Kompressio - vaikuttavaa haavojen hoitoa

Alaraajaturvotus on kroonisten alaraajahaavojen riskitekijä, ja turvotus estää jo syntyneitä haavoja paranemasta. Kompressiota suositellaan siksi kaikkien alaraajahaavojen hoidoksi, jos raajassa on turvotusta eikä hoidolle ole vasta-aiheita. Jos turvotuksen syytä ei ole mahdollista poistaa, kompressiohoidon tarve on pysyvä. Kompressiohoito jää kuitenkin usein puutteelliseksi tai sitä ei aloiteta lainkaan. Alaraajahaavaa sairastavia potilaita hoitavien on kyettävä tunnistamaan ja ratkaisemaan tavallisimmat kompressiohoitoon liittyvät ongelmat. Tämä onnistuu vain tuntemalla kompressiohoidon ja käytettävien välineiden perusperiaatteet.</p

Congruence between perceived and theoretical knowledge before and after an internet-based continuing education program about VLU nursing care

Background: Previous research has revealed nurses' knowledge gaps in venous leg ulcer (VLU) nursing care, and continuing education is needed. The closer nurses' perceived knowledge is to their evidence-based theoretical knowledge, the better possibilities they have to conduct evidence-based VLU nursing care.Objectives: To assess the congruence between nurses' perceived and theoretical knowledge about VLU nursing care before and after an internet-based education about VLU nursing care (eVLU).Design: Quasi-experimental study with intervention and comparison groups and pre- and post-measurements.Setting: Home health care in two Finnish municipalities.Participants: Nurses (n = 946) working in home health care were invited to participate. In the intervention group, 239 nurses and 229 nurses in the comparison group met the inclusion criteria, and they were all recruited to the study.Method: Nurses were divided into intervention and comparison groups with lottery between the municipalities. Nurses in both groups took care of patients with VLU according to their organizations' instructions. In addition to this, nurses in the intervention group received a 6-week eVLU while those in the comparison group did not. Data were collected with a questionnaire about perceived and theoretical knowledge before education, at six weeks, and at 10 weeks. The percentages of congruence were calculated at every measurement point, and the McNemar test was used to detect statistical significance of changes between measurements.Results: The increase of congruence was more often statistically significant in the intervention group than in the comparison group.Conclusion: The results support the hypothesis that the congruence between perceived and theoretical knowledge will be higher among nurses receiving eVLU. Because of the low participation and drop-outs, the results should be interpreted with caution.</p

Characterization of globulin storage proteins of a low prolamin cereal species in relation to celiac disease

Brachypodium distachyon, a small annual grass with seed storage globulins as primary protein reserves was used in our study to analyse the toxic nature of non-prolamin seed storage proteins related to celiac disease. The main storage proteins of B. distachyon are the 7S globulin type proteins and the 11S, 12S seed storage globulins similar to oat and rice. Immunoblot analyses using serum samples from celiac disease patients were carried out followed by the identification of immune-responsive proteins using mass spectrometry. Serum samples from celiac patients on a gluten-free diet, from patients with Crohn's disease and healthy subjects, were used as controls. The identified proteins with intense serum-IgA reactivity belong to the 7S and 11-12S seed globulin family. Structure prediction and epitope predictions analyses confirmed the presence of celiac disease-related linear B cell epitope homologs and the presence of peptide regions with strong HLA-DQ8 and DQ2 binding capabilities. These results highlight that both MHC-II presentation and B cell response may be developed not only to prolamins but also to seed storage globulins. This is the first study of the non-prolamin type seed storage proteins of Brachypodium from the aspect of the celiac disease

Increasing prevalence and high incidence of celiac disease in elderly people: A population-based study

<p>Abstract</p> <p>Background</p> <p>Celiac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s).</p> <p>Methods</p> <p>The study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy.</p> <p>Results</p> <p>Within three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002–2005 was 0.23%, giving an annual incidence of 0.08% in this population.</p> <p>Conclusion</p> <p>The prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.</p

Impact of improved recording of work-relatedness in primary care visits at occupational health services on sickness absences: study protocol for a randomised controlled trial

