Transition : en betydelsefull fas i den långtidssjuka ungas vård

The aim of this caring science thesis is to deepen the understanding for the long-term ill adolescents care. In particular it aims to reach a better understanding of transition in health care, with a focus on how young people perceive health care. The goal is to build a model, a consistent theoretical framework that makes it possible to listen to the adolescent´s own voice, providing a better understanding of what good care consists in from their point of view. This Master's thesis consists of a literature overview on the concept of transition and a themed interview with young patients regarding transition of health care. The overall issue is 1. What is good care during the transition according to the adolescents themselves? 2. How does transition affect the young people's health and lives? The theoretical perspective of this thesis lies in the caring science tradition that has been developed at the Åbo Akademi University department of caring science with the caritative nursing theory as a basis. The epistemological and ontological assumptions are based on the caritative nursing theory, which in itself is ethical. Understanding of the concept of transition is based on A. Meleis transitions theory. The methodological approach is hermeneutical. The theme interview has been analyzed by using S. Kvales method. The material consists of a thematic interview with 10 long-term ill adolescents, about their views of the care received. This thesis research even in how NOBABs standards appears in the litterature as well as how they are implemented from the point of view of young people. The findings of this thesis shows that good care for the adolescent is a true presence with the young and an understanding of the direction in which the young move toward during the transition of care. Good care for an adolescent consists in being recognized as a person who is seen, known, appreciated and understood. Good care for the young involves recognizing her strength and joy of life including the contrast she experiences between health and suffering. To recognize their personal strength and courage supports the adolescents during the process of transitions of care Good care for the young involves responsibility for the individual person and humility in approaching her, giving attention to her view of life and aspirations. Openness and humility in the approach lays the foundation for a trusting relation during the transition of care. A unified theoretical framework is needed to promote the long-term ill adolescents care during transition of care. When the young and her individual needs is the centerpiece of healthcare creates this the basis for empowering care that supports the young in her quest for health. This master thesis adds a given model to the long-term ill adolescents` healthcare.

Irinotecan and oxaliplatin: an overview of the novel chemotherapeutic options for the treatment of advanced colorectal cancer

Colorectal cancer is one of the most frequent malignancies in humans and an important cause of cancer death. Metastatic colorectal cancer remains incurable with available systemic therapeutic options. The most active cytotoxic drug against this malignancy, the antimetabolite 5-fluorouracil, was developed more than forty years ago, and as a single agent produces responses in only 10 to 15% of patients which in general last less than one year. Efforts to ameliorate these poor results resulted in the 5-fluorouracil/leucovorin combination, which enhances response rates about two-fold, without, however, significantly improving survival rates. The recent emergence of a handful of new 5-fluorouracil analogues and folate antagonists, as well as the topoisomerase I inhibitor irinotecan, and the third-generation platinum compound oxaliplatin, is likely to alter this gloomy scenario. These agents are at least as effective as 5-fluorouracil in patients with advanced colorectal carcinoma, both untreated and previously treated with 5-fluorouracil-based regimens. This has led to the approval of irinotecan as second-line treatment for 5-fluorouracil-refractory disease, while the use of oxaliplatin has been suggested for patients having a defective 5-fluorouracil catabolism. Recently, FDA approved the combination of irinotecan with 5-fluorouracil and leucovorin for first-line treatment of advanced colon cancer. Based on the synergistic preclinical antitumor effects of some of these agents, their meaningful single-agent activity, distinct mechanisms of cytotoxicity and resistance, and only partially overlapping toxicity profiles, effective combination regimens are now being developed, which are likely to lead to a new, more hopeful era for patients suffering from advanced colorectal carcinoma.

