Preparedness of Finnish Emergency Medical Services for Chemical Emergencies.
Jama, Timo J; Kuisma, Markku J
2016-08-01
Introduction The preparedness level of Finnish Emergency Medical Services (EMS) for treating chemical emergencies is unknown. The aim of this study was to survey the preparedness level of EMS systems for managing and handling mass-casualty chemical incidents in the prehospital phase in Finland. Hypothesis The study hypothesis was that university hospital districts would have better clinical capability to treat patients than would central hospital districts in terms of the number of patients treated in the field within one hour after dispatching as well as patients transported to hospital within one hour or two hours after dispatching. This cross-sectional study was conducted as a Webropol (Wuppertal, Germany) survey. All hospital districts (n=20) in continental Finland were asked about their EMS preparedness level in terms of capability of treating and transporting chemically affected patients in the field. Their capability for decontamination of affected patients in the field was also inquired. University hospital district-based EMS systems had at least 20% better absolute clinical capacity than central hospital-based EMS systems for treating chemically affected patients concerning all treatments inquired about, except the capacity for non-invasive ventilation (NIV)/continuous positive airway pressure (CPAP) treatment in the field. Overall, there was a good level of preparedness for treating chemical accident patients with supplemental oxygen, bronchodilators, and inhaled corticosteroids. Preparedness for providing antidote therapy in cases of cyanide gas exposure was, in general, low. The variation among the hospital districts was remarkable. Only nine of 15 central hospital district EMS had a mobile decontamination unit available, whereas four of five university hospital districts had one. Emergency Medical Services capacity in Finland for treating chemically affected patients in the field needs to be improved, especially in terms of antidote therapy. Mobile decontamination units should be available in all hospital districts. Jama TJ , Kuisma MJ . Preparedness of Finnish Emergency Medical Services for chemical emergencies. Prehosp Disaster Med. 2016;31(4):392-396.
Kaltiala-Heino, Riittakerttu; Mattila, Aino; Kärnä, Teemu; Joutsenneimi, Kaisla
2015-01-01
Transsexualism and other variations of gender identity are based on a stable sense of identity. The aetiology of this phenomenon is not fully known. Suffering caused by gender dysphoria is alleviated with sex reassignment. The psychiatric assessment of both adolescents and adults has been centralized in Finland to two university hospitals, the Helsinki University Hospital and Tampere University Hospital. In both hospitals, multidisciplinary teams aim at differential diagnosis by using well-known psychiatric and psychological instruments. Wishes for sex reassignment that are caused by a mental health disorder are excluded. Assessment in adolescence is challenging because the identity in youth is still forming.
Excess healthcare costs of a large waterborne outbreak in Finland.
Huovinen, Elisa; Laine, Janne; Virtanen, Mikko J; Snellman, Marja; Hujanen, Timo; Kiiskinen, Urpo; Kujansuu, Eila; Lumio, Jukka; Ruutu, Petri; Kuusi, Markku
2013-11-01
The economic effects of waterborne outbreaks have rarely been reported. A large waterborne outbreak occurred in the town of Nokia in Finland in 2007 with half of the population in the contaminated area suffering from gastroenteritis. We studied the healthcare costs of this outbreak. Healthcare costs were studied using register data from the Nokia Health Care Centre, data collected in the regional university hospital, and data from laboratory register on stool samples. Total excess healthcare costs were EUR 354,496, which is approximately EUR 10 per resident of Nokia. There were 2052 excess visits because of gastroenteritis in Nokia Health Care Centre, 403 excess episodes in the university hospital, and altogether over 2000 excess stool samples due to the outbreak. Care in the Nokia Health Care Centre accounted for 44% and care in the university hospital for 42% of the excess healthcare costs while stool samples accounted for only 10%. Despite the high morbidity, the total cost was low because most patients had a relatively mild illness. The situation would have been worse if the microbes involved had been more hazardous or if the financial situation of the community had been worse. Prevention of waterborne outbreaks is important, as there is a risk of severe short- and long-term health effects and substantial health-economic costs.
Evaluation of the work of hospital districts' research ethics committees in Finland.
Halila, Ritva
2014-12-01
The main task of research ethics committees (RECs) is to assess research studies before their start. In this study, 24 RECs that evaluate medical research were sent questionnaires about their structure and functions. The RECs were divided into two separate groups: those working in university hospital districts (uRECs) and those in central hospital districts (non-uRECs). The two groups were different in many respects: the uRECs were bigger in size, covered a wider range of disciplines (both medical and non-medical), had better resources and more frequent and regular meetings. After the survey was performed and analysed, the Medical Research Act was amended so that only hospital districts with a medical faculty in their region had a duty to establish ethics committees. After the amendment, the number of RECs evaluating medical research in Finland decreased from 25 to 9. The ethics committees that remained had wider expertise and were better equipped already by the time of this survey. Only one non-uREC was continuing its work, and this was being done under the governance of a university hospital district. Simple measures were used for qualitative analysis of the work of RECs that evaluate medical research. These showed differences between RECs. This may be helpful in establishing an ethics committee network in a research field or administrational area. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Mäkinen, M; Aune, S; Niemi-Murola, L; Herlitz, J; Varpula, T; Nurmi, J; Axelsson, A B; Thorén, A-B; Castrén, M
2007-02-01
Construction of an effective in-hospital resuscitation programme is challenging. To document and analyse resuscitation skills assessment must provide reliable data. Benchmarking with a hospital having documented excellent results of in-hospital resuscitation is beneficial. The purpose of this study was to assess the resuscitation skills to facilitate construction of an educational programme. Nurses working in a university hospital Jorvi, Espoo (n=110), Finland and Sahlgrenska University Hospital, Göteborg (n=40), Sweden were compared. The nurses were trained in the same way in both hospitals except for the defining and teaching of leadership applied in Sahlgrenska. Jorvi nurses are not trained to be, nor do they act as, leaders in a resuscitation situation. Their cardiopulmonary resuscitation (CPR) skills using an automated external defibrillator (AED) were assessed using Objective Structured Clinical Examination (OSCE) which was build up as a case of cardiac arrest with ventricular fibrillation (VF) as the initial rhythm. The subjects were tested in pairs, each pair alone. Group-working skills were registered. All Sahlgrenska nurses, but only 49% of Jorvi nurses, were able to defibrillate. Seventy percent of the nurses working in the Sahlgrenska hospital (mean score 35/49) and 27% of the nurses in Jorvi (mean score 26/49) would have passed the OSCE test. Statistically significant differences were found in activating the alarm (P<0.001), activating the AED without delay (P<0.01), setting the lower defibrillation electrode correctly (P<0.001) and using the correct resuscitation technique (P<0.05). The group-working skills of Sahlgrenska nurses were also significantly better than those of Jorvi nurses. Assessment of CPR-D skills gave valuable information for further education in both hospitals. Defining and teaching leadership seems to improve resuscitation performance.
Kananen, Jukka; Ovaska, Tuulevi; Saarti, Jarmo
2006-09-01
This article discusses the collection policies of a university library in a modern digital environment. A brief description of national collection policy decisions in Finland is provided. The rapid evolution and growth of scientific publication places new demands on building a collection in a health and bioscience orientated university, and it requires an evidence-based approach to support effective service processes. The aim of the study was to identify the needs of the university's students and staff. Usage statistics were surveyed and analysed. Both usage statistics and user surveys indicate that the library use is divided half-and-half between the traditional use of printed material and library premises and the modern use of digital materials via the Web. The former is mainly the way that the students and hospital staff use the library, and the latter can be viewed as the researchers' way of using the library. Librarians and information specialists act in this as service providers and/or guides and tutors to the end-users. These results, however, must be validated with a longer timescale data collation and analysis, both of which are an ongoing process within the library. It is important that requirements and needs of the library's users are monitored regularly and acquisition policies are updated frequently. It also seems that the needs have changed quite dramatically in response to modern ways of disseminating publications, but this supposition will require further study.
Use of resources and postoperative outcome.
Niskanen, M M; Takala, J A
2001-09-01
To characterise those surgical patients who consume one half of all hospital patient days, and to compare their outcome with that of low consumers. A retrospective cohort study. Tertiary referral centre, Finland. 13025 surgical patients who were admitted to a university hospital in Kuopio, Finland, during 1997. The length of stay below which half of all patient days fell was chosen as a cut-off value to divide patients into low and high consumers. Hospital and 12-month mortality and standardised mortality ratios (SMR: observed deaths/expected deaths based on the corresponding general population). The 2239 patients (17%) whose length of stay exceeded 9 days (high consumers) took up one half of all patient days. The pattern of resource use varied between operative specialities. At 12 months the SMRs showed excess mortality among high consumers (5.0, 95% confidence interval 4.4 to 5.7) compared with low consumers (2.1, 95% CI 1.9 to 2.3). Relating the length of stay to the proportion of resources consumed may provide a feasible tool for the recognition of different patterns of use of resources. SMRs may be more relevant measures of outcome than hospital mortality when assessing the efficacy of operative treatment.
Children in the hospital: elements of quality in drawings.
Pelander, Tiina; Lehtonen, Kimmo; Leino-Kilpi, Helena
2007-08-01
Not much is known about how children perceive the quality of care that they receive in hospitals. This study set out to describe elements of quality in children's drawings of an ideal hospital. Thirty-five drawings were collected from children aged between 4 and 11 years during their stay in a university hospital in Finland. They were coded using the method of content analysis. The two main categories extracted from the analysis were the environment and the people of their ideal hospital. The emphasis was on the environment; patients, parents, and nurses appeared less frequently in the drawings. The findings showed that children are capable of offering valuable insights into the elements of quality through the medium of drawing.
The University-Innovation Nexus in Finland. Go8 Backgrounder 29
ERIC Educational Resources Information Center
Grabert, Martin
2012-01-01
The objective of this "backgrounder" is to better understand the contributions of universities to innovation in Finland, as a means of widening the consideration of policy options in Australia. Finland is a small but advanced industrial economy with limited resources and markets, dependent on external trade and the internationalisation…
Raivio, Risto; Holmberg-Marttila, Doris; Mattila, Kari J
2014-10-01
Continuity of care is an essential aspect of quality in general practice. This study is the first systematic follow-up of Finnish primary care patients' assessments with regard to personal continuity of care. To ascertain whether patient-reported longitudinal personal continuity of care is related to patient characteristics and their consultation experiences, and how this had changed over the study period. A 15-year follow-up questionnaire survey that took place at Tampere University Hospital catchment area, Finland. The survey was conducted among patients attending health centres in the Tampere University Hospital catchment area from 1998 until 2013. From a sample of 363 464 patients, a total of 157 549 responded. The responses of patients who had visited a doctor during the survey weeks (n = 97 468) were analysed. Continuity of care was assessed by asking the question: 'When visiting the health centre, do you usually see the same doctor?'; patients could answer 'yes' or 'no'. Approximately half of the responders had met the same doctor when visiting the healthcare centre. Personal continuity of care decreased by 15 percentage points (from 66% to 51%) during the study years. The sense of continuity was linked to several patients' experiences of the consultation. The most prominent factor contributing to the sense of continuity of care was having a doctor who was specifically appointed (odds ratio 7.28, 95% confidence interval = 6.65 to 7.96). Continuity of care was proven to enhance the experienced quality of primary care. Patients felt that continuity of care was best realised when they could consult a doctor who had been specifically appointed to them. Despite efforts of the authorities, over the past 15 years patient-reported continuity of care has declined in Finland. © British Journal of General Practice 2014.
University Mergers in Finland: Mediating Global Competition
ERIC Educational Resources Information Center
Välimaa, Jussi; Aittola, Helena; Ursin, Jani
2014-01-01
University mergers have become a common strategy for increasing global competitiveness. In this chapter, the authors analyze the implementation of mergers in Finnish universities from the perspective of social justice as conceived within Finland and other Nordic countries.
The validation of AORN recommended practices in Finnish perioperative nursing documentation.
Tiusanen, Teija Susanna; Junttila, Kristiina; Leinonen, Tuija; Salanterä, Sanna
2010-02-01
In Finland, there are no common guidelines or recommended practices for perioperative documentation. Thus, perioperative nursing documentation varies from one operating department to another. To create minimum criteria for nursing documentation in Finland, we conducted an investigation in a university hospital district in 2006. Purposive sampling was used to invite experts in perioperative nursing documentation (N = 42) to serve as a Delphi panel. The final criteria are 120 items, 71% of which are based on the AORN standards and recommended practices. These criteria may be used to educate students and new perioperative personnel and to enhance the quality of nursing practice. To ensure relevance and usability, the criteria should be tested in various perioperative settings with a variety of surgical patients. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.
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Xia, Belle Selene; Liitiainen, Elia; Rekola, Mika
2012-01-01
This study explores the implications of higher education on earnings in Finland. The challenges as well as opportunities of obtaining a university degree as compared to graduating from polytechnics are evaluated using the REFLEX (The Flexible Professional in the Knowledge Society) data. As a Nordic country, Finland is known for its educated…
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Saarti, Jarmo; Suntioinen, Sirpa; Karjalainen, Kirsi; Tirronen, Jarkko
2012-01-01
At the turn of the century the higher education legislation and structure was reorganized in Finland. The number of universities was reduced by merging seven existing universities into three new universities. One of these new universities is the University of Eastern Finland, which was formed from the Universities of Joensuu and Kuopio. The merger…
Healthcare professionals' work engagement in Finnish university hospitals.
Lepistö, Sari; Alanen, Seija; Aalto, Pirjo; Järvinen, Päivi; Leino, Kaija; Mattila, Elina; Kaunonen, Marja
2017-10-10
Concerns about the sufficiency and dedication of the healthcare workforce have arisen as the baby boomer generation is retiring and the generation Y might have different working environment demands. To describe the association between work engagement of healthcare professionals' and its background factors at five Finnish university hospitals. Survey data were collected from nurses, physicians and administrative staff (n = 561) at all five university hospitals in Finland. Data were collected using an electronic questionnaire that comprised the Utrecht Work Engagement Scale (9 items) and 13 questions regarding the respondents' backgrounds. Descriptive and correlational analyses were used to examine the data. Most respondents were female (85%) and nursing staff (72%). Baby boomers (49%) were the largest generational cohort. The work engagement composite mean for the total sample was 5.0, indicating high work engagement. Significant differences in work engagement existed only among sex and age groups. The highest work engagement scores were among administrative staff. Work engagement among healthcare professionals in Finnish university hospitals is high. High work engagement might be explained by suitable job resources and challenges, as well as opportunities provided by a frontline care environment. Attention should especially be paid to meeting the needs of young people entering the workforce to strengthen their dedication and absorption. © 2017 Nordic College of Caring Science.
Einarson, Thomas R; Pudas, Hanna; Zilbershtein, Roman; Jensen, Rasmus; Vicente, Colin; Piwko, Charles; Hemels, Michiel E H
2013-09-01
In Finland, regional rates of schizophrenia exceed those in most countries, impacting the healthcare burden. This study determined the cost-effectiveness of long-acting antipsychotic (LAI) drugs paliperidone palmitate (PP-LAI), olanzapine pamoate (OLZ-LAI), and risperidone (RIS-LAI) for chronic schizophrenia. This study adapted a decision tree analysis from Norway for the Finnish National Health Service. Country-specific data were sought from the literature and public documents, guided by clinical experts. Costs of health services and products were retrieved from literature sources and current price lists. This simulation study estimated average 1-year costs for treating patients with each LAI, average remission days, rates of hospitalization and emergency room visits and quality-adjusted life-years (QALY). PP-LAI was dominant. Its estimated annual average cost was €10,380/patient and was associated with 0.817 QALY; OLZ-LAI cost €12,145 with 0.810 QALY; RIS-LAI cost €12,074 with 0.809 QALY. PP-LAI had the lowest rates of hospitalization, emergency room visits, and relapse days. This analysis was robust against most variations in input values except adherence rates. PP-LAI was dominant over OLZ-LAI and RIS-LAI in 77.8% and 85.9% of simulations, respectively. Limitations include the 1-year time horizon (as opposed to lifetime costs), omission of the costs of adverse events, and the assumption of universal accessibility. In Finland, PP-LAI dominated the other LAIs as it was associated with a lower cost and better clinical outcomes.
Puhakka, Laura; Renko, Marjo; Helminen, Merja; Peltola, Ville; Heiskanen-Kosma, Tarja; Lappalainen, Maija; Surcel, Heljä-Marja; Lönnqvist, Tuula; Saxen, Harri
2017-06-01
Both primary and non-primary maternal cytomegalovirus (CMV) infection during pregnancy can lead to vertical transmission. We evaluated the proportion of maternal primary/non-primary infections among 26 babies with symptomatic congenital CMV infection born in Finland from 2000 to 2012. We executed a database search on hospital records from all five university hospitals in Finland to identify infants with congenital CMV infection. The preserved maternal serum samples drawn at the end of the first trimester were analysed for CMV antibodies. Maternal infection was classified to be non-primary, if there was high avidity CMV immunoglobulin G (IgG) in the early pregnancy samples. Infection was considered primary in the case of either low avidity IgG (primary infection in the first trimester or near conception) or absent CMV IgG at the end of the first trimester (primary infection in the second or third trimester). The majority of the symptomatic congenital CMV infections (54%) were due to maternal non-primary infection, 27% due to maternal primary infection in the first trimester or near conception, and 19% during the second or third trimester. Long-term sequelae occurred in 59% of patients: in 6/7 after primary infection in the first trimester, in 0/5 after primary infection in the second or third trimester, and in 9/14 after non-primary infection. In this register-based cohort, non-primary infections caused the majority of symptomatic congenital CMV infections, and resulted in significant morbidity.
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Pulkki, Jutta Maarit; Rissanen, Pekka; Raitanen, Jani A.; Viitanen, Elina A.
2011-01-01
This study focuses on a large set of rehabilitation services used between 2004 and 2005 in one hospital district area in Finland. The rehabilitation system consists of several subsystems. This complex system is suggested to produce arbitrary rehabilitation services. Despite the criticisms against the system during decades, no attempts have been…
Kujala, Veikko; Jokinen, Jaana; Ebeling, Hanna; Pohjola, Anneli
2017-01-01
Introduction Making change towards child and family-based and coordinated services is critical to improve quality, outcomes and value. The Let’s Talk about Children (LTC) approach, which consists of brief psychoeducational discussions with parents of kindergarten-aged and school-aged children, has been launched as a municipality-specific programme in the Council of Oulu Region. The aim of this paper is to present a protocol of an ecological study evaluating the group-specific effects of an intervention about LTC activities in a geographically defined population. The programme is designed to promote children’s socioemotional well-being. Methods and analysis A quasi-experimental ecological study protocol is implemented to evaluate whether systematic LTC practices improve children’s well-being. A multi-informant setting covers 30 municipalities in northern Finland and involves all the municipal teachers, social and healthcare workers. In each municipality, a Local Management Team is responsible for implementing the LTC programme and collecting the annual data of LTC discussions and network meetings. The outcome data are retrieved from child welfare statistics and hospital registers. The population data, child welfare statistics and referrals to hospitals was retrieved at baseline (2014), and will be retrieved annually. Furthermore, the annual data of LTC discussions and network meetings will be collected of the years 2015–2018. Ethics and dissemination The study design has been approved by the management of the Oulu University Hospital in accordance with the guidelines given by The Regional Ethics Committee of the Northern Ostrobothnia Hospital District in Oulu, Finland. All data are treated and implemented according to national data security laws. Study findings will be disseminated to provincial and municipal partners, collaborative community groups and the research and development community. The Let’s Talk about Children Evaluation study databases will guide future regional development action and policies. PMID:28710220
Societal and Economic Engagement of Universities in Finland: An Evaluation Model
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Ritsila, Jari; Nieminen, Mika; Sotarauta, Markku; Lahtonen, Jukka
2008-01-01
This paper is based on the work of an expert team invited by the Ministry of Education of Finland to develop criteria and an evaluation framework for societal and economic engagement for use in university performance management. The paper maps out possible indicators for the societal and economic engagement of universities in the light of national…
ERIC Educational Resources Information Center
Kaataja, Sampsa
2011-01-01
Regardless of the increased interest in technological innovation in universities, relatively little is known about the technology developed by academic scientists. Long-term analyses of researchers' technological contribution are notably missing. This paper examines university-based technology in Finland during the period 1900-85. The focus is on…
Dental anomalies associated with cleft lip and palate in Northern Finland.
Lehtonen, V; Anttonen, V; Ylikontiola, L P; Koskinen, S; Pesonen, P; Sándor, G K
2015-12-01
Despite the reported occurrence of dental anomalies of cleft lip and palate, little is known about their prevalence in children from Northern Finland with cleft lip and palate. The aim was to investigate the prevalence of dental anomalies among patients with different types of clefts in Northern Finland. Design and Statistics: patient records of 139 subjects aged three years and older (with clefts treated in Oulu University Hospital, Finland during the period 1996-2010 (total n. 183) were analysed for dental anomalies including the number of teeth, morphological and developmental anomalies and their association with the cleft type. The analyses were carried out using Chi-square test and Fisher's exact test. Differences between the groups were considered statistically significant at p values < 0.05. More than half of the patients had clefts of the hard palate, 18% of the lip and palate, and 13% of the lip. At least one dental anomaly was detected in 47% of the study population. Almost one in three (26.6%) subjects had at least one anomaly and 17.9% had two or three anomalies. The most common type of anomaly in permanent teeth were missing teeth followed by supernumerary teeth. Supernumerary teeth were significantly more apparent when the lip was involved in the cleft compared with palatal clefts. Missing teeth were less prevalent among those 5 years or younger. The prevalence of different anomalies was significantly associated with the cleft type in both age groups. Dental anomalies are more prevalent among cleft children than in the general population in Finland. The most prevalent anomalies associated with cleft were missing and supernumerary teeth.
Pneumonic tularaemia: experience of 58 cases from 2000 to 2012 in Northern Finland.
Väyrynen, Sara A; Saarela, Elina; Henry, Janne; Lahti, Sini; Harju, Terttu; Kauma, Heikki
2017-10-01
Pneumonic tularaemia is less common clinical form of tularaemia compared with the ulceroglandular form, with only a limited number of case reports and case series in Europe. In Finland, Northern Ostrobothnia is an endemic area of tularaemia with occasional seasonal outbreaks. In our study, a consecutive series of 58 pneumonic tularaemia cases diagnosed and treated in Oulu University Hospital in 2000-2012 were retrospectively analysed in terms of epidemiology, clinical course, and prognosis. The incidence of pneumonic tularaemia showed peaks in cycles of a few years and most cases were diagnosed in late summer or early autumn. Respiratory symptoms were absent in 47% of patients, and 7% had normal chest X-ray. The chest computed tomography (CT) was performed in 81% of patients, demonstrating variable findings associated with pneumonic tularaemia. Bronchoscopy was performed for 22 (38%) patients and four (18%) of these also proceeded into mediastinoscopy. Moreover, thoracoscopy was performed for one (2%) patient. Two (3%) patients were treated shortly in the intensive care unit (ICU) during their stay in hospital. No mortality was observed. Most cases of pneumonic tularaemia are diagnosed during the seasonal outbreaks. The lack of specific symptoms often complicates the diagnosis and leads to unnecessarily invasive examinations.
Contaminated water caused the first outbreak of giardiasis in Finland, 2007: a descriptive study.
Rimhanen-Finne, Ruska; Hänninen, Marja-Liisa; Vuento, Risto; Laine, Janne; Jokiranta, T Sakari; Snellman, Marja; Pitkänen, Tarja; Miettinen, Ilkka; Kuusi, Markku
2010-08-01
The severe sewage contamination of a drinking water distribution network affected inhabitants in the town of Nokia, Finland in November 2007-February 2008. One of the pathogens found in patient and environmental samples was Giardia, which for the first time was detected as the causal agent of an outbreak in Finland. To describe the existence and the importance of Giardia infections related to this outbreak, we described characteristics of the giardiasis cases and calculated the incidence of giardiasis as well as the frequency of positive Giardia tests both before and during the outbreak. Persons reported to the Finnish Infectious Disease Registry (FIDR) with Giardia infections were interviewed. The number of persons tested for Giardia was obtained from the Centre for Laboratory Medicine at the Tampere University Hospital. The investigations provided strong evidence that Giardia infections in Nokia resulted from the contaminated water. The proportion of persons testing positive for Giardia and the incidence of giardiasis multiplied during the outbreak. To improve outbreak management, national guidelines on testing environmental samples for Giardia should be developed, and further resources should be allocated to both clinical and environmental laboratories that perform parasitological analyses.
Kruger, Tina M; Gilland, Sarah; Frank, Jacquelyn B; Murphy, Bridget C; English, Courtney; Meade, Jana; Morrow, Kaylee; Rush, Evan
2017-01-01
In May 2014, a short-term study-abroad experience was conducted in Finland through a course offered at Indiana State University (ISU). Students and faculty from ISU and Eastern Illinois University participated in the experience, which was created to facilitate a cross-cultural comparison of long-term-care settings in the United States and Finland. With its outstanding system of caring for the health and social needs of its aging populace, Finland is a logical model to examine when considering ways to improve the quality of life for older adults who require care in the United States . Those participating in the course visited a series of long-term-care facilities in the region surrounding Terre Haute, Indiana, then travelled to Lappeenranta, Finland to visit parallel sites. Through limited-participation observation and semistructured interviews, similarities and differences in experiences, educations, and policies affecting long-term care workers in the United States and Finland were identified and are described here.
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Sakurai, Yusuke; Pyhältö, Kirsi; Lindblom-Ylänne, Sari
2014-01-01
This article is based on a study which investigated whether Chinese international students at a university in Finland are more likely to rely on a Surface approach to learning and dismiss a Deep approach than are other international students in the same university educational context. In responding to a survey, students' scores with respect to the…
ERIC Educational Resources Information Center
1999
This document presents the proceedings from the 5th International European University Information Systems (EUNIS) Conference on Information Technology that took place in Helsinki, Finland on June 7-9, 1999. Topics of the conference proceedings were divided into five tracks (A through E): Use of Information Technology in Learning and Teaching;…
Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas
2010-12-01
The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.
Miilunpohja, S; Jyrkkä, J; Kärkkäinen, J M; Kastarinen, H; Heikkinen, M; Paajanen, H; Rantanen, T; Hartikainen, Jek
2017-11-01
Upper gastrointestinal bleeding (UGIB) is a common emergency, with in-hospital mortality between 3 and 14%. However, the long-term mortality and causes of death are unknown. We investigated the long-term mortality and causes of death in UGIB patients in a retrospective single-centre case-control study design. A total of 569 consecutive patients, aged ≥18 years, admitted to Kuopio University Hospital for their first endoscopically verified UGIB during the years 2009-2011 were identified from hospital records. For each UGIB patient, an age, sex and hospital district matched control patient was identified from the Statistics Finland database. Data on endoscopy procedures, laboratory values, comorbidities and medication were obtained from patient records. Data on deaths and causes of death were obtained from Statistics Finland. In-hospital mortality of UGIB patients was low at 3.3%. The long-term (mean follow-up 32 months) mortality of UGIB patients was significantly higher than controls (34.1 versus 12.1%, p < .001). During the 6 months following UGIB, the risk of death compared to controls was highest (HR 19.2, 95% CI 7.0-52.4, p < .001) and remained higher up to 3 years after the bleeding. Beyond 3 years' follow-up, there was no difference in mortality between the groups (HR 0.7, 95% CI 0.4-1.6, p = .436). During the first 3 months after the UGIB episode, mortality was related to gastrointestinal diseases; after 3 months, the causes of death were related to comorbidities and did not differ from causes of death in controls. UGIB patients have three times higher long-term mortality than population controls.
The implementation of quality management systems in hospitals: a comparison between three countries
Wagner, C; Gulácsi, L; Takacs, E; Outinen, M
2006-01-01
Background Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. Methods The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. Results A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. Conclusion The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be assessed. The hypothesis that governmental legislation or financial reimbursement can stimulate the implementation of QM-activities, more than voluntary recommendations, could not be confirmed. However, the results show that specific obligations can stimulate the implementation of QM-activities more than general, framework legislation. PMID:16608510
Kujala, Veikko; Jokinen, Jaana; Ebeling, Hanna; Pohjola, Anneli
2017-07-13
Making change towards child and family-based and coordinated services is critical to improve quality, outcomes and value. The Let's Talk about Children (LTC) approach, which consists of brief psychoeducational discussions with parents of kindergarten-aged and school-aged children, has been launched as a municipality-specific programme in the Council of Oulu Region. The aim of this paper is to present a protocol of an ecological study evaluating the group-specific effects of an intervention about LTC activities in a geographically defined population. The programme is designed to promote children's socioemotional well-being. A quasi-experimental ecological study protocol is implemented to evaluate whether systematic LTC practices improve children's well-being. A multi-informant setting covers 30 municipalities in northern Finland and involves all the municipal teachers, social and healthcare workers. In each municipality, a Local Management Team is responsible for implementing the LTC programme and collecting the annual data of LTC discussions and network meetings. The outcome data are retrieved from child welfare statistics and hospital registers. The population data, child welfare statistics and referrals to hospitals was retrieved at baseline (2014), and will be retrieved annually. Furthermore, the annual data of LTC discussions and network meetings will be collected of the years 2015-2018. The study design has been approved by the management of the Oulu University Hospital in accordance with the guidelines given by The Regional Ethics Committee of the Northern Ostrobothnia Hospital District in Oulu, Finland. All data are treated and implemented according to national data security laws. Study findings will be disseminated to provincial and municipal partners, collaborative community groups and the research and development community. The Let's Talk about Children Evaluation study databases will guide future regional development action and policies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Mäenpää, Helena; Autti-Rämö, Ilona; Varho, Tarja; Forsten, Wivi; Haataja, Leena
2017-03-01
To develop a national consensus on outcome measures that define functional ability in children with cerebral palsy (CP) according to the International Classification of Functioning, Disability and Health (ICF) framework. The project started in 2008 in neuropaediatric units of two university hospitals and one outpatient clinic. Each professional group selected representatives to be knowledge brokers for their own specialty. Based on the evidence, expert opinion, and the ICF framework, multiprofessional teams selected the most valid measures used in clinical practice (2009-2010). Data from 269 children with CP were analysed, classified by the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System, and evaluated. The process aimed at improving and unifying clinical practice in Finland through a national consensus on the core set of measures. The selected measures were presented by professional groups, and consensus was reached on the recommended core set of measures to be used in all hospitals treating children with CP in Finland. A national consensus on relevant and feasible measures is essential for identifying differences in the effectiveness of local practices, and for conducting multisite intervention studies. This project showed that multiprofessional rehabilitation practices can be improved through respect for and inclusion of everyone involved. © 2016 Mac Keith Press.
Educating an Aging Society: The University of the Third Age in Finland.
ERIC Educational Resources Information Center
Yenerall, Joseph D.
2003-01-01
The University of the Third Age in Finland has evolved from English and French models to include lectures, discussion groups, and research groups. A survey of 165 adult learners found their primary reason for participating was to acquire general education and self-knowledge. Socializing and meeting people were among the lowest ranked motivations.…
Inclusive Special Education: The Role of Special Education Teachers in Finland
ERIC Educational Resources Information Center
Takala, Marjatta; Pirttimaa, Raija; Tormanen, Minna
2009-01-01
This study concentrates on the work of special education teachers in mainstream education in Finland, where these professionals work with children from various classes, usually in a separate room. The research reported in this article by Marjatta Takala of the University of Helsinki, Raija Pirttimaa of the University of Oulu and Minna Tormanen,…
Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena
2013-01-01
The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles-visionary, coaching, affiliate, democratic, commanding, and isolating-were reflected on. Almost all respondents in every age group considered four leadership styles-visionary, coaching, affiliate, and democratic-to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing.
Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena
2013-01-01
The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four leadership styles—visionary, coaching, affiliate, and democratic—to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing. PMID:23691356
Hubert, Gordian J; Meretoja, Atte; Audebert, Heinrich J; Tatlisumak, Turgut; Zeman, Florian; Boy, Sandra; Haberl, Roman L; Kaste, Markku; Müller-Barna, Peter
2016-12-01
Intravenous thrombolysis with tissue-type plasminogen activator (tPA) for acute ischemic stroke is more effective when delivered early. Timely delivery is challenging particularly in rural areas with long distances. We compared delays and treatment rates of a large, decentralized telemedicine-based system and a well-organized, large, centralized single-hospital system. We analyzed the centralized system of the Helsinki University Central Hospital (Helsinki and Province of Uusimaa, Finland, 1.56 million inhabitants, 9096 km 2 ) and the decentralized TeleStroke Unit network in a predominantly rural area (Telemedical Project for Integrative Stroke Care [TEMPiS], South-East Bavaria, Germany, 1.94 million inhabitants, 14 992 km 2 ). All consecutive tPA treatments were prospectively registered. We compared tPA rates per total ischemic stroke admissions in the Helsinki and TEMPiS catchment areas. For delay comparisons, we excluded patients with basilar artery occlusions, in-hospital strokes, and those being treated after 270 minutes. From January 1, 2011, to December 31, 2013, 912 patients received tPA in Helsinki University Central Hospital and 1779 in TEMPiS hospitals. Area-based tPA rates were equal (13.0% of 7017 ischemic strokes in the Helsinki University Central Hospital area versus 13.3% of 14 637 ischemic strokes in the TEMPiS area; P=0.078). Median prehospital delays were longer (88; interquartile range, 60-135 versus 65; 48-101 minutes; P<0.001) but in-hospital delays were shorter (18; interquartile range, 13-30 versus 39; 26-56 minutes; P<0.001) in Helsinki University Central Hospital compared with TEMPiS with no difference in overall delays (117; interquartile range, 81-168 versus 115; 87-155 minutes; P=0.45). A decentralized telestroke thrombolysis service can achieve similar treatment rates and time delays for a rural population as a centralized system can achieve for an urban population. © 2016 American Heart Association, Inc.
LIEKKI -- Combustion and gasification research in Finland 1988--1998
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hupa, M.; Matinlinna, J.
