ENSIAPUTAITOJA MIELENTERVEYSKUNTOUTUJILLE ¬Koulutustilaisuus ja opaslehtinen Kuntoutuskoti Päivännousun asukkaille

OPINNÄYTETYÖ Tammikuu 2017 Hoitotyön koulutusohjelma Tikkarinne 9 80200 JOENSUU p. 050 405 4816 Tekijät Inka Ikonen, Laura Piltonen Nimeke Ensiaputaitoja mielenterveyskuntoutujille – Koulutustilaisuus ja opaslehtinen Kuntoutuskoti Päivännousun asukkaille Toimeksiantaja Lehmon Kuntoutuskoti Oy, Kuntoutuskoti Päivännousu Tiivistelmä Ensiavulla tarkoitetaan apua, joka annetaan loukkaantuneelle tai sairastuneelle jo tapahtumapaikalla. Ensiavun tarkoituksena on ensisijaisesti turvata autettavan henkilön peruselintoiminnot, kuten hapensaanti ja verenkierto, ennen ammattiavun paikalle tuloa. Ensiaputaidoilla voidaan auttaa joko itseä tai toista hätätilanteen sattuessa. Hyvät ensiaputaidot mahdollistavat sen, että osataan tunnistaa avun tarve ja toimia erilaisissa ensiaputilanteissa. Mielenterveyskuntoutujat ovat hyvä kohdejoukko ensiapukoulutukselle. Mielenterveyskuntoutuja on henkilö, jolla on diagnosoitu jokin mielenterveyden häiriö tai sairaus, joka on tällä hetkellä hallinnassa ja josta hän on toipumassa. Opinnäytetyö toteutettiin toiminnallisena opinnäytetyönä. Tarkoituksena on kehittää mielenterveyskuntoutujien ensiaputaitoja. Työn tehtävänä oli järjestää ensiapukoulutus mielenterveyskuntoutujille ja tuottaa kirjallinen opaslehtinen ensiaputaitoihin liittyen. Opinnäytetyön teoriaosassa käsiteltiin Kuntoutuskodissa yleisimmin esiintyviä ensiaputilanteita. Palautteiden perusteella koulutus koettiin ajankohtaiseksi ja hyödylliseksi. Selkeä opaslehtinen tukee koulutusta. Molemmissa tuotoksissa huomioidaan maallikon toiminta ja arkeen sopivat tilanteet, ja näin ollen ensiaputaitojen koettiin karttuneen niiden avulla. Jatkokehitysideana voidaan järjestää ensiaputaitoihin liittyvä rastimuotoinen kertauskoulutus sekä Kuntoutuskodin asukkaille että henkilökunnalle. Kieli suomi Sivuja 42 Liitteet 5 Liitesivumäärä 29 Asiasanat ensiapu, ensiaputaidot, mielenterveyskuntoutuja, ensiapukoulutus, opaslehtinen ensiaputaidoistaTHESIS January 2017 Degree Programme in Nursing Tikkarinne 9 FI 80200 JOENSUU FINLAND +358 50 405 4816 Authors Inka Ikonen and Laura Piltonen Title First Aid Skills to Mental Health Rehabilitees — A Training Session and an Information Leaflet for the Residents of Päivännousu Rehabilitation Home Commissioned by Lehmo Rehabilitation Home Ltd., Päivännousu Rehabilitation Home Abstract The term first aid refers to basic help given to a sick or injured person on the site of the accident. The purpose of first aid is to secure the basic vital functions in the patient, like breathing and blood circulation, before the arrival of the paramedics. Excellent first aid skills can help you or the others in an emergency. Competence in basic first aid skills makes it easier to recognize the need for help and act in situations requiring first aid. Mental health rehabilitees are a good target group for first aid courses. A mental health rehabilitee is a person who has been diagnosed with some mental health problem or disorder which is under control and the person is recovering from it. The purpose of this practise-based thesis was to enhance first aid skills among mental health rehabilitees. The aim of this thesis was to organize a first aid training session for mental health rehabilitees and to produce an information leaflet on first aid skills. Based on the feedback, the training session was experienced as current and useful. The explicit information leaflet supported the training. Both the training session and the leaflet addressed the layman’s action and everyday situations, and therefore, according to the participants, their competence in first aid skills increased. This thesis can be further developed by organising a first aid refresher training session in the form of control points for both the residents of the rehabilitation home as well as for the personnel. Language Finnish Page 42 Appendices 5 Pages of Appendices 29 Keywords first aid, first aid skills, mental health rehabilitee, first aid training session, information leaflet on first aid skill

Age-related androgen secretion in healthy women and in women with polycystic ovary syndrome

AbstractThe number of ovarian follicles declines with age resulting in a significant decrease of fertility by the age of 40. However, the age when follicle loss starts to affect ovarian endocrine function is not well recognized. The purpose of the present study was to investigate age-related ovarian/adrenal androgen secretion, which is crucial for estrogen biosynthesis in healthy women and in women with polycystic ovarian syndrome (PCOS). Another aim of the study was to compare the usefulness of different serum markers in assessing ovarian aging and in diagnosing polycystic ovaries (PCOs) and PCOS. The human chorionic gonadotropin (hCG) test was used to study the endocrine potential of ovaries/adrenals. The ovarian capacity to secrete and synthesize androgens was found to be decreased as early as at the age of 30 in regularly menstruating women. In women with PCOS, both basal and hCG-stimulated androgen levels were about 50% higher than in healthy women and they remained high until late reproductive age. Similarly to regularly menstruating women, the androgen secretion capacity in PCOS subjects decreased with age, and estradiol concentrations remained unchanged until the age of 44 years. Adrenal androgen synthesis was not changed during hCG-tests. Since serum antimüllerian hormone (AMH) and follicle stimulating hormone (FSH) levels were changed significantly after the age of 25 years in regularly menstruating women, they may be considered as useful serum markers reflecting the ovarian aging process. In women with PCOS, AMH levels were continuously 2- to 3-fold higher than in healthy women possibly reflecting high follicle number in these women.A decline in ovarian endocrine function before the age of 30 is one of the first signs of ovarian aging. However, in women with PCOS ovarian androgen secretion capacity is markedly increased and remain high throughout the reproductive years. The results of the present studies also indicate that LH/hCG does not play a role in adrenal androgen synthesis, since LH/hCG did not stimulate adrenal androgen synthesis. The measurement of AMH is a useful tool to estimate ovarian aging process as well as to diagnose PCOs/PCOS.Academic Dissertation to be presented with the assent of the Faculty of Medicine, University of Oulu, for public discussion in the Auditorium 4 of Oulu University Hospital, on September 24th, 2004, at 12 noon.Abstract The number of ovarian follicles declines with age resulting in a significant decrease of fertility by the age of 40. However, the age when follicle loss starts to affect ovarian endocrine function is not well recognized. The purpose of the present study was to investigate age-related ovarian/adrenal androgen secretion, which is crucial for estrogen biosynthesis in healthy women and in women with polycystic ovarian syndrome (PCOS). Another aim of the study was to compare the usefulness of different serum markers in assessing ovarian aging and in diagnosing polycystic ovaries (PCOs) and PCOS. The human chorionic gonadotropin (hCG) test was used to study the endocrine potential of ovaries/adrenals. The ovarian capacity to secrete and synthesize androgens was found to be decreased as early as at the age of 30 in regularly menstruating women. In women with PCOS, both basal and hCG-stimulated androgen levels were about 50% higher than in healthy women and they remained high until late reproductive age. Similarly to regularly menstruating women, the androgen secretion capacity in PCOS subjects decreased with age, and estradiol concentrations remained unchanged until the age of 44 years. Adrenal androgen synthesis was not changed during hCG-tests. Since serum antimüllerian hormone (AMH) and follicle stimulating hormone (FSH) levels were changed significantly after the age of 25 years in regularly menstruating women, they may be considered as useful serum markers reflecting the ovarian aging process. In women with PCOS, AMH levels were continuously 2- to 3-fold higher than in healthy women possibly reflecting high follicle number in these women. A decline in ovarian endocrine function before the age of 30 is one of the first signs of ovarian aging. However, in women with PCOS ovarian androgen secretion capacity is markedly increased and remain high throughout the reproductive years. The results of the present studies also indicate that LH/hCG does not play a role in adrenal androgen synthesis, since LH/hCG did not stimulate adrenal androgen synthesis. The measurement of AMH is a useful tool to estimate ovarian aging process as well as to diagnose PCOs/PCOS

Psychological Distress Is More Prevalent in Fertile Age and Premenopausal Women With PCOS Symptoms : 15-Year Follow-Up

Context: Polycystic ovary syndrome (PCOS) is associated with increased psychological distress, obesity and hyperandrogenism being suggested as key promoters. Objectives: To investigate the prevalence of anxiety/depression and their coexistence in women with PCOS/PCOS-related symptoms at ages 31 and 46. The roles of obesity, hyperandrogenism, and awareness of PCOS on psychological distress were also assessed. Design: Population-based follow-up. Setting: Northern Finland Birth Cohort 1966 with 15-year follow-up. Participants: At age 31, a questionnaire-based screening for oligoamenorrhea (OA) and hirsutism (H): 2188 asymptomatic (controls), 331 OA, 323 H, and 125 OA plus H (PCOS). Follow-up at age 46: 1576 controls, 239 OA, 231 H, and 85 PCOS. Interventions: Questionnaire-based screening for anxiety and depression symptoms (Hopkins Symptom Checklist-25) and previously diagnosed/treated depression at ages 31 and 46. Body mass index (BMI), serum testosterone/free androgen index, and awareness of polycystic ovaries/PCOS on psychological distress were also assessed. Main Outcomes: Population-based prevalence of anxiety and/or depression in women with PCOS/PCOS-related symptoms at ages 31 and 46. Results: Anxiety and/or depression symptoms, their coexistence, and rate of depression were increased at ages 31 and 46 in women with PCOS or isolated H compared with controls. High BMI or hyperandrogenism did not associate with increased anxiety or depression symptoms. The awareness of PCOS was associated with increased anxiety. Conclusions: Women with PCOS or isolated H present more often with anxiety and/or depression symptoms and their coexistence compared with controls. High BMI or hyperandrogenism did not provoke psychological distress in PCOS. The awareness of PCOS increased anxiety but did not associate with severe anxiety or depression.Peer reviewe

Psychological Distress Is More Prevalent in Fertile Age and Premenopausal Women With PCOS Symptoms : 15-Year Follow-Up

Context: Polycystic ovary syndrome (PCOS) is associated with increased psychological distress, obesity and hyperandrogenism being suggested as key promoters. Objectives: To investigate the prevalence of anxiety/depression and their coexistence in women with PCOS/PCOS-related symptoms at ages 31 and 46. The roles of obesity, hyperandrogenism, and awareness of PCOS on psychological distress were also assessed. Design: Population-based follow-up. Setting: Northern Finland Birth Cohort 1966 with 15-year follow-up. Participants: At age 31, a questionnaire-based screening for oligoamenorrhea (OA) and hirsutism (H): 2188 asymptomatic (controls), 331 OA, 323 H, and 125 OA plus H (PCOS). Follow-up at age 46: 1576 controls, 239 OA, 231 H, and 85 PCOS. Interventions: Questionnaire-based screening for anxiety and depression symptoms (Hopkins Symptom Checklist-25) and previously diagnosed/treated depression at ages 31 and 46. Body mass index (BMI), serum testosterone/free androgen index, and awareness of polycystic ovaries/PCOS on psychological distress were also assessed. Main Outcomes: Population-based prevalence of anxiety and/or depression in women with PCOS/PCOS-related symptoms at ages 31 and 46. Results: Anxiety and/or depression symptoms, their coexistence, and rate of depression were increased at ages 31 and 46 in women with PCOS or isolated H compared with controls. High BMI or hyperandrogenism did not associate with increased anxiety or depression symptoms. The awareness of PCOS was associated with increased anxiety. Conclusions: Women with PCOS or isolated H present more often with anxiety and/or depression symptoms and their coexistence compared with controls. High BMI or hyperandrogenism did not provoke psychological distress in PCOS. The awareness of PCOS increased anxiety but did not associate with severe anxiety or depression.Peer reviewe

