Tähdenlentoja : Onnistumisen kokeminen sosiaalityössä

Only abstract. Paper copies of master’s theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of master’s theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmä. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnäytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet på nätet eller endast tillgängliga i bibliotekets avhandlingsterminaler.Tutkimuksen ensimmäisenä tehtävänä oli selvittää sosiaalityöntekijöiden onnistumisen kokemuksia työssään. Tutkimuksessa tutustuttiin onnistuneisiin asiakastapauksiin sosiaalityöntekijöiden itsensä kuvaamina. Analyysissä kiinnitettiin huomiota erityisesti siihen, minkälaisia sisältöjä onnistumisille ja epäonnistumisille annettiin, sekä siihen, mitä nämä sisällöt merkitsivät työntekijöiden itsensä kannalta. Keskeinen tavoite oli myös suhteuttaa yksittäiset kokemukset sosiaalityön kokonaisuuteen. Tutkimuksen toinen tehtävä oli selvittää, minkälaisia ristiriitoja sosiaalityöntekijä työn arjessa kohtaa ja mitä ristiriidat ja niiden ratkontayritykset merkitsevät sekä työntekijän että työn kokonaisuuden kannalta. Tutkimuksen kirjallisuusosuudessa käsiteltiin mm. postmodernisaatiokehityksen vaikutuksia sosiaalityöhön, julkisten palveluiden järjestämisen yleistä problematiikkaa, kehittävää työntutkimusta, sekä sosiaalityön työntutkimuksen alalta erityisesti reflektiivisyyden käsitettä. Empiirisen osuuden aineistona oli viiden sosiaalitoimistossa työskentelevän aluetyöntekijän temaattinen haastattelu ja avovastauksin toteutettu lomakekysely. Aineistoa käsiteltiin aineistolähtöisen analyysin konstruktionistisesti suuntautuneella sovellutuksella. Keskeisimmäksi onnistumisen kokemuksia yhdistävistä tekijöistä nousi toimiva kontakti sosiaalityöntekijän ja asiakkaan välillä. Onnistunut kontakti auttoi tavoitteiden saavuttamisessa ja kantoi työtä yli vaikeidenkin vaiheiden. Onnistumisen "asiasisältö" - substanssi - puolestaan saattoi sisältää myös julkitavoitteiden (työllistyminen tms. sosiaalistuminen) suhteen ristikkäisiä edistysaskelia. Onnistuneen asiakastapauksen sisällöksi kuvautuikin siis paitsi toimiva kontakti, myös työntekijän reflektiivinen - usein työn julkitavoitteiden suhteen epälinjainen - tilannearvio työn mahdollisista etenemissuunnista, sekä tilannekohtaisesti oikein arvioitu etenemisvauhti ja -tapa. Epäonnistumisen kokemuksia leimasi puolestaan molemminpuolinen kyvyttömyys saavuttaa riittävän toimivaa kontaktia asiakkaan ja työntekijän välille. Vastaavasti epäonnistumisen substanssiksi kertomuksissa muodostui kaikkein vaikeimmin marginalisoituneen asiakaskunnan menettäminen sosiaalityön avun ulottumattomiin. Kehittävän työntutkimuksen esittelemän työn systeemisen mallin mukaan tulkittuja ristiriita-asetelmia aineistosta löytyi nk. sosiaalityön palkkatyöläistämistoimivuuteen liittyvä ristiriita-asetelma, sekä vaihtoehtoiseen, emansipatoriseen työorientaatioon liittyvä ristiriita-asetelma. Sosiaalityön kokonaisuuden kannalta olennaiseksi tekijäksi analyysissä nousi onnistumisen kokemusten hauras ja epäselvä olemus: Työn julkitavoitteiden ulkopuolisella "harmaalla alueella" liikuttaessa onnistuminen tapahtuu usein hyvin pienin ja vaikeasti tulkittavin edistysaskelin. Tämän vuoksi paitsi työn tuloksellisuutta, myös käytettyjen keinojen vaikutusta lopputulokseen on yksittäisissä onnistuneissa tapauksissa hankalaa arvioida niin, että niistä voisi tuottaa yleisempiä toimintakäytäntöjä tai esim. kannattavuusarvioita. Myöskään metodisuuden säännönmukaiseen soveltamiseen liittyviä käytäntöjä ei työntekijöiden toiminnasta ollut havaittavissa, joten myös työntekijän perspektiivistä eteneminen ja työssä onnistuminen näytti sattumanvaraiselta ja epäselvältä. Mahdolliset jatkotutkimussuunnat liittyvätkin arviointitutkimukseen: Miten kyetä tulkitsemaan pienimuotoisia, tapauskohtaisia onnistumisia niin, että niistä kyettäisiin tuottamaan yhteismitallista ja (mm. taloudellisesti) ymmärrettävää tietoa niin sosiaalityöntekijöille kuin ulkopuolisille toimijoillekin

Accelerometer-Based Method for Extracting Respiratory and Cardiac Gating Information for Dual Gating during Nuclear Medicine Imaging

