Lahden ammattikorkeakoulu
Recent publications
Background Ambulatory monitoring is gaining popularity in mental and somatic health care to capture an individual's wellbeing or treatment course in daily-life. Experience sampling method collects subjective time-series data of patients' experiences, behavior, and context. At the same time, digital devices allow for less intrusive collection of more objective time-series data with higher sampling frequencies and for prolonged sampling periods. We refer to these data as parallel data. Combining these two data types holds the promise to revolutionize health care. However, existing ambulatory monitoring guidelines are too specific to each data type, and lack overall directions on how to effectively combine them. Methods Literature and expert opinions were integrated to formulate relevant guiding principles. Results Experience sampling and parallel data must be approached as one holistic time series right from the start, at the study design stage. The fluctuation pattern and volatility of the different variables of interest must be well understood to ensure that these data are compatible. Data have to be collected and operationalized in a manner that the minimal common denominator is able to answer the research question with regard to temporal and disease severity resolution. Furthermore, recommendations are provided for device selection, data management, and analysis. Open science practices are also highlighted throughout. Finally, we provide a practical checklist with the delineated considerations and an open-source example demonstrating how to apply it. Conclusions The provided considerations aim to structure and support researchers as they undertake the new challenges presented by this exciting multidisciplinary research field.
Background The role of self-management in health promotion, as well as prevention and rehabilitation, is increasing through the use of mobile health (mHealth) apps. Such mHealth apps are also increasingly being used for self-management of low back pain (LBP), but their effectiveness has not been sufficiently explored. Objective The aim of this scoping review was to provide an overview of the literature on self-management mHealth apps and their effects on the levels of pain and disability in people with LBP. Methods We applied the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) methodology, including a priori research questions. A literature search was conducted in 2 databases (PubMed and PEDro) for studies published between January 1, 2015, and June 17, 2021. Interventional, cohort, or case series studies with an interventional period were included if the mHealth app included built-in self-management content, the app was used for self-management for people with LBP, and the study reported outcomes regarding pain and disability in people with LBP. Results In total, 7 studies were selected for the review with overall 2307 persons with LBP, of whom 1328 (57.56%) were women. Among the studies (5/7, 71%) that reported the type of pain, 85% (390/459) of the participants were experiencing chronic LBP. A total of 5 different mHealth apps were identified, of which 4 contributed to a statistically significant reduction in LBP and clinically meaningful changes. Of the 7 studies, 4 (57%) used 4 different assessments for disability, of which 3 (75%) showed statistically significant improvements in the level of functional ability of participants in the experimental groups using an mHealth app with built-in self-management content for LBP. Conclusions This scoping review supports the conclusion that people with LBP may benefit from mHealth apps that provide self-management content. However, the generalizability of the findings is limited because of heterogeneity in the pain characterization of the included participants and the intervention durations. More high-quality studies with longer follow-up periods to investigate personalized mHealth approaches are recommended for LBP self-management.
The transition from a linear economy to a circular economy requires a new way of thinking. In a circular economy, products are used more intensively, for example, by sharing them with others. To understand the possibilities of the sharing economy, environmental, social and economic impacts all need to be considered. The purpose of this paper is to shed light on the importance of the sharing economy as well as to increase understanding of how public sharing-economy services can be launched. The research methods used include a case-study approach and assessment of greenhouse gas emissions. In this paper, an implemented cooperation process of creating a tool and device library (the Library of Things) in a small Finnish municipality is described. Furthermore, the library’s impact on greenhouse gas emissions during the first 14 months of operation is assessed. The results indicate that approximately 5752 kg CO2eq was avoided during the 14-month period, assuming that with each loan, manufacturing of a new good was avoided. In addition, strong implications of local positive effects on social sustainability were found.