1996-12-31
The objective of the Combustion and Gasification Research Program LIEKKI is to develop environmentally sound energy production techniques that are based on combustion and/or gasification. The research supports equipment manufacturers in Finland as they develop and improve their top export products, such as the fluidized bed boilers, black liquor recovery boilers, and heavy diesel power plants. The research is also heavily focused on new techniques not yet on the market, ones with higher efficiency of electricity production and, simultaneously, significantly simpler emission control systems. The most important concepts here include combustors or gasifiers based on fluidized bed technology at elevatedmore » pressures. At present the LIEKKI program includes 49 research projects and it connects some 150 scientists and research engineers in the universities and research centers of Finland. The overall annual budget of the program has been around 10 Mill. USD, co-funded by the industry and the government agency TEKES (Technology Development Centre) in Finland. The program is coordinated by Aabo Akademi University in Turku, Finland.« less
ERIC Educational Resources Information Center
Saarivirta, Toni; Karppinen, Jenni
2016-01-01
Finnish university students graduate later than their counterparts in other countries. For several years, Finnish higher education policy, regulated by Finland's Ministry of Education and Culture, has aimed at fostering the graduation of students in a shorter time than at present. The study at hand provides insights into one of the reforms carried…
Epidemiology of Guillain‐Barré syndrome in Finland 2004–2014
Soilu‐Hänninen, Merja; Ruuskanen, Jori O.; Rautava, Päivi; Kytö, Ville
2017-01-01
Abstract At total mean incidence of 0.84–1.1/100,000 the occurrence of Guillain‐Barré syndrome (GBS) is reported to be low in Finland compared to other Caucasian populations. However, a recent study from Southwestern Finland reported an incidence of 1.82/100,000 which is comparable to other Caucasian populations. We analyzed discharge data covering the years 2004 through 2014 on all neurological admissions in all Finnish university and central hospitals with a primary diagnosis of GBS. A total of 989 admissions due to GBS (917 individuals) were identified. The standardized (European population) annual incidence rate was 1.70/100,000 person‐years (95% confidence interval 1.60–1.81). GBS incidence had an increasing trend with age. The likelihood of GBS was higher among girls and adolescent women than boys and men of same age (male:female incidence rate ratio [IRR] 0.56), while in the older age groups (>19 years) the occurrence of GBS was higher among males than females (male:female IRR 1.59). The incidence of GBS remained stable during the study period. There was no seasonal variation in GBS admission frequencies (p = 0.28). No significant effect of the 2009–2010 H1N1 influenza or vaccination against it for GBS occurrence was observed. We suggest that GBS is as common, and has similar age‐distribution in Finland as in other European countries. Sex‐associated susceptibility for GBS appears to be different in children‐adolescents and adults. PMID:29095548
Analgesics in postoperative care in hip fracture patients with dementia - reported by nurses.
Rantala, Maija; Hartikainen, Sirpa; Kvist, Tarja; Kankkunen, Päivi
2014-11-01
To describe the analgesic use in hip fracture patients with dementia during the first two postoperative days as reported by nurses. Nurses play a pivotal role in treating postoperative pain in patients with dementia and monitoring the effects of administered analgesics. Cross-sectional descriptive questionnaire study in seven university hospitals and 10 central hospitals in Finland. The study was conducted from March until May in 2011 in Finland. For this analysis, the focus was on the sample of nurses (n = 269) who were working in orthopaedic units. Analgesics were classified according to the Anatomical Therapeutic Chemical Classification System. Nonparametric tests were applied to find out the significant differences between analgesic use and different hospitals. Paracetamol and strong opioids administered orally or parenterally seemed to be the most typical of postoperatively used types of analgesics in patients with dementia. Nonsteroidal anti-inflammatory analgesics and weak opioids were also commonly reported to be in use. There were no statistically significant differences between hospitals in typical daily doses. The majority of the nurses reported that the primary aim of postoperative pain management in hip fracture patients with dementia was 'slight pain, which does not prevent normal functioning' (72%). The pharmacological postoperative pain treatment in acute care was commonly based on the use of strong opioids and paracetamol in hip fracture patients with dementia. The reported use of transdermal opioids and codeine combination warrants further examination. Further studies are also needed to find out whether the pain is appropriately and adequately treated. Transdermal opioids and codeine combination may not be relevant analgesics for acute pain management in older adults. It is important to create a balance between sufficient pain relief and adverse effects of analgesics to allow early mobilisation and functional recovery. © 2014 John Wiley & Sons Ltd.
ERIC Educational Resources Information Center
Moran, Anne; Clarke, Linda
2012-01-01
The paper examines the school-based element of initial teacher education (ITE) and the ways in which it contributes to the professional learning of student teachers in Finland (University of Helsinki) and Northern Ireland (University of Ulster). In particular it seeks to assess the potential of Training Schools for Northern Ireland. Universities…
ERIC Educational Resources Information Center
Lundkvist, Marina; Nyby, Josefine; Autto, Janne; Nygård, Mikael
2017-01-01
Universal public childcare for children under seven has been central in Finland since the mid-1990s, capacitating both gender equality and children's human capital and wellbeing. In 2015, as a further step in the development of this system, early learning and childhood pedagogy was strengthened through the early childhood education and care (ECEC)…
Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden
Westman, J; Wahlbeck, K; Laursen, T M; Gissler, M; Nordentoft, M; Hällgren, J; Arffman, M; Ösby, U
2015-01-01
Objective To analyse mortality and life expectancy in people with alcohol use disorder in Denmark, Finland and Sweden. Method A population-based register study including all patients admitted to hospital diagnosed with alcohol use disorder (1 158 486 person-years) from 1987 to 2006 in Denmark, Finland and Sweden. Results Life expectancy was 24–28 years shorter in people with alcohol use disorder than in the general population. From 1987 to 2006, the difference in life expectancy between patients with alcohol use disorder and the general population increased in men (Denmark, 1.8 years; Finland, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Denmark (0.3 years) but decreased in Finland (−0.8 years) and Sweden (−1.8 years). People with alcohol use disorder had higher mortality from all causes of death (mortality rate ratio, 3.0–5.2), all diseases and medical conditions (2.3–4.8), and suicide (9.3–35.9). Conclusion People hospitalized with alcohol use disorder have an average life expectancy of 47–53 years (men) and 50–58 years (women) and die 24–28 years earlier than people in the general population. PMID:25243359
Suhonen, Riitta; Välimäki, Maritta; Katajisto, Jouko; Leino-Kilpi, Helena
2007-03-01
To examine the association between hospitals' organizational variables and patients' perceptions of individualized care. There is lack of evidence related to the effects that the hospital environment has on patient perceptions of the individuality of care they receive. A cross-sectional design was used. The questionnaire survey data were obtained from 861 (response rate 82%) hospital patients and 35 (100%) nurse managers in Finland. Results An inverse relationship between the size of the hospital and ward and patients' perceptions of individualized care was found. Increased staffing or skill mix failed to predict a higher patient perception of individualized care, but primary nursing care delivery did. Instead of increasing the amount of nursing staff, there is a need to improve the quality of the nurse-patient interactions to facilitate individualized care. The generalizability of the study is limited by the regional nature of the setting.
Nurses' readiness for evidence-based practice at Finnish university hospitals: a national survey.
Saunders, Hannele; Stevens, Kathleen R; Vehviläinen-Julkunen, Katri
2016-08-01
The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. A cross-sectional descriptive survey design. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. © 2016 John Wiley & Sons Ltd.
Pirhonen, J P; Grenman, S E; Haadem, K; Gudmundsson, S; Lindqvist, P; Siihola, S; Erkkola, R U; Marsal, K
1998-11-01
Anal sphincter rupture is a serious complication of vaginal delivery and almost half the affected women have persistent defecatory symptoms despite adequate primary repair. During the past decade, the incidence of anal sphincter ruptures has been increasing in Sweden and is currently estimated to occur in 2.5% of vaginal deliveries. The aim of the study was to report the frequency of anal sphincter ruptures in two university hospitals in two Scandinavian countries, Malmö in Sweden and Turku in Finland, and analyze the potential determinants. Retrospective analysis of a population of 30,933 deliveries (26,541 vaginal) during the years 1990 to 1994. The incidence of anal sphincter ruptures in Malmö, Sweden was 2.69%, and in Turku, Finland 0.36%. There were no significant population differences for the known risk factors (fetal weight, nulliparity or fetal head circumference). However, there is a difference in manual support given to the perineum and to the baby's head when crowning through the vaginal introitus between Malmö and Turku. The proportion of operative vaginal deliveries and abnormal presentations was significantly higher in Turku reflected in the lower Apgar score at 5 minutes and longer duration of second phase of labor. When high risk deliveries (operative vaginal delivery, abnormal presentation and newborns over 4,000 g) were excluded, the risk for anal sphincter ruptures was estimated to be 13 times higher in Malmö than in Turku. The difference in the incidence of anal sphincter rupture between Malmö, Sweden and Turku, Finland may be due to the difference in manual control of the baby's head when crowning.
Kaipio, Johanna; Stenhammar, Hanna; Immonen, Susanna; Litovuo, Lauri; Axelsson, Minja; Lantto, Minna; Lahdenne, Pekka
2018-01-01
Patient feedback is considered important for healthcare organizations. However, measurement and analysis of patient reported data is useful only if gathered insights are transformed into actions. This article focuses on gathering and utilization of patient experience data at hospitals with the aim of supporting the development of patient-centered services. The study was designed to explore both current practices of collecting and utilizing patient feedback at hospitals as well as future feedback-related opportunities. Nine people working at different hierarchical levels of three university hospitals in Finland participated in in-depth interviews. Findings indicate that current feedback processes are poorly planned and inflexible. Some feedback data are gathered, but not systematically utilized. Currently, it is difficult to obtain a comprehensive picture of the situation. One future hope was to increase the amount of patient feedback to be able to better generalize and utilize the data. Based on the findings the following recommendations are given: attention to both patients' and healthcare staff's perspectives when collecting feedback, employing a coordinated approach for collecting and utilizing patient feedback, and organizational transformation towards a patient-centric culture.
Hetemaa, T; Keskimaki, I; Manderbacka, K; Leyland, A; Koskinen, S
2003-01-01
Design: Register based linkage study; information on coronary procedures from the Finnish Hospital Discharge Register in 1988 and 1996 was individually linked to national population censuses in 1970–1995 to obtain patients' socioeconomic data. Data on both hospitalisations and mortality attributable to coronary heart disease obtained from similar linkage schemes were used to approximate the relative need of procedures in socioeconomic groups. Setting: Finland, 2 094 846 inhabitants in 1988 and 2 401 027 in 1996 aged 40 years and older, and Discharge Register data from all Finnish hospitals offering coronary procedures in 1988 and 1996. Main results: The overall rate of coronary revascularisations in Finland increased by about 140% for men and 250% for women from 1988 to 1996. Over the same period, socioeconomic and gender disparities in operation rates diminished, as did the influence of regional supply of procedures on the extent of these differences. However, men, and better off groups in terms of occupation, education, and family income, continued to receive more operations than women and the worse off with the same level of need. Conclusions: Although revascularisations in Finland increased 2.5-fold overall, some socioeconomic and gender inequities persisted in the use of cardiac operations relative to need. To improve equity, a further increase of resources may be needed, and practices taking socioeconomic and gender equity into account should be developed for the referral of coronary heart disease patients to hospital investigations. PMID:12594194
Hoikka, M H; Liisanantti, J H; Dunder, T
2013-07-01
To evaluate the incidence, clinical features and outcome of acute poisoning in children of less than 6 years of age in northern Finland. Children hospitalized with acute poisoning at the Oulu University Hospital between 1991 and 2010 were retrospectively evaluated from hospital records. There were 334 hospital admissions due to acute poisoning during the study period, with an overall incidence rate of 5.2 per 10 000 per year, decreasing slightly from 6.7 in 1991-1995 to 4.5 in 2006-2010. Mean length of a hospital stay was 1.2 (SD ± 1.26) days. The most common substances ingested were terbutaline (12.3%), benzodiazepines (12.0%) and dishwasher powder (9.3%). Almost half of the patients were admitted to the paediatric intensive care unit, but most only required supportive care. Specific antidotes were administered in 16 cases. Three patients suffered from aspiration pneumonia as a result of ingesting poison, but no children died during the study. Poisoning is a fairly common cause of hospital admission in children under the age of six. In most cases, their clinical condition is good, and they can be discharged after a short surveillance period. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J
2006-12-01
To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.
The Regional Impact of Universities in Finland.
ERIC Educational Resources Information Center
Antikainen, Ari
1981-01-01
The impact of a decentralized system of higher education on the regional development of Finland is discussed. Higher education and scientific research are seen as part of the social infrastracture that a change from agrarian to industrial or post-industrial society presupposes in the world of scientific-technological revolution. (Author/MLW)
Eight Years of Severe Allergic Reactions in Finland: A Register-Based Report
2008-01-01
Background No data have been available on severe allergic reactions in Finland. Materials and Methods We summarize the data accumulated from 2000 to 2007 in the national register established at the Skin and Allergy Hospital of the Helsinki University Central Hospital, where physicians voluntarily report on patients with severe allergic reactions. Results During the period, the 530 reported cases of severe allergic reactions represented an annual frequency of 0.001%. Of the patients, 66% were adults and 56% were female, with a median age of 27 years. Food was the causative agent in 53% of the cases, drugs in 26%, allergen preparations in 12%, and insects in 8%. Dermatologic symptoms were reported in 85%, respiratory in 76%, cardiovascular in 50%, gastrointestinal in 33%, and eye/nose symptoms in 18%. The reaction was a life-threatening anaphylactic shock in 26% of the cases, with no deaths reported. Patients were treated with intramuscular adrenaline in 75% of the cases. Not only nuts and seeds, but also fruit and vegetables were the most important allergens for the adults. Nuts were also important allergens for children, along with milk, egg, and wheat. In addition, many "exotic" allergens were identified: patent blue, carmine dye, yeast, buckwheat, and macrogol. Conclusions Severe allergic reactions are underreported, but a register reflects the real-life situation and helps to identify new causative agents. It also contributes to improvements in first aid treatment practice. PMID:23282762
Paranormal Beliefs and Their Implications in University Students from Finland and the United States.
ERIC Educational Resources Information Center
Tobacyk, Jerome J.; Pirttila-Backman, Anna-Maija
1992-01-01
Compares 117 Finnish and 351 southern U.S. college students for the following: (1) paranormal beliefs; (2) personality adjustment constructs (anomie, death concerns, alienation, and death threat); and (3) relationships between the beliefs and constructs. The secularization process, further advanced in Finland than the United States, moderates…
The Effect of Pollution on Newly-Formed Particle Composition in Boreal Forest
NASA Astrophysics Data System (ADS)
Vaattovaara, Petri
2010-05-01
Petri Vaattovaara (1), Tuukka Petäjä (2), Jorma Joutsensaari (1), Pasi Miettinen (1), Boris Zaprudin (1,6), Aki Kortelainen (1), Juha Heijari (3,7), Pasi Yli-Pirilä (3), Pasi Aalto (2), Doug R. Worsnop (4), and Ari Laaksonen(1,5) (1) University of Eastern Finland, Finland (2) University of Helsinki, Finland (3) University of Eastern Finland, Finland (4) Aerodyne Research Inc., USA (5) Finnish Meteorological Institute, Finland (6) Currently at University of Turku, Finland (7) Currently at Maritime Research Centre, Finland Email address of the Corresponding author: Petri.Vaattovaara@uef.fi The geographical extent of the tropical, temperate and boreal forests is about 30% of the Earth's land surface. Those forests are located around the world in different climate zones effecting widely on atmospheric composition via new particle formation. The Boreal forests solely cover one third of the forests extent and are one of the largest vegetation environments, forming a circumpolar band throughout the northern hemisphere continents, with a high potential to affect climate processes [1]. In order to more fully understand the possible climatic effects of the forests, the properties of secondary organic aerosols (SOA) in varying conditions (e.g. a change in meteorological parameters or in the concentrations of biogenic and antropogenic trace gases) need to be better known. In this study, we applied the UFO-TDMA (ultrafine organic tandem differential mobility analyzer [2]) and the UFH-TDMA (ultrafine hygroscopicity tandem differential mobility analyzer [3]) methods parallel to shed light on the evolution of the nucleation and Aitken mode particle compositions (via physic-chemical properties) at a virgin boreal forest site in varying conditions. The measurements were carried out at Hyytiälä forest station in Northern Europe (Finland) during 15 spring nucleation events. We also carried out a statistical analysis using linear correlations in order to explain the variability in the composition behaviour of the particles during multiple nucleation events. The overall results show a clear anthropogenic influence on the nucleation and Aitken mode particle compositions during the events. The SO2/MTOP and NOx/MTOP (MTOP, monoterpene oxidation products) ratios explain most strongly the variation in the nucleation mode composition during clean and pollution-affected events, suggesting also the importance of organic sulfur compounds, in addition to other sulfur, nitrogen and organic compounds, in particle formation, composition and properties. During the cleanest events, MTOP explain significantly the time behaviour of the 10 nm particle composition with an estimated organic fraction of over 95%. [1] P. Tunved et al., 2006, Science, 312, 261-263. [2] P. Vaattovaara et al., 2005, Atmos. Chem. Phys., 5, 3277-3287. [3] K. Hämeri et al., 2000, J. Geophys. Res. 105(D17), 22231-22242. [4] K. Sellegri et al., Atmos. Chem. Phys., 5, 373-384. [5] M. Boy et al., Atmos. Chem. Phys., 5, 863-878.
Overtreatment of displaced midshaft clavicle fractures
Ban, Ilija; Nowak, Jan; Virtanen, Kaisa; Troelsen, Anders
2016-01-01
Background and purpose The best treatment for displaced clavicle fractures has been debated for decades. Operative treatment has become more common. However, several randomized trials comparing non-operative and operative treatment have not shown any compelling evidence in favor of surgery. We identified the preferred treatment of displaced midshaft clavicle fractures at public hospitals in 3 countries in Scandinavia. Patients and methods A purpose-made multiple-choice questionnaire in English was sent to all public hospitals in Denmark, Sweden, and Finland. This was addressed to the orthopedic surgeon responsible for treatment of clavicle fractures, and completed questionnaires were obtained from 85 of 118 hospitals. Results In the 3 countries, 69 of the 85 hospitals that responded would treat displaced clavicle fractures operatively. Clear criteria for treatment allocation were used at 58 of the hospitals, with the remaining 27 using individual assessment in collaboration with the patient. Precontoured locking plates were mostly used, placed either superiorly (64/85) or anteriorly (10/85). Interpretation Displaced midshaft clavicle fractures are mainly treated operatively in Sweden, Denmark, and Finland. This treatment is not supported by compelling evidence. PMID:27225678
Overtreatment of displaced midshaft clavicle fractures.
Ban, Ilija; Nowak, Jan; Virtanen, Kaisa; Troelsen, Anders
2016-12-01
Background and purpose - The best treatment for displaced clavicle fractures has been debated for decades. Operative treatment has become more common. However, several randomized trials comparing non-operative and operative treatment have not shown any compelling evidence in favor of surgery. We identified the preferred treatment of displaced midshaft clavicle fractures at public hospitals in 3 countries in Scandinavia. Patients and methods - A purpose-made multiple-choice questionnaire in English was sent to all public hospitals in Denmark, Sweden, and Finland. This was addressed to the orthopedic surgeon responsible for treatment of clavicle fractures, and completed questionnaires were obtained from 85 of 118 hospitals. Results - In the 3 countries, 69 of the 85 hospitals that responded would treat displaced clavicle fractures operatively. Clear criteria for treatment allocation were used at 58 of the hospitals, with the remaining 27 using individual assessment in collaboration with the patient. Precontoured locking plates were mostly used, placed either superiorly (64/85) or anteriorly (10/85). Interpretation - Displaced midshaft clavicle fractures are mainly treated operatively in Sweden, Denmark, and Finland. This treatment is not supported by compelling evidence.
Exploitation of Wireless Technology in Remote Care Processes
NASA Astrophysics Data System (ADS)
Hämäläinen, Matti; Taparugssanagorn, Attaphongse; Iinatti, Jari; Kohno, Ryuji
The average age of population is predicted to be raised universally but the number of nursing staff is not increasing at the same rate. This leads us to the situation where, e.g., we have too many patients for one nurse. On the other hand, sparse population in some regions, such as Northern or Eastern Finland, causes a severe problem that doctors are far away from patient. In this paper, we summarize the possibilities and applications that utilize wireless technologies in healthcare sector and which can be useful in nursing activities. The use of new innovations is one way to solve the problems that are based on the expected lack of professional staff in the future. Despite of the very natural hospital link, the developed technical solutions have applications outside hospital. Remote care of aging people and other special groups need to be done daily and almost real-time. Keeping people home instead of hospital is one way to decrease the entire care costs. In addition to the obvious human context, we derive some other applications where we can benefit wireless nursing and remote sensing techniques.
Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri
2012-03-01
The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. Data were collected from the two countries randomly sampling the countries' National Nurses Association' membership databases. In this paper, the results from Registered Nurses working in hospital settings are used. In total, 869 hospital nurses participated: 535 from Finland and 334 from the Netherlands with the response rate of 44.9 and 33.4%, respectively. Fifty-five items from the Nursing Work Index-Revised were used as a main tool for the practice environment. Exploratory factor analysis was used to identify a set of internally consistent subscales. Further, logistic regression analysis and T-tests were used. Three practice environment characteristics were identified: adequacy of resources, supportiveness of management and assurance of care quality via collaborative relationships. Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
Lyme Borreliosis in Finland, 1995-2014.
Sajanti, Eeva; Virtanen, Mikko; Helve, Otto; Kuusi, Markku; Lyytikäinen, Outi; Hytönen, Jukka; Sane, Jussi
2017-08-01
We investigated the epidemiology of Lyme borreliosis (LB) in Finland for the period 1995-2014 by using data from 3 different healthcare registers. We reviewed data on disseminated LB cases from the National Infectious Diseases Register (21,051 cases) and the National Hospital Discharge Register (10,402 cases) and data on primary LB (erythema migrans) cases from the Register for Primary Health Care Visits (11,793 cases). Incidence of microbiologically confirmed disseminated LB cases increased from 7/100,000 population in 1995 to 31/100,000 in 2014. Incidence of primary LB cases increased from 44/100,000 in 2011 to 61/100,000 in 2014. Overall, cases occurred predominantly in women, and we observed a bimodal age distribution in all 3 registers. Our results clearly demonstrate that the geographic distribution of LB has expanded in Finland and underscore the importance of LB as an increasing public health concern in Finland and in northern Europe in general.
Outside the Golden Gate: Prospects and Comparisons in Finnish Adult Higher Education.
ERIC Educational Resources Information Center
Parjanen, Matti, Ed.; And Others
This book contains four articles on adult higher education (AHE) in Finland. In the preface, Matti Parjanen outlines the development of AHE in Finland and discusses the rationale for the book. In "Adult Education and Universities in the Era of Economic Depression," Osmo Kivinen and Risto Rinne examine the dilemma between the mission of…
ERIC Educational Resources Information Center
Haapakorpi, Arja
2017-01-01
In Finland, doctoral employment outside the academy has been increasing. Universities can no longer absorb the numbers in the doctoral labour force and research and development (R&D) policy emphasises the need for specialised research capacity in non-academic sectors; the highest academic degree is assumed to add value. However, the transition…
ERIC Educational Resources Information Center
Vakeva, Lauri; Kurkela, Vesa
2012-01-01
This paper reports a project organized by Sibelius-Academy Department of Folk Music and Tampere University, Department of Music Anthropology in 2008-2010. The goal of the project was to develop and implement a master program for "rytmimusiikki" (lit. "rhythm music" in Seinajoki, Finland--a musically active provincial area…
Suvikas-Peltonen, Eeva; Palmgren, Joni; Häggman, Verner; Celikkayalar, Ercan; Manninen, Raija; Airaksinen, Marja
2017-01-01
On the hospital wards in Finland, nurses generally reconstitute intravenous medicines, such as antibiotics, analgesics, and antiemetics prescribed by doctors. Medicine reconstitution is prone to many errors. Therefore, it is important to identify incorrect practices in the reconstitution of medicine to improve patient safety in hospitals. The aim of this study was to audit the compounding and reconstituting of intravenous medicines on hospital wards in a secondary-care hospital in Finland by using an assessment tool and microbiological testing for identifying issues posing patient safety risks. A hospital pharmacist conducted an external audit by using a validated 65-item assessment tool for safe-medicine compounding practices on 20 wards of the selected hospital. Also, three different microbiological samples were collected to assure the aseptics. Practices were evaluated using a four-point rating scale of "never performed," "rarely performed," "often performed," and "always performed," and were based on observation and interviews with nurses or ward pharmacists. In addition, glove-, settle plate-, and media fill-tests were collected. Associations between microbial sample results and audit-tool results were discussed. Altogether, only six out of the 65 items were fully implemented in all wards; these were related to logistic practices and quality assurance. More than half of the wards used incorrect practices ("rarely performed" or "never performed") for five items. Most of these obviated practices related to aseptic practices. All media-fill tests were clean but the number of colony forming units in glove samples and settle- plate samples varied from 0 to >100. More contamination was found in wards where environmental conditions were inadequate or the use of gloves was incorrect. Compounding practices were [mostly] quite well adapted, but the aseptic practices needed improvement. Attention should have been directed particularly to good aseptic techniques and compounding environment on the wards. These results can be used for updating the guidelines and for training nurses involved in compounding. Copyright© by International Journal of Pharmaceutical Compounding, Inc.
Entrepreneurship in Finnish Universities
ERIC Educational Resources Information Center
Nurmi, Piia; Paasio, Kaisu
2007-01-01
Purpose: The purpose of this paper is to discuss the role of universities in fostering and promoting entrepreneurship in Finland. In particular it seeks to examine the university-entrepreneurship relationship: its nature and how universities are addressing the entrepreneurship agenda. Design/methodology/approach: The paper is based on a large…
Intercultural caring from the perspectives of immigrant new mothers.
Wikberg, Anita; Eriksson, Katie; Bondas, Terese
2012-01-01
To describe and interpret the perceptions and experiences of caring of immigrant new mothers from an intercultural perspective in maternity care in Finland. Descriptive interpretive ethnography using Eriksson's theory of caritative caring. A maternity ward in a medium-sized hospital in western Finland. Seventeen mothers from 12 countries took part in the study. Interviews, observations, and field notes were analyzed and interpreted. Most mothers were satisfied with the equal access to high-quality maternity care in Finland, although the stereotypes and the ethnocentric views of some nurses negatively influenced the experiences of maternity care for some mothers. The cultural background of the mother, as well as the Finnish maternity care culture, influenced the caring. Four patterns were found. There were differences between the expectations of the mothers and their Finnish maternity care experience of caring. Caring was related to the changing culture. Finnish maternity care traditions were sometimes imposed on the immigrant new mothers, which likewise influenced caring. However, the female nurse was seen as a professional friend, and the conflicts encountered were resolved, which in turn promoted caring. The influence of Finnish maternity care culture on caring is highlighted from the perspective of the mothers. Intercultural caring was described as universal, cultural, contextual, and unique. Women were not familiar with the Finnish health care system, and many immigrant mothers lacked support networks. The nurse/patient relationship could partly replace their support if the relationship was perceived as caring. The women had multiple vulnerabilities and were prone to isolation and discrimination if they experienced communication problems. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
NASA Astrophysics Data System (ADS)
Sormunen, Jani; Kulha, Niko; Klemola, Tero
2017-04-01
Ticks (Acari: Ixodidae) and tick-borne diseases constitute a growing welfare problem in northern Europe and Russia. Surveys conducted in Russia, Sweden and Norway have revealed a northwards shift in distribution and an increase in tick abundance over the past few decades. In southwestern Finland, surveys have revealed a similar increase in tick abundance, as well as the presence of novel tick-borne pathogens. As avoiding risk areas and removing attached ticks as quickly as possible are the best available methods for preventing tick-borne diseases, accessible and up-to-date data on tick occurrence is essential. However, consistently tracking the nationwide distribution of ticks is impossible using traditional collection methods. Therefore, GIS-based predictive modelling for tick occurrence is required. In May 2015, a national tick collection campaign was launched by the University of Turku tick project, with the objective of mapping the current geographical distribution of the two tick species responsible for tick-borne infections in Finland, Ixodes ricinus and Ixodes persulcatus. During the collection campaign, citizens were asked to send any ticks they found to the University of Turku by letter, along with information on the collection locality. The campaign ended in September 2015 and was a great success, with nearly 7000 letters delivered to the University. These letters contained more than 20 000 individual ticks from all around Finland. The geographic data from the letters was converted into coordinate points after the campaign was concluded. Data from the national tick collection campaign revealed not only a northwards shift in the distribution of I. ricinus, but also novel foci for I. persulcatus in Finland. Strikingly, while they were otherwise found throughout Finland, I. persulcatus were absent from the south-southwestern coast, where I. ricinus is nevertheless abundant. The exact cause for this phenomenon is unclear, as I. persulcatus are found further south in nearby Estonia and Russia. Using the location and tick species data from the collection campaign, as well as nationwide data sets regarding several different environmental factors (e.g. temperature sum, soil type), we seek to identify potential environmental causes for the realized geographical distributions of these two tick species in Finland. Particularly, we seek to identify factors limiting tick occurrence in certain areas, especially I. persulcatus occurrence in southern Finland. The ultimate goal is to determine whether quantifiable environmental factors linked to tick occurrence can be found, and, if found, use them to apply GIS models to map and predict changes in tick distribution in Finland. In the poster presented here, we showcase the methodology used in assessing effects of different environmental factors on tick occurrence, and present preliminary results from GIS analysis of coordinate, tick species and environmental data.
Built to Be Excellent? The Aalto University Merger in Finland
ERIC Educational Resources Information Center
Tienari, Janne; Aula, Hanna-Mari; Aarrevaara, Timo
2016-01-01
In the Finnish higher education system, government steering and the interests of industry and business have come to focus on the impact of the university in society. In 2010, "Aalto University" was created in a merger of three universities representing different academic fields. The new university developed a forward-looking strategy,…
ERIC Educational Resources Information Center
Askham, Janet; Gilhooly, Mary; Parkatti, Terttu; Vega, Jose-Luis
2007-01-01
Postgraduate education in gerontology is now widespread within European universities, but, even so, such developments remain very uneven. This paper outlines the variety of provision by describing Master's programmes in a sample of countries: England, Scotland, Finland, and Spain. These programmes illustrate some of the common problems: lack of…
The University in the Making of the Welfare State: The 1970s Degree Reform in Finland
ERIC Educational Resources Information Center
Jalava, Marja
2012-01-01
In just a couple of decades, Finland evolved from one of Europe's lowest educated countries to the top performer of the international PISA ranking. Behind this "success story", there was a conscious strategy to use educational policies for creating a more equal society. Tracing the development of Finnish higher education system after…
ERIC Educational Resources Information Center
Kallo, Johanna; Semchenko, Anzhelika
2016-01-01
This article analyses the localisation of the United Nations Educational Scientific and Cultural Organisation (UNESCO)/Organisation for Economic Co-operation and Development (OECD) "Guidelines for Quality Provision in Cross-Border Higher Education" (2005) at the national and university levels in Finland and Russia. The article engages…
What American Colleges Can Learn from the Finns
ERIC Educational Resources Information Center
Casey, Kevin
2009-01-01
As large as Finland is small, as rich in natural resources as Finland is not, bordered by smaller, peaceable nations to the north and south and large oceans to the east and west, nobody has ever come to America and forced its people to rename and reorganize their colleges and universities--or, for that matter, to do anything else. Americans are…
Teacher Education in Finland: A Review of a National Effort for Preparing Teachers for the Future
ERIC Educational Resources Information Center
Malinen, Olli-Pekka; Vaisanen, Pertti; Savolainen, Hannu
2012-01-01
The quality of teachers is one of the most frequently cited factors explaining the quality of an education system. This article discusses the nature and role teacher education plays as a part of the Finnish education system. Teacher education in Finland is a highly competitive field of masters' degree university studies and is provided in…
ERIC Educational Resources Information Center
Aspfors, Jessica; Eklund, Gunilla
2017-01-01
Much of the international debate and research on teacher education has centred on how the preparation of teachers should be organised. In contrast to many other countries, teacher education in Finland has been university-based for decades and has a strong research-based approach. This inductive study describes newly qualified teachers' (NQTs)…
Patients' rights in laboratory examinations: do they realize?
Leino-Kilpi, H; Nyrhinen, T; Katajisto, J
1997-11-01
This article discusses the rights of patients who are attending hospital for the most common laboratory examinations and who may also be taking part in research studies. A distinction is made between five kinds of rights to: protection of privacy, physical integrity, mental integrity, information and self-determination. The data were collected (n = 204) by means of a structured questionnaire specifically developed for this study in the clinical chemistry, haematological, physiological and neurophysiological laboratories of one randomly selected university hospital in Finland. The analysis of the data was statistical. On the whole, patients' rights were realized reasonably well. This was most particularly the case with protection of privacy, as well as with the rights of physical and mental integrity. The rights to information and self-determination were less well realized. There are various steps that health care professionals and organizations can take to make sure that patients can enjoy their full rights, by counselling the patient, by giving opportunities to plan the examinations in advance, and by arranging a sufficient number of small examination rooms.
Poggetti, Renato; Leppanemi, Ari; Ferrada, Paula; Puyana, Juan Carlos; Peitzman, Andrew B; Ansaloni, Luca; Catena, Fausto; Pinna, Antonio D; Moore, Ernest E
2009-01-01
Emergency surgery is performed in every hospital with a A and E unit all around the world. However it is organized in different ways with different results. Aim of this paper is to present history, current scope, current training program and new politics for training national program of 3 countries of different continents. Brazil, Finland and US emergency surgery models are presented discussing all criticisms showed during the WSES Summer Meeting 2008. PMID:19331673
NASA Astrophysics Data System (ADS)
Vuorinen, Tommi; Korja, Annakaisa
2017-04-01
FIN-EPOS consortium is a joint community of Finnish national research institutes tasked with operating and maintaining solid-earth geophysical and geological observatories and laboratories in Finland. These national research infrastructures (NRIs) seek to join EPOS research infrastructure (EPOS RI) and further pursue Finland's participation as a founding member in EPOS ERIC (European Research Infrastructure Consortium). Current partners of FIN-EPOS are the University of Helsinki (UH), the University of and Oulu (UO), Finnish Geospatial Research Institute (FGI) of the National Land Survey (NLS), Finnish Meteorological Institute (FMI), Geological Survey of Finland (GTK), CSC - IT Center for Science and MIKES Metrology at VTT Technical Research Centre of Finland Ltd. The consortium is hosted by the Institute of Seismology, UH (ISUH). The primary purpose of the consortium is to act as a coordinating body between various NRIs and the EPOS RI. FIN-EPOS engages in planning and development of the national EPOS RI and will provide support in EPOS implementation phase (IP) for the partner NRIs. FIN-EPOS also promotes the awareness of EPOS in Finland and is open to new partner NRIs that would benefit from participating in EPOS. The consortium additionally seeks to advance solid Earth science education, technologies and innovations in Finland and is actively engaging in Nordic co-operation and collaboration of solid Earth RIs. The main short term objective of FIN-EPOS is to make Finnish geoscientific data provided by NRIs interoperable with the Thematic Core Services (TCS) in the EPOS IP. Consortium partners commit into applying and following metadata and data format standards provided by EPOS. FIN-EPOS will also provide a national Finnish language web portal where users are identified and their user rights for EPOS resources are defined.