Long-Term Intravitreal Ranibizumab as a Potential Additional Risk Factor for Neurodegeneration in Parkinson's Disease: A Case Report.

In November 2012, a 72-year old patient was diagnosed with left eye wet age-related macular degeneration. The patient received three monthly intravitreal injections of ranibizumab, with complete resolution of retinal hemorrhage and edema and reinstatement of visual acuity. In May 2015, symptomatic relapse was detected. The patient was again treated with intravitreal ranibizumab, with overall six injections till the end of February 2016. In May 2016, the patient complained of left hand resting tremor, bradykinesia, and postural rigidity of head and trunk. A diagnosis of clinically established PD was made based on new criteria of the Movement Disorders Society. Single Photon Emission Computerized Tomography of the Dopamine Transporter with (123I) ioflupane documented a low Dopamine Transporter (DAT) uptake mostly in the right striatum. Due to the documented protective role of vascular endothelial growth factor (VEGF) on the dopaminergic neurons, intensive intravitreal injections of the anti-VEGF agent ranibizumab may have played as an additional risk factor accelerating the neurodegeneration process related to PD and the onset of the related clinical signs and symptoms

Sphagnum moss as a functional reinforcement agent in castor oil-based biopolyurethane composites

Abstract(1) Sphagnum mosses are an abundant source of structural molecules, similar to lignocelluloses in rooted plants, having properties advantageous in biopolyurethane composites: their hydrophobicity when dry facilitates dispersion into biopolyols; hydroxyl groups provide cross-linking with the polyurethane (PU) matrix; and easy grindability enables small particle size, down to 10 μm with low energy consumption and a large interface for isocyanate to react with.(2) The present study introduces a novel use of Sphagnum moss as a reinforcement filler incorporated into castor oil. Two moss grades, a slightly and a moderately humified moss (having hydroxyl, equivalent to KOH, of 255 and 359 mg g⁻¹, respectively), were pulverised and dispersed into castor oil (KOH equivalent 160mg g⁻¹) in mass proportions of 0–28 %. Mixtures were reacted with polymeric diphenylmethane diisocyanate to produce reinforced biopolyurethane (bioPU) composites.(3) The mechanical properties tested according to ISO 527 improved similarly with both fillers. With increasing filler content, tensile strength increased monotonically up to 450 % and Young’s modulus up to 350 % while the strain at break point (at around 90 %) remained almost unchanged over the whole range of filler contents. The shift of the ‘′tan delta′ peak’ (energy damping coefficient during deformation) toward higher temperatures with increasing filler content indicated strong cross-linking between the filler and the PU matrix, while the width of the peaks was narrow and remained virtually unchanged showing the filler to be homogeneously dispersed within the matrix.(4) Overall, Sphagnum filler may provide a straightforward and cost-effective reinforcement for (bio)polyurethanes.Abstract (1) Sphagnum mosses are an abundant source of structural molecules, similar to lignocelluloses in rooted plants, having properties advantageous in biopolyurethane composites: their hydrophobicity when dry facilitates dispersion into biopolyols; hydroxyl groups provide cross-linking with the polyurethane (PU) matrix; and easy grindability enables small particle size, down to 10 μm with low energy consumption and a large interface for isocyanate to react with. (2) The present study introduces a novel use of Sphagnum moss as a reinforcement filler incorporated into castor oil. Two moss grades, a slightly and a moderately humified moss (having hydroxyl, equivalent to KOH, of 255 and 359 mg g⁻¹, respectively), were pulverised and dispersed into castor oil (KOH equivalent 160mg g⁻¹) in mass proportions of 0–28 %. Mixtures were reacted with polymeric diphenylmethane diisocyanate to produce reinforced biopolyurethane (bioPU) composites. (3) The mechanical properties tested according to ISO 527 improved similarly with both fillers. With increasing filler content, tensile strength increased monotonically up to 450 % and Young’s modulus up to 350 % while the strain at break point (at around 90 %) remained almost unchanged over the whole range of filler contents. The shift of the ‘′tan delta′ peak’ (energy damping coefficient during deformation) toward higher temperatures with increasing filler content indicated strong cross-linking between the filler and the PU matrix, while the width of the peaks was narrow and remained virtually unchanged showing the filler to be homogeneously dispersed within the matrix. (4) Overall, Sphagnum filler may provide a straightforward and cost-effective reinforcement for (bio)polyurethanes