Objectives: To explore patients' agreement and reasons for agreement or disagreement with the EULAR recommendations for patient education (PE) for people with inflammatory arthritis (IA). Methods: This mixed-method survey collected data using snowball sampling. The survey had been translated into 20 languages by local healthcare professionals, researchers and patient research partners. It explored the degree to which patients with IA agreed with each recommendation for PE (0=do not agree at all and 10=agree completely) and their rationale for their agreement level in free text questions. Descriptive statistics summarised participants' demographics and agreement levels. Qualitative content analysis was used to analyse the free text data. Sixteen subcategories were developed, describing the reasons for agreement or disagreement with the recommendations, which constituted the categories. Results: The sample comprised 2779 participants (79% female), with a mean (SD) age 55.1 (13.1) years and disease duration 17.1 (13.3) years. Participants strongly agreed with most recommendations (median 10 (IQR: 9-10) for most recommendations). Reasons for agreement with the recommendations included the benefit of using PE to facilitate collaborative care and shared decision making, the value of flexible and tailored PE, and the value of gaining support from other patients. Reasons for disagreement included lack of resources for PE, not wanting information to be tailored by healthcare professionals and a reluctance to use telephone-based PE. Conclusion: The EULAR recommendations for PE have been disseminated among patients with IA. Overall, agreement levels were very high, suggesting that they reflect patients' preferences for engaging in collaborative clinical care and using PE to facilitate and supplement their own understanding of IA. Reasons for not completely agreeing with the recommendations can inform implementation strategies and education of healthcare professionals.
Participatory Budgeting (PB) empowers the constituents to decide on how to spend a part of the public money. The citizens create proposals, which are then (if they are within the given rules of the PB) voted on by the public. It is believed that PBs strengthen democracy and increase the efficiency of public spending. Information and communication technology (ICT) can support these PB initiatives. There are several software solutions available for implementing a PB. However, picking the right solution is far from an easy task as the solutions are as diverse as the needs and possible requirements of administrations. This paper scrutinizes different solutions in aiming to provide support for aspiring municipalities in selecting the right PB software. The following work sheds light on the differences between the available software solutions. First, we shortly describe the applications and then lay out the tested capabilities of the software. Afterward, we show the fulfillment level of these capabilities and present an excel tool for making individual, informed decisions. The paper is concluded with a description of the tool selection process in two Finnish municipalities.
Background Patient safety is a priority worldwide. When things go wrong in the provision of patient care, the healthcare professionals involved can be psychologically affected (second victims, SVs). Recently, different initiatives have been launched to address this phenomenon. Aim To identify through the ERNST Pan-European Consortium the current study lines in Europe on SVs and other topics related to how the lack of well-being of healthcare professionals can affect the quality of care. Methods A cross-sectional study was conducted based on an ad hoc online survey. All 82 academics and clinicians who had formalized their membership to the COST Action 19113 by September 2020 and represented 27 European and one neighboring country were invited to participate. The survey consisted of 19 questions that explored the participants’ scientific profile, their interests, and previous experiences in the SVs’ topic, and related areas of work in Europe. Results Seventy (85.4%) COST Action members responded to the survey. Thirty-seven (37.1%) had conducted SV studies in the past or were doing so at the moment of the survey. Seventeen participants were involved in implementing interventions to support SVs. Future lines of study included legal issues, open disclosure, training programs, and patient safety curricula. Conclusions Studies have been conducted in Europe on the magnitude of the SV phenomenon and the usefulness of some techniques to promote resilience among healthcare professionals. New gaps have been identified. The COST Action 19113 aims to foster European collaboration to reinforce the healthcare professionals’ well-being and thus contribute to patient safety.
Background The shortage of FFP2 and FFP3 respirators posed a serious threat to the operation of the healthcare system at the onset of the COVID-19 pandemic.AimOur aim was to develop and validate a large-scale facility that uses hydrogen peroxide vapour for the decontamination of used respirators.MethodsA multidisciplinary and multisectoral ad hoc group of experts representing various organisations was assembled to implement the collection and transport of used FFP2 and FFP3 respirators from hospitals covering 86% of the Finnish population. A large-scale decontamination facility using hydrogen peroxide vapour was designed and constructed. Microbiological tests were used to confirm efficacy of hydrogen peroxide vapour decontamination together with a test to assess the effect of decontamination on the filtering efficacy and fit of respirators. Bacterial and fungal growth in stored respirators was determined by standard methods.ResultsLarge-scale hydrogen peroxide vapour decontamination of a range of FFP2 and FFP3 respirator models effectively reduced the recovery of biological indicators: Geobacillus stearothermophilus and Bacillus atrophaeus spores, as well as model virus bacteriophage MS2. The filtering efficacy and facial fit after hydrogen peroxide vapour decontamination were not affected by the process. Microbial growth in the hydrogen peroxide vapour-treated respirators indicated appropriate microbial cleanliness.Conclusions Large-scale hydrogen peroxide vapour decontamination was validated. After effective decontamination, no significant changes in the key properties of the respirators were detected. European Union regulations should incorporate a facilitated pathway to allow reuse of appropriately decontaminated respirators in a severe pandemic when unused respirators are not available.
Open innovation is becoming the frontline strategy to develop new products and services in most R&D based firms. This paper focuses on the strategies of the companies which protect their R&D capabilities and their effect on the open innovation process in new product development. The theoretical framework of this research was extracted from open innovation, product development and management science literature. Data from 20 countries have been collected from 60 open innovation and intensive R&D dependent firms. Statistical techniques were used to analyse the data. The data analysis showed five protectionist motives involved in open innovation-based product development between companies. The results provided the validation of the theoretical framework and explored these motives based on managers' feedback. The study implies strong linkages between open innovation, product development and protectionist motives of companies.
Online learning is a cost-effective way of promoting social inclusion and enhancing the work-life economy. International employees and higher education students can find that they have limited opportunities to access comprehensive supplemental training opportunities, related to employment, in Finland. Tailored services based on UX design can be beneficial for their supplemental studies. This paper explores key elements identified on the basis of UX design, and how these elements can be utilized to develop effective online learning designs. An innovative case design was implemented in a Finnish firm (with 270 service users) between 2015 and 2019. The key design elements identified relate to types of accessibility, namely pedagogical, lingual, technological and economical. The study explains noticeable improvements in the overall process due to UX design utilization, such as flexibility, cost-effectiveness, user-empathetic solutions and an interactive learning experience. The practical implications of this service include enhancing required competencies and strengthening sustainable work culture.
Background Stress plays an important role in the development of mental illness, and an increasing number of studies is trying to detect moments of perceived stress in everyday life based on physiological data gathered using ambulatory devices. However, based on laboratory studies, there is only modest evidence for a relationship between self-reported stress and physiological ambulatory measures. This descriptive systematic review evaluates the evidence for studies investigating an association between self-reported stress and physiological measures under daily life conditions. Methods Three databases were searched for articles assessing an association between self-reported stress and cardiovascular and skin conductance measures simultaneously over the course of at least a day. Results We reviewed findings of 36 studies investigating an association between self-reported stress and cardiovascular measures with overall 135 analyses of associations between self-reported stress and cardiovascular measures. Overall, 35% of all analyses showed a significant or marginally significant association in the expected direction. The most consistent results were found for perceived stress, high-arousal negative affect scales, and event-related self-reported stress measures, and for frequency-domain heart rate variability physiological measures. There was much heterogeneity in measures and methods. Conclusion These findings confirm that daily-life stress-dynamics are complex and require a better understanding. Choices in design and measurement seem to play a role. We provide some guidance for future studies.
Due to the high energy consumption of buildings, there is a demand for both economically and environmentally effective designs for building energy system retrofits. While multi-objective optimization can be used to solve complicated problems, its use is not yet widespread in the industry. This study first aims to develop an efficient and applicable multi-objective building energy system optimization method, used to dimension energy production and storage retrofit components in a case campus building in Lahti, Finland. Energy consumption data of the building are obtained with a dynamic energy model. The optimization model includes economic and environmental objectives, and the approach is found to function satisfactorily. Second, this study aims to assess the feasibility and issues of multi-objective single-building energy system optimization via the analysis of the case optimization results. The results suggest that economically beneficial local energy production and storage retrofits could not always lead to life cycle CO2-eq emission reductions. The recognized causes are high life cycle emissions from the retrofit components and low Nordic grid energy emissions. The performed sensitivity and feasibility analyses show that correctness and methodological comparability of the used emission factors and future assumptions are crucial for reliable optimization results.
This study investigates the effect of urban vegetation on thermal comfort in a neighbourhood of Lahti (Finland) by means of modeling simulations performed with the Computational Fluid Dynamics-based and microclimate model ENVI-met. A scenario without vegetation and the current one (with vegetation) are considered to assess the effects of vegetation in different seasons and provide suggestions for thermal comfort improvement.