Vitikainen, Kirsi; Street, Andrew; Linna, Miika
2009-02-01
Hospital efficiency has been the subject of numerous health economics studies, but there is little evidence on how the chosen output and casemix measures affect the efficiency results. The aim of this study is to examine the robustness of efficiency results due to these factors. Comparison is made between activities and episode output measures, and two different output grouping systems (Classic and FullDRG). Non-parametric data envelopment analysis is used as an analysis technique. The data consist of all public acute care hospitals in Finland in 2005 (n=40). Efficiency estimates were not found to be highly sensitive to the choice between episode and activity descriptions of output, but more so to the choice of DRG grouping system. Estimates are most sensitive to scale assumptions, with evidence of decreasing returns to scale in larger hospitals. Episode measures are generally to be preferred to activity measures because these better capture the patient pathway, while FullDRGs are preferred to Classic DRGs particularly because of the better description of outpatient output in the former grouping system. Attention should be paid to reducing the extent of scale inefficiency in Finland.
Häkkinen, Unto; Rosenqvist, Gunnar; Iversen, Tor; Rehnberg, Clas; Seppälä, Timo T
2015-12-01
The aim of the present study was to compare the quality (survival), use of resources and their relationship in the treatment of three major conditions (acute myocardial infarction (AMI), stroke and hip fracture), in hospitals in five European countries (Finland, Hungary, Italy, Norway and Sweden). The comparison of quality and use of resources was based on hospital-level random effects models estimated from patient-level data. After examining quality and use of resources separately, we analysed whether a cost-quality trade-off existed between the hospitals. Our results showed notable differences between hospitals and countries in both survival and use of resources. Some evidence would support increasing the horizontal integration: higher degrees of concentration of regional AMI care were associated with lower use of resources. A positive relation between cost and quality in the care of AMI patients existed in Hungary and Finland. In the care of stroke and hip fracture, we found no evidence of a cost-quality trade-off. Thus, the cost-quality association was inconsistent and prevailed for certain treatments or patient groups, but not in all countries. Copyright © 2015 John Wiley & Sons, Ltd.
Civil Engineering Applications of Ground Penetrating Radar in Finland
NASA Astrophysics Data System (ADS)
Pellinen, Terhi; Huuskonen-Snicker, Eeva; Olkkonen, Martta-Kaisa; Eskelinen, Pekka
2014-05-01
Ground penetrating radar (GPR) has been used in Finland since 1980's for civil engineering applications. First applications in this field were road surveys and dam inspections. Common GPR applications in road surveys include the thickness evaluation of the pavement, subgrade soil evaluation and evaluation of the soil moisture and frost susceptibility. Since the 1990's, GPR has been used in combination with other non-destructive testing (NDT) methods in road surveys. Recently, more GPR applications have been adopted, such as evaluating bridges, tunnels, railways and concrete elements. Nowadays, compared with other countries GPR is relatively widely used in Finland for road surveys. Quite many companies, universities and research centers in Finland have their own GPR equipment and are involved in the teaching and research of the GPR method. However, further research and promotion of the GPR techniques are still needed since GPR could be used more routinely. GPR has been used to evaluate the air void content of asphalt pavements for years. Air void content is an important quality measure of pavement condition for both the new and old asphalt pavements. The first Finnish guideline was released in 1999 for the method. Air void content is obtained from the GPR data by measuring the dielectric value as continuous record. To obtain air void content data, few pavement cores must be taken for calibration. Accuracy of the method is however questioned because there are other factors that affect the dielectric value of the asphalt layer, in addition to the air void content. Therefore, a research project is currently carried out at Aalto University in Finland. The overall objective is to investigate if the existing GPR technique used in Finland is accurate enough to be used as QC/QA tool in assessing the compaction of asphalt pavements. The project is funded by the Finnish Transport Agency. Further research interests at Aalto University include developing new microwave asphalt radar for the thickness evaluation of thin asphalt layers. This work benefited from networking activities carried out within the EU funded COST Action TU1208 "Civil Engineering Applications of Ground Penetrating Radar".
Almeida, Álvaro S
2017-06-01
The national health services (NHS) of England, Portugal, Finland and other single-payer universalist systems financed by general taxation, are based on the theoretical principle of an integrated public sector payer-provider. However, in practice one can find different forms of participation of non-public healthcare providers in those NHS, including private for profit providers, but also third sector non-profit organizations (NPO). This paper reviews the role of non-public non-profit healthcare organizations in NHS systems. By crossing a literature review on privatization of national health services with a literature review on the comparative performance of non-profit and for-profit healthcare organizations, this paper assesses the impact of contracting private non-profit healthcare organizations on the efficiency, quality and responsiveness of services, in public universal health care systems. The results of the review were then compared to the existing evidence on the Portuguese hospital devolution to NPO program. The evidence in this paper suggests that NHS health system reforms that transfer some public-sector hospitals to NPO should deliver improvements to the health system with minimal downside risks. The very limited existing evidence on the Portuguese hospital devolution program suggests it improved efficiency and access, without sacrificing quality. Copyright © 2017 Elsevier B.V. All rights reserved.
Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi
2016-01-01
Introduction: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. Methods: A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. Results: There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. Conclusions: The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services. PMID:27761106
Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi
2016-07-08
Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. A comparative, register-based cross-sectional design was used. The data of women (N = 2741) who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.
Parhi, Katariina
2018-01-01
This article examines the case files of patients diagnosed with Transvestitismus [transvestism] in the Psychiatric Clinic of the Helsinki University Central Hospital in the years 1954–68. These individuals did not only want to cross-dress, but also had a strong feeling of being of a different sex from their assigned one. The scientific concept of transsexuality had begun to take form, and this knowledge reached Finland in phases. The case files of the transvestism patients show that they were highly aware of their condition and were very capable of describing it, even if they had no medical name for it. Psychiatrists were willing to engage in dialogue with the patients, and did not treat them as passive objects of study. Although some patients felt that they had been helped, many left the institution as frustrated, angered or desperate as before. They had sought medical help in the hope of having their bodies altered to correspond to their identity, but the Clinic psychiatrists insisted on seeing the problem in psychiatric terms and did not recommend surgical or hormonal treatments in most cases. This attitude would gradually change over the course of the 1970s and 1980s. PMID:29199927
Clinical research in Finland in 2002 and 2007: quantity and type
2013-01-01
Background Regardless of worries over clinical research and various initiatives to overcome problems, few quantitative data on the numbers and type of clinical research exist. This article aims to describe the volume and type of clinical research in 2002 and 2007 in Finland. Methods The research law in Finland requires all medical research to be submitted to regional ethics committees (RECs). Data from all new projects in 2002 and 2007 were collected from REC files and the characteristics of clinical projects (76% of all submissions) were analyzed. Results The number of clinical projects was large, but declining: 794 in 2002 and 762 in 2007. Drug research (mainly trials) represented 29% and 34% of the clinical projects; their total number had not declined, but those without a commercial sponsor had. The number of different principal investigators was large (630 and 581). Most projects were observational, while an experimental design was used in 43% of projects. Multi-center studies were common. In half of the projects, the main funder was health care or was done as unpaid work; 31% had industry funding as the main source. There was a clear difference in the type of research by sponsorship. Industry-funded research was largely drug research, international multi-center studies, with randomized controlled or other experimental design. The findings for the two years were similar, but a university hospital as the main research site became less common between 2002 and 2007. Conclusions Clinical research projects were common, but numbers are declining; research was largely funded by health care, with many physicians involved. Drug trials were a minority, even though most research promotion efforts and regulation concerns them. PMID:23680289
Clinical research in Finland in 2002 and 2007: quantity and type.
Hemminki, Elina; Virtanen, Jorma; Veerus, Piret; Regushevskaya, Elena
2013-05-16
Regardless of worries over clinical research and various initiatives to overcome problems, few quantitative data on the numbers and type of clinical research exist. This article aims to describe the volume and type of clinical research in 2002 and 2007 in Finland. The research law in Finland requires all medical research to be submitted to regional ethics committees (RECs). Data from all new projects in 2002 and 2007 were collected from REC files and the characteristics of clinical projects (76% of all submissions) were analyzed. The number of clinical projects was large, but declining: 794 in 2002 and 762 in 2007. Drug research (mainly trials) represented 29% and 34% of the clinical projects; their total number had not declined, but those without a commercial sponsor had. The number of different principal investigators was large (630 and 581). Most projects were observational, while an experimental design was used in 43% of projects. Multi-center studies were common. In half of the projects, the main funder was health care or was done as unpaid work; 31% had industry funding as the main source. There was a clear difference in the type of research by sponsorship. Industry-funded research was largely drug research, international multi-center studies, with randomized controlled or other experimental design. The findings for the two years were similar, but a university hospital as the main research site became less common between 2002 and 2007. Clinical research projects were common, but numbers are declining; research was largely funded by health care, with many physicians involved. Drug trials were a minority, even though most research promotion efforts and regulation concerns them.
Fostering Organizational Change through Deliberations: The Deliberative Jury in a University Setting
ERIC Educational Resources Information Center
Lindell, Juha
2014-01-01
Universities in Europe face a variety of reform initiatives, and university reform can be seen as a wicked problem that should be resolved through collaborative efforts. In Finland, there has been considerable resistance to proposed reforms, with university personnel complaining that they have not been heard. Students, on the other hand, seem…
Medication adherence: a review of pharmacy education, research, practice and policy in Finland
Bell, J. Simon; Enlund, Hannes; Vainio, Kirsti
2010-01-01
Aims To describe pharmacy education, research, practice and policy related to medication adherence in Finland since the year 2000. Methods The three universities that provide pharmacy education (Åbo Akademi, University of Eastern Finland, and University of Helsinki) completed a structured pro-forma questionnaire regarding education related to medication adherence. A MEDLINE and EMBASE literature search was performed to identify English language peer-reviewed research that reported medication compliance, adherence or persistence. The Ministry of Social Affairs and Health was invited to nominate policies and documents related to medication adherence. A narrative review of medication counselling practices and professional service delivery through Finnish community pharmacies was undertaken. Results Medication adherence was a theme integrated into obligatory and elective courses for bachelors and masters degree students. The literature search identified 33 English language peer-reviewed research articles reporting medication compliance, adherence or persistence published since the year 2000. Policy documents of the Ministry of Social Affairs and Health recognise that poor medication adherence may lead to suboptimal treatment outcomes, and encourage patient participation in treatment decision making. Adherence practice in Finnish pharmacies has been strongly linked to the development of medication counselling services. Conclusions Adherence research and education has focused on understanding and addressing the contextual factors that contribute to medication nonadherence. Adherence practice in community pharmacies has tended to focus on medication counselling and programs specific to particular disease states. Medication adherence is a topic that is integrated into courses for bachelor’s and master’s level pharmacy students in Finland. PMID:25126134
Tyynelä, Petri; Goebeler, Sirkka; Ilveskoski, Erkki; Mikkelsson, Jussi; Perola, Markus; Lehtimäki, Terho; Karhunen, Pekka J
2013-05-01
Mortality from coronary heart disease (CHD) has been constantly higher in eastern late settlement regions compared to western early settlements in Finland, unrelated to classical risk factors. In line with this, eastern birthplace was an age-dependent predictor of severe coronary atherosclerosis and pre-hospital sudden coronary death among male residents of Helsinki. We investigated a possible interaction of apolipoprotein E (APOE) gene with birthplace on the risk of myocardial infarction (MI) and coronary atherosclerosis. APOE genotypes were analyzed in the Helsinki Sudden Death Study series comprising out-of-hospital deaths among males aged 33-70 years (n = 577), who were born in high (east, n = 273) or low (west, n = 304) CHD mortality area. Eastern-born men ≤ 55 years carried 30% more often (P = 0.017) and older men 40% less often (P = 0.022) the APOE ϵ4 allele compared to western-born men (P = 0.003 for birthplace-by-age interaction). In multivariate analysis, the ϵ4 allele associated with the risk of out-of-hospital MI (odds ratio 2.58; 95% CI 1.20-5.55; P = 0.016) only in eastern-born men and with advanced atherosclerosis in both regions of origin, respectively. Birthplace-bound risk of CHD was age-dependently modified by APOE ϵ4 allele, suggesting genetic differences in CHD susceptibility between early and late settlement regions in Finland and providing one explanation for the eastern high mortality.
Saarinen, Sini; Castrén, Maaret; Virkkunen, Ilkka; Kämäräinen, Antti
2015-08-22
Aim of this study was to compare post resuscitation care of out-of-hospital cardiac arrest (OHCA) patients in Nordic (Denmark, Finland, Iceland, Norway, Sweden) intensive care units (ICUs). An online questionnaire was sent to Nordic ICUs in 2012 and was complemented by an additional one in 2014. The first questionnaire was sent to 188 and the second one to 184 ICUs. Response rates were 51 % and 46 %. In 2012, 37 % of the ICUs treated all patients resuscitated from OHCA with targeted temperature management (TTM) at 33 °C. All OHCA patients admitted to the ICU were treated with TTM at 33 °C more often in Norway (69 %) compared to Finland (20 %) and Sweden (25 %), p 0.02 and 0.014. In 2014, 63 % of the ICUs still use TTM at 33 °C, but 33 % use TTM at 36 °C. Early coronary angiography (CAG) and possible percutaneous coronary intervention (PCI) was routinely provided for all survivors of OHCA in 39 % of the hospitals in 2012 and in 28 % of the hospitals in 2014. Routine CAG for all actively treated victims of OHCA was performed more frequently in Sweden (51 %) and in Norway (54 %) compared to Finland (13 %), p 0.014 and 0.042. Since 2012, TTM at 36 °C has been implemented in some ICUs, but TTM at 33 °C is used in majority of the ICUs. TTM at 33 or 36 °C and primary CAG are not routinely provided for all OHCA survivors and the criteria for these and ICU admission are variable. Best practices as a uniform approach to the optimal care of the resuscitated patient should be sought in the Nordic Countries.
Uniformity and Diversity in an Evolving University Federation
ERIC Educational Resources Information Center
Pratt, John
2013-01-01
In 2008, three universities of applied sciences in the Helsinki metropolitan area of Finland signed a partnership agreement to form the Federation of Universities of Applied Sciences (FUAS). In 2011 FUAS invited a small team of international experts to undertake a curriculum review of a sample of its programmes. This article reports some of the…
The Situation of Women Who Teach in Universities: Contrasts and Common Ground.
ERIC Educational Resources Information Center
Sutherland, Margaret B.
1985-01-01
Interviews were conducted with 244 women teaching in universities in Finland, France, East Germany, West Germany, and Great Britain to discover causes for the minority position of women who teach in universities. Women's position appeared to depend not on characteristics of individual educational systems but on common factors--social attitudes,…
ERIC Educational Resources Information Center
Rontu, Heidi; Tuomi, Ulla-Kristiina
2014-01-01
The role of research in university institutions whose primary task is to provide teaching remains ambiguous and controversial. In principle, all university teaching is based on pertinent research. However, for some university units, such as language centres, the basic tasks, and consequently their funding, are very often defined in a manner which…
Checklist of tapeworms (Platyhelminthes, Cestoda) of vertebrates in Finland
Haukisalmi, Voitto
2015-01-01
Abstract A checklist of tapeworms (Cestoda) of vertebrates (fishes, birds and mammals) in Finland is presented, based on published observations, specimens deposited in the collections of the Finnish Museum of Natural History (Helsinki) and the Zoological Museum of the University of Turku, and additional specimens identified by the present author. The checklist includes 170 tapeworm species from 151 host species, comprising 447 parasite species/host species combinations. Thirty of the tapeworm species and 96 of the parasite/host species combinations have not been previously reported from Finland. The total number of tapeworm species in Finland (170 spp.) is significantly lower than the corresponding figure for the Iberian Peninsula (257 spp.), Slovakia (225 spp.) and Poland (279 spp.). The difference between Finland and the other three regions is particularly pronounced for anseriform, podicipediform, charadriiform and passeriform birds, reflecting inadequate and/or biased sampling of these birds in Finland. It is predicted that there are actually ca. 270 species of tapeworms in Finland, assuming that true number of bird tapeworms in Finland corresponds to that in other European countries with more comprehensive knowledge of the local tapeworm fauna. The other main pattern emerging from the present data is the seemingly unexplained absence in (northern) Fennoscandia of several mammalian tapeworms that otherwise have extensive distributions in the Holarctic region or in Eurasia, including the northern regions. Previously unknown type specimens, that is, the holotype of Bothrimonus nylandicus Schneider, 1902 (a junior synonym of Diplocotyle olrikii Krabbe, 1874) (MZH 127096) and the syntypes of Caryophyllaeides fennica (Schneider, 1902) (MZH 127097) were located in the collections of the Finnish Museum of Natural History. PMID:26668540
Forensic age assessment of asylum seekers in Finland.
Metsäniitty, Mari; Varkkola, Olli; Waltimo-Sirén, Janna; Ranta, Helena
2017-01-01
In Finland, forensic age assessment is strictly regulated by legislation. According to the Aliens Act (301/2004) and the amendment of the Act (549/2010), the police authorities, the frontier guard authorities, and the immigration authorities have the right to refer asylum seekers to the University of Helsinki, Department of Forensic Medicine, for age assessment. These assessments are especially performed to solve if the person is of major age, the cutoff being 18 completed years. The forensic age assessment is largely based on dental development, since the special permit of the Radiation and Nuclear Safety Authority (STUK) to the Department of Forensic Medicine of the University of Helsinki, allowing the use of ionizing radiation for non-medical purposes, includes dental and hand X-rays. Forensic age assessment is always performed by two forensic odontologists. In 2015, the total number of forensic age assessment examinations was 149, and the countries of origin of the asylum seekers were most commonly Iraq, Afghanistan, and Somalia. The current legislation on forensic age assessment has been well received and approved. Radiological and other examinations can be performed in different parts of Finland, but the forensic odontologist at the University of Helsinki is always involved in the process and ensures joint quality standards for the forensic age assessment.
Motherhood, milk, and money: infant mortality in pre-industrial Finland.
Moring, B
1998-08-01
This article presents an analysis of the levels, trends and determinants of infant mortality in various regions of Finland between the late seventeenth and early twentieth centuries. Nursing habits were of critical importance as were diet and hygiene. It is suggested that there were differences in the frequency of breastfeeding with the landless being more and the farmers being less likely to breastfeed their children. In areas where cows milk was readily available as a substitute for breast milk other influences on infant mortality were the contamination of drinking water and the water in which feeding utensils were washed. At the end of the eighteenth century, in the south-west of Finland, the introduction of the potato created a suitable food for women and children and lowered the mortality rate of infants aged 3-6 months. By contrast, in the regions where the first solid food given to infants was chewed by the mothers, infant mortality remained high. In the part of Finland adjacent to St Petersburg infant mortality actually increased as local mothers were engaged as wet-nurses by the city's foundling hospital.
ERIC Educational Resources Information Center
Virolainen, M.; Persson Thunqvist, D.
2017-01-01
The Nordic countries are often referred to as a group even though their education systems and training models are very different. The aim of this study is to advance understanding of those differences and compare the developments and organisation of initial vocational education and training (IVET) in Finland and Sweden since the 1990s as examples…
Kaunonen, Marja; Salin, Sirpa; Aalto, Pirjo
2015-07-01
To explore factors associated with nursing intensity, work environment intensity and nursing resources that may affect nurse job satisfaction and risk of dissatisfaction in outpatient care at one university hospital in Finland. Much research has been done to study how nursing intensity, work environment intensity and nursing resources are associated with nurse job satisfaction, but not in the context of outpatient care. This research used a cross-sectional design. The data were collected from the hospital information systems of outpatient units (n = 12) in autumn 2010. Management style showed a statistically significant association with job satisfaction. The risk of dissatisfaction increased when nursing staff had no influence over the design of their jobs, when conflicts and contradictions were not addressed in the workplace and when feedback was not processed. Nursing intensity and work environment intensity had no effect on nurse job satisfaction. Nursing resources and patient satisfaction, on the other hand, were important to nurses' job satisfaction. The results indicate that nursing management should involve nursing staff in the development of their jobs and the care delivery model. © 2013 John Wiley & Sons Ltd.
Waaramaa, Teija
2015-10-01
The present study focused on the identification of emotions in cross-cultural conditions on different continents and among subjects with divergent language backgrounds. The aim was to investigate whether the perception of the basic emotions from nonsense vocal samples was universal, dependent on voice quality, musicality, and/or gender. Listening tests for 350 participants were conducted on location in a variety of cultures: China, Egypt, Estonia, Finland, Russia, Sweden, and the USA. The results suggested that the voice quality parameters played a role in the identification of emotions without the linguistic content. Cultural background may affect the interpretation of the emotions more than the presumed universality. Musical interest tended to facilitate emotion identification. No gender differences were found.
A Blind Segmentation Approach to Acoustic Event Detection Based on I Vector
2013-08-25
Hui Lee1 1 School of ECE, Georgia Institute of Technology , Atlanta, GA. 30332-0250, USA 2 School of Computing, University of Eastern Finland, Finland...recordings obtained at low signal-to-noise-ratio (SNR) enviroments with highly-mixed events in a single acous- tic segment. Research in AED [1] is...2532–2535. [28] C.-C. Chang and C.-J. Lin, “LIBSVM: A library for support vector machines,” ACM Transactions on Intelligent Systems and Technology
ERIC Educational Resources Information Center
Vartiainen, Perttu
2017-01-01
This paper analyzes the campus-based tensions which are emerging in the multi-campus university during a critical period of structural development. A multi-campus system easily generates intrinsic tensions between "localist" campus-based interests and system-level interests, in which the interests of external stakeholders often play a…
Performance Dialogs Implemented in a Finnish University
ERIC Educational Resources Information Center
Takala, Marjatta; Keskinen, Soili
2014-01-01
This article analyses performance dialogs (PDs) in the university context in Finland. These are held annually between employers and employees. The study was carried out to assess the efficacy of this technique. Research methods included an electronic questionnaire over two different years delivered to the whole staff of the Department of Teacher…
ERIC Educational Resources Information Center
Jääskelä, Päivikki; Häkkinen, Päivi; Rasku-Puttonen, Helena
2017-01-01
Higher education calls for reform, but deeper knowledge about the prerequisites for teaching development and pedagogical change is missing. In this study, 51 university teachers' experiences of supportive or constraining factors in teaching development were investigated in the context of Finland's multidisciplinary network. The findings reveal…
Nurmi-Lüthje, I; Tiihonen, R; Paattiniemi, E-L; Naboulsi, H; Pigg, S; Sarkkinen, H; Kaukonen, J-P; Toivanen, A; Salmio, K; Kataja, M; Lüthje, P
2018-04-01
Hypovitaminosis D is a problem among hip fracture patients. In a 1-year cohort study comprising 245 hip fracture patients (mean age of females 81 years and males 78 years) from south-eastern Finland, the mean 25-hydroxyvitamin D [S-25(OH)D] concentration was 73(SD 31) nmol/L. Vitamin D supplementation has been integrated into our current practice. The objectives of this study are to verify vitamin D levels among hip fracture patients and to compare the results with a similar study conducted in the same two hospitals covering the same geographic area 12 years ago. A prospective cohort comprising 245 Caucasian hip fracture patients was enrolled in the study in two acute hospitals in south-eastern Finland (61° N) over a 12-month period in 2015-2016. The S-25(OH)D was measured using 25-hydroxyvitamin D electrochemiluminescence binding assay. The S-25(OH)D concentrations were compared with the corresponding concentrations of a similar cohort analyzed in the same two hospitals 12 years ago. Of the 245 patients, 70% were women with a mean age of 81 (SD 10) years, while the men had a mean age of 78 (SD 12) years (p < 0.01). The total mean S-25(OH)D concentration was 73 (SD 31.3) nmol/L. Regional differences were found: 15% in hospital A and 36% in hospital B had a S-25(OH(D level < 50 nmol/L, and the mean S-25(OH)D level was 79.2 (SD 31.7) nmol/L in hospital A and 62.4 (SD 27.5) nmol/L in hospital B (p < 0.001). No differences were found in S-25(OH)D concentrations by either the place of residence or the time of year. Overall, the percentage of patients with a sufficient vitamin D level (> 50 nmol/L) was remarkably higher in 2015-2016 (77%) than in 2003-2004 (22%). Our results indicate that vitamin D supplementation has been widely integrated into our current practice. However, regional differences were found in the S-25(OH)D concentrations for which the reasons are unknown.
Mäkelä, Pia; Osterberg, Esa
2009-04-01
To review the consequences of the changes in Finnish alcohol policy in 2004, when quotas for travellers' tax-free imports of alcoholic beverages from other European Union (EU) countries were abolished, Estonia joined the EU and excise duties on alcoholic beverages were reduced in Finland by one-third, on average. A review of published research and routinely available data. Finland. Prices of alcoholic beverages, recorded and unrecorded alcohol consumption, data on criminality and other police statistics, alcohol-related deaths and hospitalizations, service use. Alcohol consumption increased 10% in 2004, clearly more than in the early 2000s. With few exceptions, alcohol-related harms increased. Alcohol-induced liver disease deaths increased the most, by 46% in 2004-06 compared to 2001-03, which indicates a strong effect on pre-2004 heavy drinkers. Consumption and harms increased most among middle-aged and older segments of the population, and harms in the worst-off parts of the population in particular. Alcohol taxation and alcohol prices affect consumption and related harms, and heavy drinkers are responsive to price. In Finland in 2004, the worst-off parts of the population paid the highest price in terms of health for cuts in alcohol prices. The removal of travellers' import quotas, which was an inherent part of creating the single European market, had serious public health consequences in Finland.
Morbidities and hospital resource use during the first 3 years of life among very preterm infants.
Korvenranta, Emmi; Lehtonen, Liisa; Peltola, Mikko; Häkkinen, Unto; Andersson, Sture; Gissler, Mika; Hallman, Mikko; Leipälä, Jaana; Rautava, Liisi; Tammela, Outi; Linna, Miika
2009-07-01
The objective of this study was to determine how the use of hospital resources during the first 3 years of life was associated with prematurity-related morbidity in very preterm infants (gestational age of <32 weeks or birth weight of <1501 g). The study was a retrospective, national register study including all very preterm infants born alive in Finland between 2000 and 2003 (N = 2148). Infants who died before the age of 3 years (n = 264) or who had missing register data (n = 88) were excluded from the study. The relationship between 6 morbidity groups and the need for hospital care during the first 3 years of life was studied by using a negative binomial model. A total of 66.2% of the infants did not have any of the morbidities studied. Infants who were subsequently diagnosed as having cerebral palsy (6.1% of the study group), later obstructive airway disease (20.0%), hearing loss (2.5%), visual disturbances or blindness (3.8%), or other ophthalmologic problems (13.4%) had initial hospital stays that were a mean of 7, 8, 12, 17, and 3 days longer, respectively, than those for infants without these conditions. All morbidity groups were associated with increased numbers of hospital visits during either the second or third year of life, compared with infants without these morbidities. The need for hospitalizations and outpatient hospital care decreased with postnatal age for infants with later morbidities and for infants without later morbidities. Most very preterm infants born in Finland survived without severe morbidities and required relatively little hospital care after the initial discharge. However, those with later morbidities had a long initial length of stay and more readmissions and outpatient visits during the 3-year follow-up period.
Poisonings in the Nordic countries in 2007: a 5-year epidemiological follow-up.
Andrew, Erik; Tellerup, Markus; Termälä, Anna-Mariia; Jacobsen, Peter; Gudjonsdottir, Gudborg A
2012-03-01
To map mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway and Sweden in 2007 and undertake a comparison with a corresponding study in 2002. Morbidity was as for 2002 defined as acute poisoning (ICD-10 codes, main and subsidiary diagnoses) treated in hospitals. The figures were extracted from the National Patient/Hospital Registers. Deaths recorded as acute poisoning (using corresponding ICD-10 codes) were collected from the National Cause of Death Registers. Annual mortality of acute poisonings per 100,000 inhabitants (rate) for 2007 was 22.4 in Finland, an important increase from 16.7 per 100,000 in 2002. The increase was mainly due to a change in coding of alcohol, but also represented a slight increase in fatal alcohol intoxications per se. The poisoning death rate in the other Nordic countries varied between 8-13 and was at the same level as for 2002. The morbidity rates for 2007 between 158-285 per 100,000 inhabitants represented a slight increase compared to 2002 figures. The increase in poisoning death rate for alcohol, and thus total rate in Finland in 2007 compared to 2002, has further increased the gap to the other Nordic countries. Poisoning morbidity rates in the Nordic countries are of the same level, but the variability shown indicates that more harmonization and collaboration is needed to increase the data quality.
Suicide in children and young adolescents: a 25-year database on suicides from Northern Finland.
Lahti, Anniina; Harju, Aleksi; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko
2014-11-01
Despite the large amount of research on adolescent suicidality, there are few detailed studies illustrating the characteristics of child and adolescent completed suicide. Our study presents the characteristics of child and adolescent suicides occurring over a period of 25 years within a large geographical area in Northern Finland, with a special focus on gender differences. The study sample included all 58 suicides among children and adolescents (<18 years) occurring in the province of Oulu in Finland between 1988 and 2012. The data is based on documents pertaining to establish the cause of death from forensic autopsy investigations. A register linkage to the data from the Finnish Hospital Discharge Register (FHDR) was also made. 79% of the suicide victims were male. Violent suicide methods predominated in both genders (males 98%, females 83%). While symptoms of mental illness were common, only a minority (15% of males and 17% of females) had a previous history of psychiatric hospitalization. 17% of females but none of the males had been hospitalized previously due to self-poisoning. A greater proportion of females than males had a history of self-cutting (33% vs. 7%) and previous suicide attempts (25% vs. 4%). 48% of males and 58% of females were under the influence of alcohol at the time of their suicide, and alcohol intoxication was related to suicides during the night. One fifth of the adolescents screened positive for substances other than alcohol. The results of this study indicate that there are similarities but also some differences in the characteristics of male and female suicides in adolescents. Copyright © 2014 Elsevier Ltd. All rights reserved.
Toll-like receptors 3, 7, and 9 in Juvenile nasopharyngeal angiofibroma.
Renkonen, Suvi; Cardell, Lars-Olaf; Mattila, Petri; Lundberg, Marie; Haglund, Caj; Hagström, Jaana; Mäkitie, Antti A
2015-05-01
Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign tumor affecting adolescent males. The etiology of JNA as well as the causes determining the variable growth patterns of individual tumors remains unknown. Toll-like receptors (TLRs) are part of the innate immune response to microbes; by recognition of distinct features, they link to induction of pro-inflammatory signaling pathways. We immunostained TLR 3, 7, and 9 in 27 JNA specimens of patients treated at the Helsinki University Central Hospital, Helsinki, Finland, during the years 1970-2009. TLR 3, 7, and 9 expressions were found in stromal and endothelial cells of JNA, and their expression levels varied from negative to very strong positive. TLR 3 expression was found to have a significant correlation with the clinical stage of JNA. The present results propose a putative role of TLRs in the growth process of JNA. © 2015 APMIS. Published by John Wiley & Sons Ltd.
Tenure Track Career System as a Strategic Instrument for Academic Leaders
ERIC Educational Resources Information Center
Pietilä, Maria
2015-01-01
This study examines the purposes for which leaders in universities use academic career systems. It focuses on the tenure track system which is new to Finland. Tenure track represents a newly established internal career path in a situation in which Finnish universities' organizational autonomy increased via new legislation from 2010. Drawing…
Individual Differences in Faculty Research Time Allocations across 13 Countries
ERIC Educational Resources Information Center
Bentley, Peter James; Kyvik, Svein
2013-01-01
In research universities, research time is often too scarce to satiate the wishes of all faculty and must be allocated according to guidelines and principles. We examine self-reported research hours for full-time faculty at research universities in 13 countries (Argentina, Australia, Brazil, Canada, China, Finland, Germany, Italy, Malaysia,…
Assessing Technology Based Instruction in Biology and Geography
ERIC Educational Resources Information Center
Jeronen, Eila
2002-01-01
The article is a report on a development project arising from collaboration between the Department of Education in the University of Oulu, the university training school in Oulu, and some secondary schools in Northern Finland. The key aims of the project have been to promote the use of Information and Communication Technology (ICT) in teacher…
The Status of Continuing Higher Education at German Universities: A Metaphor Analysis
ERIC Educational Resources Information Center
Franz, Melanie; Feld, Timm C.
2015-01-01
Many European countries are currently witnessing an increased development and expansion of continuing higher education at universities. In Germany, this development has until now been rather modest in comparison to countries such as England, France, Finland and the United States. The status of continuing education still seems just as unclear as…
The Social and Cultural Realization of Diversity: An Interview with Donal Carbaugh
ERIC Educational Resources Information Center
Berry, Michael
2009-01-01
This article presents an interview with Donal Carbaugh, a Professor of Communication at the University of Massachusetts (Amherst) and Chair of the International Studies Council (2004 to present). In 2007-2008, Carbaugh was Distinguished Fulbright Professor and Bicentennial Chair of American Studies at the University of Helsinki, Finland. He has…
Individualized Sex Equality in Transforming Finnish Academia
ERIC Educational Resources Information Center
Lätti, Johanna
2017-01-01
This article examines the equality agenda in the context of Finnish university reform in the 21st century. In Finland, the academic regime went through an organizational transformation after the Universities Act in 2009. However, little attention has been paid to the questions of sex or equality. Since the policy influences on equality in…
Heikkinen, Rauno; Kivastik, Jana; Kingisepp, Peet-Henn; Hirvonen, Leo; Näyhä, Simo
2006-01-01
To provide information on smoking differences between university faculties. Data from smoking surveys performed on 1,441 staff members and 2,308 students at the University of Tartu, Estonia, soon after the fall of communism, were analysed by faculties, using similar data from the University of Oulu, Finland (1,830 staff members, 5,947 students) for reference. Wide variations in smoking were found between faculties in Tartu, the prevalence being high among male students of theology (54%) and low among staff and students in the faculties of exercise & sports sciences (< 5%) and mathematics (< 15%). Less variation was seen in Oulu. The medical faculty showed low smoking rates in Oulu but not in Tartu. High percentages of smokers were typical of Tartu faculties representing disciplines closely connected with the country's transition (e.g. theology), and low percentages in faculties emphasising physical and mental performance (e.g. sports). The relatively high percentage of smokers in the Tartu medical faculty compared with that in Oulu can be interpreted as delayed diffusion of medical information beyond the former Iron Curtain.
A cluster of measles linked to an imported case, Finland, 2017.
Seppälä, Elina; Zöldi, Viktor; Vuorinen, Sakari; Murtopuro, Satu; Elonsalo, Ulpu; van Beek, Janko; Haveri, Anu; Kontio, Mia; Savolainen-Kopra, Carita; Puumalainen, Taneli; Sane, Jussi
2017-08-17
One imported and five secondary cases of measles were detected in Finland between June and August 2017. The measles sequences available for five laboratory-confirmed cases were identical and belonged to serotype D8. The large number of potentially exposed Finnish and foreign individuals called for close cooperation of national and international public health authorities and other stakeholders. Raising awareness among healthcare providers and ensuring universally high vaccination coverage is crucial to prevent future clusters and outbreaks. This article is copyright of The Authors, 2017.
