Asiakkaan hyvän kohtelun edistäminen - fokuksena johtamisen kehittäminen : lasten, nuorten ja aikuisten erityisryhmien asumispalveluissa

Opinnäytteenä toteutetussa hankemuotoisessa kehittämisprojektissa keskityttiin johtamisen kehittämiseen erityisen tuen asiakkaiden hyvän kohtelun edistämiseksi. Prosessi käynnistyi syksyllä 2016 kehittämistarpeesta ja jatkui vaiheittain kevääseen 2018 yksityisellä sosiaali- ja terveyspalvelujen tuottajalla. Tiedon hankinta suoritettiin prosessin aikana tutkimuksista, säädöksistä, kokemusasiantuntijoilta, osallisuus-, johtamis- ja kehittämiskirjallisuudesta sekä fokusryhmätyöskentelystä. Projektissa toimittiin asiakaslähtöisen kehittämismenetelmän mukaisesti. Asiakkaiden osallisuus ja asiakaslähtöinen kehittäminen olivat merkittävä osa kehittämistyötä ja toivat sille lisäarvoa. Asiakkaiden osallisuutta sekä kokemusasiantuntijuutta hyödynnettiin kuulemalla asiakkaita kahdessa asiakasfoorumissa. Asiakasfoorumien tarkoitus oli tuottaa asiakaskokemuksia, mitä on hyvä kohtelu ja miten työntekijä toimii hyvin. Erityisen tuen asiakkaat osasivat tuottaa tarvittavan tiedon. Asiakasfoorumeissa selvitettiin samalla organisaation omaan käyttöön laadullisen tutkimuksen elementtejä hyödyntäen, ovatko asiakkaat kokeneet epäasiallista toimintaa tai kaltoinkohtelua. Vakavaa kaltoinkohtelua ei ilmennyt. Silti epäasiallisuuksien vähentämisen johtamiseen ja ennaltaehkäiseviin toimenpiteisiin tuli kuitenkin kiinnittää huomiota, kartoittaa riskejä sekä kehittää toimintatapoja. Asiakasfoorumeita seurasi esimiesten fokusryhmätyöskentelyt, joita käytettiin kehittämismenetelmänä osaamisen lisäämiseksi. Asiakasfoorumien tuottama referoitu tieto esiteltiin ja hyödynnettiin kehittämistarpeena. Valviran kaltoinkohteluun liittyvän tutkimuksen (2015) johtamispuutteita arvioitiin organisaation näkökulmasta. Fokusryhmissä kehitettiin kaltoinkohtelun ilmoitusprosessin toimintaohje ja yleisempi toimintamalli esimiestyön kehittämiseksi kaltoinkohtelun ennaltaehkäisemiseksi. Projektin tuotoksena saatiin kasvatettua johtamisosaamisen pääomaa, kehitettiin kaltoin kohtelun ilmoituskäytäntöjen prosessiohjeistus esimiehille ja henkilökunnalle sekä yleinen toimintamalli esimieskäyttöön kaltoinkohtelun ennaltaehkäisemiseksi. Kaikkien käytettyjen menetelmien ja materiaalien päätelmänä voidaan sanoa, että kaikkein suurimmassa vaarassa kaltoinkohtelulle ovat heikommassa asemassa olevat, kuten puheella heikosti kommunikoivat tai puhumattomat vammaiset asiakkaat. Heikompien asiakkaiden asema ilmeni tutkimuksissa, asiakkaiden tuottamassa tiedossa sekä fokusryhmätyöskentelyssä ja juuri siksi tämän tyyppinen kehittämistyö on tarpeellista.In this thesis the focus was on the development of leadership in order to improve fair treatment of clients with special needs. The process started with the need of development in autumn 2016 and continued in stages until the spring of 2018 in a private social and health care service provider’s units of special groups’ intensified housing services for adults including also a residential child care’s special unit. Data acquisition consisted of studying the various research and statutes in the field as well as acquiring data from experts by experience, from literature about inclusion, leadership, and development, and from focus group work. A significant part of the development work was client inclusion and client oriented development, which also added value to the development of leadership in social services. Clients were heard on client forums to ensure the client oriented approach and the inclusion of clients as well as the utilisation of experts by experience. The purpose of the client forums was to give an insight into the clients’ perception of what fair treatment is and how the employees should act. In addition, a qualitative study was conducted for the own organisation´s use to find out whether the clients have experienced inappropriate action or maltreatment. Although no severe maltreatment was discovered, procedures on how to diminish and prevent inappropriate action should be studied and developed further. The information provided by the client forums was presented and the development work was then continued as Valvira (National Supervisory Authority for Welfare and Health) conducted a study on maltreatment (2015) and the study’s results concerning the deficiencies of leadership were assessed. As a continuation of the client forums, focus groups consisting of the superiors, designed follow-ups and instructions on how to make the process of notification on maltreatment easier, as well as a more general approach for the development of leadership work. As a result, the resources of leadership know-how were increased; the instructions on the process of notifications on maltreatment for the superiors and personnel were designed, along with a general approach on the prevention of maltreatment for managerial use. As a conclusion, it can be stated that clients with a weaker position, such as clients with speech deficits or clients who are nonverbal, are at the greatest risk of maltreatment. This position of the weaker clients became apparent from the research, from information provided by the clients as well as from the focus group work, which underlines the importance of development work in this area

