistuvia teemoja sekä kehitysideoita. Lisäksi havainnoin hankkeen menetelmiä valmennusta ja sparrausta osallistumalla yhdentoista valmennukseen valitun järjestön yhteiseen valmennuspäivään sekä Nuorisoseurojen ja heidän hanke-kohtaisen valmentajansa valmennustapaamiseen. Valmennus- ja sparrausmenetelmien käytöstä haastattelen myös Nuorisoseurojen valmentajaa. Osan opinnäytetyötä suunnittelen ja toteutan osallistavia tehtäviä järjestöille valmennuksien väliseen kommunikointiin tarkoitetussa Facebook-ryhmässä ja yhteisessä valmennustapaamisessa. Menetelmillä pyrin aktivoimaan Facebook-ryhmää, tuomaan kehittämistyöhön positiivisen näkökulman sekä ryhmäyttämään eri järjestöjen toimijoita ja saamaan aikaan hedelmällistä keskustelua toiminnan kehittämisen eri puolista.In my Bachelor’s thesis I examine organisational development with viewpoints in promoting youth participation and listening to members of organisations. I conducted a theme-based interview in the organisation Nuorisoseurat to figure out what thoughts, ideas and possible actions they are going to recieve from the project Vetovoima as a result of its coaching methods. This thesis is both a quality and case study. The organisation Nuorisoseurat carried out an idea changing the council meeting to interviews that demanded participating. Interviewing was continued with the theme of listening to the members in development work. In my thesis I analyse the interviews of the council meetings by changing the answers into themes by using coding in order to put the results into tables and patterns. My aim is to bring out frequent themes and ideas with these methods. I also observe the methods of the project, coaching and instructing by taking part in one coaching day, which includes every eleven organization chosen in the project, and coaching meeting of Nuorisoseurat and their project-specific coach. I interview the coach of Nuorisoseurat about the use of different coaching methods. A part of my study is that I planned and organised tasks which demand participating in organisations in a Facebook group that intends to communicate between coaching days and during coaching days within every organisation. I strive to activate the Facebook group with my methods and bring a positive point of view into developing work and mixed groups from different organisations and create a space for productive conversation of the different angles in operational development

On assumed usefulness of wearable sensors in early recognition of migraine attacks perceived by patients

This study analysed how migraine patients assume to improve their daily life if wearable sensors provide them pre-warnings of approaching or impending migraine attacks. The study analysed the use of new technology in identifying pre-symptoms in migraine patients using the Technology Acceptance Model (TAM) focusing on the assumed usefulness of a wearable device. The study added understanding of getting migraine patients to accept smart technology to support their own treatments. The results were drawn from a sample of altogether 582 migraine patients with or without an aura. The difference between migraine with aura and without aura is that migraine with aura precedes physical symptoms like visual disturbances, numbness, and difficulty in speech, while there are no pre-symptoms in migraine without aura. The assumed wearable device (WBAN) notifies, however, the bio-signals of an oncoming migraine attack. Due to current achievements with available digitalised tools to monitor health and wellbeing, also self-care is benefiting. Pre-migraine symptoms are among the biggest challenges in identifying migraine. Noting this, our study addressed the value of wearable sensors in early recognition of migraine attacks

Pancreatic cancer - the past, the present, and the future

Background Pancreatic cancer has been and still is associated with a very poor prognosis. This is due to a lack of major breakthroughs with respect to early diagnosis, prognostication, prediction, as well as novel, targeted therapies. The benefits of surgery and chemotherapy are evident, but the fact that only some 10% of all patients have early, localized disease highlights the unmet need for new early detection methods. An improved understanding of tumor biology and the development of molecular markers detectable both in the circulation and in cancer tissues may underlie the development of new tools for optimizing both diagnosis and treatment. Material and methods Review of the literature. Results and conclusion If we do not improve precision oncology for pancreatic ductal adenocarcinoma, the prognosis will still remain dismal and the" burden" on society will increase substantially.Peer reviewe

Optimal Perioperative Fluid Therapy Associates with Fewer Complications After Pancreaticoduodenectomy