Integrating Internships with Professional Study in Pharmacy Education in Finland
Löfhjelm, Ulla; Passi, Sanna; Airaksinen, Marja
2014-01-01
Pharmacy internships are an important part of undergraduate pharmacy education worldwide. Internships in Finland are integrated into professional study during the second and third year, which has several pedagogic advantages, such as better understanding of the association between academic studies and pharmaceutical work-life during the studies, and enhanced self-reflection through the feedback from preceptors and peers during the internships. The objective of this paper is to describe the Finnish integrated internship using the pharmacy curriculum at the University of Helsinki as an example. PMID:26056411
Vottonen, Pasi; Kankaanpää, Eila
2016-11-01
Wet age-related macular degeneration (AMD) is the leading cause of blindness worldwide, which can be treated with regular intraocular anti-vascular endothelial growth factor (VEGF) injections. In this study, we wanted to evaluate whether less frequent injections of aflibercept would make it more cost-effective when compared with ranibizumab and low priced bevacizumab. We used a two-eye model to simulate the progression and the treatment of the disease. We selected an 8-year period, 3-month cycles and five health states based on the visual acuity of the better-seeing eye. The transition probabilities and utilities attached to the health states were gathered from previous studies. We conducted the analysis from the hospital perspective and we used the health care costs obtained from Kuopio University Hospital. The costs of intraocular adverse events were taken into account. The incremental cost-effectiveness ratio (ICER) with 3% discount rate (€/QALY) for aflibercept compared with monthly bevacizumab was 1 801 228 and when compared with ranibizumab given as needed, the ICER was minus 3 716 943. The sensitivity analysis showed that a change of 20% of the estimated model parameters or a longer follow-up period did not influence these conclusions. A two-eye Markov transition model was developed to analyse the cost-effectiveness of wet AMD treatment, as quality of life years (QALYs) are largely based on the visual acuity of the better-seeing eye. Monthly injected bevacizumab was the most cost-effective treatment and monthly ranibizumab the least effective. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Ringdal, K G; Lossius, H M
2007-01-01
The organisation of trauma care in Scandinavia has several similarities, including trauma registries, but so far there are limited amount of research on efficiency and outcome. Data and results from trauma outcome studies like the US MTOS are not fully applicable to the Scandinavian trauma population. To reveal the feasibility of using data from existing trauma registries of major hospitals in Scandinavia, for a minimal common dataset, in a joint, prospective Scandinavian MTOS. We collected data points, data point definitions, and inclusion/exclusion criteria, from the major trauma registries of the Swedish trauma registry standard, three university hospitals in Denmark, one university hospital in Finland, and the Norwegian National Trauma Registry. The collected material was compared to reveal common data points, inclusion criteria, and the compatibility of data point definitions. The median number of data points was 147 (range 71-257; interquartile range = 90-205). Most registries lacked precise data definition catalogues. Only 16 data points could be considered as common, of which just a few were core trauma data. Four data points had the same data category options but were not considered having the same data point definitions. The inclusion criteria were not uniform. Trauma registries in Scandinavia have few common core data and data point definitions. There were data points for calculating the Trauma and Injury Severity Score (TRISS) but the inclusion criteria varied too much to ensure a valid comparison. A consensus process for a joint trauma core data set will be initiated by the Scandinavian Networking Group for Trauma and Emergency Management (SCANTEM) to increase research on trauma efficiency and outcome.
Use of illicit stimulant drugs in Finland: a wastewater study in ten major cities.
Kankaanpää, Aino; Ariniemi, Kari; Heinonen, Mari; Kuoppasalmi, Kimmo; Gunnar, Teemu
2014-07-15
Estimations of drug use at the national level are generally based on various sources of information, such as drug seizures, socio-scientific studies, toxicological data and hospital records. Nevertheless, all of these approaches have limitations that cannot be overcome, even if conclusions are drawn from combined data retrieved from different sources. Drug epidemiology through wastewater analysis has the potential to provide unique perspectives, internationally comparable data, and up-to-date information on the use of both traditional illicit drugs and new psychoactive substances (NPSs). In Finland, no large-scale studies on regional illicit drug consumption, based on a wastewater approach, have been reported. In this study, 24-h influent composite samples were collected during two 1-week study periods from ten different wastewater treatment plants in May and November-December 2012. The cities included in the study represent the geographical areas throughout Finland and cover 40% of the Finnish population. The samples were analyzed with an in-house validated, ultra high-performance liquid-chromatography mass spectrometric (UHPLC-MS/MS) method for various common illicit drugs and some NPS type stimulant drugs. The results were also compared with available statistics, information on drug seizures and laboratory-confirmed toxicological data, as well as other studies available based on wastewater analysis. The data show that illicit stimulant drug use is more common in the larger cities of Southern Finland. Amphetamine was the most commonly used drug in all 10 cities during both collection periods (excluding the collection period in May in Lappeenranta). Cocaine consumption remains very low in Finland in comparison to other European countries; it was concentrated in the biggest cities in Southern Finland. This study shows interesting temporal and spatial differences in drug use in Finland, as well as the possibilities of using wastewater analytics to reveal local hotspots of NPS consumption. Copyright © 2013 Elsevier B.V. All rights reserved.
Laukkanen, Matti; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko
2008-01-01
This study investigated whether adolescent's family type was associated with regular smoking or the use of illicit substances (cannabis or hard drugs) among underage adolescent psychiatric in-patients. The sample consisted of 471 adolescents aged 12-17 years admitted to psychiatric hospital between April 2001 and March 2006 at Oulu University Hospital, Finland. The information on family factors and substance use was based on the Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime interview and the European modification of the Addiction Severity Index questionnaire. Compared to adolescent boys from two-parent families, those from child welfare placement were more likely to regularly use both cannabis (odds ratio [OR]=4.4; 95%confidence interval [CI]=1.4-13.7; P=.012) and hard drugs (OR=8.4; 95% CI=1.7-42.1; P=.01).Among girls, no association was found between family type and the use of illicit substances. Two-parent or foster family units may protect adolescents from involvement with illicit substances. In clinical adolescent psychiatric practice more attention should be paid to family interventions and parental support.
Välimäki, Maritta; Korkeila, Jyrki; Kauppi, Kaisa; Kaakinen, Johanna K; Holm, Suvi; Vahlo, Jukka; Tenovuo, Olli; Hämäläinen, Heikki; Sarajuuri, Jaana; Rantanen, Pekka; Orenius, Tage; Koponen, Aki
2016-02-09
Traumatic brain injury (TBI) is a critical public health problem. The recovery process for people with TBI is typically slow and dependent on complex and intensive assisted rehabilitation programs. To evaluate the effects and feasibility of digital games for cognitive functioning and general well-being among people with traumatic brain injury. This is a single-site feasibility study conducted in Finland, which uses a pragmatic, randomized controlled trial with three arms, and will recruit patients from the Turku University Hospital, Division of Clinical Neurosciences in Finland. Participants must meet the following inclusion criteria: (1) a Finnish speaking adult, aged 18-65 years; (2) diagnosed with a traumatic brain injury (diagnostic criteria ICD-10, S06.X, T90.5) in the University Hospital; (3) access to a TV, a computer, and the Internet at home; (4) not an active digital gamer (5 hours or less a week); (5) willing to participate in the study. Participants must have been discharged from the neurologic treatment period for traumatic brain injury for over 12 months before the commencement of the trial, and they may not have actively participated in cognitive rehabilitation during the 3 months prior to the trial. Written informed consent will be mandatory for acceptance into the trial. Exclusion criteria are as follows: (1) sensory, cognitive, or physical impairment (eg, severe cognitive impairment); (2) a deficiency restricting the use of computers or computer game control system unaided (eg, impairment in vision, severe astigmatism, hemiplegia, disorder in visuospatial perception, dysfunction of the central vestibular system); (3) apathy identified in previous neuropsychological evaluations; (4) diagnosed severe mental disorders (eg, schizophrenia or severe depressive disorders to be identified in medical records as the secondary diagnosis). The preparatory phase for the study is fulfilled. Recruitment started in June 2015 and finished November 2015. Results will be reported in 2016. The specific outcomes such as primary outcome measures were selected because they are widely used psychological tests and thought to be sensitive to changes in the cognitive functions related to TBI. Clinicaltrials.gov NCT02425527; https://clinicaltrials.gov/ct2/show/NCT02425527 (Archived by WebCite at http://www.webcitation.org/6esKI1uDH).
Korkeila, Jyrki; Kauppi, Kaisa; Kaakinen, Johanna K; Holm, Suvi; Vahlo, Jukka; Tenovuo, Olli; Hämäläinen, Heikki; Sarajuuri, Jaana; Rantanen, Pekka; Orenius, Tage; Koponen, Aki
2016-01-01
Background Traumatic brain injury (TBI) is a critical public health problem. The recovery process for people with TBI is typically slow and dependent on complex and intensive assisted rehabilitation programs. Objective To evaluate the effects and feasibility of digital games for cognitive functioning and general well-being among people with traumatic brain injury. Methods This is a single-site feasibility study conducted in Finland, which uses a pragmatic, randomized controlled trial with three arms, and will recruit patients from the Turku University Hospital, Division of Clinical Neurosciences in Finland. Participants must meet the following inclusion criteria: (1) a Finnish speaking adult, aged 18-65 years; (2) diagnosed with a traumatic brain injury (diagnostic criteria ICD-10, S06.X, T90.5) in the University Hospital; (3) access to a TV, a computer, and the Internet at home; (4) not an active digital gamer (5 hours or less a week); (5) willing to participate in the study. Participants must have been discharged from the neurologic treatment period for traumatic brain injury for over 12 months before the commencement of the trial, and they may not have actively participated in cognitive rehabilitation during the 3 months prior to the trial. Written informed consent will be mandatory for acceptance into the trial. Exclusion criteria are as follows: (1) sensory, cognitive, or physical impairment (eg, severe cognitive impairment); (2) a deficiency restricting the use of computers or computer game control system unaided (eg, impairment in vision, severe astigmatism, hemiplegia, disorder in visuospatial perception, dysfunction of the central vestibular system); (3) apathy identified in previous neuropsychological evaluations; (4) diagnosed severe mental disorders (eg, schizophrenia or severe depressive disorders to be identified in medical records as the secondary diagnosis). Results The preparatory phase for the study is fulfilled. Recruitment started in June 2015 and finished November 2015. Results will be reported in 2016. Conclusions The specific outcomes such as primary outcome measures were selected because they are widely used psychological tests and thought to be sensitive to changes in the cognitive functions related to TBI. Trial Registration Clinicaltrials.gov NCT02425527; https://clinicaltrials.gov/ct2/show/NCT02425527 (Archived by WebCite at http://www.webcitation.org/6esKI1uDH) PMID:26860741
Kuusio, Hannamaria; Lämsä, Riikka; Aalto, Anna-Mari; Manderbacka, Kristiina; Keskimäki, Ilmo; Elovainio, Marko
2014-08-07
In many developed countries, including Finland, health care authorities customarily consider the international mobility of physicians as a means for addressing the shortage of general practitioners (GPs). This study i) examined, based on register information, the numbers of foreign-born physicians migrating to Finland and their employment sector, ii) examined, based on qualitative interviews, the foreign-born GPs' experiences of accessing employment and work in primary care in Finland, and iii) compared experiences based on a survey of the psychosocial work environment among foreign-born physicians working in different health sectors (primary care, hospitals and private sectors). Three different data sets were used: registers, theme interviews among foreign-born GPs (n = 12), and a survey for all (n = 1,292; response rate 42%) foreign-born physicians living in Finland. Methods used in the analyses were qualitative content analysis, analysis of covariance, and logistic regression analysis. The number of foreign-born physicians has increased dramatically in Finland since the year 2000. In 2000, a total of 980 foreign-born physicians held a Finnish licence and lived in Finland, accounting for less than 4% of the total number of practising physicians. In 2009, their proportion of all physicians was 8%, and a total of 1,750 foreign-born practising physicians held a Finnish licence and lived in Finland. Non-EU/EEA physicians experienced the difficult licensing process as the main obstacle to accessing work as a physician. Most licensed foreign-born physicians worked in specialist care. Half of the foreign-born GPs could be classified as having an 'active' job profile (high job demands and high levels of job control combined) according to Karasek's demand-control model. In qualitative interviews, work in the Finnish primary health centres was described as multifaceted and challenging, but also stressful. Primary care may not be able in the long run to attract a sufficient number of foreign-born GPs to alleviate Finland's GP shortage, although speeding up the licensing process may bring in more foreign-born physicians to work, at least temporarily, in primary care. For physicians to be retained as active GPs there needs to be improvement in the psychosocial work environment within primary care.
ERIC Educational Resources Information Center
Haapakorpi, Arja; Geirsdóttir, Guðrún; Jóhannsdóttir, Gyða
2013-01-01
With quality assurance related to the Bologna goals, universities are required to fulfil internationally accepted standardized criteria of quality. This tends to reinforce control in assessment. However, control-oriented evaluations seem to lack meaning for academic staff. The article explored the possibilities and space for improvement-oriented…
ERIC Educational Resources Information Center
Tuomainen, Satu
2014-01-01
In recent years Finnish university language centres have increasingly developed procedures for assessing and recognising the skills in English for Specific Purposes (ESP) that students acquire in various non-formal and informal learning environments. This article describes the procedures developed by the University of Eastern Finland Language…
A Framework for Measuring Student and Staff Satisfaction with University Campus Facilities
ERIC Educational Resources Information Center
Kärnä, Sami; Julin, Päivi
2015-01-01
Purpose: The purpose of the study is to evaluate and discuss the extent of the satisfaction as perceived by the students and staff towards university facilities and services in two campuses in Finland. The aim is to analyse which facility-related factors have the greatest impacts on students' and staff's overall satisfaction.…
ERIC Educational Resources Information Center
Chiang, Kuang-Hsu
2011-01-01
This paper examines the educational implications of research collaboration between university and industry for the research training of doctoral students. It is concerned with the issues of how research training is constructed in such collaborations and what might be the effects of collaboration on doctoral students' learning. The study adopts a…
Measuring Distributive Justice Preferences of Finnish University Students via the State Budget
ERIC Educational Resources Information Center
Venetoklis, Takis
2007-01-01
We measure the distributive justice preferences of students within eight departments in the faculty of Social Sciences at the University of Turku, Finland. We use the Finnish government's annual budget and its specific appropriations as a proxy to measure the students' underlying preferences. We test whether the type of studies of the respondents…
ERIC Educational Resources Information Center
Haapakorpi, Arja
2011-01-01
In Finland, quality assurance related to the Bologna process has been adapted to existing systems of higher education at the national level and a form of implementation is also recognised at the level of the higher education institution. In universities, varied outcomes of quality assurance are based on interaction of organisational structures,…
Why (Not) Assess? Views from the Academic Departments of Finnish Universities
ERIC Educational Resources Information Center
Huusko, Mira; Ursin, Jani
2010-01-01
In Europe, national quality assurance systems of higher education have begun to be established. In Finland, this development has had the consequence of forcing universities to take notice of assessment procedures. However, little is known about the procedures taking place in individual academic departments as a result of this pan-European trend.…
ERIC Educational Resources Information Center
Pesonen, Hanna-Leena
2003-01-01
Reviews the history and foundations of a master's program in corporate environmental management at a Finnish university. Provides insights for program development: (1) clear commitment from administrators; (2) content based on environmental science and technology; (3) interdisciplinary approach; (4) diverse approaches to sustainability; and (5)…
ERIC Educational Resources Information Center
Repo-Tiihonen, Eila; Vuorio, Osmo; Koivisto, Hanna; Paavola, Paula; Hakola, Panu
2004-01-01
Patient satisfaction studies concerning various treatment modalities are few among involuntary forensic psychiatric treatment. They indicate general satisfaction with medication, interactive treatment and occupational therapy but dissatisfaction with lack of privacy, insufficiently explained rules and inadequately explained reasons of seclusion.…
Validation of the Hospital Ethical Climate Survey for older people care.
Suhonen, Riitta; Stolt, Minna; Katajisto, Jouko; Charalambous, Andreas; Olson, Linda L
2015-08-01
The exploration of the ethical climate in the care settings for older people is highlighted in the literature, and it has been associated with various aspects of clinical practice and nurses' jobs. However, ethical climate is seldom studied in the older people care context. Valid, reliable, feasible measures are needed for the measurement of ethical climate. This study aimed to test the reliability, validity, and sensitivity of the Hospital Ethical Climate Survey in healthcare settings for older people. A non-experimental cross-sectional study design was employed, and a survey using questionnaires, including the Hospital Ethical Climate Survey was used for data collection. Data were analyzed using descriptive statistics, inferential statistics, and multivariable methods. Survey data were collected from a sample of nurses working in the care settings for older people in Finland (N = 1513, n = 874, response rate = 58%) in 2011. This study was conducted according to good scientific inquiry guidelines, and ethical approval was obtained from the university ethics committee. The mean score for the Hospital Ethical Climate Survey total was 3.85 (standard deviation = 0.56). Cronbach's alpha was 0.92. Principal component analysis provided evidence for factorial validity. LISREL provided evidence for construct validity based on goodness-of-fit statistics. Pearson's correlations of 0.68-0.90 were found between the sub-scales and the Hospital Ethical Climate Survey. The Hospital Ethical Climate Survey was found able to reveal discrimination across care settings and proved to be a valid and reliable tool for measuring ethical climate in care settings for older people and sensitive enough to reveal variations across various clinical settings. The Finnish version of the Hospital Ethical Climate Survey, used mainly in the hospital settings previously, proved to be a valid instrument to be used in the care settings for older people. Further studies are due to analyze the factor structure and some items of the Hospital Ethical Climate Survey. © The Author(s) 2014.
[Trampoline injuries in children].
Sinikumpu, Juha-Jaakko; Antila, Eeva; Korhonen, Jussi; Rättyä, Johanna; Serlo, Willy
2012-01-01
Trampolines for home use have become common in Finland during the past ten years, being especially favored by children. Trampoline jumping is beneficial and constructive physical exercise, but poses a significant risk for injuries. The most common injuries include sprains and strains. During summertime, trampoline injuries account for as many as 13% of children's accidents requiring hospital care. Fractures are by far the most common trampoline injuries requiring hospital care. Injuries can be prevented by using safety nets. Only one child at a time is allowed to jump on the trampoline.
Reciprocal Commitment in Academic Careers? Finnish Implications and International Trends
ERIC Educational Resources Information Center
Siekkinen, Taru; Kuoppala, Kari; Pekkola, Elias; Välimaa, Jussi
2017-01-01
This study explores the nature of reciprocal commitment in academic careers. The article is based on a survey conducted in autumn 2013 among fixed-term employees at eight major universities in Finland (N = 810). The analysis is focusing on researchers who have a doctoral degree and who are working on a fixed-term contract at their university (n =…
Treatment of acute Achilles tendon ruptures in Central Finland Central Hospital in 2010-2015.
Reito, Aleksi; Logren, Hanna-Liina; Ahonen, Katri; Nurmi, Heikki; Paloneva, Juha
The epidemiology of Achilles tendon ruptures and treatment strategies have undergone a major change in recent years. We investigated the incidence of acute Achilles tendon ruptures, the choice of treatment strategies and treatment implementation. The research material consisted of patients living in the catchment area of Central Finland Hospital District who had been diagnosed with an acute Achilles tendon rupture between 2010 and 2015. The final sample consisted of 266 patients. Conservative treatment was started for 207 patients, and the remaining 59 were referred for surgery. During the study period, the proportion of patients undergoing surgery fell from 41% to 10%. Three patients (1.4%) were referred for surgery during conservative treatment, and 10 patients (4.7%) developed deep vein thrombosis while wearing a cast or an orthosis. Twelve patients (5.8%) sustained a re-rupture after conservative treatment. Two surgically-treated patients (3.5%) sustained a re-rupture, and one patient (1.7%) developed deep vein thrombosis. The strategies for treating acute Achilles tendon ruptures have clearly become more conservative in our hospital. Conservative treatment is safe and rarely fails. However, it is important to bear in mind that surgery still has a role in the treatment of acute Achilles tendon ruptures.
Siponen, Ulla; Välimäki, Maritta; Kaivosoja, Matti; Marttunen, Mauri; Kaltiala-Heino, Riittakerttu
2011-08-01
The last decade in Finland has seen a vast increase both in involuntary psychiatric treatment of adolescents and in the numbers of adolescents taken into care under the Child Welfare Act. Moreover, the variation in figures between different hospital districts is remarkable. The reasons for this are not known, but it cannot be due to variation in the epidemiology of mental disorders in minors. The aim of the study was to explore features associated with compulsory care of adolescents at regional level by comparing two hospital districts clearly differing in this regard. The characteristics of involuntarily treated adolescents and adolescents taken into care, the resources and structures of adolescent psychiatric services and child welfare services, and the environmental factors associated with adolescent well-being and adaptation, such as indicators of social deprivation of families were all considered. For the present study, 2 out of the 22 hospital districts in Finland were selected, one using compulsory psychiatric care and taking into care of 13-17-year olds above and the other below the average in Finland. Register data on patient characteristics, services, and social deprivation were used. Absolute and population adjusted figures (95% confidence intervals) from the variables are given. The differences in incidences between health care districts were compared using Poisson regression analysis. Proportions of divorces, single parent families, social exclusion and outpatient mental health service use, and detoxification treatment use of adults were higher in the health care district with above average coercion figures than in the area with below average coercion figures. The numbers of adolescent psychiatric outpatient visits were higher in the health care district with coercion figures below average despite the fact that the number of positions in adolescent outpatient services was lower than in the health care district with above average coercion figures. Factors other than the characteristics of the adolescents themselves are associated with use of compulsory care on them, although an ecological study design cannot establish causality.
The use of local natural stone in construction of St. Petersburg region and south-east Finland
NASA Astrophysics Data System (ADS)
Luodes, Hannu; Härmä, Paavo; Panova, Elena; Pirinen, Heikki; Selonen, Olavi
2013-04-01
A three-year project, started in 2012, "Efficient use of natural stone in the Leningrad region and South-East Finland", studies the use and durability of natural stone in the city environments in the Nordic climate and especially along the Eastern Baltic Sea coastline between Helsinki and St. Petersburg. The project is lead by the Geological Survey of Finland (GTK) and the partners in the project are Saimaa University of Applied Sciences from Finland and Federal State Unitary Enterprise "Petersburg Complex Geological Expedition" Russian together with Saint-Petersburg State University from the Russian Federation. As associates in this project are also natural stone companies from Finland, Ylämaa Group Oy and Palin Granit Oy. The project is co-funded by the European Union, the Russian Federation and the Republic of Finland through the European Neighbourhood and Partnership Instrument (ENPI). A great potential of natural stone that can be used in construction is located in the border zone between South-East Finland and the Leningrad region. Rapakivi granite from that area has been utilized for several important buildings worldwide since 18th century and the area holds still potential for future economic growth. The use of the stone particularly from this area is based on its visual expression and good properties with high durability and long life cycle that can be used as arguments in the future development. Strengthening of the knowledge of the material reserves in the area gives a long term basement for economic development. Special aim of the project is to promote the use of natural stone in the city construction, especially the use of left-over stone generated in the production. In the project the use of natural stone in larger cities from the 18th century until today including the towns St. Petersburg, Vyborg, Helsinki, Kuopio and Kotka will be reported. Also an analysis of the near future needs of natural stone (qualities and quantities) in reconstruction and construction in the southern Finland and St. Petersburg regions will be documented. That is to generate ideas for definition of new environmental building products using left-over natural stone from quarrying. The project will provide detailed data about long term durability of stone structures in the cities that are along the Baltic Sea shoreline (St. Petersburg, Helsinki) and subject to both mechanical and biological weathering. Mechanical weathering by several annual freeze-thaw cycles is especially typical in these coastal climate conditions. The data will be used in characterization of the durability and weathering mechanisms of different stone types and is used in preparation of guidelines of stone selection for construction and renovation. The data on natural stone resources in the project area will be evaluated and collected in a database. Also the best natural stone evaluation methods from Finland and Russia will be assessed to produce a guidance of best practices for prospecting and evaluation of natural stone occurrences. The project will also generate suggestions for making the natural stone trade between the EU and Russia easier.
The RAFAELA system: a workforce planning tool for nurse staffing and human resource management.
Fagerström, Lisbeth; Lønning, Kjersti; Andersen, Marit Helen
2014-05-01
The RAFAELA system was developed in Finland during the 1990s to help with the systematic and daily measurement of nursing intensity (NI) and allocation of nursing staff. The system has now been rolled out across almost all hospitals in Finland, and implementation has started elsewhere in Europe and Asia. This article describes the system, which aims to uphold staffing levels in accordance with patients' care needs, and its structure, which consists of three parts: the Oulu Patient Classification instrument; registration of available nursing resources; and the Professional Assessment of Optimal Nursing Care Intensity Level method, as an alternative to classical time studies. The article also highlights the benefits of using a systematic measurement of NI.
2014-01-01
Background In many developed countries, including Finland, health care authorities customarily consider the international mobility of physicians as a means for addressing the shortage of general practitioners (GPs). This study i) examined, based on register information, the numbers of foreign-born physicians migrating to Finland and their employment sector, ii) examined, based on qualitative interviews, the foreign-born GPs’ experiences of accessing employment and work in primary care in Finland, and iii) compared experiences based on a survey of the psychosocial work environment among foreign-born physicians working in different health sectors (primary care, hospitals and private sectors). Methods Three different data sets were used: registers, theme interviews among foreign-born GPs (n = 12), and a survey for all (n = 1,292; response rate 42%) foreign-born physicians living in Finland. Methods used in the analyses were qualitative content analysis, analysis of covariance, and logistic regression analysis. Results The number of foreign-born physicians has increased dramatically in Finland since the year 2000. In 2000, a total of 980 foreign-born physicians held a Finnish licence and lived in Finland, accounting for less than 4% of the total number of practising physicians. In 2009, their proportion of all physicians was 8%, and a total of 1,750 foreign-born practising physicians held a Finnish licence and lived in Finland. Non-EU/EEA physicians experienced the difficult licensing process as the main obstacle to accessing work as a physician. Most licensed foreign-born physicians worked in specialist care. Half of the foreign-born GPs could be classified as having an ‘active’ job profile (high job demands and high levels of job control combined) according to Karasek’s demand-control model. In qualitative interviews, work in the Finnish primary health centres was described as multifaceted and challenging, but also stressful. Conclusions Primary care may not be able in the long run to attract a sufficient number of foreign-born GPs to alleviate Finland’s GP shortage, although speeding up the licensing process may bring in more foreign-born physicians to work, at least temporarily, in primary care. For physicians to be retained as active GPs there needs to be improvement in the psychosocial work environment within primary care. PMID:25103861
ERIC Educational Resources Information Center
Rasi, Paivi; Ruokamo, Heli; Maasiita, Mari
2017-01-01
Internationalization presents both opportunities and challenges for higher education policies and curricula, as well as for teaching and learning methods. This article describes and discusses ongoing exploration and development of the planned curriculum of the MA in Media Education at the Faculty of Education at the University of Lapland, Finland,…
[Fast-track treatment--second revolution of colorectal surgery].
Kellokumpu, Ilmo
2012-01-01
The fast-track treatment model can be regarded as the second revolution of colorectal surgery after the introduction of laparoscopic surgery. In the gastro-surgical unit of the Central Hospital of Central Finland, results equivalent to international studies in colorectal surgery have been achieved by using fast-track model. In a study setting, this treatment model has resulted in significant decrease of total treatment costs and speeded up discharge of the patients from the hospital. The fast-track treatment model requires both a motivated, trained medical team and a motivated patient.
Parents' Use of Nonpharmacologic Methods to Manage Procedural Pain in Infants.
Pölkki, Tarja; Korhonen, Anne; Laukkala, Helena
2018-01-01
To describe parents' use of nonpharmacologic methods to manage infant procedural pain in the NICU and determine the demographic factors related to such use. A cross-sectional and descriptive study design. Level III and Level II NICUs (seven units) of four University Hospitals in Finland. Parents (N = 178) whose infants were treated in Finnish NICUs. Parents were asked to respond to a structured questionnaire during their infants' hospitalizations. We analyzed the data using the nonparametric Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test. Most parents reported that they used physical methods, such as touching, holding, and positioning, nearly always/always (86%, 76%, and 55%, respectively). However, less commonly used strategies included recorded music (2%), breastfeeding (2%), and non-nutritive sucking with oral sucrose (6%). Many characteristics of the infants, such as their gestational ages and their conditions, were significantly related to the implementation of nonpharmacologic methods. There is a clear need to extend parents' use of nonpharmacologic methods to manage their infants' procedural pain in the NICU. Because many methods were not considered as pain-relieving strategies, it is important to increase knowledge about the effectiveness of these interventions among parents and nurses. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Kielinen, Marko; Rantala, Heikki; Timonen, Eija; Linna, Sirkka-Liisa; Moilanen, Irma
2004-01-01
A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated…
ERIC Educational Resources Information Center
Käyhkö, Mari
2015-01-01
In Finland, the financial status of a family does not in general place any restrictions on a person's studies. However, in spite of equality of opportunity, class as a cultural and social issue is a significant factor guiding the education of young people. In the article, I analyse women with a working-class background studying at university,…
NASA Astrophysics Data System (ADS)
Rousi, A. M.; Branch, B. D.; Kong, N.; Fosmire, M.
2013-12-01
In their Finnish National Spatial Strategy 2010-2015 the Finland's Ministry of Agriculture and Forestry delineated e.g. that spatial data skills should support citizens everyday activities and facilitate decision-making and participation of citizens. Studies also predict that open data, particularly open spatial data, would create, when fully realizing their potential, a 15% increase into the turnovers of Finnish private sector companies. Finnish libraries have a long tradition of serving at the heart of Finnish information society. However, with the emerging possibilities of educating their users on open spatial data a very few initiatives have been made. The National Survey of Finland opened its data in 2012. Finnish technology university libraries, such as Aalto University Library, are open environments for all citizens, and seem suitable of being the first thriving entities in educating citizens on open geospatial data. There are however many obstacles to overcome, such as lack of knowledge about policies, lack of understanding of geospatial data services and insufficient know-how of GIS software among the personnel. This framework examines the benefits derived from an international collaboration between Purdue University Libraries and Aalto University Library to create local strategies in implementing open spatial data education initiatives in Aalto University Library's context. The results of this international collaboration are explicated for the benefit of the field as a whole.
Knowledge Searching and Sharing on Virtual Networks.
ERIC Educational Resources Information Center
Helokunnas, Tuija; Herrala, Juha
2001-01-01
Describes searching and sharing of knowledge on virtual networks, based on experiences gained when hosting virtual knowledge networks at Tampere University of Technology in Finland. Discusses information and knowledge management studies; role of information technology in knowledge searching and sharing; implementation and experiences of the…
Partinen, Markku; Saarenpää-Heikkilä, Outi; Ilveskoski, Ismo; Hublin, Christer; Linna, Miika; Olsén, Päivi; Nokelainen, Pekka; Alén, Reija; Wallden, Tiina; Espo, Merimaaria; Rusanen, Harri; Olme, Jan; Sätilä, Heli; Arikka, Harri; Kaipainen, Pekka; Julkunen, Ilkka; Kirjavainen, Turkka
2012-01-01
Background Narcolepsy is a rare neurological sleep disorder especially in children who are younger than 10 years. In the beginning of 2010, an exceptionally large number of Finnish children suffered from an abrupt onset of excessive daytime sleepiness (EDS) and cataplexy. Therefore, we carried out a systematic analysis of the incidence of narcolepsy in Finland between the years 2002–2010. Methods All Finnish hospitals and sleep clinics were contacted to find out the incidence of narcolepsy in 2010. The national hospital discharge register from 2002 to 2009 was used as a reference. Findings Altogether 335 cases (all ages) of narcolepsy were diagnosed in Finland during 2002–2009 giving an annual incidence of 0.79 per 100 000 inhabitants (95% confidence interval 0.62–0.96). The average annual incidence among subjects under 17 years of age was 0.31 (0.12–0.51) per 100 000 inhabitants. In 2010, 54 children under age 17 were diagnosed with narcolepsy (5.3/100 000; 17-fold increase). Among adults ≥20 years of age the incidence rate in 2010 was 0.87/100 000, which equals that in 2002–2009. Thirty-four of the 54 children were HLA-typed, and they were all positive for narcolepsy risk allele DQB1*0602/DRB1*15. 50/54 children had received Pandemrix vaccination 0 to 242 days (median 42) before onset. All 50 had EDS with abnormal multiple sleep latency test (sleep latency <8 min and ≥2 sleep onset REM periods). The symptoms started abruptly. Forty-seven (94%) had cataplexy, which started at the same time or soon after the onset of EDS. Psychiatric symptoms were common. Otherwise the clinical picture was similar to that described in childhood narcolepsy. Interpretation A sudden increase in the incidence of abrupt childhood narcolepsy was observed in Finland in 2010. We consider it likely that Pandemrix vaccination contributed, perhaps together with other environmental factors, to this increase in genetically susceptible children. PMID:22470463
Aalto, Anna-Mari; Heponiemi, Tarja; Keskimäki, Ilmo; Kuusio, Hannamaria; Hietapakka, Laura; Lämsä, Riikka; Sinervo, Timo; Elovainio, Marko
2014-06-01
Although international migration of physicians is increasing, research information on their adjustment to working in a new country is scarce. This study examined the differences in employment, perceptions of psychosocial work environment and well-being between migrant and native physicians in Finland. A cross-sectional survey was sent to a random sample of physicians in Finland (N = 7000) and additionally to all foreign-born physicians licensed to practice in Finland (N = 1292). The final response rates were 56% (n = 3646) among native Finns and 43% (n = 553) among foreign-born physicians. Migrant physicians worked more often in primary care and on-call services and less often in leadership positions than native Finns. They more often experienced lack of professional support and lower work-related well-being compared with native Finns. Those migrant physicians who had lived for a shorter time in Finland perceived less stress related to electronic patient records systems and higher organizational justice compared with native physicians or those foreign physicians who had migrated earlier. Foreign-born physicians are more often employed in the primary care sector, where there are most difficulties in recruiting from the native workforce in Finland. Attention should be paid to enhancing equitable career opportunities and well-being among foreign-born physicians working in Finnish health care. Although migrant physicians are relatively well adjusted to Finnish health care in terms of perceptions of psychosocial work environment, their lower well-being calls for attention. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Thompson, J W; Stocks, R M; Shmerling, J E; Dempsey, J
1996-03-01
Global competition, a faltering Finnish economy, and deep recession are forcing difficult decisions on the health care administrators of this Nordic country known for its extensive social welfare safety net and socialized health care system. In the first part of this article the Finnish health care system and its problems, as well as possible solutions, are presented. Similarities to our own system are noted and discussed. In an interview, the director general for the Minister of Social Affairs and Health of Finland, Kimmo Leppo, expressed concern about future funding sources in his country for the same levels of social welfare and health care programs that presently exist. The Finns are considering managed competition among providers, increasing copayments, excess hospital beds, anticipated hospital closures in their country, block grants, and how to deal with rising physician unemployment. He was interested in the proposed US government health care plans, and especially the state of Tennessee's TennCare plan, a state plan that closely resembled the failed Clinton health care reform package. The second part of this article explores how global competition has brought the pressure of modern competitive economics into the US medical arena.