Evaluasi Pengetahuan Sebelum dan Sesudah Penyuluhan Tentang Kanker Payudara dan Praktek Sadari di Madrasah Aliyah Hidayatul Muslimin 2 Kecamatan Sungai Raya Kabupaten Kubu Raya Tahun 2017

Pengetahuan merupakan hasil dari tahu dan ini terjadi setelah orang melakukan pengindraan terhadap suatu objek tertentu. Kanker payudara adalah suatu penyakit dimana terjadi pertumbuhan berlebihan atau perkembangan tidak terkontrol dari sel-sel (jaringan) payudara. Diperkirakan bahwa di seluruh dunia lebih dari 508 000 wanita meninggal pada tahun 2011 karena kanker payudara. prevalensi kanker payudara di Indonesia mencapai 0,5 per 1000 perempuan. Pada tahun 2003 berjumlah 221 orang, mengalami kenaikan tiga kali lipat pada tahun 2012. Tujuan umum dari penelitian ini adalah untuk mengevaluasi pengetahuan sebelum dan sesudah penyuluhan tentang kanker payudara dan praktek SADARI di Madrasah Aliyah Hidayatul Muslimin 2 Kecamatan Sungai Raya Kabupaten Kubu Raya tahun 2017. Desain penelitian ini adalah Quasi Eksperimen. Dengan rancangan penelitian One Group Pre- Post test. Dengan menggunakan alat ukur kuesioner dan lembar checklist. Dari hasil penelitian Sebelum penyuluhan dan praktek didapatkan sebagian dari responden dengan pengetahuan baik yaitu 41 responden (56,9%) dan sebagian dari responden dengan praktek baik yaitu 33 responden (45,8%). Dan sesudah penyuluhan dan praktek sebagian dari responden dengan pengetahuan baik yaitu 38 responden (52,8%) dan sebagian besar responden dengan praktek baik yaitu 47 responden (65,3%), diketahui hasil uji statistik T-Test pengetahuan -4, 947 dan T-Test praktek yaitu -14,761 didapatkan nilai P-Value 0,0001 < 0,05 yang berarti Ha diterima yaitu ada perbedaan pengetahuan sebelum dan sesudah diberikan penyuluhan,dan.praktek. Kesimpulan hasil penelitian ini sebaiknya siswi rutin melakukan SADARI setiap bulan pada hari ke 5-10 menstruasi sehingga dapat mendeteksi dini adanya kelainan pada payudara

Niche matters : The comparison between bone marrow stem cells and endometrial stem cells and stromal fibroblasts reveal distinct migration and cytokine profiles in response to inflammatory stimulus

