Rakenteisen kirjaamisen erityiskysymykset lastensuojelun palvelutehtävässä, 3. porras

Esityksen sisältö: Johdanto Asiakasasiakirjat ja asiankäsittely lastensuojelussa Näkökulmia lastensuojelun kirjaamiseen Kirjaamisen merkityksestä Lopuksi – tukea rakenteisen kirjaamisen edistämiseen </ul

Specialfrågor inom strukturerad dokumentation i serviceuppgiften för barnskydd, steg 3

Presentationens innehåll: Inledning Klienthandlingar och ärendebehandling inom barnskyddet Synpunkter på dokumentationen inom barnskyddet Dokumentationens betydelse Avslutningsvis – stöd för främjandet av strukturerad dokumentation </ul

Työkaluja seksuaalisuuden puheeksi ottamiseen: Plissitistä Betteriin

Seksuaali- ja lisääntymisterveyden kysymyksiin on Suomessa kiinnitetty huomiota ja niiden edistämiseksi on julkaistu kansallinen toimintaohjelma. Sosiaali- ja terveydenhuollon peruskoulutuksessa saadaan perusvalmiudet muun muassa seksuaalisuuden puheeksiottoon asiakkaiden kanssa. Toisaalta kuitenkin näyttää siltä, että käytännön tasolla tarvitaan lisää osaamista seksuaalisuutta koskevien kysymysten käsittelyyn. Potilaat ja asiakkaat odottavat sosiaali- ja terveydenhuollon ammattilaisilta tietoa ja valmiuksia kysyä seksuaalisuuteen liittyvistä asioista. Keskustelua käydään harvoin ja useimmiten potilaan aloitteesta, vaikka aloitetta odotetaan ammattilaisilta. Ammattilaisilla on useita puheeksi ottamisen malleja apuvälineeksi käytännön työhön. Puheeksi ottamisen välineenä on Suomessa käytetty Plissit-mallia, joka määrittää puheeksi ottamisen tasoja ja ammattilaisilta edellytettävää osaamista. Vähemmän käytetty Better -malli taas tukee ohjaustilanteen rakenteen jäsentämistä ja ohjaustilanteen systemaattista etenemistä. Better-mallin avulla ohjaustilanne jäsentyy yksityiskohtaisesti ja malli sisältää myös kirjaamisen velvoitteen, jolloin hoidon jatkuvuuden ja vaikuttavuuden seuranta mahdollistuu. Terveydenhuollon koulutuksissa tulee systemaattisesti vahvistaa seksuaalisuuden puheeksi ottamisen menetelmällistä osaamista

The Finnish Meteorological Institute : final report for the open data project

The purpose of the Open Data project of the Finnish Meteorological Institute (FMI) was to make some of the institute’s data freely available for public use. The project came about as a result of the INSPIRE directive adopted in 2007, which requires public authorities to describe spatial data covered by the directive and to offer them for shared use via information networks. Another factor was the government resolution on the improved availability of digital public sector information and on the promotion of its reuse. The data sets that have been made available by the Finnish Meteorological Institute are continuous observational and model forecast data produced by the institute. The data sets were specified on the basis of the INSPIRE directive, but in practice, the implementation goes far beyond the regulatory requirements. A new online service was built as part of the project to allow users to freely download data as a self-service. The Open Data project was started at the institute back in 2007 upon the adoption of the INSPIRE directive. The Open Data online service was launched on 15 May 2013.Ilmatieteen laitoksen Avoin data –projektin tavoitteena oli vapauttaa Ilmatieteen laitoksen tietoaineistoja julkiseen, vapaaseen käyttöön. Projektin taustalla vaikuttivat mm. vuonna 2007 hyväksytty Inspire-direktiivi, joka velvoittaa viranomaiset kuvailemaan direktiivin piiriin kuuluvat paikkatietoaineistot ja tarjoamaan ne yhteiskäyttöön tietoverkon kautta, sekä valtioneuvoston periaatepäätös julkisen sektorin digitaalisten tietoaineistojen saatavuuden parantamisesta ja uudelleenkäytön edistämisestä. Ilmatieteen laitoksen avaamat tietoaineistot ovat laitoksen tuottamia jatkuvaluonteisia havainto- ja malliennusteaineistoja. Avattavien tietoaineistojen määrittelyjen taustalla olivat INSPIRE-direktiivin periaatteet, mutta käytännön toteutus on huomattavasti velvoitteita laajempi. Projektissa rakennettiin uusi verkkopalvelu, josta aineistoja voi ladata vapaasti itsepalveluna. Avoin data –projekti alkoi Ilmatieteen laitoksella jo vuonna 2007 Inspire-direktiivin tultua voimaan. Avoimen datan verkkopalvelu avattiin 15.5.2013

Radiological and pathological assessment of response to neoadjuvant CDK4/6 inhibitor and endocrine treatments in a real-life setting : initial results

publishedVersionPeer reviewe

Breast density and the likelihood of malignant MRI-detected lesions in women diagnosed with breast cancer

Objectives: To assess whether mammographic breast density in women diagnosed with breast cancer correlates with the total number of incidental magnetic resonance imaging (MRI)-detected lesions and the likelihood of the lesions being malignant. Methods: Patients diagnosed with breast cancer meeting the EUSOBI and EUSOMA criteria for preoperative breast MRI routinely undergo mammography and ultrasound before MRI at our institution. Incidental suspicious breast lesions detected in MRI are biopsied. We included patients diagnosed with invasive breast cancers between 2014 and 2019 who underwent preoperative breast MRI. One reader retrospectively determined breast density categories according to the 5th edition of the BI-RADS lexicon. Results: Of 946 patients with 973 malignant primary breast tumors, 166 (17.5%) had a total of 175 (18.0%) incidental MRI-detected lesions (82 (46.9%) malignant and 93 (53.1%) benign). High breast density according to BI-RADS was associated with higher incidence of all incidental enhancing lesions in preoperative breast MRIs: 2.66 (95% confidence interval: 1.03–6.86) higher for BI-RADS density category B, 2.68 (1.04–6.92) for category C, and 3.67 (1.36–9.93) for category D compared to category A (p < 0.05). However, high breast density did not predict higher incidence of malignant incidental lesions (p = 0.741). Incidental MRI-detected lesions in the contralateral breast were more likely benign (p < 0.001): 18 (27.3%)/48 (72.7%) vs. 64 (58.7%)/45 (41.3%) malignant/benign incidental lesions in contralateral vs. ipsilateral breasts. Conclusion: Women diagnosed with breast cancer who have dense breasts have more incidental MRI-detected lesions, but higher breast density does not translate to increased likelihood of malignant incidental lesions. Clinical relevance statement: Dense breasts should not be considered as an indication for preoperative breast MRI in women diagnosed with breast cancer. Key Points: • The role of preoperative MRI of patients with dense breasts diagnosed with breast cancer is under debate. • Women with denser breasts have a higher incidence of all MRI-detected incidental breast lesions, but the incidence of malignant MRI-detected incidental lesions is not higher than in women with fatty breasts. • High breast density alone should not indicate preoperative breast MRI.Peer reviewe

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat