Expectations of elderly people on the nurse-client relationship and interaction in home care : "When I see the nurse's smiling face it feels likes sunshine on a rainy and gloomy day"

The purpose of the thesis was to explore expectations of elderly people on the nurse-client relationship and interaction in home care. The aim is to improve the quality of care to better meet the needs of the clients. A qualitative approach was adopted. Semi-structured theme interviews were used for data collection. The interviews were conducted during spring 2006. Six elderly clients of a private home care company in Southern Finland acted as informants. Content analysis was used as the method of data analysis. The findings suggest that clients expect nurses to provide professional care with loving-kindness. Trust and mutual, active interaction were expected from the nurse-client relationship. Clients considered it important that the nurse recognizes each client's individual needs. The nurse was expected to perform duties efficiently, but in a calm and unrushed manner. A mechanic performance of tasks was considered negative. Humanity was viewed as a crucial element in the nurse-client relationship. Clients expressed their need to be seen as human beings. Seeing beyond the illness was considered important. A smiling nurse was described to be able to alleviate pain and anxiety. Clients hoped to have a close relationship with the nurse. The development of a close relationship was considered to be more likely if the nurse is familiar and genuine. Clients wish the nurses to have a more attending presence. Clients suggested that the work areas of the nurses could be limited so that they would have more time to transfer from one place to another. Clients felt that they would benefit from this as well. The nurses were expected to be more considerate. Clients wished for more information regarding changes that affect their care. They wished to be informed about changes in schedules and plans. Clients hoped for continuity from the nurse-client relationship. Considering the expectations of clients promotes client satisfaction. Home care providers have an opportunity to reflect their own care behaviour on the findings. To better meet the needs of the clients, nurses could apply the concept of loving-kindness in their work, and strive for a more attending presence.

Estimation of genetic parameters for test-day milk production at different stages of lactation of Finnish Ayrshire heifers

Selostus: Ayrshire-ensikoiden koelypsykohtaisen maidontuotannon perinnölliset tunnusluvut laktaation eri vaiheissa

Study of present day folk poetry

Kirja-arvio

Derby Day race card for british charities i Finland

14 x 21 cm

The New-Day Jewett Six

kuv., 20 x 27 cm

The New-Day Jewett Six

kuv., 20 x 27 cm

The New-Day Jewett Six

kuv., 19 x 38 cm

Price spike forecasting in a competitive day-ahead energy market

Electricity price forecasting has become an important area of research in the aftermath of the worldwide deregulation of the power industry that launched competitive electricity markets now embracing all market participants including generation and retail companies, transmission network providers, and market managers. Based on the needs of the market, a variety of approaches forecasting day-ahead electricity prices have been proposed over the last decades. However, most of the existing approaches are reasonably effective for normal range prices but disregard price spike events, which are caused by a number of complex factors and occur during periods of market stress. In the early research, price spikes were truncated before application of the forecasting model to reduce the influence of such observations on the estimation of the model parameters; otherwise, a very large forecast error would be generated on price spike occasions. Electricity price spikes, however, are significant for energy market participants to stay competitive in a market. Accurate price spike forecasting is important for generation companies to strategically bid into the market and to optimally manage their assets; for retailer companies, since they cannot pass the spikes onto final customers, and finally, for market managers to provide better management and planning for the energy market. This doctoral thesis aims at deriving a methodology able to accurately predict not only the day-ahead electricity prices within the normal range but also the price spikes. The Finnish day-ahead energy market of Nord Pool Spot is selected as the case market, and its structure is studied in detail. It is almost universally agreed in the forecasting literature that no single method is best in every situation. Since the real-world problems are often complex in nature, no single model is able to capture different patterns equally well. Therefore, a hybrid methodology that enhances the modeling capabilities appears to be a possibly productive strategy for practical use when electricity prices are predicted. The price forecasting methodology is proposed through a hybrid model applied to the price forecasting in the Finnish day-ahead energy market. The iterative search procedure employed within the methodology is developed to tune the model parameters and select the optimal input set of the explanatory variables. The numerical studies show that the proposed methodology has more accurate behavior than all other examined methods most recently applied to case studies of energy markets in different countries. The obtained results can be considered as providing extensive and useful information for participants of the day-ahead energy market, who have limited and uncertain information for price prediction to set up an optimal short-term operation portfolio. Although the focus of this work is primarily on the Finnish price area of Nord Pool Spot, given the result of this work, it is very likely that the same methodology will give good results when forecasting the prices on energy markets of other countries.

Anaesthesia and Pain Management for Use in Orthopaedic Day Surgery

Day surgery has gained a large popularity during the last decades. In Finland, 57% of the elective procedures, and 50% at Turku University Hospital, were already conducted on day basis during 2012. The steady growth of day surgery is mostly due to an increased safety in perioperative care and cost-effectiveness. The development of surgical techniques and anaesthetic methods has advanced the modern day surgery and extended the repertory of the procedures for use in day surgery operations. Day surgery also offers certain benefits like reduced risk for hospital-related infections, stress and confusion. Patient satisfaction, regarding several issues, is high. Most concerns and complaints are related to postoperative pain, nausea and vomiting pain and nausea. Pain can hamper recovery and pain management is a crucial factor for hospital discharge. Appropriate pain treatment is effective, safe, easy and economical. A procedure-specific approach and an individually planned, multimodal analgesia should be the basis of modern pain management. The main aim of this thesis was to evaluate the effectiveness and safety of anaesthetic technique and methods in pain treatment of orthopaedic day case surgery, and following conclusions were made. Unilateral spinal block was achieved using hyperbaric bupivacaine with a small dose of clonidine but clonidine prolonged the block. Continuous subacromial bupivacaine was found to be safe but conferring only moderate efficacy in pain care after shoulder arthroscopy. Transdermal fentanyl, 12 g/h, as part of multimodal analgesia, offered a safe and easy option to pain management in this patient group. However, after forefoot surgery, it did not reduce pain any further. In general, pain scores in all patient groups were low and the need for rescue opioid moderate.