Objective Intrinsic inflammatory characteristics play a pivotal role in stem cell recruitment and homing through migration where the subsequent change in niche has been shown to alter these characteristics. The bone marrow mesenchymal stem cells (bmMSCs) have been demonstrated to migrate to the endometrium contributing to the stem cell reservoir and regeneration of endometrial tissue. Thus, the aim of the present study was to compare the inflammation-driven migration and cytokine secretion profile of human bmMSCs to endometrial mesenchymal stem cells (eMSCs) and endometrial fibroblasts (eSFs). Materials and methods The bmMSCs were isolated from bone marrow aspirates through culturing, whereas eMSCs and eSFs were FACS-isolated. All cell types were tested for their surface marker, proliferation profiles and migration properties towards serum and inflammatory attractants. The cytokine/chemokine secretion profile of 35 targets was analysed in each cell type at basal level along with lipopolysaccharide (LPS)-induced state. Results Both stem cell types, bmMSCs and eMSCs, presented with similar stem cell surface marker profiles as well as possessed high proliferation and migration potential compared to eSFs. In multiplex assays, the secretion of 16 cytokine targets was detected and LPS stimulation expanded the cytokine secretion pattern by triggering the secretion of several targets. The bmMSCs exhibited higher cytokine secretion of vascular endothelial growth factor (VEGF)A, stromal cell-derived factor-1 alpha (SDF)-1 alpha, interleukin-1 receptor antagonist (IL-1RA), IL-6, interferon-gamma inducible protein (IP)-10, monocyte chemoattractant protein (MCP)1, macrophage inflammatory protein (MIP) 1 alpha and RANTES compared to eMSCs and/or eSFs after stimulation with LPS. The basal IL-8 secretion was higher in both endometrial cell types compared to bmMSCs. Conclusion Our results highlight that similar to bmMSCs, the eMSCs possess high migration activity while the differentiation process towards stromal fibroblasts seemed to result in loss of stem cell surface markers, minimal migration activity and a subtler cytokine profile likely contributing to normal endometrial functionPeer reviewe

Designing greener participant centred trials : an analysis of 'carbon relevant' factors within items that influence participants decisions about trial recruitment and retention

Peer reviewe

Expression of NAD(P)H quinone dehydrogenase 1 (NQO1) is increased in the endometrium of women with endometrial cancer and women with Polycystic Ovary Syndrome

OBJECTIVE: Women with a prior history of polycystic ovary syndrome (PCOS) have an increased risk of endometrial cancer (EC). AIM: To investigate whether the endometrium of women with PCOS possess gene expression changes similar to those found in EC. DESIGN AND METHODS: Patients with EC, PCOS and control women unaffected by either PCOS or EC were recruited into a cross-sectional study at the Nottingham University Hospital, UK. For RNA sequencing, representative individual endometrial biopsies were obtained from women with EC, PCOS and a woman unaffected by PCOS or EC. Expression of a subset of differentially expressed genes identified by RNA sequencing, including NAD(P)H quinone dehydrogenase 1 (NQO1), were validated by quantitative reverse transcriptase PCR validation (n=76) and in the cancer genome atlas UCEC (uterine corpus endometrioid carcinoma) RNA sequencing dataset (n=381). The expression of NQO1 was validated by immuno-histochemistry in EC samples from a separate cohort (n=91) comprised of consecutive patients who underwent hysterectomy at St Mary's Hospital, Manchester between 2011 and 2013. A further 6 postmenopausal women with histologically normal endometrium who underwent hysterectomy for genital prolapse were also included. Informed consent and local ethics approval was obtained for the study. RESULTS: We show for the first that that NQO1 expression is significantly increased in the endometrium of women with PCOS and EC. Immunohistochemistry confirms significantly increased NQO1 protein expression in EC relative to non-malignant endometrial tissue (p<0.0001). CONCLUSIONS: The results obtained here support a previously unrecognized molecular link between PCOS and EC involving NQO1