Kallet til livets embete : mødre i helse og lidelse

Mothers represent the natural caring. Natural caring is the object of caring science and of research interest because it establishes the central core of professional caring. In this study, we encounter patients who are mothers in need of care in a psychiatric context. Motherhood involves taking responsibility that extends beyond one's own life, because the child represents possibilities in a yet unknown future. Understanding and knowledge about the mothers' struggle in health and suffering are of crucial importance to enable clinical practice to make provisions for and adapt to the individual patient. The overall purpose of this dissertation is to illuminate how the innermost essence of caring emerges in health and suffering in patients who are mothers in psychiatric care. The purpose of the study in a clinical sense is to seek to understand and illuminate the patient's inner world in health and suffering in terms of contextual, existential, ontological and ethical dimensions. The dissertation is exploratory and descriptive in nature and encompasses induction, deduction and abduction as logics tools of reasoning. A theoretical model of natural caring and a universal theoretical model of the innermost essence of caring is developed as seen from the patient's world in a psychiatric context. The dissertation is anchored in human science's view of the human being and the world and in caring science's perspective. Caring science's view of the human being as a unity comprising body, soul and spirit is central in the study's concept of the patient. This multi-dimensional conception of the human being encompasses the dissertation's basic values and is decisive for choice of methodology. Hermeneutic epistemology guided the interpretation of the empirical data, the paradigmatic theses and assumptions. The dialectical movement in interpretation moves back and forth between empirical data, caring science theory and philosophical theory and reveals deeper insight into meaningful content in the clinical context. The interpretation process comprises four levels of abstraction: rational, contextual, existential and ontological. Hermeneutic philosophy guides the inductive and deductive approach to interpretation, as well as the movement between the clinical context and the caring science paradigm. In this encounter between the visible and invisible reality, the image of natural caring – motherliness emerged. The dissertation consists of four studies. The first study is a systematic review of nineteen research articles. The three other studies are hermeneutical interpretations based on text materials from open interviews. Fifteen participants were interviewed, all of whom are mothers of children between 0 and 18 years of age. All were outpatients in the psychiatric specialist health service. In the interpretation process, the mothers' struggle in health and suffering emerges as a struggle between the inner and outer world. Being a mother and patient in health and suffering in a psychiatric context means to struggle to be oneself, to create oneself, to live and realize one's good deeds as a mother and human being. To be oneself, to possess oneself as a mother is not only a question of tending, playing and learning in order to master a practical situation or to survive. It involves constituting a deep, inner desire to courageously create oneself so that the child is able to realize his or her potential in health and suffering. Motherliness manifests itself in caring as a call to ministering humanity and life. The voice of motherliness is understood as the voice of life—the eternal, inner call of love and freedom. The inner call craves fulfilment. Motherliness in natural caring does not retreat. Motherliness defines the Other as freedom and proceeds without regard for all other exterior requirements to realizing wellbeing. The inner essence of caring is attentive, aware and heeds the call of the heart. The innermost essence of caring is to be and to make oneself responsible for the Other. Responsibility cannot be relinquished; free choice consists in whether or not to follow the call. To renounce the inner call to responsibility is to deny oneself and one's dignity as a human being. The theoretical models provide clinical and systematic caring science with knowledge and understanding based on the natural caring spirit inherent in the human being. The study elucidates and strengthens the ontological basic assumptions about the human being as a unity of body, soul and spirit, the sanctity of the human being and the core of caring, ethos. The results of the dissertation will provide clinical practice with knowledge about the inner movements of the mothers' souls in relation to their responsibility as mothers and human beings. Being able to understand the basic conditions for responsibility is crucial for developing care that encompasses mother and child and the mutual relationship between them. This is basic knowledge for developing attitudes and actions that meet and provide for the needs of the patient as mother and as a whole, suffering human being.

The growing competition in Brazilian science: rites of passage, stress and burnout

Brazil's scientific community is under pressure. Each year there is an increase in its contribution to international science and in the number of students who are trained to do research and teach at an advanced level. Most of these activities are carried out in state and federal universities, but with government funding that has decreased by more than 70% since 1996. Interviews with graduate students, post-doctoral fellows and professors in one university department with a strong research tradition illustrate the level of stress engendered by the conflict between increasing competition and diminishing resources, and serve to underscore the negative effects on creativity and on the tendency to choose science as a career.