Both respiratory and cardiac motions reduce the quality and consistency of medical imaging specifically in nuclear medicine imaging. Motion artifacts can be eliminated by gating the image acquisition based on the respiratory phase and cardiac contractions throughout the medical imaging procedure. Electrocardiography (ECG), 3-axis accelerometer, and respiration belt data were processed and analyzed from ten healthy volunteers. Seismocardiography (SCG) is a noninvasive accelerometer-based method that measures accelerations caused by respiration and myocardial movements. This study was conducted to investigate the feasibility of the accelerometer-based method in dual gating technique. The SCG provides accelerometer-derived respiratory (ADR) data and accurate information about quiescent phases within the cardiac cycle. The correct information about the status of ventricles and atria helps us to create an improved estimate for quiescent phases within a cardiac cycle. The correlation of ADR signals with the reference respiration belt was investigated using Pearson correlation. High linear correlation was observed between accelerometer-based measurement and reference measurement methods (ECG and Respiration belt). Above all, due to the simplicity of the proposed method, the technique has high potential to be applied in dual gating in clinical cardiac positron emission tomography (PET) to obtain motion-free images in the future.</p

Validation of an Accelerometer Based BCG Method for Sleep Analysis

Sleep problems are one of the most common medical complaints today. Polysomnography (PSG) as the current standard for sleep analysis is expensive, intrusive and complex. Thus, finding a reliable and unobtrusive method for longer-term home use is important. Ballistocardiography (BCG) based methods have shown potential in sleep analysis recently. The usability and performance of a BCG based method in qualitative and quantitative analysis of sleep was evaluated. The method was validated in a clinical test on 20 subjects using PSG as a reference. Heart rate (HR), heart rate variability (HRV), respiratory rate (RR), respiratory rate variability (RRV), respiratory depth (Rdepth) and movement were utilized for sleep stage detection. The BCG parameter accuracy was presented as the mean error from PSG with 95% confidence interval. The errors were -0.1 ± 4.4 beats per minute for HR, -0.9 ± 14.7 ms for high frequency (HF) HRV, -3.0 ± 29.9 ms for low frequency (LF) HRV, 0.3 ± 4.5 breaths per minute for RR and -40 ± 424 ms for RRV respectively. Correlation coefficient was 0.97 for HR, 0.67 for HF HRV, 0.71 for LF HRV, 0.54 for RR and 0.49 for RRV. HR, RRV and Rdepth were typically at an increased level in REM sleep and wakefulness and decreased in deep sleep. RRV was at its highest during wakefulness. HRV was at a decreased level in REM and wakefulness and increased in deep sleep. Movement was higher during wakefulness than in sleep

Cardiac monitoring of dogs via smartphone mechanocardiography : a feasibility study

Abstract Background In the context of monitoring dogs, usually, accelerometers have been used to measure the dog’s movement activity. Here, we study another application of the accelerometers (and gyroscopes)—seismocardiography (SCG) and gyrocardiography (GCG)—to monitor the dog’s heart. Together, 3-axis SCG and 3-axis GCG constitute of 6-axis mechanocardiography (MCG), which is inbuilt to most modern smartphones. Thus, the objective of this study is to assess the feasibility of using a smartphone-only solution to studying dog’s heart. Methods A clinical trial (CT) was conducted at the University Small Animal Hospital, University of Helsinki, Finland. 14 dogs (3 breeds) including 18 measurements (about one half of all) where the dog’s status was such that it was still and not panting were further selected for the heart rate (HR) analysis (each signal with a duration of 1 min). The measurement device in the CT was a custom Holter monitor including synchronized 6-axis MCG and ECG. In addition, 16 dogs (9 breeds, one mixed-breed) were measured at home settings by the dog owners themselves using Sony Xperia Android smartphone sensor to further validate the applicability of the method. Results The developed algorithm was able to select 10 good-quality signals from the 18 CT measurements, and for 7 of these, the automated algorithm was able to detect HR with deviation below or equal to 5 bpm (compared to ECG). Further visual analysis verified that, for approximately half of the dogs, the signal quality at home environment was sufficient for HR extraction at least in some signal locations, while the motion artifacts due to dog’s movements are the main challenges of the method. Conclusion With improved data analysis techniques for managing noisy measurements, the proposed approach could be useful in home use. The advantage of the method is that it can operate as a stand-alone application without requiring any extra equipment (such as smart collar or ECG patch)

Mechanocardiography in the Detection of Acute ST Elevation Myocardial Infarction: The MECHANO-STEMI Study