Argumentation through Computer Conferencing in an Academic Context.
ERIC Educational Resources Information Center
Marttunen, Miika
This paper describes a computer conferencing experiment carried out at the University of Jyvaskyla in Finland. The conference provided the students an interactive learning environment appropriate for practicing argumentation and developing their argumentation skills. Participants were 31 undergraduate students. Two tutors, who were top students in…
Reframing Teachers' Work for Educational Innovation
ERIC Educational Resources Information Center
Kunnari, Irma; Ilomäki, Liisa
2016-01-01
The universities of applied sciences in Finland aim to support students in achieving work life competences by integrating authentic research, development and innovation (RDI) practices into learning. However, pursuing an educational change from a traditional higher education culture to a networked model of working is challenging for teachers. This…
Surveillance of patients with acute flaccid paralysis in Finland: report of a pilot study.
Hovi, T.; Stenvik, M.
2000-01-01
WHO recommends that surveillance of patients with acute flaccid paralysis (AFP) be used to demonstrate the eradication of wild poliovirus. In this article we report the results of a study to assess the frequency of AFP patients referred to Finnish hospitals and whether virological diagnostic coverage could be improved by repeated reminders and active feedback. For this purpose, we sent monthly questionnaires to all neurological and paediatric neurological units in Finland, requesting retrospective reporting on investigated paralytic patients with defined clinically relevant diagnoses, rather than AFP. Reminder letters included a pre-paid return envelope. Virological investigations were offered cost free. Of the 492 reporting forms sent, 415 (84%) were returned, evenly covering both the population and the study period (July 1997 to June 1998). Of the 90 patients reported, 83 were evaluable. The apparent incidences of the diagnoses covered were 1.6 per 100,000 at any age, and 1.0 per 100,000 for under--15-year-olds. Guillain-Barré syndrome was the most common diagnosis (0.80 per 100,000). The two faecal specimens required were virologically investigated in nine out of the 10 patients under 15 years of age, but in only 46% of all patients. Four adenovirus strains, but no polioviruses or other enteroviruses, were isolated. We conclude that a satisfactory monthly reporting system was readily established and that a sufficient number of patients with diagnoses resembling AFP are being referred to Finnish hospitals. Active feedback did not increase the proportion of virologically investigated patients to an acceptable level in all age groups. It is clear that other approaches must be used to quantify the circulation of poliovirus in Finland. PMID:10812725
Mikkola, Riitta; Huhtala, Heini; Paavilainen, Eija
2017-10-01
To describe fear, the threats causing fear and the occurrence of fear among emergency department nursing staff and physicians. The emergency department is a challenging workplace where the staff is often confronted by factors that cause fear. A cross-sectional study. A survey was conducted in 16 hospitals (n = 544). Nurses, practical nurses, orderlies and physicians from those hospitals participated in the survey. The survey questionnaire was based on the analysis of interviews of 30 nurses from one university hospital and one central hospital. The results of the interviews were analysed using the inductive content analysis method. The analysis of the survey was performed using statistical methods, such as frequencies, cross-tabulation and principal component analysis. The results showed that nearly all of the emergency department personnel had experienced work-related fear. Generally, the fear had been momentary. According to the survey results, fear was most often caused by medication errors, the resuscitation of a child, a catastrophic accident, urgent or violent situations or patients armed with weapons. Threats that caused fear included insecurity, danger in the work environment, threat of loss of one's health and threat of the consequences of one's mistakes and actions. The staff of emergency departments often encountered factors or situations that caused fear. The main threats causing fear that were raised by the respondents were insecurity and danger in the work environment. The data obtained from this study can be utilised in identifying and describing work-related fear and threats of fear among emergency department nursing staff and physicians. Based on the information herein, it will be possible to develop methods to prevent situations that cause fear in emergency departments. © 2016 John Wiley & Sons Ltd.
EDITORIAL: The 24th Nordic Semiconductor Meeting The 24th Nordic Semiconductor Meeting
NASA Astrophysics Data System (ADS)
Páll Gunnlaugsson, Haraldur; Nylandsted Larsen, Arne; Uhrenfeldt, Christian
2012-03-01
A Nordic Semiconductor Meeting is held every other year with the venue rotating amongst the Nordic countries of Denmark, Finland, Iceland, Norway and Sweden. The focus of these meetings remains 'original research and science being carried out on semiconductor materials, devices and systems'. Reports on industrial activity have usually featured. The topics have ranged from fundamental research on point defects in a semiconductor to system architecture of semiconductor electronic devices. Proceedings from these events are regularly published as a Topical Issue of Physica Scripta. All of the papers in this Topical Issue have undergone critical peer review and we wish to thank the reviewers and the authors for their cooperation, which has been instrumental in meeting the high scientific standards and quality of the series. This 24th meeting of the Nordic Semiconductor community, NSM 2011, was held at Fuglsøcentret, close to Aarhus, Denmark, 19-22 June 2011. Support was provided by the Carlsberg Foundation, Danfysik and the semiconductor group at Aarhus University. Over 30 participants presented a broad range of topics covering semiconductor materials and devices as well as related material science interests. The conference provided a forum for Nordic and international scientists to present and discuss new results and ideas concerning the fundamentals and applications of semiconductor materials. The aim of the meeting was to advance the progress of Nordic science and thus aid in future worldwide technological advances concerning technology, education, energy and the environment. The 25th Nordic Semiconductor Meeting will be organized in June 2013 in Finland, chaired by Dr Filip Tuomisto, Aalto University. A Nordic Summer School on Semiconductor Science will be organized in connection with the conference (just before), chaired by Dr Jonatan Slotte, Aalto University. Information on these events can be found at physics.aalto.fi/nsm2013. List of participants Søren Vejling AndersenAalborg University, Aalborg, Denmark Pia BomholtAarhus University, Aarhus, Denmark Hafliði P GíslasonUniversity of Iceland, Reykjavik, Iceland Haraldur Páll GunnlaugssonAarhus University, Aarhus, Denmark John HansenAarhus University, Aarhus, Denmark Britta JohansenAarhus University, Aarhus, Denmark Volodymyr KhranovskyyLinköping University, Linköping, Sweden Arne Nylandsted LarsenAarhus University, Denmark Helge MalmbekkUniversity of Oslo, Oslo, Norway Erik Stensrud MarsteinInstitute for Energy Technology, Kjeller, Norway Antonio MartiUniversidad Politécnica de Madrid, Madrid, Spain Torben MølholtUniversity of Iceland, Reykjavik, Iceland Sveinn ÓlafssonUniversity of Iceland, Reykjavik, Iceland Thomas PedersenTechnical University of Denmark, Kgs. Lyngby, Denmark Thomas Garm PedersenAalborg University, Aalborg, Denmark Dirch Hjorth PetersenTechnical University of Denmark, Kgs. Lyngby, Denmark Vincent QuemenerUniversity of Oslo, Oslo, Norway Henry RadamsonKTH Royal Institute of Technology, Kista, Sweden Bahman RaeissiUniversity of Oslo, Oslo, Norway Jonatan SlotteAalto University, Aalto, Finland Xin SongUniversity of Oslo, Oslo, Norway Einar Örn SveinbjörnssonUniversity of Iceland, Reykjavik, Iceland Mikael SyväjärviLinköping University, Linköping, Sweden Chi Kwong TangUniversity of Oslo, Oslo, Norway Erik V ThomsenTechnical University of Denmark, Kgs. Lyngby, Denmark Christian UhrenfeldtAarhus University, Aarhus, Denmark Hans Ulrik UlriksenAalborg University, Aalborg, Denmark Muhammad UsmanKTH Royal Institute of Technology, Kista, Sweden Lasse VinesUniversity of Oslo, Oslo, Norway Ulrich WahlUnidade de Física e Aceleradores, Sacavém, Portugal Helge WemanNTNU, Trondheim, Norway Gerd WeyerAarhus University, Denmark
Kantanen, Anne-Mari; Reinikainen, Matti; Parviainen, Ilkka; Kälviäinen, Reetta
2017-07-01
Refractory status epilepticus (RSE) is a neurological emergency with significant morbidity and mortality. We aimed to analyze the long-term outcome of intensive care unit (ICU)-treated RSE and super-refractory status epilepticus (SRSE) patients in a population based cohort. A retrospective study of ICU- and anesthesia-treated RSE patients in Kuopio University Hospital's (KUH) special responsibility area hospitals in the central and eastern part of Finland from Jan. 1, 2010 to Dec. 31, 2012 was conducted. KUH's catchment area consists of five hospitals-one university hospital and four central hospitals-and covers a population of 840 000. We included all consecutive adult (16 years or older) RSE patients admitted in the participating ICUs during the 3-year period and excluded patients with postanoxic etiologies. We used a modified Rankin Scale (mRS) as a long-term (1-year) outcome measure: good (mRS 0-3, recovered to baseline function) or poor (mRS 4-6, major functional deficit or death). We identified 75 patients with ICU- and anesthesia-treated RSE, corresponding to an annual incidence of 3.0 (95% confidence interval (CI) 2.4-3.8). 21% of the patients were classified as SRSE, with the annual incidence being 0.6/100 000 (95% CI 0.4-1.0). For RSE, the ICU mortality was 0%, hospital mortality was 7% (95% CI 1.2%-12.8%) (n=5), and one-year mortality was 23% (CI 95% 13.4%-32.5%) (n=17). 48% (n=36) of RSE patients recovered to baseline, and 29% (n=22) showed neurological deficit at 1year. Poor outcome (mRS 4-6) was recorded for 52% (n=39) of the patients. Older age was associated with poorer outcome at 1year (p=0.03). For SRSE, hospital mortality was 6% (n=1) and 1-year mortality was 19% (n=3) (95%CI 0%-38.2%). During 1-year follow-up, nearly 50% of the ICU-treated RSE patients recovered to baseline function, whereas 30% showed new functional defects and 20% died. SRSE does not have a necessarily poorer outcome. The outcome is worse in older patients and in patients with progressive or fatal etiologies. SE should be treated with generalized anesthesia only in refractory cases after failure of adequately used first- and second-line antiepileptic drugs. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Women in Higher Education Management.
ERIC Educational Resources Information Center
Commonwealth Secretariat, London (England).
This volume contains 11 papers on the under-representation of women in higher education management in Bahrain, Finland, France, India, Indonesia, Malaysia, Nigeria, Peru, the United States and Canada, the South Pacific and the West Indies. All papers were written by women vice-chancellors, presidents and senior managers of universities in those…
Music Education for a Nation: Teaching Patriotic Ideas and Ideals in Global Societies
ERIC Educational Resources Information Center
Kallio, Alexis Anja; Partti, Heidi
2013-01-01
In this article the author's examine, through the cases of Finland and Cambodia, expressions of constructive patriotism in educational policy, curriculum documents and music teacher actions and reflections. This study is part of a broader cross-cultural exchange project: "Multicultural Arts University", between researchers and music…
ERIC Educational Resources Information Center
Ruohotie-Lyhty, Maria
2011-01-01
This paper explores the professional development of 11 newly qualified foreign language teachers. It draws on a qualitative longitudinal study conducted at the University of Jyvaskyla, Finland between 2002 and 2009. The paper concentrates on the personal side of teacher development by analysing participants' discourses concerning language…
Goofy Guide Game: Affordances and Constraints for Engagement and Oral Communication in English
ERIC Educational Resources Information Center
Enticknap-Seppänen, Kaisa
2017-01-01
This study investigates tourism undergraduates' perceptions of learning engagement and oral communication in English through their experiences of testing a pilot purpose-designed educational digital game. Reflecting the implementation of digitalization strategy in universities of applied sciences in Finland, it examines whether single instances of…
Student Portfolios as Windows into Intercultural Knowledge and Knowing
ERIC Educational Resources Information Center
Johnson, Esko; Hynynen, Nina
2018-01-01
This research paper deals with intercultural knowledge and knowing as displayed in higher education student portfolios. The portfolios were written by student pairs taking a global education course at Centria University of Applied Sciences, Finland, during seven academic years. Conceptual metaphor theory and metaphor analysis were utilised to…
Improving data collection processes for routine evaluation of treatment cost-effectiveness.
Monto, Sari; Penttilä, Riku; Kärri, Timo; Puolakka, Kari; Valpas, Antti; Talonpoika, Anna-Maria
2016-04-01
The healthcare system in Finland has begun routine collection of health-related quality of life (HRQoL) information for patients in hospitals to support more systematic cost-effectiveness analysis (CEA). This article describes the systematic collection of HRQoL survey data, and addresses challenges in the implementation of patient surveys and acquisition of cost data in the case hospital. Challenges include problems with incomplete data and undefined management processes. In order to support CEA of hospital treatments, improvements are sought from the process management literature and in the observation of healthcare professionals. The article has been written from an information system and process management perspective, concluding that process ownership, automation of data collection and better staff training are keys to generating more reliable data.
Tervo, Laura; Mäkelä, Satu; Syrjänen, Jaana; Huttunen, Reetta; Rimpelä, Arja; Huhtala, Heini; Vapalahti, Olli; Vaheri, Antti; Mustonen, Jukka
2015-01-01
Background Previous studies indicate that smoking affects the outcome of some infections and is a risk factor for Puumala virus (PUUV) infection. The aim of this study was to assess the effect of smoking on the clinical severity of PUUV infection and the prevalence of smoking in patients with PUUV infection. Methods A questionnaire on smoking habits was sent to 494 patients in 2012, who had been treated in Tampere University Hospital, Finland, for serologically confirmed PUUV infection during years 1982–2012. Results Of all patients, 357 (72%) participated. Maximum plasma creatinine level measured during acute illness was significantly higher in current smokers than in non-smokers (median: 273 versus 184 µmol/L, P < 0.001). Current smokers had a higher maximum blood leucocyte count than non-smokers (median: 10.8 versus 8.9 × 109/L, P < 0.001) and they were younger than non-smokers (38 versus 45 years, P < 0.001). There were no differences between current smokers and non-smokers in the other variables reflecting the severity of PUUV infection. Altogether 51% were current smokers at the time of onset of the illness, 57% of males and 36% of females. During these years in Finland, smoking among males in the same aged population has decreased from 33 to 22% and among females, smoking has varied between 14 and 20%. Conclusions Smoking is common in patients with PUUV infection. Current smokers suffer from more severe acute kidney injury (AKI) and they have higher leucocyte count than non-smokers in PUUV infection. Smoking cessation decreases the risk of severe AKI to the same level as observed in never-smokers. PMID:26150428
Invasive Group A Streptococcal Infections in Children: A Nationwide Survey in Finland.
Tapiainen, Terhi; Launonen, Saana; Renko, Marjo; Saxen, Harri; Salo, Eeva; Korppi, Matti; Kainulainen, Leena; Heiskanen-Kosma, Tarja; Lindholm, Laura; Vuopio, Jaana; Huotari, Tiina; Rusanen, Jarmo; Uhari, Matti
2016-02-01
The incidence of invasive group A streptococcus (iGAS) infections varies in time and geographically for unknown reasons. We performed a nationwide survey to assess the population-based incidence rates and outcomes of children with iGAS infections. We collected data on patients from hospital discharge registries and the electronic databases of microbiological laboratories in Finland for the period 1996-2010. We then recorded the emm types or serotypes of the strains. The study physician visited all university clinics and collected the clinical data using the same data entry sheet. We identified 151 children with iGAS infection. Varicella preceded iGAS infection in 20% of cases and fasciitis infection in 83% of cases. The annual incidence rate of iGAS infection was 0.93 per 100,000 in 1996-2000, 1.80 in 2001-2005 and 2.50 in 2006-2010. The proportion of emm 1.0 or T1M1 strains peaked in 1996-2000 and again in 2006-2010, to 44% and 37% of all typed isolates. The main clinical diagnoses of the patients were severe soft-tissue infection (46%), sepsis (28%), empyema (10%), osteoarticular infection (9%) and primary peritonitis (5%). Severe pain was the most typical symptom for soft-tissue infections. More than half of the patients underwent surgery and received clindamycin. The readmission rate was 7%, and the case fatality rate was 2%. The incidence rate of pediatric iGAS infections tripled during our study. The increase was not, however, the result of a change in the strain types causing iGAS. Varicella immunization would likely have prevented a significant number of the cases.
The Helsinki Face Transplantation: Surgical aspects and 1-year outcome.
Lassus, Patrik; Lindford, Andrew; Vuola, Jyrki; Bäck, Leif; Suominen, Sinikka; Mesimäki, Karri; Wilkman, Tommy; Ylä-Kotola, Tuija; Tukiainen, Erkki; Kuokkanen, Hannu; Törnwall, Jyrki
2018-02-01
Since 2005, at least 38 facial transplantations have been performed worldwide. We herein describe the surgical technique and 1-year clinical outcome in Finland's first face transplant case. A 34-year-old male who had a severe facial deformity following ballistic trauma in 1999 underwent facial transplantation at the Helsinki University Hospital on 8th February 2016. Three-dimensional (3D) technology was used to manufacture donor and recipient patient-specific osteotomy guides and a donor face mask. The facial transplant consisted of a Le Fort II maxilla, central mandible, lower ⅔ of the midface muscles, facial and neck skin, oral mucosa, anterior tongue and floor of mouth muscles, facial nerve (three bilateral branches), and bilateral hypoglossal and buccal nerves. At 1-year follow-up, there have thus far been no clinical or histological signs of rejection. The patient has a good aesthetic outcome with symmetrical restoration of the mobile central part of the face, with recovery of pain and light touch sensation to almost the entire facial skin and intraoral mucosa. Electromyography at 1 year has confirmed symmetrical muscle activity in the floor of the mouth and facial musculature, and the patient is able to produce spontaneous smile. Successful social and psychological outcome has also been observed. Postoperative complications requiring intervention included early (nasopalatinal fistula, submandibular sialocele, temporomandibular joint pain and transient type 2 diabetes) and late (intraoral wound and fungal infection, renal impairment and hypertension) complications. At 1 year, we report an overall good functional outcome in Finland's first face transplant. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Paediatric eye injuries in Finland - Helsinki eye trauma study.
Haavisto, Anna-Kaisa; Sahraravand, Ahmad; Holopainen, Juha M; Leivo, Tiina
2017-06-01
To determine the current population-based epidemiology, treatment, use of resources and outcomes of children's eye injuries in Finland. The study included all new patients, 16 years of age or under, with ocular or orbital traumas taken into care to the Helsinki University Eye Hospital (population base 1.5 million people) in 1 year. The follow-up period was 3 months. Two hundred and two children's eye injuries were treated. The eye injury incidence was 5.2-8.3 per 10 000 per year, including all minor and major eye traumas. Eye injury most likely occurred at the junior high school age (13-16 years). Thirty-three percentage of accidents took place at home and 24% at school or in day care. The most common causes were sports equipment (15%), contact with human body (12%) and superficial foreign bodies (11%). Excluding minor injuries, contusion was the most common diagnosis (n = 60, 30%). Eighty-seven percentage of contusion patients were estimated to need lifelong follow-up due to elevated glaucoma risk. Nine percentage of all patients had a permanent disability. Guns, fireworks, tools and pellet guns were relatively the most dangerous objects. Pellet guns caused 6% of eye injuries, 36% of them causing permanent impairment. The number of outpatient visits was altogether 443, inpatient days were 49, and 60 children had major surgeries. Use of protective eyewear would have prevented or diminished eye traumas caused by pellet gun, floorball, most of the firework and in many superficial foreign body. The use of pellet guns and protective eyewear should be more supervised. Fireworks and tools are not suitable toys for children. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Heponiemi, Tarja; Elovainio, Marko; Presseau, Justin; Eccles, Martin P
2014-06-01
Many countries, including the UK and Finland, face difficulties in recruiting GPs and one reason for these difficulties may be due to negative psychosocial work environments. To compare psychosocial resources (job control and participative safety), distress and sickness absences between GPs from the UK and those from Finland. We also examined differences in how psychosocial resources are associated with distress and sickness absence and how distress is associated with sickness absence for both countries. Two independent cross-sectional surveys conducted in general practice in the UK and Finland. Analyses of covariance were used for continuous outcome variables and logistic regression for dichotomized variable (sickness absence) adjusted for gender, qualification year and response format. UK GPs reported more opportunities to control their work and had higher levels of participative safety but were more distressed than Finnish GPs. Finnish GPs were 2.3 (95% confidence interval = 1.8-3.1) times more likely to report sickness absence spells than UK GPs. Among Finnish GPs, job control opportunities and high participative safety were associated with lower levels of distress, but not among UK GPs. Among UK GPs, higher distress was associated with 2.1 (95% confidence interval = 1.3-3.6) times higher likelihood of sickness absence spells, but among Finnish GPs there were no such association. In Finland, primary health care organizations should try to improve participative safety and increase control opportunities of physicians to decrease GP distress, whereas in the UK, other work or private life factors may be more important. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Rantala, Maija; Hartikainen, Sirpa; Kvist, Tarja; Kankkunen, Päivi
2015-08-01
Registered nurses (RNs) play a pivotal role in treating pain and preventing and recognizing the adverse effects (AEs) of analgesics in patients with dementia. The purpose of this study was to determine RNs' knowledge of potentially clinically relevant AEs of analgesics. A descriptive, cross-sectional study design was used. In all, 267 RNs treating orthopedic patients, including patients with dementia, in 7 university hospitals and 10 central hospitals in Finland, completed a questionnaire. Analgesics were defined according to the Anatomic Therapeutic Classification as strong opioids, weak opioids, nonsteroidal anti-inflammatory analgesics (NSAIDs), and paracetamol. Definitions of AEs were based on the literature. Logistic regression analysis was applied to analyze which variables predicted nurses' knowledge. The RNs had a clear understanding of the AEs of paracetamol and strong opioids. However, the AEs of NSAIDs, especially renal and cardiovascular AEs, were less well known. The median percentage of correct answers was 87% when asked about strong opioids, 73% for weak opioids, and 60% for NSAIDs. Younger RNs had better knowledge of opioid-related AEs (odds ratio [OR] per 1-year increase, 0.97; 95% confidence interval [CI], 0.94-1.00) and weak opioids (OR, 0.96; 95% CI, 0.93-0.99). This study provides evidence of a deficiency in RNs' knowledge, especially regarding the adverse renal and cardiovascular effects of NSAIDs. Such lack of knowledge indicates that hospitals may need to update the knowledge of older RNs, especially those who treat vulnerable patients with dementia. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Costs of Robotic-Assisted Versus Traditional Laparoscopy in Endometrial Cancer.
Vuorinen, Riikka-Liisa K; Mäenpää, Minna M; Nieminen, Kari; Tomás, Eija I; Luukkaala, Tiina H; Auvinen, Anssi; Mäenpää, Johanna U
2017-10-01
The purpose of this study was to compare the costs of traditional laparoscopy and robotic-assisted laparoscopy in the treatment of endometrial cancer. A total of 101 patients with endometrial cancer were randomized to the study and operated on starting from 2010 until 2013, at the Department of Obstetrics and Gynecology of Tampere University Hospital, Tampere, Finland. Costs were calculated based on internal accounting, hospital database, and purchase prices and were compared using intention-to-treat analysis. Main outcome measures were item costs and total costs related to the operation, including a 6-month postoperative follow-up. The total costs including late complications were 2160 &OV0556; higher in the robotic group (median for traditional 5823 &OV0556;, vs robot median 7983 &OV0556;, P < 0.001). The difference was due to higher costs for instruments and equipment as well as to more expensive operating room and postanesthesia care unit time. Traditional laparoscopy involved higher costs for operation personnel, general costs, medication used in the operation, and surgeon, although these costs were not substantial. There was no significant difference in in-patient stay, laboratory, radiology, blood products, or costs related to complications. According to this study, robotic-assisted laparoscopy is 37% more expensive than traditional laparoscopy in the treatment of endometrial cancer. The cost difference is mainly explained by amortization of the robot and its instrumentation.
Breast cancer patients in Libya: Comparison with European and central African patients
BODER, JAMELA MOSTAFA E.; ELMABROUK ABDALLA, FATHI B.; ELFAGEIH, MOHAMED AHMED; ABUSAA, ABUAGELA; BUHMEIDA, ABDELBASET; COLLAN, YRJÖ
2011-01-01
The present study evaluated the incidence of breast cancer in Libya and described the clinicopathological and demographic features. These features were then compared with corresponding data from patients from sub-Saharan Africa (Nigeria) and Europe (Finland). The study consisted of 234 patients with breast carcinoma, admitted to the African Oncology Institute in Sabratha, Libya, during the years 2002–2006. The pathological features were collected from pathology reports, patient histories from hospital files and the Sabratha Cancer Registry. The demographic differences between the Libyan, Nigerian and Finnish populations were prominent. The mean age of breast cancer patients in Libya was 46 years which was almost identical to that of Nigeria, but much lower than that of Finland. The Libyan breast cancer incidence was evaluated as 18.8 per 100,000 female individuals. This incidence was markedly higher in Finland, but was also high in Nigeria. Libyan and Nigerian breast cancer is predominantly of premenopausal type and exhibits unfavorable characteristics such as high histological grade and stage, large tumor size and frequent lymph node metastases. However, the histological types and histopathological risk features show similar importance regarding survival as European breast cancer cases. Survival in Libya ranks between the rates of survival in Nigeria (lowest) and Finland (highest). In conclusion, in Libya and other African countries, premenopausal breast cancer is more common than postmenopausal breast cancer. However, the opposite is true for Europe. Population differences may be involved, as suggested by the known variation, in the distribution of genetic markers in these populations. Different types of environmental impacts, however, cannot be excluded. PMID:22866085
Volunteers in a hospital - opportunity or threat? Exploratory study from Finland.
Koivula, Ulla-Maija; Karttunen, Sirkka-Liisa
2014-01-01
Finland represents one of the Nordic welfare states where the role of the public sector as the organiser and provider of health and social care is strong. However, the amount of voluntary work in social and health care services is surprisingly big. The strongest advocates for keeping the volunteers outside are hospitals and health centres while at the same time they are suffering from shortages of staff and staff is reporting lack of time to provide needed care for their patients. The purpose of this paper is to report the results of a study of the attitudes of professionals towards voluntary work in hospitals. The paper is based on an exploratory study done in three hospitals, two from an urban area and one in a rural area. The interviewees represent nursing and care staff (n=21). The main questions were how staff members see options, constraints and drawbacks of volunteering regarding professional roles, work division, coordination and management. Attitudes of staff varied from positive to conditional. The approaches towards voluntary work varied from holistic to task-centred or patient-centred and were linked with organisational approach, professional approach or considerations of patients' well-being. Critical views were expressed related to managerial issues, patients' safety and quality of care. Increasing the amount of voluntary work done in hospitals would require a considered strategy and a specifically designed process for coordination, management and rules on the division of labour. The research raised themes for further quantitative studies to elaborate the findings on the similarities and differences of the opinions of different staff categories and to be able to develop further the heuristic model of volunteer management triangle suggested in the paper. The study raises questions of the need and promotion of volunteers in general and especially in health care services. It also raises critical views related to voluntary work in hospitals. The study is a new initiative to discuss voluntary work and how to manage volunteers in hospitals. It provides valuable knowledge for practitioners in health care involved in volunteer management and coordination.
ERIC Educational Resources Information Center
Jokela, Timo
2007-01-01
The purpose of this article is to describe how the Department of Art Education at the University of Lapland in Finland has developed winter art as a method of environmental and community-based art education. I will focus on the Snow Show Winter Art Education Project, a training project funded by the European Union and the State Provincial Office…
Institutional Autonomy and Academic Freedom in the Nordic Context--Similarities and Differences
ERIC Educational Resources Information Center
Nokkala, Terhi; Bladh, Agneta
2014-01-01
Owing to their common history, similarities in language and culture, long traditions in political collaboration and the shared Nordic societal model, an assumption is often made that the operational and regulatory context of universities is similar in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. In this article, we…
L'Education populaire en Europe. 2. Scandinavie (Mass Adult Education in Europe. 2. Scandinavia).
ERIC Educational Resources Information Center
Trichaud, Lucien
Covering Denmark, Norway, Sweden, and Finland in turn, this comparative survey of mass adult education in Scandinavia provides a historical and descriptive background on each country, followed by the development and present situation of folk high schools, cooperatives, university extension, correspondence study, labor education, mass media, and…
Evaluation of the Centres of Excellence in Higher Education
ERIC Educational Resources Information Center
Kettunen, Juha Matti
2011-01-01
This study presents an evaluation of the centres of excellence in higher education in Finland. This approach is an example of enhancement-led evaluation aiming to improve the long-term development of education. The study presents the Degree Programme in Civil Engineering of the Turku University of Applied Sciences, which was awarded the…
ERIC Educational Resources Information Center
Stubb, J.; Pyhalto, K.; Lonka, K.
2011-01-01
This paper explores doctoral students' experiences of their scholarly communities in terms of socio-psychological well-being. Further, the study examines how experiences were related to study engagement and to self-reported stress, exhaustion, and anxiety. Altogether 669 doctoral students from the University of Helsinki, Finland, responded a…
Leadership of Special Students in Strengthening Their Ability by Understanding Their Weaknesses
ERIC Educational Resources Information Center
Rajbhandari, Mani Man Singh
2016-01-01
This paper explores the traits of the leadership dexterity of special students. Leadership in special students is not an expected phenomenon. Cases of special students studying at the University of Tampere, Finland are reported on here. Each case contributes uniqueness and offers qualitative insight into this phenomenon. Interviews were conducted…
Young "Netizens" Creating Public Citizenship in Cyberspace
ERIC Educational Resources Information Center
Robertson, Margaret
2009-01-01
Collaborating with universities in Hong Kong, Finland, the United Kingdom and Australia the research project outlined in this paper takes up one of the key initial findings related to the importance of children's online spaces away from school. The project brings together complementary strengths from each partner nation to assist our mutual need…
Effects of Webcams on Multimodal Interactive Learning
ERIC Educational Resources Information Center
Codreanu, Tatiana; Celik, Christelle Combe
2013-01-01
This paper describes the multimodal pedagogical communication of two groups of online teachers; trainee tutors (second year students of the Master of Arts in Teaching French as a Foreign Language at the University Lumiere-Lyon 2) and experienced teachers based in different locations (France, Spain and Finland). They all taught French as a Foreign…
Principles of neuroanesthesia in aneurysmal subarachnoid hemorrhage: The Helsinki experience.
Randell, Tarja; Niemelä, Mika; Kyttä, Juha; Tanskanen, Päivi; Määttänen, Markku; Karatas, Ayse; Ishii, Keisuke; Dashti, Reza; Shen, Hu; Hernesniemi, Juha
2006-10-01
Aneurysmal subarachnoid hemorrhage is a devastating disease that is followed by a marked stress response affecting other organs besides the brain. The aim in the management of patients with aSAH is not only to prevent rebleedings by treating the aneurysm by either microneurosurgery or endovascular surgery, but also to evacuate acute space-occupying hematomas and to treat hydrocephalus. This review is based on the experience of the authors in the management of more than 7500 patients with aSAH treated in the Department of Neurosurgery at Helsinki University Central Hospital, Finland. The role of the neuroanesthesiologist together with the neurosurgeon may begin in the emergency department to assess and stabilize the general medical and neurologic status of the patients. Early preoperative management of patients in the NICU, prevention of rebleeding, and providing a slack brain during microneurosurgical procedures are further steps. Postoperative management, prevention, and treatment of possible medical complications and cerebrovascular spasm are as necessary as high-quality microsurgery. Multidisciplinary and professional teamwork is essential in the management of patients with cerebral aneurysms.
Diagnosis of dementia as a turning point among Finnish families: a qualitative study.
Pesonen, Hanna-Mari; Remes, Anne M; Isola, Arja
2013-12-01
The experiences of receiving a diagnosis of dementia from the viewpoint of people with dementia and their family members were explored in this study. Purposive sampling was used to recruit people with newly-diagnosed dementia (n = 8) and their family members (n = 8) from a university hospital's memory clinic in northern Finland. Data were collected using low-structured interviews, and analyzed using the stages of grounded theory. The diagnosis of dementia was a mutual turning point in the family, and it was experienced and responded to in shared processes within the family. In a changing life situation, close ones became a significant resource, and focus on the present day was emphasized. Individuals with dementia and their family members aimed to live meaningful lives by being active agents. Understanding the individual and shared experiences of both those with dementia and their family members can help health professionals design and carry out tailored early psychosocial interventions for families to assist them to create a shared understanding of living with dementia. © 2013 Wiley Publishing Asia Pty Ltd.
Anti-adalimumab antibodies in juvenile idiopathic arthritis-related uveitis.
Leinonen, Sanna T; Aalto, Kristiina; Kotaniemi, Kaisu M; Kivelä, Tero T
2017-01-01
To evaluate the association of adalimumab trough levels and anti-adalimumab antibodies with activity of uveitis in juvenile idiopathic arthritis-related uveitis. This was a retrospective observational case series in a clinical setting at the Department of Ophthalmology, Helsinki University Hospital, Finland in 2014-2016. Thirty-one paediatric patients with chronic anterior juvenile idiopathic arthritis-related uveitis in 58 eyes and who had been on adalimumab ≥6 months were eligible for the study. Uveitis activity during adalimumab treatment, adalimumab trough levels and anti-adalimumab antibody levels were recorded. Anti-adalimumab antibody levels ≥12 AU /ml were detected in nine patients (29%). This level of anti-adalimumab antibodies was associated with a higher grade of uveitis (p<0.001), uveitis that was not in remission (p=0.001) and with lack of concomitant methotrexate therapy (p=0.043). In patients with anti-adalimumab antibody levels <12 AU/ml, higher serum trough levels did not associate with better control of uveitis (p=0.86). Adalimumab treatment might be better guided by monitoring anti-adalimumab antibody formation in treating JIA-related uveitis.
Raatiniemi, Lasse; Liisanantti, Janne; Niemi, Suvi; Nal, Heini; Ohtonen, Pasi; Antikainen, Harri; Martikainen, Matti; Alahuhta, Seppo
2015-11-05
Emergency medical services are an important part of trauma care, but data comparing urban and rural areas is needed. We compared 30-day mortality and length of intensive care unit (ICU) stay for trauma patients injured in rural and urban municipalities and collected basic data on trauma care in Northern Finland. We examined data from all trauma patients treated by the Finnish Helicopter Emergency Medical Services in 2012 and 2013. Only patients surviving to hospital were included in the analysis but all pre-hospital deaths were recorded. All data was retrieved from the national Helicopter Emergency Medical Services database, medical records, and the Finnish Causes of Death Registry. Patients were defined as urban or rural depending on the type of municipality where the injury occurred. A total of 472 patients were included. Age and Injury Severity Score did not differ between rural and urban patients. The pre-hospital time intervals and distances to trauma centers were longer for rural patients and a larger proportion of urban patients had intentional injuries (23.5% vs. 9.3%, P <0.001). The 30-day mortality for severely injured patients (Injury Severity Score >15) was 23.9% in urban and 13.3% in rural municipalities. In the multivariate regression analysis the odds ratio (OR) for 30-day mortality was 2.8 (95% confidence interval 1.0 to 7.9, P = 0.05) in urban municipalities. There was no difference in the length of ICU stay or scores. Twenty patients died on scene or during transportation and 56 missions were aborted because of pre-hospital death. The severely injured urban trauma patients had a trend toward higher 30-day mortality compared with patients injured in rural areas but the length of ICU stay was similar. However, more pre-hospital deaths occurred in rural municipalities. The time before mobile ICU arrival appears to be critical for trauma patients' survival, especially in rural areas.