Background Optimal fluid management in pancreaticoduodenectomy patients remains contested. We aimed to examine the association between perioperative fluid administration and postoperative complications. Methods We studied 168 pancreaticoduodenectomy patients operated in 2015 (n = 93) or 2017 (n = 75) at Helsinki University Hospital. In 2015, patients received intraoperative fluids following a goal-directed approach and, in 2017, according to anesthesiologist's clinical practice (conventional fluid management). We analyzed the differences in perioperative fluid administration between the groups, specifically examining the occurrence of severe complications (Clavien-Dindo >= III), pancreatic fistulas, cardiovascular complications, and the length of hospital stay. Results The goal-directed group received more intraoperative fluids than the conventional fluid management group (12.0 ml/kg/h vs. 8.3 ml/kg/h, p < 0.001). Urine output (770 ml vs. 575 ml, p = 0.004) and intraoperative fluid balance (9.4 ml/kg/h vs. 6.3 ml/kg/h, p < 0.001) were higher in the goal-directed group than in the conventional fluid management group. Severe surgical complications (19.4% vs. 38.7%, p = 0.009) as well as clinically relevant pancreatic fistulas (1.1% vs. 10.7%, p = 0.011) occurred more frequently in patients receiving conventional fluid management. Moreover, the conventional fluid management group experienced longer hospital stays (9.0 vs. 11.5 days, p = 0.02). Lower intraoperative fluid volume accompanying conventional fluid management was associated with a higher risk of severe postoperative complications compared with higher volume in the goal-directed group (odds ratio 2.58 (95% confidence interval 1.04-6.42), p = 0.041). Conclusions The goal-directed group experienced severe complications less frequently. Our findings indicate that optimizing the intraoperative fluid administration benefits patients, while adopting a too-restrictive approach represents an inferior choice.Peer reviewe

Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients : a cross-sectional study

Background No previous studies have examined the possible relationship between intraductal papillary mucinous neoplasm (IPMN) and the developmental ductal variations of the pancreas, such as an ansa pancreatica and a meandering main pancreatic duct (MMPD). Methods This retrospective cross-sectional study enrolled 214 patients, 108 with IPMN disease and 106 subjects from a community at the tertiary care unit. The main pancreatic duct (MPD) was evaluated in the head of the pancreas by its course, which were non-MMPD: descending, vertical, and sigmoid, or MMPD including loop types, reverse-Z subtypes, and an N-shape, which was identified for the first time in this study. IPMN patients were also evaluated for worrisome features (WF) or high-risk stigmata (HRS), and the extent of IPMN cysts. Results Among IPMN patients, 18.4% had MMPD, which we observed in only 3.0% of the control group (P < 0.001). Patients with MMPD were more likely to belong to the IPMN group compared with non-MMPD patients [odds ratio (OR) 6.4, 95% confidence interval (CI) 2.2-24.9]. Compared with a descending shape MPD, IPMN patients with an N-shaped MPD were more likely to have a cystic mural nodule (OR 5.9, 95% CI 1.02-36.0). The presence of ansa pancreatica associated with more extent IPMN disease (OR 12.8, 95% CI 2.6-127.7). Conclusions IPMN patients exhibited an MMPD more often than control patients. Ansa pancreatica associated with multiple cysts. Furthermore, an N-shape in IPMN patients associated with cystic mural nodules, suggesting that this shape serves as a risk factor for more severe IPMN.Peer reviewe

Changes in CRP and CA19-9 during Preoperative Oncological Therapy Predict Postoperative Survival in Pancreatic Ductal Adenocarcinoma

Introduction: Tumor and systemic inflammatory markers predict survival. This retrospective study aimed to explore the changes in CRP, CA19-9, and other routine laboratory tests during preoperative oncological therapy as prognostic factors in pancreatic ductal adenocarcinoma (PDAC). Methods: Between 2000 and 2016, 68 borderline resectable PDAC patients received preoperative oncological therapy and underwent subsequent surgery at Helsinki University Hospital, Finland. We investigated changes in CRP, CA19-9, CEA, albumin, leukocytes, bilirubin, and platelets and examined the impact on survival. Results: In the multivariate analysis, CRP remaining at >= 3 mg/L after preoperative oncological therapy predicted a poorer postoperative outcome when compared to CRP decreasing to or remaining at 90% during preoperative treatment predicted a favorable postoperative outcome (HR 0.297, 95% CI: 0.124-0.708, p = 0.006). In the Kaplan-Meier analysis, the median survival for patients with CRP remaining at = 3 mg/L (42 months vs. 24 months, p = 0.001). Patients with a CA19-9 decrease >90% or level normalization (toPeer reviewe

