Audit of the University of Turku 2015

The Finnish Education Evaluation Centre has conducted an audit of the University of Turku. Based on the audit report, the Higher Education Evaluation Committee has decided to require the institution to undergo a re-audit. The audit took place throughout 2014 with the final decision being made in early 2015

Iäkkäiden asukkaiden ravitsemustila Helsingin pitkäaikaisen ympärivuorokautisen hoidon yksiköissä

Helsingissä vuosina 2003-2017 tehtyjen ravitsemustutkimusten tarkoituksena on ollut tutkia ympärivuorokautisessa hoidossa olevien vanhusten ravitsemustilaa. Tässä artikkelissa kuvataan ravitsemustilan ja -hoidon kehittymistä tehostetussa palveluasumisessa vuosina 2007, 2011 ja 2017 sekä laitoshoidossa (vanhainkodeissa) vuosina 2003, 2011 ja 2017 tehtyjen tutkimusten tulosten pohjalta. Helsingin ravitsemustutkimukset on toteutettu käyttäen samaa strukturoitua kyselylomaketta ja MNA-ravitsemusarviota (Mini Nutritional Assessment). Tässä artikkelissa esitetään tutkimuslomakkeiden muuttujia (ikä, sukupuoli, siviilisääty, koulutustaso, fyysinen ja kognitiivinen toimintakyky, sairaudet ja lääkitys) kuvaamaan asukasrakenteen eroja eri asumismuodoissa. Ravitsemukseen liittyvistä muuttujista esitetään välipalojen syömistä, täydennysravintovalmisteiden ja D-vitamiinivalmisteiden käyttöä sekä painon seurantaa ja painehaavoja. Tulosten mukaan asukkaiden toiminnanvajeet ja muistisairaiden osuus ovat merkittävästi lisääntyneet. Tästä huolimatta ravitsemustilan mukaan riski- tai virheravitsemustilassa olevien osuudessa ei ole tapahtunut lisäystä. Ravitsemushoitokäytännöt ovat parantuneet. Tässä artikkelissa raportoidaan keskeiset trenditiedot eri tutkimusvuosilta. Noin 15 vuotta kestänyt tutkimus- ja kehittämishanke on ollut hyödyllinen asukkaiden hyvinvoinnin kannalta. Hyvä ravitsemus on merkittävä tekijä ikääntyneiden hyvinvoinnissa.Peer reviewe

Dietary fat intake and quality in long-term care residents in two cohorts assessed 10 years apart

Purpose To describe and compare detailed dietary fat intake, fat quality and associative factors between two measuring points 10 years apart of residents living in long-term care facilities, and to reflect how fat composition and fat quality corresponds to current nutrition recommendations. Methods In 2007 long-term care residents (n = 374) of 25 assisted-living facilities and nursing homes and in 2017-18 long-term care residents (n = 486) of 17 respective facilities in Helsinki metropolitan area were recruited for this study. Information on the residents' heights, demographic information and use of calcium and vitamin D supplementation were retrieved from medical records. Residents' clinical assessment included Clinical Dementia Rating (CDR), the Mini Nutritional Assessment (MNA) and questionnaire related to nutrition care. Participants' energy and fat intake were determined from 1--2-day food diaries kept by the ward nurses, and fat quality indicators calculated. Results Age, gender distribution, MNA score or body mass index did not differ between the two cohorts. Residents' cognitive status, subjective health and mobility were poorer in 2017 compared to 2007. Total fat and saturated fatty acid (SFA) intakes were higher and fat quality indicators lower in the 2017 cohort residents than in the 2007 cohort residents. Sugar intake, male gender, eating independently, eating larger amounts and not having dry mouth predicted higher SFA intake in the 2017 cohort. Conclusions The fat quality in long-term care residents in our study worsened in spite of official recommendations between the two measurement points.Peer reviewe

Burden of Oral Symptoms and Its Associations With Nutrition, Well-Being, and Survival Among Nursing Home Residents.