Fire-related injuries with inpatient care in Finland: a 10-year nationwide study.
Haikonen, Kari; Lillsunde, Pirjo M; Lunetta, Philippe; Lounamaa, Anne; Vuola, Jyrki
2013-06-01
The aim of this study was to examine fire-related injuries leading to inpatient care in Finland. The Finnish National Hospital Discharge Register (2000-2009) and a sample of 222 patients from the Helsinki Burn Centre who sustained flame burns was used. During the 10-years study period, the incidence of fire-related injuries with inpatient care was approximately 5.6 per 100000 persons-years (n=295; males 74%, females 26%). Approximately three quarters involved burns and the remaining cases were mostly combustion gas poisonings. Burns declined from 5.4 in 2000 to 4.0 per 100000 person-years in 2009. The decline was accounted for by young people primarily. Socio-economic features and smoking habits differ between the injured and general population. House fire victims were mainly middle aged and older, while injures involving flammable substances, campfires, etc., were mostly associated with young people. House fires caused the worst damage in terms of Total Body Surface Area burned and inhalation burns. Significantly more people die on the scene of the incident than during the hospital care. Targeting preventive measures in particular at older people and those with a tendency for alcohol abuse and smoking could potentially reduce the burden of the most severe flame burns. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.
Advanced energy systems and technologies - National R and D programme
NASA Astrophysics Data System (ADS)
Lund, P. D.
1992-08-01
The energy R and D in Finland is accomplished through the energy research programs of the Ministry of Trade and Industry. Today there are some 12 R and D programs in operation covering the various aspects of the energy sector. The NEMO-program deals with advanced new energy technologies and systems. The NEMO-program was launched in 1988 and it ends at the end of 1992. Helsinki University of Technology has been responsible for the coordination and most of the universities, research centers, and companies on new advanced energy technologies have been involved in the realization of NEMO. The objectives of the program have been to assess the potential of new technologies in the Finnish energy supply system, encourage and support businesses, and to create necessary research tradition in Finland. At the beginning in year 1988, several new technologies were included, but as the knowledge has increased, focusing on the most promising fields has taken place. Wind and solar energy show the best promises in respect to business activities and possibilities for utilization in Finland. Energy storage some other advanced technologies such as fuel cells and hydrogen technologies represented in the NEMO-program have an important role, but the commercial applications lie more distant in the future. The NEMO-program has reached its objectives. The international evaluation in fall 1990 gave very positive feedback and the scientific quality of the work was found good. At the same time, the contents was still focused more on commercial applications to support national industries in the field. The descriptions of the ongoing NEMO research projects are included in this report.
Neuropsychology in Finland - over 30 years of systematically trained clinical practice.
Hokkanen, Laura; Nybo, Taina; Poutiainen, Erja
2016-11-01
The aim of this invited paper for a special issue of international practice in The Clinical Neuropsychologist is to provide information on training models, clinical practice, and professional issues within neuropsychology in Finland. Relevant information was gathered via literature searches, a survey by the Neuropsychology Working Group of the Finnish Psychological Association, archives of the Finnish Neuropsychological Society, and personal communication with professionals in Finland. The roots of Finnish neuropsychology are linked to the early German tradition of experimental psychology. Since the 1970s, it has been strongly influenced by both the psychometric approach in the U.S. and the qualitative approach by Luria. Systematic specialization training program began in Finland in 1983. It was first organized by the Finnish Neuropsychological Society and since 1997 by Finnish universities. At present, around 260 neuropsychologists have completed this training. According to the survey by the Finnish Psychological Association in 2014, 67% of Finnish neuropsychologists work in the public sector, 36% in the private sector, and 28% reported that they had private practice. Work includes assessments for 90% of the respondents, rehabilitation for 74%, and many are involved in teaching and research. Of the respondents, 20% worked both with adults and children, 44% with adults only and 36% with children only. Within test development, pediatric neuropsychology is an especially prominent field. A unique blend of approaches and a solid systematic training tradition has led to a strong position of neuropsychologists as distinguished experts in the Finnish health care system.
Quentin, Wilm; Scheller-Kreinsen, David; Geissler, Alexander; Busse, Reinhard
2012-02-01
As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of appendicitis treated with a procedure of appendectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that together comprised at least 97% of cases. Six standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify appendectomy patients according to different sets of variables (between two and six classification variables) into diverging numbers of DRGs (between two and 11 DRGs). The most complex DRG is valued 5.1 times more resource intensive than an index case in France but only 1.1 times more resource intensive than an index case in Finland. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the most complex case vignette amount to only 1,005
Designing Connected Learning: Emerging Learning Systems in a Craft Teacher Education Course
ERIC Educational Resources Information Center
Vartiaien, Henrikka; Pöllänen, Sinikka; Liljeström, Anu; Vanninen, Petteri; Enkenberg, Jorma
2016-01-01
This socioculturally informed study aims to apply learning by collaborative designing (LCD) as an instructional model for the creation and studying of new kinds of connected learning systems in teacher education. A case study was organized at the University of Eastern Finland in the context of an information and communication technology (ICT)…
ERIC Educational Resources Information Center
Prix, Irene
2009-01-01
This paper explores whether polytechnic and university graduates are affected in the same way by gender differences in the graduate labour market in four countries: the Netherlands, Finland, Norway and Switzerland. Using data from the Research into Employment and Professional Flexibility (REFLEX) graduate survey, the analysis is based on…
ERIC Educational Resources Information Center
Rajbhandari, Mani Man Singh; Basaran, Kenan; Hujala, Eeva; Kinos, Jarmo
2011-01-01
THEOR"ACTIVE" learning is a multi dimensional attachment of theories and practices. The study explores to identify the implementation of theories into practices and how it is being perceived by the students. The research on THEOR"ACTIVE" was conducted with the master degree student coming from different countries at the…
Do It Yourself in Education: Leadership for Learning across Physical and Virtual Borders
ERIC Educational Resources Information Center
Domingo-Coscollola, María; Arrazola-Carballo, Judith; Sancho-Gil, Juana María
2016-01-01
Today more than ever, educational institutions need educational leaders who are able to promote profound, substantive and sustainable change. This paper is based on the efforts and results of the first stage of a European project implemented in universities and primary and secondary schools in Spain, Finland and the Czech Republic. The project…
Relations of Power and Knowledge: University-Industry Relations in Business Studies in Finland
ERIC Educational Resources Information Center
Lehtimäki, Hanna; Peltonen, Tuomo
2013-01-01
In the globalized neoliberal economy, business schools and business science has become a dominant societal institution and discourse. However, this has not directly strengthened the position of business schools in the societal networks of power. This paper examines this paradox by depicting who are the actors in the field and how these actors seek…
An In-Depth Exploration of the Effects of the Webcam on Multimodal Interactive Learning
ERIC Educational Resources Information Center
Codreanu, Tatiana; Celik, Christelle Combe
2012-01-01
Current research describes multimodal pedagogical communication of two populations of online teachers; trainee tutors (second year students of the Master of Arts in Teaching French as a Foreign Language at the university Lumiere-Lyon 2, France) and experienced teachers based in different locations (France, Spain and Finland). They all taught…
Finnish Mathematics Teaching from a Reform Perspective: A Video-Based Case-Study Analysis
ERIC Educational Resources Information Center
Andrews, Paul
2013-01-01
This article offers a qualitative analysis of videotaped mathematics lessons taught by four teachers in a provincial university city in Finland. My study is framed not only by Finnish success on Programme for International Student Assessment (PISA) but also by the objectives of current mathematics education reform, which are consistent with PISA's…
Santavirta, Torsten; Santavirta, Nina; Betancourt, Theresa S; Gilman, Stephen E
2015-01-05
To compare the risks of admission to hospital for any type of psychiatric disorder and for four specific psychiatric disorders among adults who as children were evacuated to Swedish foster families during the second world war and their non-evacuated siblings, and to evaluate whether these risks differ between the sexes. Cohort study. National child evacuation scheme in Finland during the second world war. Children born in Finland between 1933 and 1944 who were later included in a 10% sample of the 1950 Finnish census ascertained in 1997 (n = 45,463; women: n = 22,021; men: n = 23,442). Evacuees in the sample were identified from war time government records. Adults admitted to hospital for psychiatric disorders recorded between 1971 and 2011 in the Finnish hospital discharge register. We used Cox proportional hazards models to estimate the association between evacuation to temporary foster care in Sweden during the second world war and admission to hospital for a psychiatric disorder between ages 38 and 78 years. Fixed effects methods were employed to control for all unobserved social and genetic characteristics shared among siblings. Among men and women combined, the risk of admission to hospital for a psychiatric disorder did not differ between Finnish adults evacuated to Swedish foster families and their non-evacuated siblings (hazard ratio 0.89, 95% confidence interval 0.64 to 1.26). Evidence suggested a lower risk of admission for any mental disorder (0.67, 0.44 to 1.03) among evacuated men, whereas for women there was no association between evacuation and the overall risk of admission for a psychiatric disorder (1.21, 0.80 to 1.83). When admissions for individual psychiatric disorders were analyzed, evacuated girls were significantly more likely than their non-evacuated sisters to be admitted to hospital for a mood disorder as an adult (2.19, 1.10 to 4.33). The Finnish evacuation policy was not associated with an increased overall risk of admission to hospital for a psychiatric disorder in adulthood among former evacuees. In fact, evacuation was associated with a marginally reduced risk of admission for any psychiatric disorder among men. Among women who had been evacuated, however, the risk of being admitted to hospital for a mood disorder was increased. © Santavirta et al 2014.
Bastola, Kalpana; Koponen, Päivikki; Härkänen, Tommi; Luoto, Riitta; Gissler, Mika; Kinnunen, Tarja I
2018-05-20
Limited information is available on delivery and its complications among migrant women in Finland. We compared mode of delivery, delivery complications, and use of pain medication during delivery between migrant women of Somali, Kurdish, and Russian origin and women in the general population in Finland. The women were of Russian (n = 318), Somali (n = 583), and Kurdish (n = 373) origin and 243 women from the general population (reference group) who had given birth in Finland between 2004 and 2014. The data were obtained from the National Medical Birth Register and the Hospital Discharge Register. The most recent birth of each woman was included in the analyses. The main statistical methods were logistic regression analyses adjusting for age, parity, body mass index, gestational age, and smoking during pregnancy. Vaginal delivery was the most common mode of delivery among all study groups (79%-89%). The prevalence of any delivery complications varied between 15% and 19% among all study groups. When adjusted for confounders, Russian women had lower odds (OR 0.49; CI 0.29-0.82) of having a cesarean delivery, whereas Somali and Kurdish women did not differ from the reference group. Somali women had an increased risk of any delivery complications (OR 1.62; CI 1.03-2.55) compared with the reference group. No differences were observed in the use of pain medication between the groups. Delivery complications were more common among migrant Somali women than among women in the general Finnish population. Somali women represent a high-risk group calling for special attention and care. © 2018 Wiley Periodicals, Inc.
Placenta previa and risk of major congenital malformations among singleton births in Finland.
Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo
2015-06-01
Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.
Riikonen, Jarno; Kaipia, Antti; Petas, Anssi; Horte, Antero; Koskimäki, Juha; Kähkönen, Esa; Boström, Peter J; Paananen, Ilkka; Kuisma, Jani; Santti, Henrikki; Matikainen, Mika; Rannikko, Antti
2016-06-01
Objective The aim of this study was to analyze the impact of introduction of robot-assisted prostate surgery and its quality measures in Finland from 2008 to 2012. Materials and methods Registry data were collected for time trends and national distribution of prostate cancer surgery in Finland, while preoperative, operative and follow-up data were collected for quality measures. Results The number and proportion of robot-assisted laparoscopic radical prostatectomies (RALPs) increased rapidly and they accounted for 68% of all radical prostatectomies in 2012. The number of centers performing prostatectomies diminished from 25 to 20 at the expense of low-volume centers. In total, 1996 patients were operated on in the four RALP centers in 2008-2012. As anticipated, the learning curve was uniform between the centers, as were mean blood loss (212 ml), hospitalization (1.8 days) and catheterization times (10.6 days). At 3 and 12 months, 49.4% and 71.2% of patients, respectively, were totally continent (no pads). After unilateral nerve-sparing surgery, 9.9% and 5.1% had partial or normal erection at 3 months postoperatively and 14.8% and 20.4% at 12 months, respectively. If bilateral nerve sparing was done, the figures were 13.0% and 13.5% at 3 months and 14.6% and 34.9% at 12 months. Clavien-Dindo grade 3, 4 or 5 complications were seen in 0.3%, 0.3% and 0.1% of patients, respectively. Limitations of the study include non-standardized collection of outcome parameters. Conclusions This report shows that the main impact of adoption of RALP on a national level was rapid spontaneous centralization of prostate cancer surgery. The main advantages of minimally invasive prostatectomy, i.e. low blood loss and short hospitalization, are easily achieved, while continuous effort is necessary for improvements in surgical outcomes.
Niela-Vilén, Hannakaisa; Axelin, Anna; Melender, Hanna-Leena; Salanterä, Sanna
2015-10-01
Preterm infants are usually breastfed less than full-term infants, and successful breastfeeding requires a supportive environment and special efforts from their mothers. A breastfeeding peer-support group, utilising social media, was developed for these mothers in order to support them in this challenge. Mothers were able to discuss breastfeeding and share experiences. The purpose of this study was to describe the perceptions of breastfeeding mothers of preterm infants based on the postings in peer-support group discussions in social media. The actively participating mothers (n = 22) had given birth <35 gestational weeks. They were recruited from one university hospital in Finland. The social media postings (n = 305) were analysed using thematic analysis. A description of the process of breastfeeding a preterm infant from the point of view of a mother was created. The process consisted of three main themes: the breastfeeding paradox in hospital, the 'reality check' of breastfeeding at home and the breastfeeding experience as part of being a mother. The mothers encountered paradoxical elements in the support received in hospital; discharge was promoted at the expense of breastfeeding and pumping breast milk was emphasised over breastfeeding. After the infant's discharge, the over-optimistic expectations of mothers often met with reality - mothers did not have the knowledge or skills to manage breastfeeding at home. Successful breastfeeding was an empowering experience for the mothers, whereas unsuccessful breastfeeding induced feelings of disappointment. Therefore, the mothers of preterm infants need evidence-based breastfeeding counselling and systematic support in a neonatal intensive care unit (NICU) and at home. © 2014 John Wiley & Sons Ltd.
Historical theses on nursing and caring sciences in Finland: a literature review.
Lukana, Anne; Leena, Salminen; Marjo, Kaartinen; Helena, Leino-Kilpi
2013-12-01
The purpose of this literature review was to review the theses (masters, licentiate and doctoral theses) on the history of nursing and caring sciences in Finland. The research questions were as follows: 1.What is the number and characteristics of these historical theses (target groups, methods and sources) on nursing and caring sciences have been produced in Finland? 2.What periods of time have been under investigation in these theses? 3.What topics have been investigated in these theses? The theses on the history of nursing and caring sciences were retrieved from the theses index of the universities that offer education in nursing and caring sciences in Finland. The literature search covered the time period 1979-2010. Altogether, 58 theses were reviewed and analysed via content analysis. Of all of the theses (n = 3969) produced in nursing and caring sciences, 58 of them focused on historical topics (<2%). The most common target group was healthcare personnel. The most common research method was the traditional historical method. Primary and secondary sources were used both together and separately. Nearly all of the theses examined the history of the 1900s, whereas only a few of them examined time periods before that. The four main topics of the theses were nursing practice, nursing education, nursing management and philosophy of nursing. The most common topic was nursing practice, especially psychiatric nursing. Research on the history of nursing and caring sciences in Finland has received only marginal attention from researchers. This literature review offers a description of the historical research produced on nursing and caring sciences and the topics of interest. In future, it will be necessary to more closely examine several historical topics that have been neglected in the study of nursing and caring sciences. © 2012 The Authors Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.
ERIC Educational Resources Information Center
Hordósy, Rita
2017-01-01
This paper analyses how three European countries produce and use data within a specific educational policy field, that of school leaving and graduation. It compares how stakeholders in England, Finland and the Netherlands know what happens to the leavers from schools and universities. Through gathering evidence about the methodological…
Developing Scholarly Communities as Learning Environments for Doctoral Students
ERIC Educational Resources Information Center
Pyhalto, Kirsi; Stubb, Jenni; Lonka, Kirsti
2009-01-01
The quality of PhD training can be conceived of as being dependent on the learning environment provided by the scholarly community. Our paper explores PhD students' ideas about themselves as a part of this community, and their perceptions of their learning environment in the context of the University of Helsinki, Finland. The study is a part of a…
ERIC Educational Resources Information Center
Helle, Laura; Nivala, Markus; Kronqvist, Pauliina
2013-01-01
The adoption of virtual microscopy at the University of Turku, Finland, created a unique real-world laboratory for exploring ways of reforming the learning environment. The purpose of this study was to evaluate the students' reactions and the impact of a set of measures designed to boost an experimental group's understanding of abnormal histology…
El Ansari, Walid; Suominen, Sakari; Berg-Beckhoff, Gabriele
2015-09-01
We examined perceived stress and food intake at University of Turku, Finland. This study was conducted as an online survey (1189 students). We computed two composite food intake pattern scores (sweets, cakes and snacks; fruits and vegetables), a dietary guideline adherence index, and the subjective importance of healthy eating. We assessed the correlations between perceived stress, and two food intake pattern scores, dietary guideline adherence index and subjective importance of healthy eating. We tested the associations between stress and the same variables, controlling for potential confounders for the whole sample, by gender, and by Body Mass Index (BMI). Fruits and vegetables intake and dietary guideline adherence were both negatively associated with stress. These negative associations were more pronounced in overweight and less pronounced in underweight compared to healthy weight students. Sweets, cookies and snacks consumption were not associated with stress. Stress was associated with lower subjective importance of healthy eating, independent of gender and BMI. Perceived stress might have relationships of different magnitudes in overweight vs. normal BMI or underweight persons. BMI could be an effect modifier of the stress-food habits association.
Atmospheric pressure and suicide attempts in Helsinki, Finland
NASA Astrophysics Data System (ADS)
Hiltunen, Laura; Ruuhela, Reija; Ostamo, Aini; Lönnqvist, Jouko; Suominen, Kirsi; Partonen, Timo
2012-11-01
The influence of weather on mood and mental health is commonly debated. Furthermore, studies concerning weather and suicidal behavior have given inconsistent results. Our aim was to see if daily weather changes associate with the number of suicide attempts in Finland. All suicide attempts treated in the hospitals in Helsinki, Finland, during two separate periods, 8 years apart, were included. Altogether, 3,945 suicide attempts were compared with daily weather parameters and analyzed with a Poisson regression. We found that daily atmospheric pressure correlated statistically significantly with the number of suicide attempts, and for men the correlation was negative. Taking into account the seasonal normal value during the period 1971-2000, daily temperature, global solar radiation and precipitation did not associate with the number of suicide attempts on a statistically significant level in our study. We concluded that daily atmospheric pressure may have an impact on suicidal behavior, especially on suicide attempts of men by violent methods ( P < 0.001), and may explain the clustering of suicide attempts. Men seem to be more vulnerable to attempt suicide under low atmospheric pressure and women under high atmospheric pressure. We show only statistical correlations, which leaves the exact mechanisms of interaction between weather and suicidal behavior open. However, suicidal behavior should be assessed from the point of view of weather in addition to psychiatric and social aspects.
The genetics of XX gonadal dysgenesis
DOE Office of Scientific and Technical Information (OSTI.GOV)
Aittomaeki, K.
1994-05-01
In a nationwide population-based study of women born between 1950 and 1976, 75 patients with XX gonadal dysgenesis (XXGD) were identified in Finland. Patients were ascertained through hospital records and the registers of chromosome laboratories. In one family 4 daughters were affected; in six families 2 daughters were affected; and 57 cases were isolated. In one additional family the two affected females were in successive generations. Population records were utilized to trace ancestors of patients back to the beginning of the 19th century, in most cases. Consanguinity was detected in 8 (12%) of 66 families. When females only are considered,more » the segregation analyses yield a proportion of .23 affected. The relatively large number of affected individuals identified (incidence 1 in 8,300 live-born girls) implies a high gene frequency in the Finnish population. The geographic distribution was highly uneven, with most families originating in the sparsely populated north-central part of Finland. These findings support the existence of an autosomal recessive (XXGD) gene (locus designation [open quotes]ODG1[close quotes]) that is highly enriched in Finland. The multiplex families already identified will make it possible to map the ODG1 gene by a random search for linkage by using polymorphic markers. Linkage-disequilibrium analysis in the sporadic patients will then be used to test for genetic homogeneity versus heterogeneity. 27 refs., 3 figs.« less
Pönkkö, Maija-Leena; Taanila, Anja; Ebeling, Hanna
2003-03-01
The problems of children and adolescents have increased in number and severity during the last years. The purpose of this study was to elicit the views of special school teachers in the Oulu Province in Finland concerning their pupils' problems and the need, use and adequacy of relevant psychiatric services. The information was collected from the Northern Ostrobothnia Hospital District in 1998 in Finland and responses were obtained from the 37 (97.4%) special schools. The data were analysed using the content analysis method. Special-needs pupils had various behavioural and emotional problems that made it difficult for them to learn and for the teachers to teach. According to the teachers, the major obstacles in the process of helping special-needs pupils were the delayed admission for treatment and the lack of information necessary for the pupils' school work and goal-oriented aftercare, although there were also favourable experiences of functional co-operation and availability of useful information. Some schools lacked a reliable network for helping pupilsand supporting teachers. The Finnish legislation on basic education obliges the providers of education to provide rehabilitation in connection with special education and to arrange relevant development, counselling and support services. The rehabilitation of special-need pupils and the collaboration between school and mental health authorities is not optimally realised in spite of the legislation.
Lüthje, P; Helkamaa, T; Nurmi-Lüthje, I; Kaukonen, J-P; Kataja, M
2014-03-01
Some hip fracture patients need one or more reoperations because of complications following initial operative treatment. The aim of this study was to identify all further surgical interventions in a cohort of patients with hip fractures over a period of 8 years after index fracture. Immediate direct costs of these reoperations were also calculated. This retrospective study investigated 221 consecutive patients with hip fractures operated on at two different hospitals in southeastern Finland. The study period in hospital A was from 1 February 2003 to 31 January 2004, and in hospital B from 1 February 2003 to 30 April 2004. About 50% were femoral neck fractures, 41% trochanteric fractures, and 9% subtrochanteric fractures. Patients' medical records were checked from the hospital records and confirmed manually. Short- and long-term complications were recorded. Survival analysis was performed using a life-table method. The actual costs for reoperations and other further procedures for each patient were calculated using diagnosis-related groups-based costs for both hospitals in 2012. A total of 20 patients (9%) needed reoperations. Overall, 10 patients (8.9%) with a femoral neck fracture (n = 112), 8 patients (8.7%) with trochanteric fracture (n = 92), and 2 patients (10.5%) with subtrochanteric fracture (n = 19) were reoperated on. The median interval between the primary operation of the acute hip fracture (n = 20) and the first reoperation was about 300 days (range: 2 weeks to 82 months). Among the women reoperated on, the excess mortality was lower than among those undergoing a single operation. The median costs of treatment per patient with one or more reoperations were €13,422 in hospital A (range: €1616-€61,755), €11,076 in hospital B (range: €1540-€17,866), and €12,850 in the total study group (p = 0.43). In the case of infections (3 patients), the mean costs per patient were €28,751 (range: €11,076-€61,755). Almost 10% of hip fracture patients required reoperations, and these reoperations caused significant direct costs to health care. However, direct costs account for only approximately 25% of the first year's total costs. These costs should be taken into account when evaluating the economics of hip fractures and the burden of health care.
Mäki, P; Koskela, S; Murray, G K; Nordström, T; Miettunen, J; Jääskeläinen, E; Veijola, J M
2014-08-01
Social withdrawal is among the first signs of the prodromal state of psychosis seen in clinical samples. The aim of this prospective study was to find out whether difficulty in making contact with others and social withdrawal precede first episode psychosis in the young general population. The members of the Northern Finland Birth Cohort 1986 (n=6274) completed the PROD-screen questionnaire in 2001-2002. The Finnish Hospital Discharge Register was used to detect both new psychotic and non-psychotic disorders requiring hospitalisation during 2003-2008. Twenty-three subjects developed psychosis and 89 developed a non-psychotic mental disorder requiring hospitalisation during the follow-up. Of those who developed psychosis, 35% had reported difficulty or uncertainty in making contact with others and 30% social withdrawal in adolescence. In hospitalised non-psychotic disorder, the corresponding precentages were 10 and 13% and in the control group without hospital-treated mental disorder 9 and 11%. The differences between psychotic and non-psychotic hospitalised subjects (P<0.01) as well as controls (P<0.001) were statistically significant regarding difficulty or uncertainty in making contact with others. In this general population-based sample self-reported difficulty or uncertainty in making contact with others in adolescence preceded psychosis specifically compared to hospitalised non-psychotic mental disorders and controls. Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Jaakkonen, A; Salmenlinna, S; Rimhanen-Finne, R; Lundström, H; Heinikainen, S; Hakkinen, M; Hallanvuo, S
2017-09-01
Shiga toxin-producing, sorbitol-fermenting Escherichia coli O157 (SF O157) has emerged as a cause of severe human illness. Despite frequent human findings, its transmission routes and reservoirs remain largely unknown. Foodborne transmission and reservoir in cattle have been suspected, but with limited supporting evidence. This study describes the outbreak of SF O157 that occurred in Finland in 2012. The outbreak originated from a recreational farm selling unpasteurized milk, as revealed by epidemiologic and microbiological investigations, and involved six hospitalized children and two asymptomatic adults with culture-confirmed infection. An identical strain of SF O157 was isolated from patients, cattle and the farm environment, and epidemiologic analysis suggested unpasteurized milk as the vehicle of transmission. This study reports the first milkborne outbreak of SF O157, provides supporting evidence of cattle as a reservoir and highlights the health risks related to the consumption of unpasteurized milk. © 2017 The Authors. Zoonoses and Public Health Published by Blackwell Verlag GmbH.
Linko, R; Pettilä, V; Ruokonen, E; Varpula, T; Karlsson, S; Tenhunen, J; Reinikainen, M; Saarinen, K; Perttilä, J; Parviainen, I; Ala-Kokko, T
2011-09-01
To evaluate the incidence, treatment, and outcome of influenza A(H1N1) in Finnish intensive care units (ICUs) with special reference to corticosteroid treatment. During the H1N1 outbreak in Finland between 11 October and 31 December 2009, we prospectively evaluated all consecutive ICU patients with high suspicion of or confirmed pandemic influenza A(H1N1) infection. We assessed severity of acute disease and daily organ dysfunction. Ventilatory support and other concomitant treatments were evaluated and recorded daily throughout the ICU stay. The primary outcome was hospital mortality. During the 3-month period altogether 132 ICU patients were tested polymerase chain reaction-positive for influenza A(H1N1). Of these patients, 78% needed non-invasive or invasive ventilatory support. The median (interquartile) length of ICU stay was 4 [2-12] days. Hospital mortality was 10 of 132 [8%, 95% confidence interval (CI) 3-12%]. Corticosteroids were administered to 72 (55%) patients, but rescue therapies except prone positioning were infrequently used. Simplified Acute Physiology Score II and Sequential Organ Failure Assessment scores in patients with and without corticosteroid treatment were 31 [24-36] and 6 [2-8] vs. 22 [5-30] and 3 [2-6], respectively. The crude hospital mortality was not different in patients with corticosteroid treatment compared to those without: 8 of 72 (11%, 95% CI 4-19%) vs. 2 of 60 (3%, 95% CI 0-8%) (P = 0.11). The majority of H1N1 patients in ICUs received ventilatory support. Corticosteroids were administered to more than half of the patients. Despite being more severely ill, patients given corticosteroids had comparable hospital outcome with patients not given corticosteroids. © 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.
Leino, Tuija; Baum, Ulrike; Scott, Peter; Ollgren, Jukka; Salo, Heini
2017-10-09
This study aimed to estimate the impact of the national rotavirus (RV) vaccination programme, starting 2009, on the total hospital-treated acute gastroenteritis (AGE) and severe RV disease burden in Finland during the first five years of the programme. This study also evaluated the costs saved in secondary healthcare by the RV vaccination programme. The RV related outcome definitions were based on ICD10 diagnostic codes recorded in the Care Register for Health Care. Incidences of hospitalised and hospital outpatient cases of AGE (A00-A09, R11) and RVGE (A08.0) were compared prior (1999-2005) and after (2010-2014) the start of the programme among children less than five years of age. The reduction in disease burden in 2014, when all children under five years of age have been eligible for RV vaccination, was 92.9% (95%CI: 91.0%-94.5%) in hospitalised RVGE and 68.5% (66.6%-70.3%) in the total hospitalised AGE among children less than five years of age. For the corresponding hospital outpatient cases, there was a reduction of 91.4% (82.4%-96.6%) in the RVGE incidence, but an increase of 6.3% (2.7%-9.9%) in the AGE incidence. The RV vaccination programme prevented 2206 secondary healthcare AGE cases costing €4.5 million annually. As the RV immunisation costs were €2.3 million, the total net savings just in secondary healthcare costs were €2.2 million, i.e. €33 per vaccinated child. The RV vaccination programme clearly controlled the severe, hospital-treated forms of RVGE. The total disease burden is a more valuable end point than mere specifically diagnosed cases as laboratory confirmation practises usually change after vaccine introduction. The RV vaccination programme annually pays for itself at least two times over. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Lindqvist, Rikard; Smeds Alenius, Lisa; Runesdotter, Sara; Ensio, Anneli; Jylhä, Virpi; Kinnunen, Juha; Strømseng Sjetne, Ingeborg; Tvedt, Christine; Wiberg Tjønnfjord, Maria; Tishelman, Carol
2014-01-01
Health care systems in Finland, Norway and Sweden share many similarities, e.g. full-coverage and tax-financed, with predominately public sector hospitals. Despite similarities, there are differences in the working situations for RNs within these Nordic countries. The aim of this study was to analyze associations between RNs' patient workload and level of involvement in direct patient care, their job satisfaction and intention to leave in these countries. A workforce survey was conducted through RN4CAST, an EU 7th framework project. The survey included 118 items derived from validated instruments or tested in prior research. Responses from 1133 RNs at 32 Finnish hospitals, 3752 RNs at 35 Norwegian hospitals, and 11 015 RNs at 71 Swedish hospitals comprise the database, which was analyzed using logistic and odds ratio regressions analyses. We found statistically significant differences in RNs' level of involvement in direct patient care (p < 0.001, Sweden compared to Norway and Finland), in patient workload and in number of patients needing ADL assistance and surveillance. A U-formed relationship was found between level of involvement in direct patient care and intention to leave in Sweden, and more satisfaction among RNs in roles with more direct patient care (OR = 1.16, 1.02 ≤ CI95% ≤ 1.32). Nearly half the Finnish sample report intention to leave, with significantly lower levels in Norway and Sweden (p < 0.001). Patient workload is associated with job satisfaction and intention to leave to some degree in all countries, i.e. greater patient workload, less job satisfaction and greater intention to leave. This study suggests that more attention paid to patient mix, workload and role of RNs in patient care might potentially diminish intention to leave and increase job satisfaction in these Nordic countries.
Somersalo, A; Paloneva, J; Lönnroos, E; Heinänen, M; Koponen, H; Kiviranta, I
2018-05-01
The death of any young individual is associated with the loss of many potentially fulfilling years of life. It has been suggested that the relative mortality of fracture patients may be higher in younger age groups than in older cohorts. We determined the mortality and causes of death in a cohort of 16- to 30-year-old patients that had been hospitalized for fractures. We collected data using criteria based on the diagnosis code (International Statistical Classification of Diseases and Related Health Problems, 10th Revision), surgical procedure code (Nordic Medico-Statistical Committee), and seven additional characteristics of patients admitted to the trauma ward at the Central Finland Hospital between 2002 and 2008. Patients were then followed to ascertain their mortality status until the end of 2012. Standardized mortality ratios were calculated and causes of death were determined by combining our registry data with data provided by Statistics Finland. During the study, 199 women and 525 men aged 16-30 years had sustained fractures. None of these patients died during the primary hospital stay. At the end of follow-up (mean duration 7.4 years), 6 women and 23 men had died. The standardized mortality ratio for all patients was 6.2 (95% Confidence Interval: 4.3-8.9). Suicides and intoxications comprised over half, and motor vehicle accidents and homicides comprised nearly a third of the post-fracture deaths. We found a concerning increase in mortality among young adults that had been hospitalized due to a fracture compared to the general population that had been standardized by age, sex, and calendar-period. Leading causes of death were suicides and intoxications or motor vehicle accidents and homicides, which may be indicative of depressive disorders or impulse control disorders, respectively. Identification of the underlying psychosocial problems may provide an opportunity for preventive interventions.
Hasegawa, Kohei; Jartti, Tuomas; Mansbach, Jonathan M.; Laham, Federico R.; Jewell, Alan M.; Espinola, Janice A.; Piedra, Pedro A.; Camargo, Carlos A.
