Elina Haavisto

University of Turku

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Co-Authors

Akseli Hemminki

University of Helsinki

Vincenzo Cerullo

University of Helsinki

Lotta Kangasniemi

University of Helsinki

Anna Kanerva

University of Helsinki

Leena Laasonen

Helsinki University Hospital

Minna Oksanen

University of Helsinki

Aila Karioja‐Kallio

University of Helsinki

Iulia Diaconu

Surgical Specialties (United States)

Liisa Holm

University of Helsinki

Tuuli Ranki

Sanofi (Finland)

Cooperative Institutions

University of Helsinki

University of Turku

Helsinki University Hospital

Institute for Molecular Medicine Finland

Tampere University

Oncos Therapeutics (Finland)

Institut Català d'Oncologia

Docrates Cancer Center

Satakunta Central Hospital

Turku University Hospital

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Data from Oncolytic Immunotherapy of Advanced Solid Tumors with a CD40L-Expressing Replicating Adenovirus: Assessment of Safety and Immunologic Responses in Patients

Sari Pesonen Iulia Diaconu Lotta Kangasniemi Tuuli Ranki Anna Kanerva

<div>Abstract<p>The immunosuppressive environment of advanced tumors is a primary obstacle to the efficacy of immunostimulatory and vaccine approaches. Here, we report an approach to arm an oncolytic virus with CD40 ligand (CD40L) to stimulate beneficial immunologic responses in patients. A double-targeted chimeric adenovirus controlled by the hTERT promoter and expressing CD40L (CGTG-401) was constructed and nine patients with progressing advanced solid tumors refractory to standard therapies were treated intratumorally. No serious adverse events resulting in patient hospitalization occurred. Moderate or no increases in neutralizing antibodies were seen, suggesting effective Th1 immunologic effects. An assessment of the blood levels of virus indicated 17.5% of the samples (<i>n</i> = 40) were positive at a low level early after treatment, but not thereafter. In contrast, high levels of virus, CD40L, and RANTES were documented locally at the tumor. Peripheral blood mononuclear cells were analyzed by IFN-γ ELISPOT analysis and induction of both survivin-specific and adenovirus-specific T cells was seen. Antitumor T-cell responses were even more pronounced when assessed by intracellular cytokine staining after stimulation with tumor type–specific peptide pools. Of the evaluable patients, 83% displayed disease control at 3 months and in both cases in which treatment was continued the effect was sustained for at least 8 months. Injected and noninjected lesions responded identically. Together, these findings support further clinical evaluation of CGTG-401. <i>Cancer Res; 72(7); 1621–31. ©2012 AACR</i>.</p></div>

Oncolytic adenovirus

10.1158/0008-5472.c.6503526.v1

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Citations (0)

The comparison of students’ satisfaction between ubiquitous and web-basedlearning environments

Education and Information Technologies (2016)

Mari Virtanen Maria Kääriäinen Eeva Liikanen Elina Haavisto

Learning environment

Blended Learning

10.1007/s10639-016-9561-2

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Citations (47)

Identifying reasoning skills for the selection of undergraduate nursing students: a focus group study

Contemporary Nurse (2020)

Jonna Vierula Maija Hupli Kirsi Talman Elina Haavisto

Background: Reasoning is a cognitive skill crucial to making solid decisions. The assessment of reasoning skills in nursing student selection is studied scarcely.Aim: To identify which reasoning skills should be assessed when selecting undergraduate nursing applicants.Design: A qualitative descriptive design.Methods: Four focus group interviews (n = 25) were undertaken with nursing students (n = 16) and experts (n = 9). The Clinical Reasoning Model was used as a deductive framework for the main categories. Subcategories were formed inductively.Results: All eight steps of the clinical reasoning process were deductively identified including 15 subcategories and representing reasoning skills in the selection phase: Consider the situation, Collect cues and information, Process information, Identify the problem, Establish goals, Take action, Evaluate outcomes and Reflect on the process of action and new learning. The beginning of the clinical reasoning process was emphasised most.Conclusion: The assessment of applicants’ reasoning skills should focus on the information processing skills.Impact statement: This study identifies reasoning skills which should be considered in the assessment of nursing applicants.