More than A to B : Understanding and managing visitor spatial behaviour in urban forests using public participation GIS

Planning and management needs up-to-date, easily-obtainable and accurate information on the spatial and social aspects of visitor behaviour in order to balance human use and impacts, and protection of natural resources in public parks. We used a web-based public participation GIS (PPGIS) approach to gather citizen data on visitor behaviour in Helsinki's Central Park in order to aid collaborative spatial decision-making. The study combined smartphone GPS tracking, route drawing and a questionnaire to examine differences between user groups in their use of formal trails, off-trail behaviour and the motivations that affect it. In our sample (n = 233), different activity types were associated with distinctive spatial patterns and potential extent of impacts. The density mapping and statistical analyses indicated three types of behaviour: predominantly on or close to formal trails (runners and cyclists), spatially concentrated off-trail behaviour confined to a few informal paths (mountain bikers), and dispersed off trail use pattern (walkers and dog walkers). Across all user groups, off-trail behaviour was mainly motivated by positive attraction towards the environment such as scenic view, exploration, and viewing flora and fauna. Study findings lead to several management recommendations that were presented to city officials. These include reducing dispersion and the spatial extent of trampling impacts by encouraging use of a limited number of well-established informal paths away from sensitive vegetation and protected habitats. (C) 2017 Elsevier Ltd. All rights reserved.Peer reviewe

Vaginal Microbiota Composition Correlates Between Pap Smear Microscopy and Next Generation Sequencing and Associates to Socioeconomic Status

Recent research on vaginal microbiota relies on high throughput sequencing while microscopic methods have a long history in clinical use. We investigated the correspondence between microscopic findings of Pap smears and the vaginal microbiota composition determined by next generation sequencing among 50 asymptomatic women. Both methods produced coherent results regarding the distinction between Lactobacillus-dominant versus mixed microbiota, reassuring gynaecologists for the use of Pap smear or wet mount microscopy for rapid evaluation of vaginal bacteria as part of diagnosis. Cytologic findings identified women with bacterial vaginosis and revealed that cytolysis of vaginal epithelial cells is associated to Lactobacillus crispatus-dominated microbiota. Education and socio-economic status were associated to the vaginal microbiota variation. Our results highlight the importance of including socio-economic status as a co-factor in future vaginal microbiota studies.Peer reviewe

Towards AI-governance in psychosocial care: A systematic literature review analysis

With increased digitalization and e-government services, Artificial Intelligence (AI) gained momentum. This paper focuses on AI-governance in Child Social Care field, exploring how aspects of individual, family/community factors are embedded in organizational level, especially when dealing with children resilience and wellbeing. A three-level based review has been conducted. In the first part we explored the interlink between individual factors associated to either resilience or wellbeing are connected to community and governance level where a new conceptual model is provided. In the second phase, we conducted an in-depth systematic literature review using PRISMA review protocol where new categorizations of identified literature with respect to individual, family and community levels in child social care field were suggested, while in the third phase, a review of relevant AI-initiatives in Europe and USA was performed. Finally, a comprehensive discussion of the literature review outcomes was carried out and a new updated conceptual model was provided.© 2023 The Author(s). Published by Elsevier Ltd on behalf of Prof JinHyo Joseph Yun. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).fi=vertaisarvioitu|en=peerReviewed

Election promises on children’s wellbeing and health 2015 to 2021 – a study of Finnish voting advice applications database