2015-01-01
Background. We investigated whether children with a higher respiratory syncytial virus (RSV) genomic load are at a higher risk of more-severe bronchiolitis. Methods. Two multicenter prospective cohort studies in the United States and Finland used the same protocol to enroll children aged <2 years hospitalized for bronchiolitis and collect nasopharyngeal aspirates. By using real-time polymerase chain reaction analysis, patients were classified into 3 genomic load status groups: low, intermediate, and high. Outcome measures were a length of hospital stay (LOS) of ≥3 days and intensive care use, defined as admission to the intensive care unit or use of mechanical ventilation. Results. Of 2615 enrolled children, 1764 (67%) had RSV bronchiolitis. Children with a low genomic load had a higher unadjusted risk of having a length of stay of ≥3 days (52%), compared with children with intermediate and those with high genomic loads (42% and 51%, respectively). In a multivariable model, the risk of having a length of stay of ≥3 days remained significantly higher in the groups with intermediate (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.20–1.69) and high (OR, 1.58; 95% CI, 1.29–1.94) genomic loads. Similarly, children with a high genomic load had a higher risk of intensive care use (20%, compared with 15% and 16% in the groups with low and intermediate genomic loads, respectively). In a multivariable model, the risk remained significantly higher in the group with a high genomic load (OR, 1.43; 95% CI, 1.03–1.99). Conclusion. Children with a higher RSV genomic load had a higher risk for more-severe bronchiolitis. PMID:25425699
Mäkelä, Mika J; Christensen, Helene Nordahl; Karlsson, Antti; Rastogi, Sarang; Kettunen, Kirsi
2018-01-01
Background : Eosinophilic airway inflammation is common in asthma patients and appears to be associated with severe exacerbations and loss of asthma control. Objective : To describe the resource utilization and clinical characteristics of patients with eosinophilic asthma. Design : Asthma patients ≥18 years with ≥1 blood eosinophil count in secondary care (South West Finland) during 2003‒2013 were included. Clinical characteristics (age, lung function, body mass index, and comorbidities) and asthma-related resource utilization (hospital admissions, outpatient visits, and emergency room [ER] visits) were retrieved. Resource utilization rates were compared for patients with blood eosinophil ≤ or >300 cells/μL, using adjusted negative binomial regression models. Results : Overall, 4,357 eligible patients were identified (mean age 60 years, females 68%), of which 1,927 (44%) had >300 eosinophil cells/μL blood. Patients with ≤300 and >300 eosinophil counts, exhibited similar clinical characteristics, including advanced age, poor lung function, and overweight. Comorbidities such as pneumonia, sinusitis, and nasal polyps, were more frequent among those with >300 eosinophil cells/μL blood compared with patients with lower counts. Eosinophil counts >300 cells/μL were associated with greater hospital admissions (rate ratio [RR] [95% confidence interval CI]: 1.13 [1.02;1.24]) and outpatient visits (RR [95% CI]: 1.11 [1.03;1.20]) compared with patients with lower eosinophil counts. Rates of ER visits were similar between the patient groups (RR [95% CI]: 0.99 [0.87;1.12]). Conclusions : Hospital admissions and outpatient visits occurred more often for patients with eosinophil counts >300 cells/µL, than for patients with lower eosinophil counts. Routine blood eosinophil screening might be useful to identify patients with an eosinophilic phenotype eligible for more targeted treatments.
Waterborne Campylobacter jejuni epidemic in a Finnish hospital for rheumatic diseases.
Rautelin, H; Koota, K; von Essen, R; Jahkola, M; Siitonen, A; Kosunen, T U
1990-01-01
A waterborne Campylobacter jejuni outbreak in the Rheumatism Foundation Hospital in Heinola, Finland, in November-December 1986 is described. 32 patients and 62 members of the staff developed gastrointestinal symptoms. C. jejuni heat-stable serotype 45 was isolated from the faeces of 32 enteritis patients and from none of the controls. No other enteropathogens were found. Positive serological responses to C. jejuni acid extract antigen were detected by enzyme immunoassay in 34% of the symptomatic hospital patients, in 40% of the symptomatic staff members, and in 10% of the controls. The clinical course of the illness was mostly mild and self-limited. No striking progress in the arthritis symptoms of the patients was found after the outbreak. The hospital has its own water supply. C. jejuni of the same serotype as the epidemic strain was isolated from the water of the pipeline system. After a careful examination some aged components of the waterworks were found to be responsible for leaks that resulted in the contamination of the water.
Lamminpää, A; Riihimäki, V
1992-11-01
Pesticide-related incidents are uncommon in Finland. They comprised 0.11% of all hospitalizations due to poisoning in 1987-88. A search of the nationwide Hospital Discharge Register revealed 78 pesticide-related incidents in a 5-year period. Some 30 different agents were involved, the most frequent being organophosphate and MCPA. Only 36 cases (46%) were judged to be unequivocal or probable pesticide poisonings; 26 (33%) were probably other illnesses because of no or minimal exposure and of the children admitted for follow-up, nine (12%) had potentially marked exposure, but no poisoning developed owing to vigorous early treatment which limited absorption, and seven (9%) cases remained undetermined. According to our analysis, the management of patients with (suspected) pesticide poisoning at hospitals could be further improved if the following procedures were emphasised: decontamination of the skin when appropriate, systematic early estimation of the likely dose involved, analytical verification of pesticide absorption whenever feasible, and consistent collaboration with a toxicological advisory service.
NASA Astrophysics Data System (ADS)
2015-11-01
The 2nd International School and Conference ''Saint Petersburg OPEN 2015'' on Optoelectronics, Photonics, Engineering and Nanostructures was held on April 6 - 8, 2015 at St. Petersburg Academic University. The School and Conference included a series of invited talks given by leading professors with the aim to introduce young scientists with actual problems and major advances in physics and technology. The keynote speakers were Mikhail V. Maximov (Ioffe Physico-Technical Institute RAS, Russia) Vladimir G. Dubrovskii (St. Petersburg Academic University and St. Petersburg State University, Russia) Anton Yu. Egorov (JSC Connector Optics, Russia) Victor V. Luchinin (St. Petersburg State Electrotechnical University, Russia) Vladislav E. Bugrov (St. Petersburg University of Internet Technologies, Mechanics and Optics, Russia) Vitali A. Schukin (VI Systems, Germany) Yuri P. Svirko (University of Eastern Finland, Finland) During the poster session all undergraduate and graduate students attending the conference presented their works. A sufficiently large number of participants, with more than 170 student attendees from all over the world, allowed the Conference to provide a fertile ground for fruitful discussions between the young scientists as well as to become a perfect platform for valuable discussions between student authors and highly experienced scientists. The best student papers, which were selected by the Program Committee and by the invited speakers basing on the theses and their poster presentation, were awarded with diplomas of the conference - see the photos. This year ''Saint Petersburg OPEN 2015'' is organized by St. Petersburg Academic University in cooperation with Peter the Great St. Petersburg Polytechnic University. The School and Conference is supported by Russian Science Foundation, SPIE (The International Society for Optics and Photonics), OSA (The Optical Society) and by Skolkovo Foundation. It is a continuation of the annual schools and seminars for youth on topical problems of physics and technology that are organized by the Academic University since 2009. We invite all the students and young scientists to attend ''Saint Petersburg OPEN'' in 2016! Please, find details at http://spbopen.spbau.com/
Berrios, X.; Koponen, T.; Huiguang, T.; Khaltaev, N.; Puska, P.; Nissinen, A.
1997-01-01
The Inter-Health Programme was launched in 1986 by WHO, with the collaboration of a coordination centre (National Public Health Institute, Finland) to control and prevent chronic noncommunicable diseases (CNCDs) among adults. Programmes for action were organized based on the concept that most major CNCDs share common risk factors and that those that are lifestyle related are modifiable through efficient interventions using multifactorial strategies involving community participation and behaviour changes carried out at the primary health care level. Twelve countries from all WHO Regions have joined the programme. A baseline survey was undertaken in all countries with a common protocol, following the criteria and methods employed in the MONICA Project. Altogether 36815 men and women aged 35-64 years were included in the present analysis from the following Inter-Health countries: Chile, China, Cyprus, Finland, Lithuanian SSR, Malta, Mauritius, Russian SFSR, United Republic of Tanzania, and USA. In addition to individual country analysis, centralized analysis was carried out at the Finnish National Public Health Institute and the Department of Community Health, Kuopio University, Finland. Reported here are the mean values of blood pressure, body mass index, and serum total cholesterol as well as specific prevalences of smoking, hypertension, obesity, and hypercholesterolaemia. PMID:9185361
Zimmermann, Peter Josef; Aarva, Pauliina; Sorsa, Minna
The official acceptance of complementary and alternative medicine (CAM) or integrative medicine in the academic discussion and in health policies in Finland is still poor. This is in contradiction to the fact that modern Finnish citizens use CAM as much as any people elsewhere in the European Union, with rates of 28-46% of the general population, or even more. This was one of the reasons for the foundation of the Finnish Forum for Research in Integrative Medicine and Healthcare (SILF) in November 2014. A first challenge for the SILF was to facilitate a research seminar to address the issue of CAM research as a part of the Finnish academic research. The seminar was organized by the Department of Health Sciences of the University of Tampere on November 13, 2015. Almost one third of the more than 400 participants were health professionals, and again one-third out of this group were physicians. As a result of the seminar, a research network was inaugurated. Obviously there is an increasing interest of health professionals in CAM and maybe even a change of attitude towards CAM also in Finland. However, genuine Finnish CAM research is essential in order to open up the academic discussion. © 2017 S. Karger GmbH, Freiburg.
ERIC Educational Resources Information Center
Turner, Ginny
To enhance the use of the Globe Watch IV public television series, produced jointly by Hampden-Sydney College (Virginia) and the University of North Carolina Center for Public Television, each lesson in this guide provides: (1) a statement of the objective of the program; (2) a synopsis of the issue discussed; (3) background information; (4) brief…
1975-12-30
that is consistent with other calculations and experiments- (H.-009). W. F. Brinkman and H. Smith (Bell Laboratories, ’Murray Hill, N.J.) presented...can depend on details of the Pd (part) of the phonon spectrum,"(S.010). D. S. Mac Lachlan , et al. (Universite de Paris-Sud, Orsay) reported in (S.011
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Tevaniemi, Johanna; Poutanen, Jenni; Lähdemäki, Riitta
2015-01-01
This article presents a case of co-designed temporary learning spaces at a Finnish academic library, together with the results of a user-survey. The experimental development of the multifunctional spaces offered an opportunity for the library to collaborate with its parent organisation thus broadening the role of the library. Hence, library can be…
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Rutanen, Niina; de Souza Amorim, Katia; Colus, Katia Miguel; Piattoeva, Nelli
2014-01-01
Early Childhood Education and Care (ECEC) policies and practices are local, historically and socially context-specific constructions. In addition to local ideals and policies, discursive practices concerning ECEC are influenced by universal ideals that are described and assigned by the member states of the United Nations Convention on the Rights…
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Milovanov, Riia; Pietila, Paivi; Tervaniemi, Mari; Esquef, Paulo A. A.
2010-01-01
The main aim of this study was to examine second language production and discrimination skills in the light of musical aptitude. Our study was conducted in university settings in south-western Finland. English was used as a model for the second language due to its popularity among young adults. There were three types of tests used in this study: a…
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Rasanen, Anne, Ed.; Marsh, David, Ed.
This volume of articles is a report from the national teacher in-service development program in teaching content through a foreign language at the Continuing Education Centre of the University of Jyvaskyla, Finland. This publication is mainly in English, because of the basic rationale of the Teaching Content through English (TCE) programme, and…
Game-Changer: The Illusion of War Without Risk
2017-04-28
War. Cambridge, MA: Harvard University Press, 1985. _____. A History of Strategy: From Sun Tzu to William S. Lind. Kuovola, Finland: Castalia House...Selected Bibliography 24 iii Paper Abstract In the late 1980s and early 1990s, the “Revolution in Military Affairs” (RMA) argued...SELECTED BIBLIOGRAPHY Books Bernstein, Peter L. Against the Gods: The Remarkable Story of Risk. New York: John Wiley & Sons, Inc., 1998
Huovinen, P; Pulkkinen, L; Helin, H L; Mäkilä, M; Toivanen, P
1986-01-01
Emergence of trimethoprim resistance among urinary tract Escherichia coli strains, isolated mostly from long-term patients in the Turku City Hospital, Turku, Finland, was studied from 1971 through 1984. Emergence of resistance to trimethoprim was associated with changes in the consumption of both trimethoprim-sulfamethoxazole and trimethoprim, with occurrence of high-level trimethoprim resistance and sequences homologous to trimethoprim resistance transposon Tn7. Since 1971, resistance of E. coli to trimethoprim-sulfamethoxazole increased from 8 to between 32 and 35% in 1983 and 1984; resistance to sulfamethoxazole varied from 39 to between 40 and 44%. The frequency of DNA sequence homology with our Tn7 probe among trimethoprim-resistant E. coli strains was 42% from 1980 to 1981 and 64% in 1983 (P less than 0.005). Fourteen years after the introduction of trimethoprim therapy in this hospital, resistance has reached the level of resistance to sulfonamide. PMID:3524425
Koivunen, Marita; Välimäki, Maritta; Hätönen, Heli
2010-01-01
Nursing professionals have long recognized the importance to practice of research and the value of research evidence. Nurses still do not use research findings in practice. The purpose of this paper was to describe nurses' skills in using literature databases and the Internet in psychiatric hospitals and associations of nurses' gender, age, and job position with their information retrieval skills. The study was carried out in 2004 among nursing staff (N=183) on nine acute psychiatric wards in two psychiatric hospitals in Finland (n=180, response rate 98%). The Finnish version of the European Computer Driving Licence test (ECDL) was used as a data collection instrument. The study showed that there were clear deficits in information retrieval skills among nurses working in psychiatric hospitals. Thus, nurses' competence does not support the realization of evidence-based practice in the hospitals. Therefore, it is important to increase nurses' information retrieval skills by tailoring continuing education modules. It would be also advisable to develop centralized systems for the internal dissemination of research findings for the use of nursing staff.
Koskinen, Katja S; Aho, Anna L; Hannula, Leena; Kaunonen, Marja
2014-04-01
to explore the relationship between maternity hospital practices and breast feeding self-efficacy. the data were collected using a cross-sectional survey. The study is a part of a larger longitudinal research and development project called 'Urban parenthood'. three urban maternity hospitals in Southern Finland. altogether 1400 questionnaires were given out and 573 primiparous and multiparous women completed the questionnaire within a week after childbirth. The response rate was 41%. early and successful initiation of breast feeding, rooming-in and exclusive breast feeding during the hospital stay were associated with higher maternal breast feeding self-efficacy in both primiparous and multiparous women. The reason (medical or non-medical), frequency or method (bottle or cup) for supplementation was not associated with breast feeding self-efficacy. breast feeding experiences during the immediate postpartum period have an association with breast feeding self-efficacy. Mothers who are not able to initiate breast feeding within an hour after birth or whose infants are supplemented during the hospital stay may benefit from additional support and breast feeding counselling. Copyright © 2013 Elsevier Ltd. All rights reserved.
[Emergency eye care in French university hospitals].
Bourges, J-L
2018-03-01
The patient's request for urgent care in ophthalmology (PRUCO) at health care centers is constantly growing. In France, university hospitals are managing 75% of these cases. We sought to quantify PRUCO referred to French university hospital emergency units as well as to approach the structure and the territorial distribution of emergency eye care provided by French university hospitals. We conducted a quick cross-sectional survey sent to the 32 metropolitan and overseas French university hospitals. It inquired for each hospital whether emergency eye care units were available, whether ophthalmologists were on duty or on call overnight and how many PRUCO were managed in 2016. The 32 university hospitals completed the survey. A total of 398650 PRUCO were managed in French university hospitals in 2016. The emergency unit was exclusively dedicated to eye care for 70% of the hospitals, with 47% (15/32) of them employing an ophthalmologist on duty overnight. Every hospital but one had at least one ophthalmologist on call. The city of Paris set aside, university hospitals took care of an annual mean of 9000 PRUCO (min=500; max=32,250). The 32 French university hospitals are actively responding to patient's requests for urgent care in ophthalmology with very heterogeneous patient volumes and organizational systems. Half of them employ ophthalmologists on duty. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Raivio, Risto; Jääskeläinen, Juhani; Holmberg-Marttila, Doris; Mattila, Kari J
2014-05-15
The aim here was to explore trends in patient satisfaction with primary health care and its accessibility and continuity, and to explore whether through reforms and improvements some of the essential goals had been achieved over a 14-year period of time in Finland. Nine questionnaire surveys were conducted over a period of 14 years among patients attending within one week in the 65 health centres in the Tampere University Hospital catchment area. A total of 147,394 responded out of a sample of 333,648 patients. The response rate varied yearly from 53% to 37%. Patient satisfaction with care in Finnish health centres decreased by nearly 9 percentage units from 1998 to 2011. The fall-off was most marked in the age-group over 64 years. There was a 20 percentage unit's reduction in ease of access as reported by patients. Respondents also reported that the continuity of care had deteriorated. Despite major reforms in Finnish health care policy, patients seem to be less satisfied. Our findings challenge both Finnish authorities and GPs to improve the accessibility and continuity of care in primary health services.
Duration of orthognathic-surgical treatment.
Paunonen, Jaakko; Helminen, Mika; Peltomäki, Timo
2017-07-01
The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p < .001, linear regression). Tooth extractions (excluding 3rd molars) included in pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.
Alastalo, Mika; Salminen, Leena; Lakanmaa, Riitta-Liisa; Leino-Kilpi, Helena
2017-10-01
The aim of this study was to provide a comprehensive description of multiple skills in patient observation in critical care nursing. Data from semi-structured interviews were analysed using thematic analysis. Experienced critical care nurses (n=20) from three intensive care units in two university hospitals in Finland. Patient observation skills consist of: information gaining skills, information processing skills, decision-making skills and co-operation skills. The first three skills are integrated in the patient observation process, in which gaining information is a prerequisite for processing information that precedes making decisions. Co-operation has a special role as it occurs throughout the process. This study provided a comprehensive description of patient observation skills related to the three-phased patient observation process. The findings contribute to clarifying this part of the competence. The description of patient observation skills may be applied in both clinical practice and education as it may serve as a framework for orientation, ensuring clinical skills and designing learning environments. Based on this study, patient observation skills can be recommended to be included in critical care nursing education, orientation and as a part of critical care nurses' competence evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.
Granö, Niklas; Oksanen, Jorma; Kallionpää, Santeri; Roine, Mikko
2017-01-01
Previous studies have shown an association between hopelessness and suicidal behaviour in clinical populations. The aim of the study was to investigate sensitivity, specificity, and predictive validity of the Beck Hopelessness Scale (BHS) for suicidal ideation in adolescents who show early risk signs on the psychiatric disorder continuum. Three-hundred and two help-seeking adolescents (mean age = 15.5 years) who were entering an early intervention team at Helsinki University Central Hospital, Finland, completed questionnaires of BHS and suicidal ideation, derived from Beck Depression Inventory (BDI-II). Results suggest that a BHS cut-off score ≥8 (sensitivity = 0.70, specificity = 0.76) or cut-off score ≥9 (sensitivity = 0.63, specificity = 0.80) may be useful to detect suicidal ideation with BHS in help-seeking adolescents population. Results remain mainly the same in a separate analysis with adolescents at risk for psychosis. The results support previous cut-off points for BHS in identification of suicidal ideation. The results suggest also that lower cut-off scores may be useful in sense of sensitivity, especially in clinical settings.
Rinne, Kirsi Marja; Kainulainen, Sakari; Aukee, Sinikka; Heinonen, Seppo; Nilsson, Carl Gustaf
2010-03-01
Support of the mid-urethra is thought to be an essential element of urinary continence in the female. Our aim was to image the behavior of the mid-urethra in healthy volunteers and in stress urinary incontinence (SUI) patients by dynamic magnetic resonance imaging (MRI). Prospective study. Gynecology outpatient clinic association with Department of Radiology in University Hospital of Kuopio, Finland. Fifteen healthy volunteers and 40 SUI women underwent dynamic MRI at rest, during pelvic floor muscle contraction, coughing and voiding with a bladder volume of 200 ml. Our aim was to determine the precise location and movement of the mid-urethra during these activities. The co-ordinate location and movement of the mid-urethra. Continent volunteers can elevate their mid-urethra significantly higher than incontinent women. Moreover, the mid-urethra of incontinent women rotated significantly more dorsocaudally during straining and coughing than in continent women. Elevation of the mid-urethra was more marked in continent compared to urinary incontinent women on pelvic floor muscle contraction suggesting sufficient support of the urethra. Downward movement of the mid-urethra was more significant in stress incontinent women than in continent volunteers.
Körber, Michael; Schmid, Klaus; Drexler, Hans; Kiesel, Johannes
2018-05-01
Medical and nursing shortages in rural areas represent a current serious public health problem. The healthcare of the rural population is at risk. This study compares perceived workload, job satisfaction and work-life balance of physicians and nurses at a clinic in a rural area with two clinics of a University hospital. Physicians and nurses were interviewed anonymously with a standardized questionnaire (paper and pencil), including questions on job satisfaction, subjective workload and work-life balance. The response rate was almost 50% in the University hospital as well as in the municipal hospital. 32 physicians and 54 nurses from the University hospital and 18 physicians and 137 nurses from the municipal hospital participated in the survey. Nurses at the University hospital assessed the organization of the daily routine with 94.1% as better than those at the municipal hospital (82.4%, p=0.03). Physicians at the University hospital were able to better implement acquired knowledge at a University clinic with 87.5% than their counterparts at the municipal hospital (55.5%, p=0.02). In contrast to their colleagues at the municipal hospital, only 50% of the physicians at the University hospital subjectively considered their workload as just right (83.3% municipal, p=0.02). 96.9% of the physicians at the University hospital were "daily" or "several times a week" under time pressure (municipal 50%, p<0.01). Nurses of both hospitals had sufficient opportunity to reconcile work and family life (62.9% University hospital, 72.8% Municipal hospital). In contrast, only 20% of the physicians at the University Hospital but 42.9% of the physicians of the municipal hospital had sufficient opportunities to balance workload and family (p=0.13). The return rate of almost 50% can be described as good. Due to the small number of physicians, especially from the municipal hospital, it can be assumed that some interesting differences could not be detected. There were only slight differences between the nurses from the two hospitals. In contrast, subjective workload and stress factors reported by physicians at the University Hospital were significantly higher than those by doctors at the municipal hospital. © Georg Thieme Verlag KG Stuttgart · New York.
Takamuku, Masatoshi
2015-01-01
University hospitals, bringing together the three divisions of education, research, and clinical medicine, could be said to represent the pinnacle of medicine. However, when compared with physicians working at public and private hospitals, physicians working at university hospitals and medical schools face extremely poor conditions. This is because physicians at national university hospitals are considered to be "educators." Meanwhile, even after the privatization of national hospitals, physicians working for these institutions continue to be perceived as "medical practitioners." A situation may arise in which physicians working at university hospitals-performing top-level medical work while also being involved with university and postgraduate education, as well as research-might leave their posts because they are unable to live on their current salaries, especially in comparison with physicians working at national hospitals, who focus solely on medical care. This situation would be a great loss for Japan. This potential loss can be prevented by amending the classification of physicians at national university hospitals from "educators" to "medical practitioners." In order to accomplish this, the Japan Medical Association, upon increasing its membership and achieving growth, should act as a mediator in negotiations between national university hospitals, medical schools, and the government.
The Secret to Finland's Success: Educating Teachers. Research Brief
ERIC Educational Resources Information Center
Sahlberg, Pasi
2010-01-01
In the last decade, Finland has emerged as the leading OECD country in educational achievement. In examining the sources of Finland's dramatic rise to the top, research shows one key element that has impacted Finland's success above all others: excellent teachers. This policy brief details the key elements of Finland's successful system, examining…
Residency hospital type and career paths in Japan: an analysis of physician registration cohorts.
Koike, Soichi; Kodama, Tomoko; Matsumoto, Shinya; Ide, Hiroo; Yasunaga, Hideo; Imamura, Tomoaki
2010-01-01
In 2004, a new postgraduate medical training system was introduced in Japan and a shift of new graduates from university hospitals to other postgraduate education hospitals happened. The aim of this study is to analyse the past trends on postgraduate medical education choices and subsequent career options to discuss possible outcomes of the current shift and policy implications. Data from the national physician survey from 1976 to 2006 were analysed. The proportion change of physicians started their career in university hospitals was calculated. The career paths for physicians by different residency type were presented. More than 90% of physicians experienced university hospital work at least once in their 20-year careers. In their first 10 years of their career, physicians who started their residency in a university hospital tended to spend more years working in university hospitals, and those who started in other post-graduate training hospitals tended to spend less in university hospitals. Then, these groups presented quite similar patterns in their career choices. University hospitals need to strengthen their function as continuing education and career development centres and to adopt a less paternalistic approach, as fewer residents start their career in university hospitals.
Mortality and causes of death among the migrant population of Finland in 2011-13.
Lehti, Venla; Gissler, Mika; Markkula, Niina; Suvisaari, Jaana
2017-02-01
Lower mortality among migrants than in the general population has been found in many, but not in all, previous studies. The mortality of migrants has not been studied in Finland, which has a relatively small and recent migrant population. People who were born abroad and whose mother tongue is not Finnish were identified from the Finnish Central Population Register (n = 185 605). A Finnish-born control matched by age, sex and place of residence was identified for each case (n = 185 605). Information about deaths was collected from the Finnish Causes of Death Register. Cox proportional hazards model was used for assessing the association between migrant status and death in 2011–13. The mortality risk was found to be significantly lower for migrants than for Finnish controls (adjusted hazard ratio 0.77, 95% CI 0.72–0.84), both for migrant men (aHR 0.80, 95% CI 0.73–0.89) and women (aHR 0.78, 95% CI 0.70–0.88). The difference was statistically significant only among people who were not married and among people who were not in employment. There was variation by country of birth, but no migrant group had higher mortality than Finnish controls. No differences in mortality were found by duration of residence in Finland. The higher mortality of Finnish controls was largely explained by alcohol-related conditions and external causes of death. The mortality risk of migrants is lower than of people who were born in Finland. Possible explanations include selection and differences in substance use and other health behaviour. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
2014-01-01
Background German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Methods Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Results Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1–2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3–4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Conclusion Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success. PMID:24755299
Degen, Christiane; Kuntz, Ludwig
2014-04-23
German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1-2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3-4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success.
Design-based research in designing the model for educating simulation facilitators.
Koivisto, Jaana-Maija; Hannula, Leena; Bøje, Rikke Buus; Prescott, Stephen; Bland, Andrew; Rekola, Leena; Haho, Päivi
2018-03-01
The purpose of this article is to introduce the concept of design-based research, its appropriateness in creating education-based models, and to describe the process of developing such a model. The model was designed as part of the Nurse Educator Simulation based learning project, funded by the EU's Lifelong Learning program (2013-1-DK1-LEO05-07053). The project partners were VIA University College, Denmark, the University of Huddersfield, UK and Metropolia University of Applied Sciences, Finland. As an outcome of the development process, "the NESTLED model for educating simulation facilitators" (NESTLED model) was generated. This article also illustrates five design principles that could be applied to other pedagogies. Copyright © 2018 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Haaranen, Ari; Saarti, Jarmo; Miettola, Juhani; Erkkilä, Arja T.
2016-01-01
The HEI-ICI project involves cooperation between the University of Eastern Finland (UEF) and three African partners. The main aim of the project, now in its fourth year, has been to develop education in health sciences and to improve the quality of teaching. The target has been to develop the skills of selected junior faculty from the Public…
ERIC Educational Resources Information Center
Elo, Janne
2016-01-01
This article is the result of an action research project conducted in 2014 in a primary school in the city of Vaasa in Finland. The project focused on developing the practice of integrating enterprise education as a part of everyday teaching in Grade Three. The project involved three class teachers, the headmaster and a university researcher. This…
Bi-Linear Shear Deformable ANCF Shell Element Using Continuum Mechanics Approach
2014-08-01
Lappeenranta University of Technology Skinnarilankatu 34, 53850 Lappeenranta, Finland Paramsothy Jayakumar US Army RDECOM TARDEC 6501 E. 11 Mile...2-0001 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Hiroki Yamashita; Antti Valkeapaa; Paramsothy Jayakumar ; Hiroyuki Sugiyama 5d...Valkeapää, A. I., Yamashita, H., Jayakumar , P. and Sugiyama, H., “Gradient Deficient Bi-Linear Plate Element Based on Absolute Nodal Coordinate
Launonen, A P; Lepola, V; Laitinen, M; Mattila, V M
2016-09-01
Proximal humerus fractures are common fragility injuries. The incidence of these fractures has been estimated to be 82-105 per 105 person-years. Treatment of this fracture, especially in the elderly, is controversial. Our study group published a systematic review of the available literature and concluded that non-operative methods are favored over operative methods in three- and four-part fractures. The aim of this multinational study was to compare treatment policies for proximal humerus fractures among the Nordic countries and Estonia. The study was conducted as a questionnaire-based survey, using the Internet-based program, Webropol(®) (webropol.com). The questionnaire link was sent to the surgeons responsible for treating proximal humerus fractures in major public hospitals in Estonia, Finland, Norway, and Sweden. Questionnaire included questions regarding the responder's hospital, patient characteristics, and examinations taken before decision making. Clinical part included eight example patient cases with treatment options. Of the 77 recipients of the questionnaire, 59 responded; consequently, the response rate was 77%. Based on the eight presented displaced fracture examples, in both Estonia and Norway and in Finland, 41% and 38%, respectively, preferred surgical treatment with locking plate. In Sweden, the percentage was 28%. The pre- and post-operative protocols showed a similarity in all participant countries. Our survey revealed a remarkable uniformity in the current practice of operative treatments and rehabilitation for proximal humerus fractures in the participant countries. © The Finnish Surgical Society 2016.
NASA Astrophysics Data System (ADS)
Kupila, Juho
2017-04-01
Since the 1990s, a huge amount of data related to the groundwater and soil has been collected in several regional projects in Finland. EU -funded project "The coordination of groundwater protection and aggregates industry in Finnish Lapland, phase II" started in July 2016 and it covers the last unstudied areas in these projects in Finland. Project is carried out by Geological Survey of Finland (GTK), University of Oulu and Finnish Environment Institute and the main topic is to consolidate the groundwater protection and extractable use of soil resource in Lapland area. As earlier, several kinds of studies are also carried out throughout this three-year research and development project. These include e.g. drilling with setting up of groundwater observation wells, GPR-survey and many kinds of point-type observations, like sampling and general mapping on the field. Due to size of a study area (over 80 000 km2, about one quarter of a total area of Finland), improvement of the field work methods has become essential. To the general observation on the field, GTK has developed a specific mobile applications for Android -devices. With these Apps, data can be easily collected for example from a certain groundwater area and then uploaded directly to the GTK's database. Collected information may include sampling data, photos, layer observations, groundwater data etc. and it is all linked to the current GPS-location. New data is also easily available for post-processing. In this project the benefits of these applications will be field-tested and e.g. ergonomics, economy and usability in general will be taken account and related to the other data collecting methods, like working with heavy fieldwork laptops. Although these Apps are designed for usage in GTK's projects, they are free to download from Google Play for anyone interested. Geological Survey of Finland has the main role in this project with support from national and local authorities and stakeholders. Project is funded by European Regional Development Fund with support from local communes, branch enterprises and executive quarters of the project. Implementation period is 2016-2019.
Nomura, Kyoko
2011-01-01
Japan now faces a serious physician shortage. After introducing the new postgraduate medical education (PGME) system and doctor-to-facility matching system, residents shifted their teaching hospitals from university hospitals to non-university hospitals. Because university hospitals had played a central role in allocating physicians to communities, the decrease in the number of physicians at university hospitals has driven this physician shortage. Japanese policymakers blame the new PGME for exacerbating this physician shortage and have tentatively agreed to reform the PGME to encourage residents to return to university hospitals. However, the PGME system should not be reformed only for political reasons; such a change requires a scientific basis. First, after the introduction of the new PGME, residents showed an improved clinical competence; therefore, it has accomplished its ultimate goal. Second, the residents' satisfaction level in terms of the residency system and clinical skills training was significantly higher at non-university hospitals than at university hospitals. This implies that training conditions at university hospitals are not as good as at non-university hospitals, which explains the decrease in the number of physicians at university hospitals. Third, in 2009, the Japanese government increased the maximum medical school enrollment to mitigate the physician shortage. However, a simple increase does not solve the problem of physician shortage unless it also addresses the problem of physician maldistribution. Fourth, the number of females entering medicine is increasing, and women constituted 30% of newly certified physicians in 2010. In this era of physician shortage, female physicians are highly recommended as a human medical resource.
Development cooperation as methodology for teaching social responsibility to engineers
NASA Astrophysics Data System (ADS)
Lappalainen, Pia
2011-12-01
The role of engineering in promoting global well-being has become accentuated, turning the engineering curriculum into a means of dividing well-being equally. The gradual fortifying calls for humanitarian engineering have resulted in the incorporation of social responsibility themes in the university curriculum. Cooperation, communication, teamwork, intercultural cooperation, sustainability, social and global responsibility represent the socio-cultural dimensions that are becoming increasingly important as globalisation intensifies the demands for socially and globally adept engineering communities. This article describes an experiment, the Development Cooperation Project, which was conducted at Aalto University in Finland to integrate social responsibility themes into higher engineering education.
West, S; Lashen, H; Bloigu, A; Franks, S; Puukka, K; Ruokonen, A; Järvelin, M-R; Tapanainen, J S; Morin-Papunen, L
2014-10-10
Do teenage girls with a history of menstrual irregularity and/or elevated androgen levels in adolescence exhibit an increased risk of polycystic ovary syndrome (PCOS) and/or infertility later on in adulthood? Our results suggest that menstrual irregularity and/or elevated androgen levels at 16 years are still associated with symptoms of PCOS at 26 years as well as infertility problems at 26 years but not with decreased pregnancy or delivery rates at 26 years. Hyperandrogenaemia is associated with menstrual irregularity, hirsutism, acne and potentially higher risk for PCOS, but there are few follow-up studies investigating whether adolescent hyperandrogenaemia and/or menstrual irregularity are an early sign of PCOS. A prospective population-based cohort study was conducted using two postal questionnaires targeting girls in the Northern Finland Birth Cohort 1986 (NFBC1986, n = 4567). The NFBC1986 comprises all expected births from the year 1986 in the two northernmost provinces of Finland. Collection of the database was performed at the age of 16 and 26. The 16-year and 26-year questionnaires included one question about the regularity and length of the menstrual cycle. The 26-year questionnaire also included questions about symptoms of PCOS, reproduction and infertility problems. The response rates for the questionnaires were 80% (n = 3669) at 16 years and 50% (n = 2270) at 26 years. At 15-16 years, of 2448 girls, 709 (29%) girls reported menstrual irregularity (symptomatic girls) and 1739 (71%) had regular periods (non-symptomatic girls). After combining data from the two questionnaires a total of 2033 girls were included in the analyses. The χ(2) and Student's t-test was used to compare reproductive outcome and prevalence of clinical hyperandrogenaemia, PCOS and infertility at 26 years between the study groups. Univariate and multivariate logistic regression models were employed to estimate the association of menstrual irregularity at 16 years with clinical hyperandrogenaemia, PCOS and infertility at 26 years. At follow-up, the proportion of symptomatic girls who had conceived at least once (68.0 versus 67.9%) and had delivered at least one child (25.7 versus 28.1%) was similar to the non-symptomatic women and the groups had similar miscarriage rates (11.6 versus 12.1%). Logistic regression analyses indicated that menstrual irregularity at 16 years was associated with an increased risk of menstrual irregularity [adjusted odds ratio (OR) 1.37, 95% confidence interval (CI) 1.00-1.88, P = 0.050], PCOS (adjusted OR 2.91, 95% CI 1.74-4.84, P < 0.001) and infertility problems (adjusted OR 2.07, 95% CI 1.16-3.76, P = 0.013) at 26 years. At 26 years, women with PCOS (P = 0.013), hirsutism (P = 0.001) and acne (P < 0.001) exhibited significantly higher values of free androgen index (FAI) at 16 years than control women. There was a significant linear trend in the higher FAI quartiles at 16 years towards higher prevalence of PCOS (P = 0.005), hirsutism (P < 0.001) and acne (P < 0.001) at 26 years. Only 10.5% of the girls with menstrual irregularity at 16 years had PCOS at 26 years. The diagnosis of menstrual irregularity was based on a self-reported questionnaire, thus introducing a risk of information bias in reporting the symptoms. Moreover, ovarian ultrasonography was not available to aid the diagnosis of PCOS and there was no clinical evaluation of hyperandrogenism. The relatively low rate of participation to the questionnaire at 26 years may also have biased the results. Our findings confirm that menstrual irregularity and/or elevated androgen levels are already present in adolescence in women with PCOS and infertility in later life, which strengthens the importance of early identification of menstrual irregularity. This work was supported by grants from the Finnish Medical Society Duodecim, the North Ostrobothnia Regional Fund, the Academy of Finland, the Sigrid Juselius Foundation, University Hospital Oulu and University of Oulu, the European Commission and the Medical Research Council, UK, Welcome Trust (089549/Z/09/Z). None of the authors have any conflict of interest. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Issues promoting and hindering girls' well-being in Northern Finland.