“Inifrån utanförskapet” : en vårdvetenskaplig studie om lidande i utanförskap

Syftet med denna vårdvetenskapliga avhandling är att tränga djupare in i fenomenet utanförskap genom att studera utanförskap och dess förhållande till och inverkan på människans hälsa och lidande. Frågeställningarna gäller vad utanförskap är och hur lidandet i utanförskap ser ut. Avhandlingen har ett vårdvetenskapligt perspektiv enligt den caritativa traditionen som utvecklats vid Åbo Akademi i Vasa. Målet med studien är att bidra med en större förståelse inom vården för det lidande som människor upplever då de befinner sig i utanförskap. Avhandlingen görs som en kvalitativ studie bestående av två delar, dels av en teoretisk studie, dels en empirisk undersökning. Den teoretiska delen består av en översikt av tidigare forskning, där materialet utgörs av nitton vetenskapliga artiklar. Materialet i den empiriska delen av studien utgörs av samtal med samt skrivna berättelser av forskningspersoner. Forskningspersonerna kommer från två olika kontexter: dels utländska studerande som studerar i Finland, dels personer som upplevt utanförskap i förhållande till ett religiöst samfund. Båda delarna av studien tolkas genom en kvalitativ innehållsanalys. Resultatet visar att utanförskap kan erfaras inom många olika kontexter. Ur den teoretiska delen av studien steg följande teman fram som lidande i utanförskap: ensamhet, främlingskap, förluster, stigma och skam, social smärta samt mental ohälsa. Den empiriska delen av studien visar att utanförskap som upplevs inom en religiös kontext är ett svårare och djupare lidande än det som upplevs av utländska studerande. Teman om lidande i utanförskap som steg fram ur den empiriska studien är: social smärta, språkbarriär och nya sociala koder. Dessutom framkom positiva aspekter: utanförskap som ett äventyr och som samhörighet. Tolkningen av det gemensamma resultatet utmynnade i tre kategorier: det inre lidandet, det yttre lidandet och positiva aspekter av utanförskap. Med en ökad förståelse för lidandet i utanförskap kan vi möta människor i deras lidande och vara delaktiga i att lindra deras lidande.

Chance of psychiatric morbidity amongst recently diagnosed cancer outpatients attending a chemotherapy unit

The prevalent rate of psychiatry morbidity amongst patients with cancer reported in various studies ranges from 5 to 50%, a variation that can be attributed to differences in sample size, the disease itself and treatment factors. The objectives of the present study were to determine the frequency of psychiatric morbidity amongst recently diagnosed cancer outpatients and try to identify which factors might be related to further psychological distress. Two hundred and eleven (70.9%) female patients and 87 (29.1%) male patients from the chemotherapy unit of the Cancer Hospital A.C. Camargo (São Paulo) completed a questionnaire that featured data on demographic, medical and treatment details. The Self Reporting Questionnaire (SRQ-20) was administered to the patients to determine their personal psychiatric morbidity. Seventy-two patients (25.8%) scored > or = 8 in the SRQ-20, the cut-off point for a patient to be considered a psychiatric case. When the low and high scoring groups were compared no differences were detected regarding age, marital status, tumor site, sex, or previous treatment. Nonetheless, patients in the lowest social class and those who were bedridden less than 50% of the time had a significantly higher probability of being a psychiatric case. Regarding help-seeking behavior in situations in which they had doubts or were frightened, about 64% of the total sample did not seek any type of support and did not talk to anyone. This frequency of psychiatric morbidity agrees with data from the cancer literature. According to many investigators, the early detection of a comorbid psychiatric disorder is crucial to relieve a patient's suffering.

Improvement of adynamic bone disease after renal transplantation

Low bone remodeling and relatively low serum parathyroid hormone (PTH) levels characterize adynamic bone disease (ABD). The impact of renal transplantation (RT) on the course of ABD is unknown. We studied prospectively 13 patients with biopsy-proven ABD after RT. Bone histomorphometry and bone mineral density (BMD) measurements were performed in the 1st and 12th months after RT. Serum PTH, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and osteocalcin were measured regularly throughout the study. Serum PTH levels were slightly elevated at transplantation, normalized at the end of the third month and remained stable thereafter. Bone biopsies performed in the first month after RT revealed low bone turnover in all patients, with positive bone aluminum staining in 5. In the 12th month, second biopsies were performed on 12 patients. Bone histomorphometric dynamic parameters improved in 9 and were completely normalized in 6, whereas no bone mineralization was detected in 3 of these 12 patients. At 12 months post-RT, no bone aluminum was detected in any patient. We also found a decrease in lumbar BMD and an increase in femoral BMD. Patients suffering from ABD, even those with a reduction in PTH levels, may present partial or complete recovery of bone turnover after successful renal transplantation. However, it is not possible to positively identify the mechanisms responsible for the improvement. Identifying these mechanisms should lead to a better understanding of the physiopathology of ABD and to the development of more effective treatments.

Livets källa kärleken : hälsans urkraft

This basic research focuses on the ethos of health and the human being's becoming in health. The theoretical perspective consists of the caring tradition within caring science developed at Åbo Akademy University. The aim of the present doctoral thesis is to uncover a new understanding as well as to deepen and attain a more nuanced understanding of the ethos of health, the essence of health, by penetrating to the core of what gives the human being the strength for experiencing a becoming in health. The research questions are as follows: l) What is the human being's source of strength? and 2) What reveals the source of strength so that the human being can perceive it and dedicate its strength in order to experience a becoming in health? The primary methodology used in the dissertation is hermeneutical. The material consists of the work Kärlekens gerningar by Kierkegaard, texts from focused interviews with respondents who have lived through severe personal suffering, as well as the book Det bländande mörkret by Wikström. These texts are interpreted through hermeneutical reading. The new horizon of understanding that emerges is reflected towards Eriksson's caritative theory, towards prior research within the tradition of caring science at Åbo Akademy University and towards previous national and international studies within this field. The new understanding shows that the human being's source of strength is love, the essence and origin of life. The substance of health is love, which, through the trinity of faith, hope and love, also makes possible the existence of the source of strength. Love has a deeper dignity than faith and hope, is connected with eternity and is the uniting link between temporality and eternity. The human being's inner longing entails an ontological attraction towards the source of strength. This source of strength is hidden, which provides and maintains its force, like a mystery connected with the darkness of suffering that hides the secret representing the source of strength, life's mystery, bu t w hi ch is revealed in both the darkness of suffering and in the light of joy. The dedication of strength requires freedom, willingness and courage to see the light, despite awareness of shame and guilt. Creative acts liberate the human being for the dedication of strength, which is preceded by a holy presence where, in solitude, the human being makes sacrifices for the sake of his or her human smallness and weakness, and allows himself or herself to be enclosed by the darkness of suffering to discover the light from the source. This entails being enraptured in a quiet "doing" in order to experience the beauty that bears witness to the holy which creates unity. The source of strength is revealed through beauty. The ethos of the human being and the ethos of health have the same fundamental substance, whilst the ethos of life possesses the deepest dimension and concerns the mysterious and infinite eternity. The ethos of life, eternity, which is a wellspring of strength, is not in itself strength-giving unless it is allied with love. Health can be understood in the light of life, of which death is an inevitable part. Life itself constitutes and creates the source which, through its alliance with eternity' s primordial wellspring of strength, generates strength from which the human being's source of strength, love, receives its eternal fervour. The human being is fundamentally interconnected with an abstract other, the first love, a universal wellspring of strength. Through Communion with this abstract other a dedication of the strength to experience a becoming in health becomes possible. Love for one's neighbour is the fundamental substance in the movement of becoming in health. Becoming in health presupposes a simultaneous movement in which the human being practices the human calling through ethos. As one loves one's neighbour through actions the still forces of eternity are in motion. When life emerges in the foreground and becomes the home of the human being, a dedication of the power of love is possible. Life itself determines the human being's becoming in health. A humble fundamental attitude towards life constitutes the basis for a continuous dedication of vitality from this source.