Background: According to the UN Convention on the Rights of the Child, children’s views should be heard in policymaking. But it remains unclear to what extent children’s wellbeing is considered in election promises Methods: We investigated the extent to which Finnish political candidates consider children and their wellbeing in their election promises. We used YLE, the national broadcaster’s voting advice application database, and analysed some 35,000 politicians’ election promises made in the 2015 and 2019 parliamentary and the 2017 and 2021 municipal elections. We calculated the proportion of candidates who mentioned children and examined the content of the election promises in which children were mentioned. Logistic regression models were used to examine the role of the background of the characteristics of candidates. Results: In the 2015 and 2019 elections, some 12% and 19% of candidates, respectively, mentioned children in their election promises. The figures for the 2017 and 2021 municipal elections were higher at 19% and 24%, respectively. In the 2021 election, the candidates considering children in their election promises were younger and had higher education qualifications. Inspection of a random set of 350 promises indicated that common issues mentioned in respect of children were education and hobby activities. Concrete proposals to improve the wellbeing of children were rarely put forward. Conclusions: Political candidates are increasingly considering children in their election promises but concrete proposals to improve the wellbeing and health of children are rare. Effective policy solutions to improve the health of children should be discussed in election debates.©2022 SAGE Publications. The article is protected by copyright and reuse is restricted to non-commercial and no derivative uses. Users may also download and save a local copy of an article accessed in an institutional repository for the user's personal reference.fi=vertaisarvioitu|en=peerReviewed

Laminopatiat - harvinaisten sairauksien kasvava joukko

English summaryPeer reviewe

Mustasotilaskärpäsen (Hermetia illucens) kasvatus Keski-Suomen olosuhteissa ja hyödyntäminen biomassojen käsittelyssä

Jyväskylän ammattikorkeakoulun Biotalouskampuksella toteutettiin hyönteiskasvatuksen demonstraatioympäristö VinsectS – Hyönteistalous osana Viitasaari-Saarijärvi seutukunnan kiertotaloutta –hankkeessa keväällä 2018.  Hankkeessa tutkittiin mustasotilaskärpäsen (Hermetia illucens) ympärivuotisia kasvatusmahdollisuuksia Keski-Suomen olosuhteissa sekä toukkien kykyä hyödyntää erilaisia biomassasivuvirtoja ravinnokseen. Mustasotilaskärpänen on tropiikin hajottaja, jolla on nopea elinkierto ja tehokas biomassan hyödynnyskyky. Optimissa kasvatusolosuhteissa sen elinkierto on 35–42 päivää, joista 14–24 päivää se viettää biomassaa prosessoivana toukkana. Toukka syö kaksi kertaa loppupainonsa verran ja konvertoi biomassasta 50–80 % toukkamassaksi. Mustasotilaskärpänen ei ole tautivektori ja toukkien biomassan prosessoinnin on havaittu vähentävän bakteerimassaa ja nopeuttavan lääkeaineiden hajoamista sekä vähentävän kasvihuonekaasupäästöjä. Hyönteiskasvattamo rakennettiin 6 metrin ISO-konttiin, johon asennettiin olosuhdehallintalaitteisto, etävalvonta ja kasvatusrullakot. Kontti eristettiin ympärivuotista kasvatusta varten. Kasvattamossa käytetään IoT-tekniikkaa automatisoidussa olosuhdehallinnassa.  Hankkeen aikana ympärivuotisen hyönteiskasvatuksen havaittiin olevan mahdollista olosuhteiden pysyessä tavoitearvoissa niin kesällä kuin talvellakin. Kasvattamon lämpötila pysyi tasaisena, ilmankosteuteen ulkoiset tekijät kuitenkin vaikuttivat. Ilmankosteudella onkin suuri rooli hyönteisten elinkierron optimointiin. Hankkeen mittakaavassa hyönteiskasvatus ei tuottanut haitallisia määriä kaasuja, vaan kasvattamon hiilidioksidi- ja ammoniakkipitoisuudet pysyivät sisätyöympäristön viitearvoissa. Mustasotilaskärpäsillä suoritettiin ruokintakokeita erilaisten biomassojen rehuarvojen määrittämiseksi. Biomassat kattoivat sivuvirtoja catering-jakeista siipikarjan lantaan. Biomassojen verrokkina käytettiin teollista siipikarjan rehua. Ruokintakokeet toteutettiin punnitsemalla 100 toukan alku- ja loppupaino ja jäljelle jääneen biomassan jäännöspaino ja kuiva-aineosuus toukkien syönnin määrittämiseksi. Lisäksi tarkkailtiin toukkien kuolleisuutta. Tuloksista voidaan päätellä usean biomassan olevan vähintään yhtä hyvää, ellei parempaa rehua mustasotilaskärpäsille kuin siipikarjan rehun. Esiin nousivat hiilihydraattipitoiset elintarvikepohjaiset biomassat kuten catering- ja leipomojakeet. Korkean (yli 20%) rasvapitoisuuden biomassat ja vaikeasti prosessoitavat kuidut, kuten ligniini, puolestaan soveltuvat heikommin mustasotilaskärpäsen rehuiksi. VinsectS-hankkeessa kartoitettiin seutukunnan hyönteistalouteen soveltuvien sivuvirtojen ja biomassojen lähteitä sekä hyönteiskasvatukseen soveltuvia ja kiinnostuneita yrityksiä ja yrittäjiä. Tulosten pohjalta hankkeessa luotiin hyönteistalouden tiekartta ja arvoketju Viitasaari-Saarijärven seutukunnalle. Mm.  Euroopan aluekehitysrahaston (EAKR) rahoittama ja VTT:n hallinnoima hanke toteutettiin 5.2.2018–30.11.2019