Novel means to minimize treatment delays in patients with ST elevation myocardial infarction (STEMI) are needed. Using an accelerometer and gyroscope on the chest yield mechanocardiographic (MCG) data. We investigated whether STEMI causes changes in MCG signals which could help to detect STEMI. The study group consisted of 41 STEMI patients and 49 control patients referred for elective coronary angiography and having normal left ventricular function and no valvular heart disease or arrhythmia. MCG signals were recorded on the upper sternum in supine position upon arrival to the catheterization laboratory. In this study, we used a dedicated wearable sensor equipped with 3-axis accelerometer, 3-axis gyroscope and 1-lead ECG in order to facilitate the detection of STEMI in a clinically meaningful way. A supervised machine learning approach was used. Stability of beat morphology, signal strength, maximum amplitude and its timing were calculated in six axes from each window with varying band-pass filters in 2–90 Hz range. In total, 613 features were investigated. Using logistic regression classifier and leave-one-person-out cross validation we obtained a sensitivity of 73.9%, specificity of 85.7% and AUC of 0.857 (SD = 0.005) using 150 best features. As a result, mechanical signals recorded on the upper chest wall with the accelerometers and gyroscopes differ significantly between STEMI patients and stable patients with normal left ventricular function. Future research will show whether MCG can be used for the early screening of STEMI.</p

Beat-by-Beat Quantification of Cardiac Cycle Events Detected From Three-Dimensional Precordial Acceleration Signals

The vibrations produced by the cardiovascular system that are coupled to the precordium can be noninvasively detected using accelerometers. This technique is called seismocardiography. Although clinical applications have been proposed for seismocardiography, the physiology underlying the signal is still not clear. The relationship of seismocardiograms of on the back-to-front axis and cardiac events is fairly well known. However, the 3-D seismocardiograms detectable with modern accelerometers have not been quantified in terms of cardiac cycle events. A major reason for this might be the degree of intersubject variability observed in 3-D seismocardiograms. We present a method to quantify 3-D seismocardiography in terms of cardiac cycle events. First, cardiac cycle events are identified from the seismocardiograms, and then, assigned a number based on the location in which the corresponding event was found. 396 cardiac cycle events from 9 healthy subjects and 120 cardiac cycle events from patients suffering from atrial flutter were analyzed. Despite the weak intersubject correlation of the waveforms (0.05, 0.27, and 0.15 for the x-, y-, and z-axes, respectively), the present method managed to find latent similarities in the seismocardiograms of healthy subjects. We observed that in healthy subjects the distribution of cardiac cycle event coordinates was centered on specific locations. These locations were different in patients with atrial flutter. The results suggest that spatial distribution of seismocardiographic cardiac cycle events might be used to discriminate healthy individuals and those with a failing heart.Peer reviewe

Multiclass Classifier based Cardiovascular Condition Detection Using Smartphone Mechanocardiography

Cardiac translational and rotational vibrations induced by left ventricular motions are measurable using joint seismocardiography (SCG) and gyrocardiography (GCG) techniques. Multi-dimensional non-invasive monitoring of the heart reveals relative information of cardiac wall motion. A single inertial measurement unit (IMU) allows capturing cardiac vibrations in sufficient details and enables us to perform patient screening for various heart conditions. We envision smartphone mechanocardiography (MCG) for the use of e-health or telemonitoring, which uses a multi-class classifier to detect various types of cardiovascular diseases (CVD) using only smartphone’s built-in internal sensors data. Such smartphone App/solution could be used by either a healthcare professional and/or the patient him/herself to take recordings from their heart. We suggest that smartphone could be used to separate heart conditions such as normal sinus rhythm (SR), atrial fibrillation (AFib), coronary artery disease (CAD), and possibly ST-segment elevated myocardial infarction (STEMI) in multiclass settings. An application could run the disease screening and immediately inform the user about the results. Widespread availability of IMUs within smartphones could enable the screening of patients globally in the future, however, we also discuss the possible challenges raised by the utilization of such self-monitoring systems.</p

A curated DNA barcode reference library for parasitoids of northern European cyclically outbreaking geometrid moths

Large areas of forests are annually damaged or destroyed by outbreaking insect pests. Understanding the factors that trigger and terminate such population eruptions has become crucially important, as plants, plant-feeding insects, and their natural enemies may respond differentially to the ongoing changes in the global climate. In northernmost Europe, climate-driven range expansions of the geometrid moths Epirrita autumnata and Operophtera brumata have resulted in overlapping and increasingly severe outbreaks. Delayed density-dependent responses of parasitoids are a plausible explanation for the 10-year population cycles of these moth species, but the impact of parasitoids on geometrid outbreak dynamics is unclear due to a lack of knowledge on the host ranges and prevalences of parasitoids attacking the moths in nature. To overcome these problems, we reviewed the literature on parasitism in the focal geometrid species in their outbreak range and then constructed a DNA barcode reference library for all relevant parasitoid species based on reared specimens and sequences obtained from public databases. The combined recorded parasitoid community of E. autumnata and O. brumata consists of 32 hymenopteran species, all of which can be reliably identified based on their barcode sequences. The curated barcode library presented here opens up new opportunities for estimating the abundance and community composition of parasitoids across populations and ecosystems based on mass barcoding and metabarcoding approaches. Such information can be used for elucidating the role of parasitoids in moth population control, possibly also for devising methods for reducing the extent, intensity, and duration of outbreaks.publishedVersio