Intracranial Nimodipine Implant: Feasibility and Implications for the Treatment of Subarachnoid Hemorrhage – A Pre-Clinical Study

Intracranial aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition requiring immediate neurocritical care. A ruptured aneurysm must be isolated from arterial circulation to prevent rebleeding. Open surgical clipping of the neck of the aneurysm or intra-arterial filling of the aneurysm sack with platinum coils are major treatment strategies in an acute phase. About 40% of the patients suffering from aSAH die within a year of the bleeding despite the intensive treatment. After aSAH, the patient may develop a serious complication called vasospasm. Major risk for the vasospasm takes place at days 5–14 after the primary bleeding. In vasospasm, cerebral arteries contract uncontrollably causing brain ischemia that may lead to death. Nimodipine (NDP) is used to treat of vasospasm and it is administrated intravenously or orally every four hours for 21 days. NDP treatment has been scientifically proven to improve patients’ clinical outcome. The therapeutic effect of L-type calcium channel blocker NDP is due to the ability to dilate cerebral arteries. In addition to vasodilatation, recent research has shown the pleiotropic effect of NDP such as inhibition of neuronal apoptosis and inhibition of microthrombi formation. Indeed, NDP inhibits cortical spreading ischemia. Knowledge of the pathophysiology of the vasospasm has evolved in recent years to a complex entity of early brain injury, secondary injuries and cortical spreading ischemia, instead of being pure intracranial vessel spasm. High NDP levels are beneficial since they protect neurons and inhibit the cortical spreading ischemia. One of the drawbacks of the intravenous or oral administration of NPD is systemic hypotension, which is harmful particularly when the brain is injured. Maximizing the beneficial effects and avoiding systemic hypotension of NDP, we developed a sustained release biodegradable NDP implant that was surgically positioned in the basal cistern of animal models (dog and pig). Higher concentrations were achieved locally and lower concentrations systemically. Using this treatment approach in humans, it may be possible to reduce incidence of harmful hypotension and potentiate beneficial effects of NDP on neurons. Intracellular calcium regulation has a pivotal role in brain plasticity. NDP blocks L-type calcium channels in neurons, substantially decreasing intracellular calcium levels. Thus, we were interested in how NDP affects brain plasticity and tested the hypothesis in a mouse model. We found that NDP activates Brain-derived neurotrophic factor (BDNF) receptor TrkB and its downstream signaling in a reminiscent of antidepressant drugs. In contrast to antidepressant drugs, NDP activates Akt, a major survival-promoting factor. Our group’s previous findings demonstrate that long-term antidepressant treatment reactivates developmental-type of plasticity mechanisms in the adult brain, which allows the remodeling of neuronal networks if combined with appropriate rehabilitation. It seems that NDP has antidepressant-like properties and it is able to induce neuronal plasticity. In general, drug induced neuronal plasticity has a huge potential in neurorehabilitation and more studies are warranted.

Incidence of heart failure in infarcted rats that die spontaneously

The present study reports for the first time the incidence of congestive heart failure (CHF) in previously infarcted rats that died spontaneously. Previously, pulmonary (PWC) and hepatic (HWC) water contents were determined in normal rats: 14 control animals were evaluated immediately after sacrifice, 8 placed in a refrigerator for 24 h, and 10 left at room temperature for 24 h. In the infarcted group, 9 rats died before (acute) and 28 died 48 h after (chronic) myocardial infarction. Thirteen chronic animals were submitted only to autopsy (N = 13), whereas PWC and HWC were also determined in the others (N = 15). Seven rats survived 48 h and died during anesthesia. Notably, PWC differed in normal rats: ambient (75.7 ± 1.3%) < control (77.5 ± 0.7%) < refrigerator (79.1 ± 1.4%) and there were no differences with respect to HWC. No clinical signs of CHF (dyspnea, lethargy or foot edema) were observed in infarcted rats before death. PWC was elevated in all chronic and anesthetized rats. HWC was increased in 48% of chronic and in all anesthetized rats. Our data showed that PWC needs to be evaluated before 24 h post mortem and that CHF is the rule in chronic infarcted rats suffering natural death. The congestive syndrome cannot be diagnosed correctly in rats by clinical signs alone, as previously proposed.