Abstract Background Employment protects and fosters health. Occupational health services, particularly in Finland, have a central role in protecting employee health and preventing work ability problems. However, primary care within occupational health services is currently underused in informing preventive activities. This study was designed to assess whether the recording of work ability problems and improvement of follow-up of work-related primary care visits can reduce sickness absences and work disability pensions after 1 year. Methods/design A pragmatic trial will be conducted using patient electronic registers and registers of the central pensions agency in Finland. Twenty-two occupational health centres will be randomised to intervention and control groups. Intervention units will receive training to improve recording of work ability illnesses in the primary care setting and improved follow-up procedures. The intervention impact will be assessed through examining rates of sickness absence across intervention and control clinics as well as before and after the intervention. Discussion The trial will develop knowledge of the intervention potential of primary care for preventing work disability pensions and sickness absence. The use of routine patient registers and pensions registers to assess the outcomes of a randomised controlled trial will bring forward trial methodology, particularly when using register-based data. If successful, the intervention will improve the quality of occupational health care primary care and contribute to reducing work disability. Trial registration ISRCTN Registry reference number ISRCTN45728263 . Registered on 18 April 2016

Varhaiserityisopettajien ajatuksia työhön kohdistuneista muutoksista

Tiivistelmä Tutkimuksessa selvitettiin yhden kunnan varhaiserityisopettajien ajatuksia heidän työhönsä kohdistuneista muutoksista. Kyseisessä kunnassa lakkautettiin päiväkodeissa aiemmin toimineet erityisryhmät ja integroidut erityisryhmät ja kaikki lapset siirtyivät yhteisiin ryhmiin. Varhaiserityisopettajien työnkuva yhdenmukaistui konsultoivaksi, useamman päiväkodin ja ryhmän yhteiseksi opettajaksi. Varhaiserityisopettajien ajatuksia muutoksesta koottiin elektronisella kyselyllä. Sama kysely toistettiin kolmen vuoden aikana kolme kertaa. Vastauksia tulkittiin muutokseen ja kerronnallisuuteen liittyvien teorioiden kautta (Bruner 1986; Fullan 2001). Vastauksissaan varhaiserityisopettajat pohtivat tehtyjä ja meneillään olevia muutoksia ja ehdottivat ratkaisuja ongelmallisiksi kokemiinsa asioihin. Vastaajat kertoivat itsensä ja oman työnsä muutoksen kohteeksi eivätkä asemoituneet muutosprosessissa sen aktiivisiksi toteuttajiksi. He kuvasivat tapahtuneita muutoksia prosessina, jota he tarkastelivat sekä ulkoapäin, että omana sisäisenä muutosprosessinaan. Varhaiserityisopettajat yhdistivät muutokset inkluusioon ja inklusiiviseen kasvatukseen. Inkluusion he ymmärsivät lähinnä tukea tarvitsevien lasten oikeutena olla samoissa ryhmissä muiden lasten kanssa. Varhaiskasvatusta he halusivat kehittää maltillisesti ja joustavia malleja etsien.Abstract This study focused on the thoughts about changes in the work of early childhood special education teachers in one Finnish municipality. In this district, all the special groups and integrated special groups that had been functioning as kindergartens were closed down, and the children were placed in regular groups. The teachers’ work profile changed to that of more consultative teachers shared by several kindergartens and groups. The early childhood special education teachers’ thoughts on change were collected with an electronic questionnaire repeated three times within a period of three years. The responses were interpreted through the theories of change and narrativity (Bruner, 1986; Fullan, 2001). In their responses, the early childhood special education teachers reflected on past and ongoing changes, suggesting solutions to issues they saw as problematic. They positioned themselves and their work as a target of change, and not as active actors in the process of change. They described the changes that had taken place as a process that they were considering both from the outside (the decisions were not theirs) and as their own internal thoughts about this process of change. The early childhood special education teachers associated the change with inclusion and inclusive education. They understood inclusion as the right of children with special needs to join the same groups as other children. They wanted to develop early childhood education in a composed manner, looking for flexible models

Touch in children’s everyday peer relations in preschools

Abstract The article explores how touch appears in children’s everyday peer relations in preschools. The narrative research material consists of video recordings produced in four Finnish preschools. Touch in children’s relations appeared as an invitation, an attempt to control and a conventional pattern. The findings show that narrative environments of the preschools produce, enable and limit touch in the children’s everyday peer relations. In terms of touch, children follow the practices created by educators and the wider society. However, the children also challenge these practices and the set limits, appearing as active agents in producing embodied acts of touch in preschools