Comatose With Basilar Artery Occlusion : Still Odds of Favorable Outcome With Recanalization Therapy

Background: Around 30-60% of patients with basilar artery occlusion (BAO) present with coma, which is often considered as a hallmark of poor prognosis. Aim: To examine factors that will help predict outcomes in patients with BAO comatose on admission. Methods: A total of 312 patients with angiography-proven BAO were analyzed. Comas were assessed as Glasgow Coma Scale (GCS) of Results: In total, 103/259 (39.8%) of BAO patients were comatose on admission. Factors associated with acute coma were higher age, coronary artery disease, convulsions, extent of early ischemia by posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) < 8, absence of patent posterior collateral vasculature, and occlusion over multiple segments of BA. A total of 21/103 (20.4%) of comatose patients had a favorable outcome (mRS 0-3), and 12/103 (11.7%) had a good outcome (mRS 0-2). Factors associated with a favorable outcome in comatose BAO patients were younger age (p = 0.010), less extensive baseline ischemia (p = 0.027), recanalization (p = 0.013), and avoiding symptomatic intracranial hemorrhage (sICH) (p = 0.038). Factors associated with the poorest outcome or death (mRS 5-6) were older age (p = 0.001), diabetes (p = 0.022), atrial fibrillation (p = 0.016), lower median GCS [4 (IQR 3.6) vs. 6 (5-8); p = 0.006], pc-ASPECTS < 8 (p = 0.003), unsuccessful recanalization (p = 0.006), and sICH (p = 0.010). Futile recanalization (mRS 4-6) was significantly more common in comatose patients (49.4 vs. 18.5%, p < 0.001). Conclusions: One in five BAO patients with acute coma had a favorable outcome. Older patients with cardiovascular comorbidities and already existing ischemic lesions before reperfusion therapies tended to have a poor prognosis, especially if no recanalization is achieved and sICH occurred.Peer reviewe

Characterization of membrane–foulant interactions with novel combination of Raman spectroscopy, surface plasmon resonance and molecular dynamics simulation

Adsorptive fouling, by phenolic compounds, is a serious issue regarding the development and use of membrane based filtration technologies for water purification and wastewater treatment. We have developed a novel, combined, protocol of Raman spectroscopy and surface plasmon resonance (SPR) experiments, along with molecular dynamics (MD) simulation, to study the interaction of vanillin, a model phenolic compound, with the polyethersulfone (PES) surface of a membrane. The adsorption of vanillin to the PES surface was found to be highly pH dependent; the source of this was determined, by MD simulation, to be the stronger interaction with the protonated form of vanillin, predominant at low pH. Vanillin interacts with the PES surface, both through entropy driven, hydrophobic, interactions and, for the case of the protonated form, H-bonding of the hydroxyl group with the sulphur oxygens of the PES molecules. In addition to general insight into the fouling process that can be used to develop new methods to inhibit adsorptive fouling, our results also elucidate the specific interaction of the PES membrane with vanillin that can be used in the development of anti-fouling coatings, based on the structure of vanillin.Peer reviewe