An inductive, qualitative content approach and participating co-creation were used to establish the Road Map for Sport, Experiences, and Well-being 2030 framework for the Päijät-Häme region of Finland. The themes of development are: With the development of conditions and infrastructure towards versatile and accessible actions; With digitalization towards effective accessibility; With the shared brand message towards an excellent customer experience; and With strong expertise towards seamless cooperation. The framework illustrates business development, sustainable solutions, dissemination and internationalization as cross-cutting perspectives. Furthermore, it provides regional guidelines for long-term collaborative development work; the identification of new synergies; the development of the sport, tourism and well-being business; and the strengthening of systematic and experimental innovation. It is a comprehensive regional plan for social interaction, and political–administrative decision-making and practice in Päijät-Häme. The framework can be used in other regions in a cross-administrative way to identify the specific characteristics of a region, highlight competitive advantages and outline the excellence of stakeholders.
Continuing professional development (CPD) is a key challenge in enabling digital transformation in the tourism sector, and its networked service provided by small and medium-sized enterprises. Communities of Practice mirror this network approach towards learning, facilitated digitally as a Virtual Community of Practice (VCoP). This research examines how an inter-organisational VCoP on digital transformation in tourism could be delivered. Following a survey strategy (n = 244), the study demonstrates that both individual interests and organisational challenges define the shared domain of interest and constitute the motivational factors for joining a VCoP. We identify four roles of engagement: knowledge provider, practitioner, facilitator, and learner, appreciating both self-paced learning and peer interaction facilitated by multiple digital tools. The organisational type as an exemplary characteristic of members correlates with various VCoP elements. An open member structure results in volatile requirements of the VCoP, why we finally discuss agile project management methodology for VCoP delivery.
Aims: The aim was to describe the experiences of nurses in broaching the issue of overweight and obesity at maternity and child health clinics. Background: The mother's obesity and excessive weight gain during pregnancy and rapid weight gain in early childhood increase the risk of obesity of the newborn baby both in childhood and throughout life. Attention must be paid to the prevention of weight gain in families already during pregnancy and before school age. Methods: Informants were nurses working at maternity and child health clinics (N = 28). The qualitative data were collected by a focus group interview in spring 2016 and analysed using inductive content analysis. Findings: The nurses interviewed considered it their duty to broach the issue and felt that they have sufficient courage to bring up overweight. They sometimes found it frustrating to talk about overweight and obesity, because families do not commit themselves to making lifestyle changes, and changes happen slowly. Nurses found the lasting relationship with families helpful for bringing up overweight. Conclusion: Nurses need more broaching skills, more training, supervising and tools for bringing up overweight and obesity with client families. The continuity of care in primary health care supports bringing up overweight.
The development of mobile technology and mobile Internet offers new possibilities in rehabilitation and clinical assessment in a longitudinal perspective for multiple sclerosis management. However, because the mobile health applications (mHealth) have only been developed recently, the level of evidence supporting the use of mHealth in people with multiple sclerosis (pwMS) is currently unclear. Therefore, this review aims to list and describe the different mHealth available for rehabilitation and self-assessment of pwMS and to define the level of evidence supporting these interventions for functioning problems categorized within the International Classification of Functioning, Disability and Health (ICF). In total, 36 studies, performed with 22 different mHealth, were included in this review, 30 about rehabilitation and six for self-assessment, representing 3091 patients. For rehabilitation, most of the studies were focusing on cognitive function and fatigue. Concerning the efficacy, we found a small but significant effect of the use of mHealth for cognitive training (Standardized Mean Difference (SMD) = 0.28 [0.12; 0.45]) and moderate effect for fatigue (SMD = 0.61 [0.47; 0.76]). mHealth is a promising tool in pwMS but more studies are needed to validate these solutions in the other ICF categories. More replications studies are also needed as most of the mHealth have only been assessed in one single study.
Digital accessibility has been the focus of initiatives, policies and standards at European and international level in the last decade. However, adoption of accessibility guidelines and the development of accessible resources and applications remain limited and education is a primary example of the multiple challenges that must be addressed. This research has highlighted the main barriers that should be overcome in order to make digital educational games accessible for learners with disabilities and it has brought forward the critical need of personalizing the game contexts and analytics to meet specific profiles of learners with disabilities. Building upon the outcomes of two case studies, the authors propose a game analytics framework for learners with disabilities, in an effort to streamline game design processes that target accessibility.