Att lindra ett lidande : en kvalitativ studie om lindrande av den mobbade elevens lidande

The study's aim is to achieve knowledge of how to relieve the suffering of the bullied student. The methodology in this study is hermeneutics. The theoretical perspective is the caritative theory. The questions in the study are: 1) What does it mean to relieve a suffering? 2) What can caregivers do to relieve the suffering of the young bullied pupil? 3) How do the caregivers experience their role in relieving the suffering? The review of previous research shows that bullying is a phenomenon that causes great harm to the health of young people. There are varying developed strategies to deal with bullying in the schools. Only one article studied the counsellor role in fighting bullying. There is a need to examine how a suffering can be relieved, how the caregiver experience handling bullying, and how caregivers can be involved in relieving the suffering the bullied youngster is going through. The empirical part of the study was conducted through qualitative semi-structured interviews with counsellors who work with high school students. The study was conducted in close collaboration with the project "Analys av ungdomsenkäten" conducted by the youth researchers at Åbo Akademi and the Swedish Ostrobothnia Youth foundation (SOU). The collected material was analyzed according to Elo and Kyngäs (2007) guidelines for inductive content analysis. The result shows that caregivers play an important role in relieving a suffering. Counsellors emphasize the importance of a mutual relationship in order to relieve the victims suffering. Lack of time was the main culprit. The core of alleviating a suffering can be compared with those factors the informants take into account in the caring encounter with the bullied pupil.

Mobile applications, solution for sustainable agriculture? - Study of mAgriculture services in Kenya

During the recent years, mobile services have spread to many different sectors, including education, health and agriculture, while changing the practices in those fields. Agriculture sector is under pressure to fill the ever-crowing food demand, while suffering from lack of agriculture resources (such as water and soil) and climate change, as well as figuring how to involve young people in the agriculture sector, in order to replace aging farmers. These issues create a need to bring new sustainable solutions to the agriculture sector. This is the demand, which mobile agriculture, mAgriculture, services are trying to answer. This thesis will examine the mAgriculture services in the Kenyan market. The thesis will provide an overview of the currently available mAgriculture services, their outcome and issues with which they are struggling. The thesis will also present recommendations on how to improve currently existing services and processes behind them. Secondly, thesis will provide four ideas for new services, which would answer for the needs of the farmers. Suitable business models, regarding the new services, are also covered. The thesis focuses with the young farmers as a target group, but findings are also applicable with other potential target groups as well.

Människans liv med sömnbesvär och hur människor med sömnbesvär upplever kognitiv beteendeterapi

Sleep disorders are a common health problem in western countries. Every third working age person suffers from sleep deprivation and that often leads to other health problems as well. One can end up in a vicious circle, which can further decrease mood and ability to function. The aim of this thesis is to illustrate how sleep deprivation affects the lives of working age population and to deepen our understanding of life with sleep deprivation. Study questions are: how does sleep deprivation affect a working age person’s life and what kind of experiences do people have about cognitive-behavioural therapy as a treatment to sleep disorders. Theoretical perspective is based on clinical nursing science theories and the humanist view of man, which sees human as an entity. The methodology used is phenomenological approach and data analysis is conducted by using Ricœur’s hermeneutic phenomenological interpretation method. The empirical part is divided into two different sections. The material of the study consists of interviews and surveys done by people who have experienced sleep deprivation or sleep disorders. Two interviewees talked about their lives with sleep disorders and there are 21 surveys conducted on people’s experiences on cognitive-behavioural therapy. The partakers in the two sections are different people. The results show that people with sleep disorders can end up in a vicious circle of sleep deprivation and in worst cases a sleep disorder can take charge of a person’s whole life. Sleep disorder can cause shame and fear of stigma. Nevertheless, someone suffering from a sleep disorder can find strength and solutions to control the difficult situation. This study proves that both nursing staff and other people have little information about difficulties in sleeping and awareness should be improved in clinical nursing. A health-care provider has an essential role in preventing someone ending up in a vicious circle of sleep deprivation and cognitive-behavioural therapy can contribute to good health. Reflection at the end of cognitive-behavioural sleep therapy course helps patients to continue their learning process. When someone is sleep deprived, it means that they have control over the situation, but when someone has a sleep disorder, that person does not have the strength to control the situation.