Analytic reasoning

Cognitive skill

Nursing Process

10.1080/10376178.2020.1743732

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Facilitating the transition from a nursing student to a Registered Nurse in the final clinical practicum: a scoping literature review

Scandinavian Journal of Caring Sciences (2017)

Anu‐Marja Kaihlanen Elina Haavisto Camilla Strandell‐Laine Leena Salminen

Background Transition from a nursing student to a Registered Nurse is a stressful and challenging process. Different postgraduate residency and orientation programmes have been developed to ease the first year of employment, but less attention has been paid to pregraduate programmes and how the final clinical practicum of nursing education should be conducted to facilitate this transition. Aim To review the empirical studies concerning interventions that aim to facilitate the transition from nursing student to Registered Nurse in the final clinical practicum of nursing education. The aim was to scrutinise the structures and contents of the interventions and factors connected with the facilitated transition. Method A scoping literature review was conducted with systematic searches in three electronic databases: CINAHL , MEDLINE and ERIC . The searches were limited to studies that were written in English, had available abstract and were published between 2005 and 2016. Two researchers assessed the studies regarding their eligibility with reference to the inclusion and exclusion criteria, and 17 articles were included in this review. Inductive content analysis was used to categorise the contents of studies. Results The structures of the interventions described included: the participation, learning environment, amount of clinical work, supervisor criteria and supervision methods. The contents of the interventions included supervisor support, transition supportive learning activities and the student's practicum duties. The factors that were connected with facilitated transition were the quality of the supervision, adjusting to a professional nurse's role, achieved comfort and confidence and achieved competence. Conclusion This scoping review offers insight into the diversity of interventions facilitating transition implemented in the final clinical practicum of nursing education. In order to unify these practices and determine the elements necessary to include, studies with stronger designs need to be conducted.

Practicum

CINAHL

Supervisor

Preceptor

Nursing Interventions Classification

10.1111/scs.12494

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Citations (58)

Learning Clinical Reasoning Through Gaming in Nursing Education: Future Scenarios of Game Metrics and Artificial Intelligence

Springer eBooks (2022)

Jaana‐Maija Koivisto Sara Havola Henna Mäkinen Elina Haavisto

10.1007/978-3-031-09687-7_10

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Citations (2)

Health and social care professionals’ perspective on the interprofessional competencies required in palliative care

Journal of Interprofessional Care (2024)

Pauliina Kesonen Leena Salminen Jaana‐Maija Koivisto Elina Haavisto

Competent professionals are essential when delivering patient-centered and individual palliative care to patients and their families. However, interprofessional competencies for health and social care professionals in specialized palliative care have not been defined. The purpose of this study was to describe the competencies required for good interprofessional teamwork in specialized palliative care from the perspective of health and social care professionals. A qualitative descriptive study design was chosen to undertake the face-to-face individual and focus-group interviews. Fifty participants working in specialized palliative care units were recruited through a purposive sampling technique. The data were analyzed using abductive content analysis. The required interprofessional competencies in specialized palliative care were identified as values and ethics for interprofessional practice, roles and responsibilities, interprofessional communication, and teams and teamwork. Professionals should be interprofessionally competent to meet patients' care needs holistically and individually. Meeting patients and relatives with respect is vital, but respectful behavior and communication among professionals are also highlighted in palliative care. Certain professional qualities, such as patience, humility, and flexibility, were emphasized in interprofessional palliative care. It is important to note that the nature of palliative care affects even experienced professionals, who should be able to face death as a team in everyday work.

Social care

Health Professionals

Interprofessional Education

10.1080/13561820.2024.2437413

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Prolonged systemic circulation of chimeric oncolytic adenovirus Ad5/3-Cox2L-D24 in patients with metastatic and refractory solid tumors

Gene Therapy (2010)

Sari Pesonen Petri Nokisalmi Sophie Escutenaire Merja Särkioja Mari Raki

Oncolytic adenovirus

Refractory (planetary science)

10.1038/gt.2010.17

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Citations (70)

Association between game metrics in a simulation game and nursing students’ surgical nursing knowledge – a quasi-experimental study

BMC Nursing (2024)