Aim This study's aim was to describe the development of new management structures for nursing services in pilot public healthcare organizations in the Republic of Kazakhstan by focusing on cultural change from the former Soviet system to the modern nursing management system. Background Since organizational culture plays an essential role in developing nursing management processes, the challenge in Kazakhstan is to change the deep-rooted Soviet administration practices, such as top-down management and the absence of a career structure in nursing, to meet the new public management system's requirements. Method Participatory method was used to generate organizational culture change in 31 pilot organizations. Results The organizational structures were reorganized with new nursing positions. Changes concerning nurses’ job descriptions and educational requirements were introduced to the legislation. Workforce planning and work division between the healthcare professionals was suggested, allowing new operational functions for nurses. The implemented changes facilitate the culture change in the healthcare and nursing service system. Conclusion The shift of healthcare organizations towards a modern nursing management system has started in Kazakhstan. Implications for Nursing Management Good understanding and competence of cultural issues related to the change processes are critical in countries, which are undergoing fundamental reforms in their healthcare systems.
This study analyses the interactions and impacts between multiple factors i.e., urban greening, building layout, and meteorological conditions that characterise the urban microclimate and thermal comfort in the urban environment. The focus was on two neighbourhoods of Lecce city (southern Italy) characterised through field campaigns and modelling simulations on a typical hot summer day. Field campaigns were performed to collect greening, building geometry, and microclimate data, which were employed in numerical simulations of several greening scenarios using the Computational Fluid Dynamics-based and microclimate model ENVI-met. Results show that, on a typical summer day, trees may lead to an average daily decrease of air temperature by up to 1.00 °C and an improvement of thermal comfort in terms of Mean Radiant Temperature (MRT) by up to 5.53 °C and Predicted Mean Vote (PMV) by up to 0.53. This decrease is more evident when the urban greening (in terms of green surfaces and trees) is increased by 1266 m2 in the first neighbourhood and 1988 m2 in the second one, with respect to the current scenario, proving that shading effect mainly contributes to improving the urban microclimate during daytime. On the contrary, the trapping effect of heat, stored by the surfaces during the day and released during the evening, induces an increase of the spatially averaged MRT by up to 2 °C during the evenings and a slight deterioration of thermal comfort, but only locally where the concentration of high LAD trees is higher. This study contributes to a better understanding of the ecosystem services provided by greening with regard to microclimate and thermal comfort within an urban environment for several hours of the day. It adds knowledge about the role of green areas in a Mediterranean city, an important hot spot of climate change, and thus it can be a guide for important urban regeneration plans.
The design for all challenge is not only to design accessible and usable solutions but to actually push people to change their behavior to more beneficial ones. The growing interest in design for behavior change is evident especially with sustainability challenges due to the environmental impact from our excess consumption habits. Despite positive attitudes towards an environmentally conscious lifestyle, realized behavior does not follow these attitudes. This attitude–behavior gap includes everyday barriers to action and a lack of drivers for sustainable behavior. This paper presents the results from a design-based, qualitative, user research on sustainable behavior. These results are compared to research-based general models from behavior change psychology and consumption research. The user-research-based findings match the factors in the COM-B model, depicting the simultaneous effects of user capabilities, motivation and contextual opportunities. The practical guidance for the realized nudges exist already in the form of some design tools such as ideation cards. The user research agrees also with the behavior science on the necessity for a process-driven approach to behavior change and matches the SHIFT framework for successful change factors acquired through consumer research meta-analysis. SHIFT describes the factors of social influence, habit formation, identity matching, feelings, cognition, and tangibility. The observations and analysis comparing different approaches to sustainable behavior change confirm that generalizable heuristics in support of design for sustainable behavior change can be found. This form of heuristics could accelerate solution creation for the changes necessary for sustainable lifestyles as a future field of design for us all.
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Leena Liimatainen
  • Health and Social care
Jing Li
  • Department of Nursing
Riikka Sinisalo
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Sami Luste
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