Kotona loppuun saakka : kotisaattohoidon opas Ylöjärven kotitiimin hoitohenkilökunnalle

Saattohoito on siirtymässä yhä enenevissä määrin ihmisten koteihin. Kotisaattohoitoon päädytään potilaan ja hänen läheistensä toiveesta. Erikoissairaanhoitoa tarjoavien kotisairaaloiden lisäksi perushoidosta huolehtivalla kotihoidolla on suuri rooli potilaan kotona tapahtuvassa saattohoidossa. Pelkän kotisairaalan ja kotihoidon avulla kotisaattohoito on kuitenkin mahdotonta, vaan se vaatii panostusta myös potilaan läheisiltä. On myös tärkeää muistaa, että hoidon keskiössä on aina potilas. Opinnäytetyö toteutettiin yhteistyössä Ylöjärven kaupungin kanssa. Opinnäytetyön tarkoituksena oli tehdä kotisaattohoidon opas Ylöjärven kaupungin kotitiimin hoitohenkilökunnalle. Lisäksi hoitohenkilökunta sai käyttöönsä opinnäytetyön kirjallisen osuuden. Tavoitteena oli auttaa Ylöjärven kaupunkia kehittämään kotisaattohoitoaan, sekä madaltaa hoitohenkilökunnan kynnystä työskennellä saattohoidettavan potilaan kotona. Tärkeimpinä tehtävinä oli selvittää, millaista on hyvä kotisaattohoito, ja minkälainen hoito-opas on hyvä henkilökunnan käyttöön. Opinnäytetyö tehtiin toiminnallisella menetelmällä, ja se painottui tuotokseen. Opinnäytetyön tuotos, eli hoito-opas, tehtiin tämän työn kirjallisen osuuden pohjalta. Lääkehoito rajattiin pois sekä työstä että hoito-oppaasta, sillä lääkehoidosta päättää aina viimekädessä lääkäri. Hyvä kotisaattohoito on yksilöllistä, potilaan kotona tapahtuvaa kuolemaa edeltävää hoitoa. Hyvä opas on selkeä ja informatiivinen, ja sen teossa on otettu huomioon kohderyhmä. Hoito-opas on suunnattu erityisesti hoitajille, jotka suorittavat valtaosan potilaan luona tapahtuvasta hoidosta. Kehittämisehdotuksena esitetään, että hoitajille pidettäisiin koulutustilaisuus, esimerkiksi luento, jossa kerrottaisiin tarkemmin kotisaattohoidosta. Se eroaa tietyiltä osin hoitolaitoksessa tapahtuvasta saattohoidosta, tapahtuuhan hoito potilaan omassa kodissa. Erityisesti vastavalmistuneet ja kokemattomat hoitajat voisivat hyötyä tästä, ja saada sen avulla varmuutta potilaan kotona toimimiseen. Hoitajille voitaisiin myös tehdä kysely tai tutkimus, josta selviäisi mitä tietoa he tarvitsevat kotisaattohoidosta.Hospice care is being provided more and more at people’s homes. Home hospice care is opted by the patient and his/her family. Along with hospital at home that provides special health care, home care has a big role in hospice care provided at patient’s home as well. Home hospice care with hospital at home and home care is impossible, however, but it also requires patient’s family’s attendance. After all it is important to remember, that patient comes always first. This bachelor’s thesis was executed in collaboration with the city of Ylöjärvi. The purpose of this thesis was to create a guide for Home hospice care guide for the city of Ylöjärvi’s home team’s nursing staff. The goal was to help the city of Ylöjärvi to improve their home hospice care, and to make working in patient’s homes easier to for the nursing staff. Thesis was made by using functional method. The result of the thesis was a care guide developed from the theory. Medication was outruled from both thesis and the guide, since it is eventually doctor’s decision. The guide is aimed especially to provide information for nurses and practical nurses, who fulfills most of the care. To improve, In-service training and educational events should be organised for nurses to improve their knowledge on Homecare. There are significant differences in Hospice provided at home and at the hospital. Newly graduated and inexperienced nurses could benefit from this work

Lastensuojelun sijaishuollon lapset ja nuoret sosiaalisessa mediassa : työkirja omahoitajatyöhön

