Browsing by Subject "OPPORTUNITIES"

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  • Jones, Marjaana; Pietilä, Ilkka Veikko (2020)
    Health policies and strategies promote the involvement of people with illness experiences in service development and production, integrating them into settings that have traditionally been domains of health professionals. In this study, we focus on the perspectives of people with personal illness experiences and explore how they justify involvement, position themselves as legitimate actors and forge collaborative relationships with health professionals. We have used discourse analysis in analysing individual interviews conducted with peer support workers and experts by experience (n = 17) who currently work in Finnish health services. The interviewees utilised discourses of empowerment, efficiency and patient-centeredness, aligning themselves with the justifications constructed by patient movements additionally to those found in current health policies. Both groups wanted to retain critical distance from professionals in order to voice criticisms of current care practices, yet they also frequently aligned themselves with professionals in order to gain legitimacy for their involvement. They adopted professional traits that moved them further from being lay participants sharing personal experiences and adopted an expert position. Although national-level policies provided backing and legitimacy for involvement, the lack of local-level guidance could hinder the practical implementation and make involvement largely dependent of professionals' discretion.
  • Locatelli, Bruno; Pramova, Emilia; Di Gregorio, Monica; Brockhaus, Maria; Chávez, Dennis Armas; Tubbeh, Ramzi; Sotes, Juan; Perla, Javier (2020)
    Increasing attention is being given to integrating adaptation and mitigation in climate change policies. Policy network analysis is a way to explore connections between adaptation and mitigation, and the opportunities or barriers to effective integration between these two policy subdomains. This study explores climate governance and policy networks by examining collaboration and information flows in national policy processes in Peru, a country with an active climate change policy domain. In contrast to most climate policy network analyses, this study distinguishes adaptation and mitigation subdomains through a multiplex approach. We used ERGM (Exponential Random Graph Models) to explain the existence of information flows and collaborations among 76 key actors in climate change policy in Peru. We identified actors who could connect adaptation and mitigation subdomains. Results show a concentration of influence in national government actors, particularly in the mitigation subdomain, and the isolation of actor groups that matter for policy implementation, such as the private sector or subnational actors. Results highlight the predominance of mitigation over adaptation and the existence of actors well positioned to broker relationships between the subdomains. The top brokers across subdomains were, however, not only actors with high centrality and brokerage roles in the subdomains, but also several "unusual key players" that were not brokers in any of the two layers separately. Key policy insights • National government institutions are central actors in climate change policy networks in Peru, reflecting national ownership of the climate change issue. • Private sector organizations and subnational actors in Peru are the least involved in information sharing and collaboration on climate change. • Actors from different levels and sectors are active in both adaptation and mitigation, which is good for climate policy integration. • Actors with the capacity to bridge the two policy subdomains are not necessarily central to each subdomain but may be actors that close structural holes between subdomains.
  • Syyrilä, Tiina; Vehviläinen-Julkunen, Katri; Härkänen, Marja (2020)
    Abstract Aim To identify the types and frequencies of communication issues (communication pairs, person related, institutional, structural, process, and prescription-related issues) detected in medication incident reports and to compare communication issues that caused moderate or serious harm to patients. Background Communication issues have been found to be amongst the main contributing factors of medication incidents, thus necessitating communication enhancement. Design A sequential exploratory mixed-method design. Methods Medication incident reports from Finland (n=500) for the year 2015 in which communication was marked as a contributing factor were used as the data source. Indicator phrases were used for searching communication issues from free texts of incident reports. The detected issues were analysed statistically, qualitatively, and considering the harm caused to the patient. Citations from free texts were extracted as evidence of issues and were classified following main categories of indicator phrases. The EQUATOR?s SRQR checklist was followed in reporting. Results Twenty-eight communication pairs were identified, with nurse-nurse (68.2%; n=341), nurse-physician (41.6%; n=208), and nurse-patient (9.6%; n=48) pairs being the most frequent. Communication issues existed mostly within unit (76.6%, n=383). The most commonly identified issues were digital communication (68.2%; n=341), lack of communication within a team (39.6%; n=198), false assumptions about work processes (25.6%; n=128) and being unaware of guidelines (25.0%; n=125). Collegial feedback, and communication from patients and relatives were the preventing issues. Moderate harm cases were often linked with lack of communication within the unit, digital communication and not following guidelines. Conclusions The interventions should be prioritized to (a) enhancing communication about work-processes, (b) verbal communication about digital prescriptions between professionals, (c) feedback among professionals, and (f) encouraging patients to communicate about medication. Relevance to clinical practice Upon identifying the most harmful and frequent communication issues, interventions to strengthen medication safety can be implemented.
  • Savela, Nina; Oksanen, Atte; Kaakinen, Markus; Noreikis, Marius; Xiao, Yu (2020)
    Augmented reality (AR) applications have recently emerged for entertainment and educational purposes and have been proposed to have positive effects on social interaction. In this study, we investigated the impact of a mobile, indoor AR feature on sociability, entertainment, and learning. We conducted a field experiment using a quiz game in a Finnish science center exhibition. We divided participants (N = 372) into an experimental group (AR app users) and two control groups (non-AR app users; pen-and-paper participants), including 28 AR users of follow-up interviews. We used Kruskal-Wallis rank test to compare the experimental groups and the content analysis method to explore AR users' experiences. Although interviewed AR participants recognized the entertainment value and learning opportunities for AR, we did not detect an increase in perceived sociability, social behavior, positive affect, or learning performance when comparing the experimental groups. Instead, AR interviewees experienced a strong conflict between the two different realities. Despite the engaging novelty value of new technology, performance and other improvements do not automatically emerge. We also discuss potential conditional factors. Future research and development of AR and related technologies should note the possible negative effects of dividing attention to both realities.
  • Aschard, Hugues; Tobin, Martin D.; Hancock, Dana B.; Skurnik, David; Sood, Akshay; James, Alan; Smith, Albert Vernon; Manichaikul, Aniw; Campbell, Archie; Prins, Bram P.; Hayward, Caroline; Loth, Daanw; Porteous, David J.; Strachan, David P.; Zeggini, Eleftheria; O'Connor, George T.; Brusselle, Guy G.; Boezen, H. Marike; Schulz, Holger; Deary, Ian J.; Hall, Ian P.; Rudan, Igor; Kaprio, Jaakko; Wilson, James F.; Wilk, Jemma B.; Huffman, Jennifer E.; Zhao, Jing Hua; de Jong, Kim; Lyytikainen, Leo-Pekka; Wain, Louise V.; Jarvelin, Marjo-Riitta; Kahonen, Mika; Fornage, Myriam; Polasek, Ozren; Cassano, Patricia A.; Barr, R. Graham; Rawal, Rajesh; Harris, Sarah E.; Gharib, Sina A.; Enroth, Stefan; Heckbert, Susan R.; Lehtimaki, Terho; Gyllensten, Ulf; Jackson, Victoria E.; Gudnason, Vilmundur; Tang, Wenbo; Dupuis, Josee; Artigas, Maria Soler; Joshi, Amit D.; London, Stephanie J.; Understanding Soc Sci Grp (2017)
    Background: Smoking is the strongest environmental risk factor for reduced pulmonary function. The genetic component of various pulmonary traits has also been demonstrated, and at least 26 loci have been reproducibly associated with either FEV1 (forced expiratory volume in 1 second) or FEV1/FVC (FEV1/forced vital capacity). Although the main effects of smoking and genetic loci are well established, the question of potential gene-by-smoking interaction effect remains unanswered. The aim of the present study was to assess, using a genetic risk score approach, whether the effect of these 26 loci on pulmonary function is influenced by smoking. Methods: We evaluated the interaction between smoking exposure, considered as either ever vs never or pack-years, and a 26-single nucleotide polymorphisms (SNPs) genetic risk score in relation to FEV1 or FEV1/FVC in 50 047 participants of European ancestry from the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) and SpiroMeta consortia. Results: We identified an interaction (beta(int) = -0.036, 95% confidence interval, -0.040 to -0.032, P = 0.00057) between an unweighted 26 SNP genetic risk score and smoking status (ever/never) on the FEV1/FVC ratio. In interpreting this interaction, we showed that the genetic risk of falling below the FEV1/FVC threshold used to diagnose chronic obstructive pulmonary disease is higher among ever smokers than among never smokers. A replication analysis in two independent datasets, although not statistically significant, showed a similar trend in the interaction effect. Conclusions: This study highlights the benefit of using genetic risk scores for identifying interactions missed when studying individual SNPs and shows, for the first time, that persons with the highest genetic risk for low FEV1/FVC may be more susceptible to the deleterious effects of smoking.
  • Camargo, Marisa Camilher; Hogarth, Nicholas J.; Pacheco, Pablo; Nhantumbo, Isilda; Kanninen, Markku (2019)
    Despite the plethora of discourse about how sustainable development should be pursued, the production of agricultural commodities is held responsible for driving c. 80% of global deforestation. Partially as a response, the private sector has made commitments to eliminate deforestation, but it is not yet clear what factors these commitments should take into account to effectively halt deforestation while also contributing to broader sustainable development. In the context of private sector commitments to zero-deforestation, this study characterizes the perceptions of different types of stakeholders along the cocoa and chocolate supply chain in order to determine the main challenges and solutions to encourage sustainable production. The main purpose is to understand the key factors that could facilitate a transition to a more sustainable supply while harmonizing the multiple actors’ interests. A qualitative thematic analysis of perceptions was conducted based on responses from 59 interviews with different stakeholders along the cocoa and chocolate supply chain in six key producing and consuming countries. Thematic analysis of the responses revealed six main themes: (1) make better use of policies, regulations and markets to help promote sustainability; (2) improve information and data (e.g., impacts of climate change on cocoa) to inform sound interventions; (3) focus on the landscape rather than the farm-level alone and improve integration of supply chain actors; (4) promote better coordination between stakeholders and initiatives (e.g., development assistance projects and corporate sustainability efforts); (5) focus on interdependent relationships between social, environmental and economic dimensions to achieve sustainable development; and (6) engage with the private sector. The study shows the importance of identifying different stakeholder priorities in order to design solutions that accommodate multiple interests. It also emphasizes the need to improve coordination and communication between stakeholders and instruments in order to address the three different dimensions of sustainability in a synergistic manner, considering the interactions from production of raw material to end consumer.
  • Mononen, Niina; Pohjanoksa-Mäntylä, Marika; Airaksinen, Marja S. A.; Hämeen-Anttila, Katri (2020)
    Objective Finland is one of the few countries that has established a national Medicines Information (MI) Strategy. The ultimate goal of the strategy is a well-implemented medication use process resulting in well-informed adherent patients. This study aimed at evaluating the implementation of the strategy 3years after its launch. Design The evaluation applied a pragmatic approach and was conducted by interviewing stakeholders involved in the National MI Network enhancing the MI Strategy's implementation. The network comprises national key stakeholders producing and using MI. Data were deductively analysed according to the medication use process of the MI Strategy using the framework method, complemented with inductively derived categories. Setting National implementation of the MI Strategy throughout the healthcare system after the first operational period (2012-2014) in 2015. Participants The members of the National MI Network (n=79/111, participation rate 71%, representing 42/53 stakeholder organisations). Outcome measures A new conceptual framework was developed based on stakeholders' views on well-implemented actions and actions needing development in the medication use process at (1) infrastructure (macro), (2) healthcare professionals (meso) and (3) patient (micro) levels. Results Medication counselling by community pharmacists was the primary implemented action, followed by physicians' actions while starting a new medication, and advice given by nurses. The major development needs concerned (1) poor access to patient information and its transfer in healthcare, particularly the lack of reconciled medication lists and electronic health records (macro); (2) poorly functioning medication use process in home care and social care units, such as nursing homes (meso); and (3) limited patient involvement in their care (micro). Conclusions Far more actions for development than well-established practices in the medication use process were identified. Major challenges found in this evaluation are considered in the ongoing Rational Pharmacotherapy Action Plan 2018-2022 by the Ministry of Social Affairs and Health.
  • Agache, Ioana; Annesi-Maesano, Isabella; Bonertz, Andreas; Branca, Francesco; Cant, Andrew; Fras, Zlatko; Ingenrieth, Frank; Namazova-Baranova, Leyla; Odemyr, Mikaela; Spanevello, Antonio; Vieths, Stefan; Yorgancioglu, Arzu; Alvaro-Lozano, Montserat; Hernandez, Domingo Barber; Chivato, Tomas; Del Giacco, Stefano; Diamant, Zuzana; Eguiluz-Gracia, Ibon; van Wijk, Roy Gert; Gevaert, Philippe; Graessel, Anke; Hellings, Peter; Hoffmann-Sommergruber, Karin; Jutel, Marek; Lau, Susanne; Lauerma, Antti; Olaguibel, Jose Maria; O'Mahony, Liam; Ozdemir, Cevdet; Palomares, Oscar; Pfaar, Oliver; Sastre, Joaquin; Scadding, Glennis; Schmidt-Weber, Carsten; Schmid-Grendelmeier, Peter; Shamji, Mohamed; Skypala, Isabel; Spinola, Monica; Spranger, Otto; Torres, Maria; Vereda, Andrea; Bonini, Sergio (2019)
    The European Academy of Allergy and Clinical Immunology (EAACI) organized the first European Strategic Forum on Allergic Diseases and Asthma. The main aim was to bring together all relevant stakeholders and decision-makers in the field of allergy, asthma and clinical Immunology around an open debate on contemporary challenges and potential solutions for the next decade. The Strategic Forum was an upscaling of the EAACI White Paper aiming to integrate the Academy's output with the perspective offered by EAACI's partners. This collaboration is fundamental for adapting and integrating allergy and asthma care into the context of real-world problems. The Strategic Forum on Allergic Diseases brought together all partners who have the drive and the influence to make positive change: national and international societies, patients' organizations, regulatory bodies and industry representatives. An open debate with a special focus on drug development and biomedical engineering, big data and information technology and allergic diseases and asthma in the context of environmental health concluded that connecting science with the transformation of care and a joint agreement between all partners on priorities and needs are essential to ensure a better management of allergic diseases and asthma in the advent of precision medicine together with global access to innovative and affordable diagnostics and therapeutics.
  • Neset, Tina-Simone; Juhola, Sirkku; Wirehn, Lotten; Kayhko, Janina; Navarra, Carlo; Asplund, Therese; Glaas, Erik; Wibeck, Victoria; Linner, Bjorn-Ola (2020)
    Background. Serious games are gaining increasing prominence in environmental communication research, but their potential to form an integrated part of participatory research approaches is still strikingly understudied. This is particularly the case for applications of interactive digital formats in research on environmental challenges of high complexity, such as climate adaptation, which is a specifically suitable case as it involves complex interaction between climate systems and society, but where the response also involves trade-offs with potentially negative - maladaptive - outcomes. Intervention. This article presents the Maladaptation Game, which was designed to facilitate dialogue about potential negative outcomes of agricultural climate adaptation. Methods. We conducted test sessions with agricultural stakeholders in Finland and Sweden, and analysed quantitative and qualitative, audio-recorded and transcribed, material for opportunities and challenges related to dialogues, engagement, interactivity and experienced relevance. Results. The qualitative analysis of recorded dialogues shows that the Maladaptation Game has potential to support dialogue by challenging players to negotiate between options with negative outcomes. The gameplay itself presents opportunities in terms of creating engagement with options that provoke disagreement and debates between players, as well as interactivity, that players reflected upon as quick and easy, while challenges were related to the experienced relevance, in particular the options provided in the game, and its general framing. Conclusions. The results indicate a need for complementary approaches to this type of game but also suggest the importance of moderation when the game design is aimed at creating dialogue around a complex environmental challenge such as agricultural climate adaptation.
  • Wang, Tianduanyi; Gautam, Prson; Rousu, Juho; Aittokallio, Tero (2020)
    While high-throughput drug screening offers possibilities to profile phenotypic responses of hundreds of compounds, elucidation of the cell context-specific mechanisms of drug action requires additional analyses. To that end, we developed a computational target deconvolution pipeline that identifies the key target dependencies based on collective drug response patterns in each cell line separately. The pipeline combines quantitative drug-cell line responses with drug-target interaction networks among both intended on- and potent off-targets to identify pharmaceutically actionable and selective therapeutic targets. To demonstrate its performance, the target deconvolution pipeline was applied to 310 small molecules tested on 20 genetically and phenotypically heterogeneous triple-negative breast cancer (TNBC) cell lines to identify cell line-specific target mechanisms in terms of cytotoxic and cytostatic drug target vulnerabilities. The functional essentiality of each protein target was quantified with a target addiction score (TAS), as a measure of dependency of the cell line on the therapeutic target. The target dependency profiling was shown to capture inhibitory information that is complementary to that obtained from the structure or sensitivity of the drugs. Comparison of the TAS profiles and gene essentiality scores from CRISPR-Cas9 knockout screens revealed that certain proteins with low gene essentiality showed high target addictions, suggesting that they might be functioning as protein groups, and therefore be resistant to single gene knock-out. The comparative analysis discovered protein groups of potential multi-target synthetic lethal interactions, for instance, among histone deacetylases (HDACs). Our integrated approach also recovered a number of well-established TNBC cell line-specific drivers and known TNBC therapeutic targets, such as HDACs and cyclin-dependent kinases (CDKs). The present work provides novel insights into druggable vulnerabilities for TNBC, and opportunities to identify multi-target synthetic lethal interactions for further studies. (C) 2020 The Author(s). Published by Elsevier B.V.
  • Ezzat, Kariem; Pernemalm, Maria; Palsson, Sandra; Roberts, Thomas C.; Järver, Peter; Dondalska, Aleksandra; Bestas, Burcu; Sobkowiak, Michal J.; Levänen, Bettina; Sköld, Magnus; Thompson, Elizabeth A.; Saher, Osama; Kari, Otto K.; Lajunen, Tatu; Ekstrom, Eva Sverremark; Nilsson, Caroline; Ishchenko, Yevheniia; Malm, Tarja; Wood, Matthew J. A.; Power, Ultan F.; Masich, Sergej; Linden, Anders; Sandberg, Johan K.; Lehtiö, Janne; Spetz, Anna-Lena; EL Andaloussi, Samir (2019)
    Artificial nanoparticles accumulate a protein corona layer in biological fluids, which significantly influences their bioactivity. As nanosized obligate intracellular parasites, viruses share many biophysical properties with artificial nanoparticles in extracellular environments and here we show that respiratory syncytial virus (RSV) and herpes simplex virus type 1 (HSV-1) accumulate a rich and distinctive protein corona in different biological fluids. Moreover, we show that corona pre-coating differentially affects viral infectivity and immune cell activation. In addition, we demonstrate that viruses bind amyloidogenic peptides in their corona and catalyze amyloid formation via surface-assisted heterogeneous nucleation. Importantly, we show that HSV-1 catalyzes the aggregation of the amyloid beta-peptide (A beta(42)), a major constituent of amyloid plaques in Alzheimer's disease, in vitro and in animal models. Our results highlight the viral protein corona as an acquired structural layer that is critical for viral-host interactions and illustrate a mechanistic convergence between viral and amyloid pathologies.
  • GBD 2015 Eastern Mediterranean Reg (2018)
    Transport injuries (TI) are ranked as one of the leading causes of death, disability, and property loss worldwide. This paper provides an overview of the burden of TI in the Eastern Mediterranean Region (EMR) by age and sex from 1990 to 2015. Transport injuries mortality in the EMR was estimated using the Global Burden of Disease mortality database, with corrections for ill-defined causes of death, using the cause of death ensemble modeling tool. Morbidity estimation was based on inpatient and outpatient datasets, 26 cause-of-injury and 47 nature-of-injury categories. In 2015, 152,855 (95% uncertainty interval: 137,900-168,100) people died from TI in the EMR countries. Between 1990 and 2015, the years of life lost (YLL) rate per 100,000 due to TI decreased by 15.5%, while the years lived with disability (YLD) rate decreased by 10%, and the age-standardized disability-adjusted life years (DALYs) rate decreased by 16%. Although the burden of TI mortality and morbidity decreased over the last two decades, there is still a considerable burden that needs to be addressed by increasing awareness, enforcing laws, and improving road conditions.
  • Pettersson, Katarina; Sakki, Inari (2017)
    Political blogs have come to constitute important channels for expressing nationalist and anti-immigration political views. The new forms that this rhetoric may take, comprising an intricate intermingling of verbal, digital, (audio-)visual, and communicative elements, present challenges for qualitative research. In this article we propose a way for analysing this new" nationalist political discourse from a qualitative social psychological perspective. The suggested approach combines analytical procedures form critical discursive and rhetorical psychology with social semiotic and rhetorical studies of images, completed with analytical tools and concepts from narrative psychology and research into online political communication. Using two empirical examples of nationalist and anti-immigration political blog-entries written during the 2015 refugee crisis," we show this approach enables the researcher to adequately study how such political messages are conveyed through the multitude of elements provided by the blogs. In so doing, our ultimate goal is to contribute to the analytical capacity of qualitative social psychological research into contemporary political communication and persuasion.