Jaana‐Maija Koivisto Tuija Buure Janne Engblom Kristiina Rosqvist Elina Haavisto

Abstract Background Simulation games are effective for acquiring surgical nursing knowledge during education by offering possibilities to learn theoretical knowledge through practical patient scenarios, thus preparing students for demanding surgical nursing care. Game metrics stored in the game system enable assessment of students’ behaviour while gameplaying. Combining game metrics with the assessment of a student’s surgical nursing knowledge allows versatile information to be obtained about the student’s learning outcomes. However, studies on game metrics stored in systems and their relationship with learning outcomes are scarce. Methods The aim here was to evaluate the association between game metrics in a simulation game and nursing students’ surgical nursing knowledge. Nursing students from three universities of applied sciences in Finland participated in a one-week simulation gameplaying intervention that included five surgical nursing scenarios. Students’ surgical nursing knowledge was investigated with a quasi-experimental, one-group, pre- and post-test design using a surgical nursing knowledge test. In total, 280 students filled in the knowledge tests. In addition, cross-sectional game data were collected at a single time point between pre- and post-tests. The data were analysed with descriptive statistics and multivariate analysis methods. Results Students’ surgical nursing knowledge improved with the intervention. The total number of playthroughs was 3562. The mean maximum score was 126.2 (maximum score range 76–195). The mean playing time of all playthroughs by all players was 4.3 minutes ( SD = 81.61). A statistically significant association was found between mean score and knowledge test total score ( p < 0.0072), but no significant association emerged between mean playing time and knowledge test total score. Conclusion The results indicated that the higher the mean score the better the students’ surgical nursing knowledge in the knowledge test. This study did not show that the time spent playing had an impact on students’ post-playing knowledge. Our findings support the idea that game metrics can be used in performance evaluation and the results can be used to improve nursing students’ readiness for challenging preoperative and postoperative clinical situations.

Association (psychology)

Nursing management

Surgical nursing

10.1186/s12912-023-01668-0

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Citations (3)

The Effects of Computer-Based Simulation Game and Virtual Reality Simulation in Nursing Students' Self-evaluated Clinical Reasoning Skills

CIN Computers Informatics Nursing (2021)

Sara Havola Elina Haavisto Henna Mäkinen Janne Engblom Jaana‐Maija Koivisto

Research has shown that nursing students can learn clinical reasoning skills by engaging in simulation games. However, there has been no research regarding the effects of simulation games on clinical reasoning skills when nursing students also engage in virtual reality simulations. Furthermore, by engaging in simulation games, neither game metrics nor their impact on students' self-evaluated clinical reasoning skills has been studied. The purpose of this study was to evaluate the effects of these two kinds of simulation games using a one-group pretest-posttest design. Forty nursing students self-evaluated their clinical reasoning skills in three phases using the Clinical Reasoning Skills scale. Furthermore, the game metrics of the simulation games were analyzed, and the results clearly showed that students' self-evaluated clinical reasoning skills were systematically improved. There was a systematic association between better playing scores and better self-evaluated clinical reasoning skills in playing both kinds of simulation games. Moreover, students engaged more time in the virtual reality simulation than the computer-based simulation game. Overall, the results suggest that the use of a combination of both kinds of simulation games is an effective way for nursing students to learn clinical reasoning skills.

10.1097/cin.0000000000000748

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Citations (33)

Safety of Glucocorticoids in Cancer Patients Treated with Oncolytic Adenoviruses

Molecular Pharmaceutics (2010)

Maria Rajecki Mari Raki Sophie Escutenaire Sari Pesonen Vincenzo Cerullo

Oncolytic adenoviruses are an emerging treatment option for advanced and refractory cancer. Such patients are often treated with corticosteroids to ameliorate tumor associated symptoms. Thus, it is important to evaluate whether safety is affected by immunosuppression possibly induced by corticosteroids. Concurrent low-dose cyclophosphamide, appealing for its immunomodulatory effects, could also impact safety. In a retrospective case-control study, we evaluated the effect of systemic corticosteroid use in cancer patients receiving oncolytic virotherapy. Four treatment groups were identified: (1) oncolytic adenovirus with oral glucocorticoids, (2) virus alone, (3) virus with glucocorticoids and cyclophosphamide and (4) virus with cyclophosphamide. Adverse events, neutralizing antibody titers, viral DNA in circulation and tumor responses were evaluated. The most common adverse effects were grade 1-2 fatigue, nausea, fever and abdominal pain. Common asymptomatic findings included self-limiting grade 1-3 hyponatremia and aspartate aminotransferase increase. Safety was good and no significant differences were observed between the groups. All patients had an increase in neutralizing antibody titers post-treatment, and no trends for differences between groups were observed. There were fewer post-treatment virus genomes circulating in patients receiving glucocorticoids when compared to their control groups. Overall, glucocorticoid use in cancer patients receiving oncolytic adenovirus, with or without low-dose cyclophosphamide, seems safe.

Immunosuppression

Oncolytic adenovirus

10.1021/mp1002174

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Citations (5)