Tämä toiminnallinen opinnäytetyö koostuu tästä raporttiosasta sekä liitteenä olevasta tuotoksesta, Some-taidot – työkirjasta. Työelämäyhteiskumppaninani tässä opinnäytetyössä on ollut Turun kaupungin sijaishuollon yksikkö, Virusmäentien lastenkoti. Virusmäentien lastenkoti on 7 paikkainen sijaishuollon yksikkö lähellä Turun keskustaa. Opinnäytetyön työstäminen ajoittuu lokakuusta 2014 vuoden 2015 huhtikuuhun. Työn aihe on valikoitunut ajankohtaisuuden vuoksi. Sosiaalinen media on lähes kaikkien lasten ja nuorten ulottuvilla. Lastensuojelun haavoittuvat lapset ja nuoret ovat hyväksyntää hakiessaan sosiaalisen media helpot uhrit. Lastenkodissa aikuiset vaihtuvat usein, eivätkä ole eläneet samanlaista nuoruutta sosiaalisessa mediassa.¨ Sisältö Some-taidot –työkirjaan on luotu asiantuntijakonsultaatioiden, työyhteisön välisen keskustelun sekä aiheeseen liittyvän kirjallisuuskatsauksen kautta. Kehittämisen tavoitteina oli lastensuojelun lasten ja nuorten seksuaalisen hyväksikäytön ennalta ehkäiseminen, sekä väärien toimintatapojen korjaaminen. Toiminnallisen opinnäytetyön kohderyhmänä on siis lastensuojelun sijaishuollon lapset ja nuoret. Työkirja on luotu omahoitajatyöhön välineeksi, jonka avulla voidaan avoimesti keskustella sosiaalisessa mediassa huolta aiheuttavista asioista.This functional Bachelor's thesis consists two parts: the report and the Social media skills workbook as an attachment. My cooperating partner in this thesis has been the city of Turku foster care unit Virusmäentie- children’s home. Virusmäentie –children’s home is a seven seated children’s home close to the center of Turku. Work on the Bachelor’s thesis took place from October in 2014 to April in 2015. The topic “Social media skills” is selected because of its topicality. Almost all the children and young people use social media applications. Clients of child protection are particularly vulnerable children and young people because of their back grounds. They want to have attention and approval at any price. The contents of the Social media skills workbook are created by professional consultation, discussion with working partners and topic related literature searching. The targets of the thesis are preventing the child protection children’s sexual abuse in social media and fixing the wrong operation ways. The target group of the bachelor’s thesis are the children and young people of child protection. The workbook is designated to the primary nursing as a means which take it easier to discuss the topic without reverse

Meat Consumption Patterns and Intentions for Change Among Finnish Consumers

During the past few decades, meat has increasingly become a subject of controversies relating to health and safety, environment, and animal welfare. Even though these changes in perceptions of meat are not yet visible in aggregate consumption figures, they can be observed in individual consumption patterns and as intentions to change the consumption. In this study, we examine changes in meat consumption among the Finnish consumers taking into account both stated changes in the past and intended changes in the future. Based on these changes, we identify consumer segments and investigate in which ways these segments differ from each other socio-demographically and with respect to current meat consumption and the stated reasons for the change. The latent class analysis based on representative Internet survey data revealed nine consumer clusters that formed three cluster blocks. The results showed that a large number of people, over 40%, had stabile consumption patterns. A cluster block of 14% of consumers had already shifted their consumer patterns to contain more vegetables and less meat. One third of the consumers were identified to be in the middle of the change with a general tendency to decrease the use of meat and increase the use of vegetables. Although, environmental effects of meat and animal welfare issues were important reasons for change in some clusters, healthiness was the most salient stated reason for change in consumption habits.Food Consumption/Nutrition/Food Safety, Livestock Production/Industries,

Kirjallisuuskatsaus kuluttajien ja tuottajien vuorovaikutuksesta elintarvikeketjussa

vo

Meta-analysis of Genome-Wide Association Studies for Extraversion : Findings from the Genetics of Personality Consortium