The expression and prognostic value of toll-like receptors (TLRs) in pancreatic cancer patients treated with neoadjuvant therapy

Publisher Copyright: Copyright: © 2022 Nurmi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objectives Toll-like receptors (TLRs) play a pivotal role in the immune system and carcinogenesis. There is no research on TLR expression and association with survival among preoperatively treated pancreatic cancer patients. We studied the expression intensity and prognostic value of TLRs in pancreatic cancer patients treated with neoadjuvant therapy (NAT) and compared the results to patients undergoing upfront surgery (US). Method Between 2000 and 2015, 71 borderline resectable patients were treated with NAT and surgery and 145 resectable patients underwent upfront surgery at Helsinki University Hospital, Finland. We immunostained TLRs 1–5, 7, and 9 on sections of tissue-microarray. We classified TLR expression as 0 (negative), 1 (mild), 2 (moderate), or 3 (strong) and divided into high (2–3) and low (0–1) expression for statistical purposes. Results Among TLRs 1, 3, and 9 (TLR1 81% vs 70%, p = 0.008; TLR3 92% vs 68%, p = 0.001; TLR9 cytoplasmic 83% vs 42%, p<0.001; TLR9 membranous 53% vs 25%, p = 0.002) NAT patients exhibited a higher immunopositivity score more frequently than patients undergoing upfront surgery. Among NAT patients, a high expression of TLR1 [Hazards ratio (HR) 0.48, p<0.05] associated with a longer postoperative survival, whereas among US patients, high expression of TLR5 (HR 0.64, p<0.05), TLR7 (HR 0.59, p<0.01, and both TLR7 and TLR9 (HR 0.5, p<0.01) predicted a favorable postoperative outcome in separate analysis adjusted for background variables. Conclusions We found higher immunopositive intensities among TLRs 1, 3, and 9 in NAT patients. A high TLR1 expression associated with a longer survival among NAT patients, however, among US patients, high expression intensity of TLR5 and TLR7 predicted a favorable postoperative outcome in the adjusted analysis.Peer reviewe

Preoperative oncologic therapy and the prolonged risk of venous thromboembolism in resectable pancreatic cancer

Background Pancreatic cancer is one of the most prothrombotic cancers. Among patients receiving preoperative chemotherapy followed by surgery, chemotherapy and surgery represent a compound risk for venous thromboembolism (VTE), rendering the postoperative time a period of interest. We aimed to analyze whether preoperative oncologic therapy increases the risk for VTE after surgery and identify which characteristics associate with VTE. Methods We first identified patients surgically treated for pancreatic cancer at Helsinki University Hospital between 2000 and 2017, collecting the following data: gender, age at surgery, preoperative medication, body mass index (BMI), preoperative chemo(radio)therapy, tumor size, positive node ratio, perineural and perivascular invasion, tumor grade, surgical technique, postoperative anticoagulation, adjuvant therapy, time of VTE, time of local disease recurrence, time of distant metastasis, and time of death. With a follow-up period of at least 2 years or until death, we compared a total of 93 preoperative oncologic therapy and 291 upfront surgery patients (n = 384, median age 66.5 years). Results Preoperative oncologic therapy increased the risk for thrombosis after surgery (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.03-2.53). The VTE incidence rate remained high for up to 2 years after surgery. BMI >= 30 kg/m(2), prior anticoagulation, and disease recurrence (p < 0.05, respectively) associated with VTE. VTE is also associated with shorter overall survival (HR 3.25; 95% CI 2.36-4.44). In 71.6% (95% CI 60.5-81.1) of patients, VTE was diagnosed after disease recurrence. Conclusions Preoperative oncologic therapy represents an independent risk factor for VTE, not only during the immediate postoperative period but up to 2 years after surgery. VTE is associated with obesity, prior anticoagulation, and disease recurrence and diminishes overall survival.Peer reviewe