Objectives: To explore how oral problems, chewing problems, dry mouth, and swallowing difficulties cluster and whether their burden is associated with nutritional status, eating habits, gastrointestinal symptoms, psychological well-being, and mortality among institutionalized residents. Design: Cross-sectional study with 1-year mortality. Setting and participants: 3123 residents living in assisted facilities and nursing homes in Helsinki, Finland. Measures: Trained nurses assessed residents in all nursing homes and assisted living facilities in Helsinki in 2011. A personal interview, the Mini Nutritional Assessment (MNA), oral symptoms, questions about eating habits, and psychological well-being were used to assess each resident. We divided the subjects first according to the number of oral symptoms into 4 groups: no oral symptoms (G0), 1 oral symptom (G1), 2 oral symptoms (G2), and all 3 symptoms (G3); and second according to the symptoms: dry mouth, chewing problems, and swallowing difficulties. The diagnoses and medications were retrieved from medical records, and mortality data were obtained from central registers. Results: In all, 26% of the subjects had 1 oral problem (G1), 11% had 2 oral problems (G2), and 4% had all 3 oral problems (G3), whereas 60% (n = 1870) had no oral symptoms. Thus, the oral symptoms moderately overlapped. The burden of oral symptoms was linearly associated with malnutrition, higher numbers of comorbidities, dependency in physical functioning, gastrointestinal symptoms, and eating less and more often alone. The higher the burden of oral symptoms, the lower the self-rated health and psychological well-being. Mortality increased along with the higher oral symptoms burden. Among residents having 1 or more symptoms, 26% had chewing problems, 18% swallowing difficulties, and 15% dry mouth. Conclusions/Implications: The burden of oral health problems was associated in a stepwise fashion with poor health and psychological well-being, malnutrition, and mortality. Clinicians should routinely assess older institutionalized residents' oral health status to improve residents' well-being. (C) 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.Peer reviewe

Filtering cube : Identifying heterogeneity driven innovation potential

The knowledge relevant to solve complex problems such as wellbeing challenges requires skills and socio-technological environments which systematically bring people together with different, complementary and even controversial points of view while forming an innovation community. Grounded on intercultural collaboration, Triple Helix, trans-disciplinary and cross-functionality theoretical approaches which are known to foster innovations, we propose open innovation driven filtering cube framework in order to evaluate the diversity of participants and topics within innovation events. By following the constructive action research approach, the usefulness of our suggested construct is tested in context of wellbeing innovation event. The observations relating to student reflections of the test event were in-line with the suggestions of our filtering cube construct and indicted somewhat low level heterogeneity among participants. However, the particular innovation event supported various other skills relating innovation capabilities

Co-creation of innovation between higher education students and actors in public, private and the third sector

The purpose of this paper is two-fold. Firstly, we shall introduce Care Innovations Arena (CIA), a novel transdisciplinary open innovation learning environment. Secondly, we shall explore the application of the CIA in two different open-innovation projects and compare the outcomes. The focus will be on co-creative innovation production processes carried out in a cooperation between higher education and actors from public, private and the third sector

Constant B cell lymphocytosis since early age in a patient with CARD11 mutation : A 20-year follow-up

