Palliatiivisen hoidon osaamisen kehittäminen edellyttää tutkimus-, kehittämis- ja innovaatiotoimintaa:EduPal-hanke kehittäjänä

Tiivistelmä Laadukas, näyttöön perustuva palliatiivinen hoito on jokaisen ihmisoikeus. Tämä edellyttää riittävän koulutuksen ja osaamisen omaavaa henkilöstöä palliatiivisen hoidon eri tasoille. Palliatiivisen hoidon koulutuksessa tutkimus- kehittämis- ja innovaatiotoiminta (TKI) on saumattomasti integroitu koulutuksen sisällölliseen ja pedagogiseen kehittämistoimintaan. Tässä artikkelissa kuvataan palliatiivisen hoidon koulutuksen kehittämiseen liittyvää TKI-toimintaa EduPal-hankkeessa, joka on toteutunut monialaisesti tiiviissä yhteistyössä ammattikorkeakoulujen, yliopistojen sekä keskeisten työelämän sidosryhmien kanssa. EduPal-hanke on kansallisesti ja kansainvälisesti merkittävä, sillä hankkeessa tarkastellaan mittavasti ja moniammatillisesti palliatiivisen hoidon opetuksen nykytilaa ja kehitetään perus- ja erityistason osaamisen kuvauksia, opetussuunnitelmasuosituksia sekä yhteistyötä ammattikorkeakoulujen ja yliopistojen välillä

Thromboinflammatory changes in plasma proteome of pregnant women with PCOS detected by quantitative label-free proteomics

Abstract Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder of fertile-aged women. Several adverse pregnancy outcomes and abnormalities of the placenta have been associated with PCOS. By using quantitative label-free proteomics we investigated whether changes in the plasma proteome of pregnant women with PCOS could elucidate the mechanisms behind the pathologies observed in PCOS pregnancies. A total of 169 proteins with ≥2 unique peptides were detected to be differentially expressed between women with PCOS (n = 7) and matched controls (n = 20) at term of pregnancy, out of which 35 were significant (p-value < 0.05). A pathway analysis revealed that networks related to humoral immune responses, inflammatory responses, cardiovascular disease and cellular growth and proliferation were affected by PCOS. Classification of cases and controls was carried out using principal component analysis, orthogonal projections on latent structure-discriminant analysis (OPLS-DA), hierarchical clustering, self-organising maps and ROC-curve analysis. The most significantly enriched proteins in PCOS were properdin and insulin-like growth factor II. In the dataset, properdin had the best predictive accuracy for PCOS (AUC = 1). Additionally, properdin abundances correlated with AMH levels in pregnant women

Ethinylestradiol in combined hormonal contraceptive has a broader effect on serum proteome compared with estradiol valerate:a randomized controlled trial

Abstract Study question: Does an estradiol-based combined oral contraceptive (COC) have a milder effect on the serum proteome than an ethinylestradiol (EE)-based COC or dienogest (DNG) only? Summary answer: The changes in serum proteome were multifold after the use of a synthetic EE-based COC compared to natural estrogen COC or progestin-only preparation. What is known already: EE-based COCs widely affect metabolism, inflammation, hepatic protein synthesis and blood coagulation. Studies comparing serum proteomes after the use of COCs containing EE and natural estrogens are lacking. Study design, size, duration: This was a spin-off from a randomized, controlled, two-center clinical trial. Women (n = 59) were randomized to use either EE + DNG, estradiol valerate (EV) + DNG or DNG only continuously for 9 weeks. Participants/materials, setting, methods: Participants were healthy, young, white volunteer women. Serum samples were collected before and after 9 weeks of hormonal exposure. Samples from 44 women were available for analysis (EE + DNG n = 14, EV + DNG n = 16 and DNG only n = 14). Serum proteins were analyzed by quantitative, discovery-type label-free proteomics. Main results and the role of chance: Altogether, 446 proteins/protein families with two or more unique peptides were detected and quantified. The number of proteins/families that altered over the 9-week period within the study groups was 121 for EE + DNG and 5 for EV + DNG, while no changes were detected for DNG only. When alterations were compared between the groups, significant differences were detected for 63 proteins/protein families, of which 58 were between the EE + DNG and EV + DNG groups. The most affected functions during the use of EE + DNG were the complement system, acute phase response signaling, metabolism and the coagulation system. The results were validated by fetuin-B and cortisol-binding globulin ELISA and sex hormone-binding globulin immunoassay. Large scale data: Data are available via ProteomeXchange with identifiers PXD033617 (low abundance fraction) and PXD033618 (high abundance fraction). Limitations, reason for caution: The power analysis of the trial was not based on the proteomic analysis of this spin-off study. In the future, targeted proteomic analysis with samples from another trial should be carried out in order to confirm the results. Wider implications of the findings: The EE-based COC exerted a broader effect on the serum proteome than the EV-based COC or the DNG-only preparation. These results demonstrate that the effects of EE in COCs go far beyond the established endpoint markers of estrogen action, while the EV combination is closer to the progestin-only preparation. The study indicates that EV could provide a preferable option to EE in COCs in the future and signals a need for further studies comparing the clinical health outcomes of COCs containing EE and natural estrogens

Palliatiivisen hoidon opettajien osaamisen vahvistaminen

Tiivistelmä Sosiaali- ja terveysalan opettajilla tulee olla riittävä osaaminen palliatiivisesta hoidosta. Osaamisen päivittäminen opetussuunnitelma- ja kansainvälisten suositusten mukaiseksi on ajankohtaista. Näin taataan koulutuksessa oleville opiskelijoille riittävä osaaminen toimia palliatiivisen potilaan ja hänen läheisensä tukena sairauden eri vaiheissa. EduPal-hankkeessa palliatiivisen hoidon opettajille suunniteltiin viiden opintopisteen laajuinen verkkokurssi, jonka tavoitteena on vahvistaa opettajien osaamista palliatiivista hoidosta sekä pedagogista osaamista.Abstract Strenghtening competencies of palliative care teachers Teachers of future healthcare professionals should have adequate expertise in palliative care, and they should update their expertise in accordance with curriculum- and international recommendations. In this way, students in education are guaranteed sufficient skills to act as support for the palliative patient and their loved ones at different stages of the disease. A fivecredit online course for palliative care teachers was designed to strengthen the teachers’ competence in palliative care and pedagogical competence