Extraversion is a relatively stable and heritable personality trait associated with numerous psychosocial, lifestyle and health outcomes. Despite its substantial heritability, no genetic variants have been detected in previous genome-wide association (GWA) studies, which may be due to relatively small sample sizes of those studies. Here, we report on a large meta-analysis of GWA studies for extraversion in 63,030 subjects in 29 cohorts. Extraversion item data from multiple personality inventories were harmonized across inventories and cohorts. No genome-wide significant associations were found at the single nucleotide polymorphism (SNP) level but there was one significant hit at the gene level for a long non-coding RNA site (LOC101928162). Genome-wide complex trait analysis in two large cohorts showed that the additive variance explained by common SNPs was not significantly different from zero, but polygenic risk scores, weighted using linkage information, significantly predicted extraversion scores in an independent cohort. These results show that extraversion is a highly polygenic personality trait, with an architecture possibly different from other complex human traits, including other personality traits. Future studies are required to further determine which genetic variants, by what modes of gene action, constitute the heritable nature of extraversion.Peer reviewe

Genetic and environmental influences on human height from infancy through adulthood at different levels of parental education

Genetic factors explain a major proportion of human height variation, but differences in mean stature have also been found between socio-economic categories suggesting a possible effect of environment. By utilizing a classical twin design which allows decomposing the variation of height into genetic and environmental components, we tested the hypothesis that environmental variation in height is greater in offspring of lower educated parents. Twin data from 29 cohorts including 65,978 complete twin pairs with information on height at ages 1 to 69 years and on parental education were pooled allowing the analyses at different ages and in three geographic-cultural regions (Europe, North America and Australia, and East Asia). Parental education mostly showed a positive association with offspring height, with significant associations in mid-childhood and from adolescence onwards. In variance decomposition modeling, the genetic and environmental variance components of height did not show a consistent relation to parental education. A random-effects meta-regression analysis of the aggregate-level data showed a trend towards greater shared environmental variation of height in low parental education families. In conclusion, in our very large dataset from twin cohorts around the globe, these results provide only weak evidence for the study hypothesis.Peer reviewe

Parental Education and Genetics of BMI from Infancy to Old Age : A Pooled Analysis of 29 Twin Cohorts

Objective The objective of this study was to analyze how parental education modifies the genetic and environmental variances of BMI from infancy to old age in three geographic-cultural regions. Methods A pooled sample of 29 cohorts including 143,499 twin individuals with information on parental education and BMI from age 1 to 79 years (299,201 BMI measures) was analyzed by genetic twin modeling. Results Until 4 years of age, parental education was not consistently associated with BMI. Thereafter, higher parental education level was associated with lower BMI in males and females. Total and additive genetic variances of BMI were smaller in the offspring of highly educated parents than in those whose parents had low education levels. Especially in North American and Australian children, environmental factors shared by co-twins also contributed to the higher BMI variation in the low education level category. In Europe and East Asia, the associations of parental education with mean BMI and BMI variance were weaker than in North America and Australia. Conclusions Lower parental education level is associated with higher mean BMI and larger genetic variance of BMI after early childhood, especially in the obesogenic macro-environment. The interplay among genetic predisposition, childhood social environment, and macro-social context is important for socioeconomic differences in BMI.Peer reviewe

Meta-analysis of Genome-Wide Association Studies for Extraversion: Findings from the Genetics of Personality Consortium

Extraversion is a relatively stable and heritable personality trait associated with numerous psychosocial, lifestyle and health outcomes. Despite its substantial heritability, no genetic variants have been detected in previous genome-wide association (GWA) studies, which may be due to relatively small sample sizes of those studies. Here, we report on a large meta-analysis of GWA studies for extraversion in 63,030 subjects in 29 cohorts. Extraversion item data from multiple personality inventories were harmonized across inventories and cohorts. No genome-wide significant associations were found at the single nucleotide polymorphism (SNP) level but there was one significant hit at the gene level for a long non-coding RNA site (LOC101928162). Genome-wide complex trait analysis in two large cohorts showed that the additive variance explained by common SNPs was not significantly different from zero, but polygenic risk scores, weighted using linkage information, significantly predicted extraversion scores in an independent cohort. These results show that extraversion is a highly polygenic personality trait, with an architecture possibly different from other complex human traits, including other personality traits. Future studies are required to further determine which genetic variants, by what modes of gene action, constitute the heritable nature of extraversion

Association of the OPRM1 Variant rs1799971 (A118G) with Non-Specific Liability to Substance Dependence in a Collaborative de novo Meta-Analysis of European-Ancestry Cohorts

Peer reviewe