Non peer reviewe

Erityisryhmien älykäs paloturvallisuus

Erityisryhmiin kuuluvilla henkilöillä on rajallisia mahdollisuuksia oman paloturvallisuutensa edistämiseen. Erityisryhmien Älykäs Paloturvallisuus (ERÄS) -hankkeen tavoitteena oli edistää liikkumis- ja toimimisesteisten henkilöiden paloturvallisuutta ja pelastustoimintaa luomalla malli poistumisturvallisuuden kehittämiseksi. 2015 tuli eurooppalaisia käytänteitä yhdenmukaistava ohje Evacuation of people with disabilities European Guideline (CFPA-E Guideline No 33: 2015 F). Se käsittää suositukset vammaisten henkilöiden evakuoimiseksi julkisissa tiloissa. Hankkeessa opas käännettiin suomeksi, ja sisältö synkronoitiin kansallisten suositusten kanssa. Nykyisiä poistumisturvallisuuskäytäntöjä verrattiin oppaan suosituksiin 20 kohteessa. Tuloksissa havaittiin mm. ettei kuulovammaisille henkilöille pääsääntöisesti ollut palohälyttimiä vilkkuvaloilla tai värinähälytyksellä. Sokeille henkilöille ei ollut poistumisreiteillä liikkumista ohjaavia ratkaisuja kuten opasteraitoja. Asiakkaat otettiin mukaan koulutuksiin, turvallisuuskävelyihin ja harjoituksiin vaihtelevasti. Oppaan mukaisia hätäpoistumisratkaisuja testattiin Oppimis- ja ohjauskeskus Valterin Ruskiksen koulun 3. kerroksessa. Lisäksi kehitettiin mobiiliteknologiaan perustuvia uusia ratkaisuja. Ratkaisujen vaikuttavuus simuloitiin Pathfinder-simulointityökalulla ja poistumisriskit arvioitiin FRAME (Fire Risk Assessment Method for Engineering) -menetelmällä. Tuloksena syntyi malli poistumisturvallisuuden edistämiseksi: 1) Ennakkotiedon tarjoaminen (Verkkosivuilla tietoa moniaistisista opastusratkaisuista; Moniaistinen poistumisreittikartta; Turvallisuuskävelyt ja ennakkoharjoittelu), 2) Hätätilanteessa tiedonvälitys monikanavaisesti (näkyy ja kuuluu), 3) Staattiset opasteet kaikille aisteille ja 4) Reaaliaikainen opastus ja ohjeet kaikille aisteille. Lisäksi tunnistettiin kehittämistarpeita mm. hälyttimien ja opasteiden sijoittelua, oven avautumissuunnan osoittamista, turvallisten evakuointitilojen merkitsemistä koskien. Hanke toteutui 1.9.2016–31.10.2017 Hämeen ammattikorkeakoulun (HAMK), Suomen Pelastusalan Keskusjärjestön (SPEK), Avaava Oy:n ja MIPSoft Oy:n yhteistyönä sekä Palosuojelurahaston rahoittamana

Changes in malnutrition and quality of nutritional care among aged residents in all nursing homes and assisted living facilities in Helsinki 2003-2011

Background: While nutritional problems have been recognized as common in institutional settings for several decades, less is known about how nutritional care and nutrition has changed in these settings over time. Objectives: To describe and compare the nutritional problems and nutritional care of residents in all nursing homes (NH) in 2003 and 2011 and residents in all assisted living facilities (ALF) in 2007 and 2011, in Helsinki, Finland. Methods: We combined four cross-sectional datasets of (1) residents from all NHs in 2003 (N= 1987), (2) residents from all ALFs in 2007 (N = 1377), (3) residents from all NHs in 2011 (N= 1576) and (4) residents from all ALFs in 2011 (N= 1585). All participants at each time point were assessed using identical methods, including the Mini Nutritional Assessment (MNA). Results: The mean age of both samples from 2011 was higher and a larger proportion suffered from dementia, compared to earlier collected samples. A larger proportion of the residents in 2011 were assessed either malnourished or at-risk for malnutrition, according to the MNA, than in 2003 (NH: 93.5% vs. 88.9%, p <0.001) and in 2007 (ALF: 82.1% vs. 78.1%, p = 0.007). The use of nutritional, vitamin D and calcium supplements, and snacks between meals was significantly more common in the 2011 residents, compared to the respective earlier samples. Conclusions: In 2011, institutionalized residents were more disabled and more prone to malnourishment than in 2003 or 2007. Institutions do seem to be more aware of good nutritional care for vulnerable older people, although there is still room for improvement.Peer reviewe