Early childhood education carries multiple experiences, activities, challenges, disappointments, achievements and encounters. Small children have difficulties to remember, piece together and pass on those experiences and feelings to their teachers or parents. The aim of this study was to examine the context and organization of early childhood education where documentation raises and develops. Furthermore it was examined what the documentation of small children means in practice and how the teachers understood it. In this study the mixed methods have been used to expose different perspectives about the subject. Also the material was collected using several methods and is a part of two other studies. The quantitative study was made with material which included 892 randomly chosen children and their teachers from 313 daycare units in the metropolitan area of Finland. The material is a part of a "Children's agentive perception uncovered" study (2010), which was carried out by the University of Helsinki. The qualitative study was made by using the material of a "VKK-Metro" development project, which was carried out also in the metropolitan area (2009). The analysis and the conclusions were made by using Reunamo's theoretical model of agentive perception and Bronfenbrenner's ecological systems theory. The angle is childcentered, constructivistic and sosioconstructivistic education. In this study a remarkable confrontation was found between the visions and the practices of the early childhood educators. The documentation was not a powerful educational tool for them and the pedagogy was not built up in a sosioconstructive way. After all it was noticeable that when the teachers got more resources and pedagogical support to the documentation of the children, they found more child-centered angel in their practices as early educators. It seemed that the teachers usally work under quite a pressure and should get more resources to become able to develop the pedagogy. This study is useful for those who are interested in the child-centered way of working and the documentation as a pedagogical tool. It is also a good basis for further studies and for the attempts to regenerate early childhood education.

Medication reviews have been highlighted as one of the most important strategies for improving medication safety and medication management especially in older adults. Current electronic health records document and communicate e-prescriptions but their medication use related patient information content should be extended to cover e.g. medication review documentation. The documentation should be in structured format to be useful in clinical practice and evidence-informed decision-making. The aim of this study was to identify medication review related patient information and other patient data that should be in a structured form in electronic health record systems (EHRs) at a national and organizational level. The aim was also to determine which medication review related patient information should be documented in electronic health record systems. The study was conducted as 3-round survey using the Delphi-method. The Delphi method is a qualitative consensus method based on the views of experts aiming at reaching consensus of the experts on the studied subject. The Delphi rounds were conducted as electronic surveys in September-December 2020. Expert panelists assessed which medication-related patient data and other data generated by healthcare providers should be documented in a structured form in EHRs and in which national digital data system services (Kanta and My Kanta Pages) the medication review related patient information should be accessible and by whom. The expert panel consisted of 41 participants: 12 physicians, 13 pharmacists, 10 nurses, and 6 information management professionals. The results of the study were analyzed both quantitatively and qualitatively. Consensus was reached on a total of 108 medication review related patient information topics that should be documented in a structured form in EHRs and that should be available for medication reviews through EHRs. Of the topics, 39 related to medication reviews in general, 25 to adverse drug reaction symptoms, 11 to the burden of adverse drug effects, 12 to laboratory tests and other test results, 12 to medication adherence and 9 to the use of intoxicants. Structuring the data was considered as important or important to some extent in most of the presented medication review related information topics. Especially, the documentation of renal function was rated by the expert panelists as a crucial piece of information to be structured. Medication adherence information and information related to the use of intoxicants were rated as less important to be documented in a structured form than other topics. Consensus was also reached on the accessibility of medication review documentation in the Kanta and My Kanta services. The expert panel of this study had a common and strong view that data related to medication reviews should be structured in EHRs. The expert panel reached a strong consensus that almost all of the data presented in the study should be structured. Based on this Delphi study, the expert panel identified the benefits of structuring and standardized recording. Because not all data can be structured at once, further prioritization of the data identified in this study is still needed. The practical implementation of the structured information could be accomplished in the form of a checklist. The study addresses a very current problem related to the shortcomings of medication information management and overall medication management.