Healthcare Services In CloudComputing

The Thesis title” Healthcare services in cloud computing” discusses the healthcare services available in the new converging technology called cloud computing. This computing technology had craved its path in the desirable market field healthcare. Healthcare is an extensive and a massive mission of maintenance and providing a complete treatment to the person suffering from ailments. In the olden days well equipped healthcare surveillance is not accessible to all communities of people due to several reasons like, geographical locations, equipment cost, and infrastructure, and skilled medical practitioners, now due to the advancement of the medicine in cloud technology has reached some of its barriers making it more viable to all the people (communities) with all the robust technologies and techniques. This study will give an overview of the healthcare transformation of different approaches of cloud computing over information technology and its strategic usage. Further enhancing better healthcare to ensure scalable, compatible functions supporting the well-being, this study also considers the techniques of cloud computing and its application, advancement in healthcare.

Sydämen eteisvärinän tunnistaminen matkapuhelimen kiihtyvyysanturilla

Yli 140 miljoonaa ihmistä kärsii kroonisesta eteisvärinästä. Monilla ihmisillä on eteisvärinää, vaikkeivat siitä itse tiedä. Hoito on yksinkertainen, mutta hoidon piiriin eivät päädy kaikki yksinkertaisten seulontamenettelyjen tuloksena. Elektrokardiogrammi (EKG) sydämen toimintojen tunnistusmenetelmänä on tällä hetkellä yleisin vaihtoehto eteisvärinän seulontaan. EKG-laitteet ovat arvokkaita ja haasteellisia yksittäisen käyttäjän arkielämän kannalta. Vaihtoehtoinen sydämen monitorointimenetelmä on ballistokardiografinen (BKG) mittaus. EKG:n ja BKG:n ominaisia piirteitä käydään lävitse ja vertaillaan vahvuuksia sekä heikkouksia näiden kahden mittausmenetelmän välillä. BKG:ta on tutkittu jo pitkään, mutta mittaukseen soveltuvia tähän käyttökohteeseen varsinaisesti suunniteltuja laitteita ei ole paljoakaan tuotteistettu markkinoille asti. Työssä tutkitaan matkapuhelimen kiihtyvyysanturin soveltuvuutta BKG-mittauksen suorittamiseen. Tällä menetelmällä on mahdollista tuoda helposti sydänmonitori lähelle ihmisiä ja jokainen voi omalla matkapuhelimellaan tarkkailla sydämensä toimintaa. Diplomityössä selvitetään erilaisten markkinoilla olevien mobiililaitteiden soveltuvuutta kiihtyvyysanturitutkimukseen. Useampaa mallia koskevan selvitystyön tuloksena valitaan parhaiten toimiva vaihtoehto, jolla jatketaan tutkimusta suunnittelemalla mittausprosessi. Ensimmäisen vaiheen mittauksissa valitaan 20 perustervettä koehenkilöä tutkimukseen. Tutkimuksen tuloksena saadaan tutkimushypoteesin mukainen tulos ja sydämen lyönnit saadaan tunnistettua kaikilla koehenkilöillä. Ensimmäisen vaiheen aikana suoritetaan myös liikehäiriötutkimusta. Tässä suoritetaan yksinkertaiset käden, jalan ja pään liikkeiden vaikutuksen arvioinnit kiihtyvyysanturisignaaliin. Lisäksi selvitetään, miten puhuminen mittauksen aikana välittyy tutkimuslaitteeseen ja suoritetaan arvio siitä, miten tämä voidaan ottaa huomioon. Ensimmäisen vaiheen havaintojen perusteella jatkokehitetään mittausprosessia ja pyritään optimoimaan tätä, jotta laajempi otosjoukko on mahdollista saavuttaa mahdollisimman vähän aikaresursseja kuluttaen. Työssä valmistellaan laajemman, 1000 koehenkilöä sisältävän, toisen tutkimusvaiheen suoritusta. Diplomityön osana valmistellaan Varsinais-Suomen Sairaanhoitopiirin eettiselle toimikunnalle lausuntohakemus tutkimukselle. Hakemuksessa käsitellään laajasti tutkimuksen suorittamista eri osa-alueilla. Toisen vaiheen tuloksen noudattaessa tutkimushypoteesia, voidaan todeta matkapuhelimen kiihtyvyysanturin olevan soveluva menetelmä sydämen toiminnan tutkimiseen.