Nurses' required end-of-life care competence in health centres inpatient ward - a qualitative descriptive study

Background Studies of nurses' required competence in EOL care in health centres are rare. It is important to produce information about experienced nurses' perceptions of the competence they consider important in their practical work.Aim The aim of this study was to describe nurses' required competence in EOL care in health centre inpatient wards as experienced by nurses.Method A descriptive qualitative study using four semi-structured group interviews (20 nurses) and inductive descriptive content analysis.Results Five categories describing nurses' required competence in EOL care in a health centre inpatient ward were identified: (1) ethics and courage in action, (2) support for the patient, (3) support for the family, (4) care planning and (5) physical care. Factors promoting nurses' competence in EOL care comprised two categories: (1) professional development in EOL care and (2) an organisation that supports EOL care.Conclusions End-of-life care in health centre inpatient wards requires wide and complex competence from nurses. Nurses' experiences of required competence are associated with holistic care of the patient, encountering the family and multiprofessional cooperation. Nurses' competence in EOL care could be enhanced with postgraduate education, and educational planning should be given more attention in the future

Surveillance of endemic foci of tick-borne encephalitis in Finland 1995-2013 : evidence of emergence of new foci

The geographical risk areas for tick-borne encephalitis (TBE) in Finland remained the same until the beginning of the 21st century, but a considerable geographical expansion has been observed in the past 10 years. In order to support public health measures, the present study describes the number of laboratory-confirmed TBE cases and laboratory tests conducted and the associated trends by hospital district, with a particular emphasis on the suspected geographical risk areas. An additional investigation was conducted on 1,957 clinical serum samples throughout the country taken from patients with neurological symptoms to screen for undiagnosed TBE cases. This study identified new TBE foci in Finland, reflecting the spread of the disease into new areas. Even in the most endemic municipalities, transmission of TBE to humans occurred in very specific and often small foci. The number of antibody tests for TBE virus more than doubled (an increase by 105%) between 2007 and 2013. Analysis of the number of tests also revealed areas in which the awareness of clinicians may be suboptimal at present. However, it appears that underdiagnosis of neuroinvasive TBE is not common.Peer reviewe

Site types revisited : comparison of traditional Russian and Finnish classification systems for European Boreal forests

doi: 10.1111/avsc.12525Questions Forest classifications are tools used in research, monitoring, and management. In Finland, the Cajanderian forest site type classification is based on the composition of understorey vegetation with the assumption that it reflects in a predictable way the site's productive value. In Russia, the Sukachevian forest classification is similarly based on understorey vegetation but also accounts for tree species, soil wetness, and paludification. Here we ask whether Cajander's and Sukachev's forest types are effectively the same in terms of species composition, site productivity, and biodiversity. Location Boreal forests on mineral soils in Finland and the Russian part of Fennoscandia. Methods We use vegetation and soil survey data to compare the Cajanderian and the Sukachevian systems in terms of the understorey community composition (that is supposed to define them), soil fertility and tree productivity (that they are expected to indicate), and biodiversity (that is of interest for conservation purposes). We create and employ class prediction models to divide Russian and Finnish sites into Cajander's and Sukachev's types, respectively, based on vegetation composition. We perform cross-comparisons between the two systems by non-metric multidimensional scaling ordination and statistical tests. Results Within both systems, the site types formed similar, meaningful gradients in terms of the studied variables. Certain site types from the two systems were largely overlapping in community composition and arranged similarly along the fertility gradient and may thus be considered comparable. Conclusions The Cajanderian and the Sukachevian systems were both developed in the European boreal zone but differ in terms of the exact rules by which site types are determined. Our results show that analogous types between the systems can be identified. These findings aid in endeavours of technology and information transfer between Finnish and Russian forests for the purposes of basic or applied ecological research and forest management.Peer reviewe

The Fecal Viral Flora of Wild Rodents

The frequent interactions of rodents with humans make them a common source of zoonotic infections. To obtain an initial unbiased measure of the viral diversity in the enteric tract of wild rodents we sequenced partially purified, randomly amplified viral RNA and DNA in the feces of 105 wild rodents (mouse, vole, and rat) collected in California and Virginia. We identified in decreasing frequency sequences related to the mammalian viruses families Circoviridae, Picobirnaviridae, Picornaviridae, Astroviridae, Parvoviridae, Papillomaviridae, Adenoviridae, and Coronaviridae. Seventeen small circular DNA genomes containing one or two replicase genes distantly related to the Circoviridae representing several potentially new viral families were characterized. In the Picornaviridae family two new candidate genera as well as a close genetic relative of the human pathogen Aichi virus were characterized. Fragments of the first mouse sapelovirus and picobirnaviruses were identified and the first murine astrovirus genome was characterized. A mouse papillomavirus genome and fragments of a novel adenovirus and adenovirus-associated virus were also sequenced. The next largest fraction of the rodent fecal virome was related to insect viruses of the Densoviridae, Iridoviridae, Polydnaviridae, Dicistroviriade, Bromoviridae, and Virgaviridae families followed by plant virus-related sequences in the Nanoviridae, Geminiviridae, Phycodnaviridae, Secoviridae, Partitiviridae, Tymoviridae, Alphaflexiviridae, and Tombusviridae families reflecting the largely insect and plant rodent diet. Phylogenetic analyses of full and partial viral genomes therefore revealed many previously unreported viral species, genera, and families. The close genetic similarities noted between some rodent and human viruses might reflect past zoonoses. This study increases our understanding of the viral diversity in wild rodents and highlights the large number of still uncharacterized viruses in mammals