Wiens, Varpu; Kyngäs, Helvi; Pölkki, Tarja
2017-08-01
Well-being is a complex concept that includes elements of inequality due to socio-economics, living environment or gender. Every person also encounters unique situations and has different experiences of well-being. This qualitative study aims to describe what issues promote and hinder the well-being of girls aged 13-16 in Northern Finland. A total of 117 girls aged 13-16 living in Northern Finland were asked to write about the issues that hinder and promote their well-being. The girls' responses were analysed using content analysis. After analysis, two combining categories were discovered: issues hindering well-being were a debilitating sphere of life and negative experiences in life, and issues promoting well-being were positive subjective sensations and favourably perceived conditions. The results of this study indicate that girls' well-being is connected to their social and physical environment. As the girls' view of the issues that promote or hinder health are connected and interact with their living environment, there is also a need for health promotion measures to take into account both the individuals and the environment in which they function and live. This view challenges us to see health promotion in a broader way-a way which takes into account structural and political factors, individual consultation and empowerment. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Mäkelä, Pia; Herttua, Kimmo; Martikainen, Pekka
2015-11-01
We make a case study of Finland to study the connections between socioeconomic status, alcohol use, related harm and possibilities for intervention by means of alcohol pricing. A review of Finnish studies on the topic. The socioeconomic differences in severe alcohol-related harm were great, and in the past two decades, these differences have widened. Alcohol-related mortality has also strongly contributed to both the level and widening of socioeconomic differences in life expectancy. Both in 2004, when alcohol prices were abruptly cut, and in the longer term with more gradual changes in lowest prices of alcohol, the lowest socioeconomic groups were most affected in absolute-but not so clearly in relative-terms, particularly among men. However, these effects are sometimes weak, not fully consistent by gender and across different measures of harm. The large and increasing socioeconomic differences in alcohol-related harm in Finland underline the importance of reducing these differences. The finding that particularly among men the impact of reduced alcohol prices on health has often in absolute terms been the greatest in the lower socioeconomic groups suggests that policies aimed at keeping the price of alcoholic beverages high may help to both minimize the overall level of alcohol-related health problems and to reduce absolute inequalities. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.
Wess, Mark L.; Embi, Peter J.; Besier, James L.; Lowry, Chad H.; Anderson, Paul F.; Besier, James C.; Thelen, Geriann; Hegner, Catherine
2007-01-01
Computerized Provider Order Entry (CPOE) has been demonstrated to improve the medication ordering process, but most published studies have been performed at academic hospitals. Little is known about the effects of CPOE at community hospitals. With a pre-post study design, we assessed the effects of a CPOE system on the medication ordering process at both a community and university hospital. The time from provider ordering to pharmacist verification decreased by two hours with CPOE at the community hospital (p<0.0001) and by one hour at the university hospital (p<0.0001). The rate of medication clarifications requiring signature was 2.80 percent pre-CPOE and 0.40 percent with CPOE (p<0.0001) at the community hospital. The university hospital was 2.76 percent pre-CPOE and 0.46 percent with CPOE (p<0.0001). CPOE improved medication order processing at both community and university hospitals. These findings add to the limited literature on CPOE in community hospitals. PMID:18693946
ERIC Educational Resources Information Center
Virtanen, Jaana; Rasi, Päivi
2016-01-01
In this article we present and discuss the process of developing and implementing a PBL-based course entitled Moving Images in Teaching and Learning that was held at the University of Lapland, Finland. In the course of the project, this fairly traditional face-to-face course was redesigned into a blended PBL course by integrating Web 2.0…
A Matched Field Processing Framework for Coherent Detection Over Local and Regional Networks
2011-06-01
Northern Finland Seismological Network, FN) and to the University of Helsinki for data from the VRF and HEF stations (part of the Finnish seismograph ...shows the results of classification with the FK measurement . Most of the events are incorrectly assigned to one particular mine (K2 – Rasvumchorr...generalization of the single-phase matched field processing method that encodes the full structure of the entire wavefield? What would this
Recent health policy initiatives in Nordic countries
Saltman, Richard B.
1992-01-01
Health care systems in Sweden, Finland, and Denmark are in the midst of substantial organizational reconfiguration. Although retaining their tax-based single source financing arrangements, they have begun experiments that introduce a limited measure of competitive behavior in the delivery of health services. The emphasis has been on restructuring public operated hospitals and health centers into various forms of public firms, rather than on the privatization of ownership of institutions. If successful, the reforms will enable these Nordic countries to combine their existing macroeconomic controls with enhanced microeconomic efficiency, effectiveness, and responsiveness to patients. PMID:10122003
Kaislasuo, Janina; Heikinheimo, Oskari; Lähteenmäki, Pekka; Suhonen, Satu
2015-07-01
Is small uterine cavity size as assessed by ultrasonography associated with bleeding problems or pain in nulligravid women using intrauterine contraception, or do other factors affect these parameters? Among levonorgestrel intrauterine system (LNG-IUS) users, small uterine cavity size is not associated with worsened clinical outcome, but is beneficial as women with the smallest cavity measurements were frequently amenorrhoeic and painless at the end of the first year but among copper intrauterine device (IUD) users, no associations between uterine cavity dimensions and clinical outcome were found. Nulligravid and nulliparous women have smaller uterine dimensions than parous women. Previously, many studies have revealed increased discontinuation rates of IUD use as a result of bleeding, pain or expulsion in these women, while recent studies with current models of IUS/IUDs indicate similar continuation and satisfaction rates irrespective of parity. In a pilot study, 165 adult nulligravid women requesting their first IUD between 1 January 2011 and 31 July 2012 were given a free choice between two IUDs with equal frames measuring 32 × 32 mm-the LNG-IUS 52 mg or a copper-releasing IUD. The women were followed for 1 year. The LNG-IUS was chosen by 113 women (68.5%) and the copper IUD by 52 (31.5%). Prior to insertion the women were interviewed concerning their menstrual characteristics and uterine cavity size was measured by 2-D ultrasonography. After insertion the women kept daily records of bleeding and pain for two reference periods of 90 days during the first year (Months 1-3 and 10-12). The correlation between uterine cavity measurements and numbers of days of bleeding/spotting and pain during the reference periods was analysed. Continuation rates were assessed and reasons for discontinuation as well as the effects of baseline participant characteristics on outcomes were analysed in regression models. Both uterine cavity size and baseline menstrual characteristics prior to IUD insertion predicted the numbers of days of bleeding/spotting and pain in LNG-IUS users. Women with small uterine cavity dimensions reported less bleeding/spotting in both reference periods and less pain in the second reference period compared with women with larger dimensions. Baseline scanty spontaneous menstrual bleeding prior to LNG-IUS use (OR 9.4, 95% CI 1.7-51.8, P = 0.01) and smoking (OR 7.8, 95% CI 1.8-33.8, P = 0.006) predicted amenorrhoea in the second reference period. Women with baseline dysmenorrhoea reported more pain with both IUDs. Continuation rates and reasons for discontinuation were similar with both IUDs. No sample size could be calculated to estimate the power as this was a pilot study. As the majority of women chose the LNG-IUS we did not achieve our initial aim of equally sized IUD groups and thus the size of the copper IUD group may have been insufficient to detect differences. These data further encourage promotion of intrauterine contraception among nulligravid women. Routine use of ultrasonography to assess uterine cavity dimensions prior to IUD insertion is not indicated. Supported by Helsinki University Central Hospital research funds, the Swedish Cultural Foundation in Finland and Finska Läkaresällskapet, who provided funds for J.K. O.H. serves on advisory boards for Bayer Healthcare, Gedeon Richter and MSD Finland (part of Merck & Co. Inc.) and has designed educational events with these companies. S.S. has lectured in educational events at Bayer and MSD Finland (part of Merck & Co. Inc.) and is a member of the Advisory Board for Contraception at MSD Finland. The other authors have no conflicts of interest to declare. www.clinicaltrials.gov, NCT01685164. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Diabetes hospitalizations and deaths in a cohort of treatment-seeking illicit drug users
Aregbesola, Alex; Olubamwo, Olubunmi; Ronkainen, Kimmo; Tiihonen, Jari; Föhr, Jaana; Kauhanen, Jussi
2018-01-01
Background: Studies on diabetes among illicit drug users are scarce in Finland. This study aimed to describe hospitalization and death due to diabetes among treatment-seeking illicit drug users. Methods: Information of 4817 treatment-seeking drug users (3365 men and 1452 women) aged 11–65 years (mean 24.5 years) was linked to the Finnish national hospital discharge register and the national death registry to identify those clients who were hospitalized or died from diabetes mellitus during 1997–2013. Results: Fifty-three persons (42 men and 11 women) had primary diagnoses of diabetes, with a total of 146 hospitalizations (121 among men and 25 among women). The total length of stay among men (1183 days) far exceeded those of women (138 days). Overall, type 1 diabetes was the main contributor to hospitalizations (67%, n = 98/146). The proportion of Type 1 diabetes with complications was 31% in men (n = 37/121) and 44% in women (n = 11/25). All cases of deaths due to diabetes (n = 7) occurred in men. Conclusion: Diabetes hospitalizations were mainly due to Type 1 diabetes. Longer length of hospital stay was observed in men, and all diabetes deaths occurred among men. Male drug users and drug users in general would require more support to reduce morbidity and mortality due to diabetes.
NASA Astrophysics Data System (ADS)
Afonin, Nikita; Kozlovskaya, Elena
2016-04-01
Understanding inner structure of seismogenic faults and their ability to reactivate is particularly important in investigating the continental intraplate seismicity regime. In our study we address this problem using analysis of ambient seismic noise recorded by the temporary DAFNE array in northern Fennoscandian Shield. The main purpose of the DAFNE/FINLAND passive seismic array experiment was to characterize the present-day seismicity of the Suasselkä post-glacial fault (SPGF) that was proposed as one potential target for the DAFNE (Drilling Active Faults in Northern Europe) project. The DAFNE/FINLAND array comprised the area of about 20 to 100 km and consisted of 8 short-period and 4 broad-band 3-component autonomous seismic stations installed in the close vicinity of the fault area. The array recorded continuous seismic data during September, 2011-May, 2013. Recordings of the array have being analyzed in order to identify and locate natural earthquakes from the fault area and to discriminate them from the blasts in the Kittilä Gold Mine. As a result, we found several dozens of natural seismic events originating from the fault area, which proves that the fault is still seismically active. In order to study the inner structure of the SPGF we use cross-correlation of ambient seismic noise recorded by the array. Analysis of azimuthal distribution of noise sources demonstrated that that during the time interval under consideration the distribution of noise sources is close to the uniform one. The continuous data were processed in several steps including single station data analysis, instrument response removal and time-domain stacking. The data were used to estimate empirical Green's functions between pairs of stations in the frequency band of 0.1-1 Hz and to calculate correspondent surface wave dispersion curves. After that S-wave velocity models were obtained as a result of dispersion curves inversion using Geopsy software. The results suggest that the area of the SPGF corresponds to a narrow region of low S-wave velocities surrounded by rocks with high S-wave velocities. We interpret this low velocity region as a non-healed mechanically weak fault damage zone (FDZ) remained after the last major earthquake that occurred after the last glaciation. Seismic instruments for the DAFNE/FINLAND experiment were provided by the institute of Seismology of the University of Helsinki and by the Sodankylä Geophysical Observatory. The study was partly funded by Posiva Oy and Geological Survey of Finland. DAFNE/FINLAND Working Group: Ilmo Kukkonen Pekka Heikkinen Kari Komminaho Elena Kozlovskaya Riitta Hurskainen Tero Raita Hanna Silvennoinen
NASA Astrophysics Data System (ADS)
Vasander, Harri; Sallantaus, Tapani; Koskinen, Markku
2010-05-01
Impacts of peatland restoration on nutrient and carbon leaching from contrasting sites in southern Finland Tapani Sallantaus1, Markku Koskinen2, Harri Vasander2 1)Finnish Environment Institute, Biodiversity unit, Box 140, FIN-00251 Helsinki, Finland, tapani.sallantaus@ymparisto.fi 2)Department of Forest Sciences, University of Helsinki, Box 27, FIN-00014 University of Helsinki, Finland, markku.koskinen@helsinki.fi, harri.vasander@helsinki.fi Less than 20 % of the original mire area of southern Finland is still in natural state. Even many peatlands in today's nature conservation areas had been partly or totally drained before conservation. Until now, about 15000 ha of peatlands have been restored in conservation areas. Here we present data concerning changes in leaching due to restoration in two contrasting areas in southern Finland. The peatlands in Seitseminen have originally been fairly open, growing stunted pine, and unfertile, either bogs or poor fens. The responses of tree stand to drainage in the 1960s were moderate, and the tree stand before restoration was about 50 m3/ha, on average. The trees were partly harvested before filling in the ditches mainly in the years 1997-1999 . The peatlands of Nuuksio are much more fertile than those in Seitseminen, and had greatly responded to drainage, which took place already in the 1930s and 1950s. The tree stand consisted mainly of spruce and exceeded 300 m3/ha in large part of the area. The ditches were dammed in the autumn 2001 and the tree stand was left standing. Runoff water quality was monitored in three basins in both areas. To obtain the leaching rates, we used simulated runoff data obtained from the Finnish Environment Institute, Hydrological Services Division. The responses in leaching were in the same direction in both cases. However, especially when calculated per restored hectare (Table 1), the responses were much stronger in the more fertile areas of Nuuksio for organic carbon and nitrogen, but not so much with phosphorus. The reasons for the greater responses in Nuuksio are partly hydrological. The mires are minerogenic, catchment fed mires, and by restoration the peat layers regain their contact with the waters from the catchment. This is not the case with the bogs of Seitseminen and of less importance in the poor fens with a small catchment. Also biological reasons exist. The peat layers have changed much more in the fertile peatlands of Nuuksio. Moreover, the living biomass is much larger in Nuuksio, and due to restoration this biomass is inundated and consequently exposed to anaerobia. This has caused death of the forest species, release of bound nutrients, and gradual colonization by mires species leading to renewed bounding of nutrients. Restoration of drained peatlands is a positive action, but harmful water impacts should be avoided. This urges for hydrological knowledge in the planning and accomplishing phases. Table 1. Annual unrestored leaching rates of organic carbon, nitrogen and phosphorus in the study sites, and increase in leaching as a sum of 6 post-restoration years, calculated per restored mire area. Site Unrestored leaching g C m-2 a-1 Increase in leaching g C m-2 6a-1 Unrestored leaching g N m-2 a-1 Increase in leaching g N m-2 6a-1 Unrestored leaching g P m-2 a-1 Increase in leaching g P m-2 6a-1 Seitseminen 10.5 58 0.19 1.18 0.009 0.21 Nuuksio 5.3 107 0.13 2.54 0.004 0.18
ERIC Educational Resources Information Center
New York State Office of the Comptroller, Albany. Div. of Management Audit.
An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…
Menon, Mohan K; Goodnight, Janelle M; Wayne, Robin J
2006-01-01
The following is a report of a study designed to measure advertising content based on the cognitive and affective elements of informational (i.e., information processing) and transformational (i.e., experiential) content using the measure of advertising informational and transformational content developed by Puto and Wells (1984). A university hospital advertising campaign designed to be high in transformational content did not appear to affect perceived quality of local university hospitals relative to private hospitals or increase the likelihood of choosing a university hospital in the future. Further, experiences with university hospitals that seemed to be in direct contrast to the content of the advertisements based on subject perceptions affected how university hospital advertisements were perceived in terms of content. Conclusions and implications for hospital advertising campaigns are discussed.
Financial Analysis of National University Hospitals in Korea.
Lee, Munjae
2015-10-01
This paper provides information for decision making of the managers and the staff of national university hospitals. In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.
Financial Analysis of National University Hospitals in Korea
Lee, Munjae
2015-01-01
Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356
Heiskanen, Marja A; Motiani, Kumail K; Mari, Andrea; Saunavaara, Virva; Eskelinen, Jari-Joonas; Virtanen, Kirsi A; Koivumäki, Mikko; Löyttyniemi, Eliisa; Nuutila, Pirjo; Kalliokoski, Kari K; Hannukainen, Jarna C
2018-05-02
Pancreatic fat accumulation may contribute to the development of beta cell dysfunction. Exercise training improves whole-body insulin sensitivity, but its effects on pancreatic fat content and beta cell dysfunction are unclear. The aim of this parallel-group randomised controlled trial was to evaluate the effects of exercise training on pancreatic fat and beta cell function in healthy and prediabetic or type 2 diabetic participants and to test whether the responses were similar regardless of baseline glucose tolerance. Using newspaper announcements, a total of 97 sedentary 40-55-year-old individuals were assessed for eligibility. Prediabetes (impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes were defined by ADA criteria. Of the screened candidates, 28 healthy men and 26 prediabetic or type 2 diabetic men and women met the inclusion criteria and were randomised into 2-week-long sprint interval or moderate-intensity continuous training programmes in a 1:1 allocation ratio using random permuted blocks. The primary outcome was pancreatic fat, which was measured by magnetic resonance spectroscopy. As secondary outcomes, beta cell function was studied using variables derived from OGTT, and whole-body insulin sensitivity and pancreatic fatty acid and glucose uptake were measured using positron emission tomography. The measurements were carried out at the Turku PET Centre, Finland. The analyses were based on an intention-to-treat principle. Given the nature of the intervention, blinding was not applicable. At baseline, the group of prediabetic or type 2 diabetic men had a higher pancreatic fat content and impaired beta cell function compared with the healthy men, while glucose and fatty acid uptake into the pancreas was similar. Exercise training decreased pancreatic fat similarly in healthy (from 4.4% [3.0%, 6.1%] to 3.6% [2.4%, 5.2%] [mean, 95% CI]) and prediabetic or type 2 diabetic men (from 8.7% [6.0%, 11.9%] to 6.7% [4.4%, 9.6%]; p = 0.036 for time effect) without any changes in pancreatic substrate uptake (p ≥ 0.31 for time effect in both insulin-stimulated glucose and fasting state fatty acid uptake). In prediabetic or type 2 diabetic men and women, both exercise modes similarly improved variables describing beta cell function. Two weeks of exercise training improves beta cell function in prediabetic or type 2 diabetic individuals and decreases pancreatic fat regardless of baseline glucose tolerance. This study shows that short-term training efficiently reduces ectopic fat within the pancreas, and exercise training may therefore reduce the risk of type 2 diabetes. ClinicalTrials.gov NCT01344928 FUNDING: This study was funded by the Emil Aaltonen Foundation, the European Foundation for the Study of Diabetes, the Finnish Diabetes Foundation, the Orion Research Foundation, the Academy of Finland (grants 251399, 256470, 281440, and 283319), the Ministry of Education of the State of Finland, the Paavo Nurmi Foundation, the Novo Nordisk Foundation, the Finnish Cultural Foundation, the Hospital District of Southwest Finland, the Turku University Foundation, and the Finnish Medical Foundation.
Varje, Pekka; Kouvonen, Anne; Kokkinen, Lauri; Koskinen, Aki; Väänänen, Ari
2018-02-01
This study aimed to examine the long-term changes and socioeconomic disparities in hospitalization for affective and neurotic disorders among the Finnish working-age population from 1976 to 2010. Register-based study, consisting of a 5-year follow-up of 3,223,624 Finnish working-age (18-64-year old) individuals in seven consecutive cohorts. We calculated the hazard ratios of psychiatric hospitalization for different occupational classes using Cox regression models. The risk of hospitalization for affective and neurotic disorders increased in all occupational classes after the economic recession in the 1990s, and then decreased in the 2000s. Before the 2000s, the risk was the highest among manual workers. In the 2000s the disparities between upper-level non-manual employees and other occupational classes increased. Hospitalization rates remained high among female manual workers and non-manual lower-level employees. This study revealed important similarities and differences between occupational classes in terms of long-term changes in hospitalization for affective and neurotic disorders. The results suggest that the labor market changes and healthcare reforms during the 1990s and 2000s in Finland have been more beneficial for higher than for lower occupational classes.
Radon measurement and mitigation activity in Finland.
Valmari, T; Arvela, H; Reisbacka, H; Holmgren, O
2014-07-01
Radon prevention, measurement and mitigation activities have been increasing in Finland during the 2000s. Nowadays, many municipal authorities, especially those located in high-radon areas, require radon prevention measures. This has activated radon measurements. Owners of new houses having radon piping installed under the floor slab are the most active group to measure and reduce the found high-radon values. Their radon awareness is apparently better than on the average, and the existing piping makes it easier and cheaper to reduce the radon levels. Local campaigns involving invitation flyers mailed to the residents have been a cost-effective means to activate measurements of older houses. So far 116,611 dwellings in low-rise residential buildings have been measured. At least 15% of the 16,860 dwellings found to exceed the reference level of 400 Bq m(-3) had their indoor radon level reduced below that. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Guest, Julian F; Valovirta, Erkka
2008-04-01
To assess the impact of the decision by Kela (The Social Insurance Institution) to adopt guidelines for the management of food allergies in children, developed by the Finnish Medical Society Duodecim, as the basis for reimbursing clinical nutrition preparations for the treatment of cow milk allergy (CMA) in Finland. A decision model was constructed using published clinical outcomes and clinician-derived resource utilisation estimates. The model was used to estimate the net resource implications and associated costs of Kela's new policy for the annual cohort of 1443 new CMA sufferers over the first 6 months following referral to a specialist. The analysis was conducted from the perspective of Kela, patients and Finnish society. Kela's new policy for reimbursing clinical nutrition preparations for the treatment of CMA is expected to increase healthcare resource use, including a 10% increase in the number of specialist visits over the first 6 months following referral. Consequently, Kela's 6-monthly expenditure on 1443 new CMA sufferers following referral is expected to increase by 12% from 889,389 euros to 992,761 euros. Additionally, parents' costs are expected to increase by 10% and fathers' absenteeism from work to increase by 11% within the first 6 months following referral. It is important to validate guidelines in clinical practice before their implementation. Within the limitations of our model, Kela's new criteria for reimbursing clinical nutrition preparations for the treatment of CMA is expected to increase healthcare resource use in paediatric departments in public hospitals in Finland and increase costs to Kela, patients and Finnish society.
Friend Influence on Achievement during Middle Childhood
ERIC Educational Resources Information Center
DeLay, Dawn
2013-01-01
This study was designed to investigate friend influence on academic achievement and task avoidance during middle childhood in a sample of 794 participants in 397 stable same-sex friendship dyads (205 girl dyads and 192 boy dyads) from four municipalities in Finland: two in Central Finland, one in Western Finland, and one in Eastern Finland.…
Membership Contests: Encountering Immigrant Youth in Finland
ERIC Educational Resources Information Center
Harinen, Paivi; Suurpaa, Leena; Hoikkala, Tommi; Hautaniemi, Petri; Perho, Sini; Keskisalo, Anne-Mari; Kuure, Tapio; Kunnapuu, Krista
2005-01-01
This article discusses different aspects of social and societal membership, when minority groups of young immigrants living in Finland are under consideration. During its history, Finland has mainly been a country of emigration. In the 1990s the direction of moving turned to the contrary and the amount of immigrants in Finland increased relatively…
International perspectives on emergency department crowding.
Pines, Jesse M; Hilton, Joshua A; Weber, Ellen J; Alkemade, Annechien J; Al Shabanah, Hasan; Anderson, Philip D; Bernhard, Michael; Bertini, Alessio; Gries, André; Ferrandiz, Santiago; Kumar, Vijaya Arun; Harjola, Veli-Pekka; Hogan, Barbara; Madsen, Bo; Mason, Suzanne; Ohlén, Gunnar; Rainer, Timothy; Rathlev, Niels; Revue, Eric; Richardson, Drew; Sattarian, Mehdi; Schull, Michael J
2011-12-01
The maturation of emergency medicine (EM) as a specialty has coincided with dramatic increases in emergency department (ED) visit rates, both in the United States and around the world. ED crowding has become a public health problem where periodic supply and demand mismatches in ED and hospital resources cause long waiting times and delays in critical treatments. ED crowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. This article describes emergency care systems and the extent of crowding across 15 countries outside of the United States: Australia, Canada, Denmark, Finland, France, Germany, Hong Kong, India, Iran, Italy, The Netherlands, Saudi Arabia, Catalonia (Spain), Sweden, and the United Kingdom. The authors are local emergency care leaders with knowledge of emergency care in their particular countries. Where available, data are provided about visit patterns in each country; however, for many of these countries, no national data are available on ED visits rates or crowding. For most of the countries included, there is both objective evidence of increases in ED visit rates and ED crowding and also subjective assessments of trends toward higher crowding in the ED. ED crowding appears to be worsening in many countries despite the presence of universal health coverage. Scandinavian countries with robust systems to manage acute care outside the ED do not report crowding is a major problem. The main cause for crowding identified by many authors is the boarding of admitted patients, similar to the United States. Many hospitals in these countries have implemented operational interventions to mitigate crowding in the ED, and some countries have imposed strict limits on ED length of stay (LOS), while others have no clear plan to mitigate crowding. An understanding of the causes and potential solutions implemented in these countries can provide a lens into how to mitigate ED crowding in the United States through health policy interventions and hospital operational changes. © 2011 by the Society for Academic Emergency Medicine.
Smart information system for gachon university gil hospital.
Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho
2012-03-01
In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.
Smart Information System for Gachon University Gil Hospital
Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho
2012-01-01
Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. Results The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Conclusions Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future. PMID:22509476
2016-09-09
5Research Program Unit, Diabetes and Obesity , University of Helsinki, 00290 Helsinki, Finland 6Department of Information and Computer Science, Aalto...Figure 6C). Altered levels of serum triglycerides are a common feature of obesity and type 2 diabetes, and hypertriglyceridemia is (B) Shown is the...composition that may contribute to childhood disease, we must first investigate the normal dynamics of the community in the developing infant. Here
2014-01-01
Background The aim here was to explore trends in patient satisfaction with primary health care and its accessibility and continuity, and to explore whether through reforms and improvements some of the essential goals had been achieved over a 14-year period of time in Finland. Methods Nine questionnaire surveys were conducted over a period of 14 years among patients attending within one week in the 65 health centres in the Tampere University Hospital catchment area. A total of 147,394 responded out of a sample of 333,648 patients. The response rate varied yearly from 53% to 37%. Results Patient satisfaction with care in Finnish health centres decreased by nearly 9 percentage units from 1998 to 2011. The fall-off was most marked in the age-group over 64 years. There was a 20 percentage unit’s reduction in ease of access as reported by patients. Respondents also reported that the continuity of care had deteriorated. Conclusions Despite major reforms in Finnish health care policy, patients seem to be less satisfied. Our findings challenge both Finnish authorities and GPs to improve the accessibility and continuity of care in primary health services. PMID:24885700
Reconstruction of facial nerve after radical parotidectomy.
Renkonen, Suvi; Sayed, Farid; Keski-Säntti, Harri; Ylä-Kotola, Tuija; Bäck, Leif; Suominen, Sinikka; Kanerva, Mervi; Mäkitie, Antti A
2015-01-01
Most patients benefitted from immediate facial nerve grafting after radical parotidectomy. Even weak movement is valuable and can be augmented with secondary static operations. Post-operative radiotherapy does not seem to affect the final outcome of facial function. During radical parotidectomy, the sacrifice of the facial nerve results in severe disfigurement of the face. Data on the principles and outcome of facial nerve reconstruction and reanimation after radical parotidectomy are limited and no consensus exists on the best practice. This study retrospectively reviewed all patients having undergone radical parotidectomy and immediate facial nerve reconstruction with a free, non-vascularized nerve graft at the Helsinki University Hospital, Helsinki, Finland during the years 1990-2010. There were 31 patients (18 male; mean age = 54.7 years; range = 30-82) and 23 of them had a sufficient follow-up time. Facial nerve function recovery was seen in 18 (78%) of the 23 patients with a minimum of 2-year follow-up and adequate reporting available. Only slight facial movement was observed in five (22%), moderate or good movement in nine (39%), and excellent movement in four (17%) patients. Twenty-two (74%) patients received post-operative radiotherapy and 16 (70%) of them had some recovery of facial nerve function. Nineteen (61%) patients needed secondary static reanimation of the face.
HIV-Related Self-Stigma and Health-Related Quality of Life of People Living With HIV in Finland.
Nobre, Nuno; Pereira, Marco; Roine, Risto P; Sutinen, Jussi; Sintonen, Harri
We examined how HIV-related self-stigma was associated with different domains of quality of life (QoL), as measured by the World Health Organization Quality of Life in HIV-infected persons instrument (WHOQOL-HIV-Bref), and health-related quality of life (HRQoL) as measured by the generic 15D (15-dimensional measure of HRQoL), to identify the factors associated with self-stigma of people living with HIV (PLWH). The study sample included 440 patients living with HIV followed at the Infectious Disease Clinic of Helsinki University Hospital. Participants with more severe self-stigma reported significantly lower QoL and HRQoL. Male gender, cohabiting with a partner, and disclosure of HIV status were associated with less self-stigma; high education level and financial difficulties were associated with greater self-stigma. Having lived longer with HIV, being unemployed, and living alone were also predictors of self-stigma via financial difficulties. The findings suggest that self-stigma is a complex and multidimensional phenomenon that impacts the HRQoL of PLWH. Psychosocial interventions to enhance the well-being of PLWH are increasingly needed. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Diagnostic trends in Clostridium difficile detection in Finnish microbiology laboratories.
Könönen, Eija; Rasinperä, Marja; Virolainen, Anni; Mentula, Silja; Lyytikäinen, Outi
2009-12-01
Due to increased interest directed to Clostridium difficile-associated infections, a questionnaire survey of laboratory diagnostics of toxin-producing C. difficile was conducted in Finland in June 2006. Different aspects pertaining to C. difficile diagnosis, such as requests and criteria used for testing, methods used for its detection, yearly changes in diagnostics since 1996, and the total number of investigations positive for C. difficile in 2005, were asked in the questionnaire, which was sent to 32 clinical microbiology laboratories, including all hospital-affiliated and the relevant private clinical microbiology laboratories in Finland. The situation was updated by phone and email correspondence in September 2008. In June 2006, 28 (88%) laboratories responded to the questionnaire survey; 24 of them reported routinely testing requested stool specimens for C. difficile. Main laboratory methods included toxin detection (21/24; 88%) and/or anaerobic culture (19/24; 79%). In June 2006, 18 (86%) of the 21 laboratories detecting toxins directly from feces, from the isolate, or both used methods for both toxin A (TcdA) and B (TcdB), whereas only one laboratory did so in 1996. By September 2008, all of the 23 laboratories performing diagnostics for C. difficile used methods for both TcdA and TcdB. In 2006, the number of specimens processed per 100,000 population varied remarkably between different hospital districts. In conclusion, culturing C. difficile is common and there has been a favorable shift in toxin detection practice in Finnish clinical microbiology laboratories. However, the variability in diagnostic activity reported in 2006 creates a challenge for national monitoring of the epidemiology of C. difficile and related diseases.
ERIC Educational Resources Information Center
Nyyssola, Kari; Hamalainen, Kimmo
The extent to which vocational education and training policy is nurturing lifelong learning in Finland was examined. The analysis focused on the following issues: the political and structural framework of education in Finland; mechanisms supporting lifelong learning; and pedagogical solutions and learning environments facilitating lifelong…
ERIC Educational Resources Information Center
Laaksovirta, Tuula H.; Haavisto, Tuula
This illustrated publication, printed in both English and Finnish, describes Finland's libraries and information services. Topics covered include: (1) library users; (2) the conceptual role of the library; (3) the growth and development of the library system through Finland's agrarian, industrial, and budding infotech social phases; (4) the…
An analysis of electronic health record-related patient safety incidents.
Palojoki, Sari; Mäkelä, Matti; Lehtonen, Lasse; Saranto, Kaija
2017-06-01
The aim of this study was to analyse electronic health record-related patient safety incidents in the patient safety incident reporting database in fully digital hospitals in Finland. We compare Finnish data to similar international data and discuss their content with regard to the literature. We analysed the types of electronic health record-related patient safety incidents that occurred at 23 hospitals during a 2-year period. A procedure of taxonomy mapping served to allow comparisons. This study represents a rare examination of patient safety risks in a fully digital environment. The proportion of electronic health record-related incidents was markedly higher in our study than in previous studies with similar data. Human-computer interaction problems were the most frequently reported. The results show the possibility of error arising from the complex interaction between clinicians and computers.
Small Particles, Big Science: The International LBNF/DUNE Project
None
2018-06-25
Neutrinos are the most abundant matter particles in the universe, yet very little is known about them. This animation shows how the Department of Energyâs Long-Baseline Neutrino Facility will power the Deep Underground Neutrino Experiment to help scientists understand the role neutrinos play in the universe. DUNE will also look for the birth of neutron stars and black holes by catching neutrinos from exploding stars. More than 800 scientists from 150 institutions in 27 countries are working on the LBNF/DUNE project, including Armenia, Belgium, Brazil, Bulgaria, Canada, Colombia, Czech Republic, Finland, France, Greece, India, Iran, Italy, Japan, Madagascar, Mexico, Netherlands, Peru, Poland, Romania, Russia, Spain, Switzerland, Turkey, Ukraine, United Kingdom, USA.
Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis.
Medin, Emma; Anthun, Kjartan S; Häkkinen, Unto; Kittelsen, Sverre A C; Linna, Miika; Magnussen, Jon; Olsen, Kim; Rehnberg, Clas
2011-12-01
This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.
Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.
Koskinen, M J; Hewetson, M; Pöytäkangas, M R
2015-09-01
Infiltrative disease of the intestine is an important cause of weight loss in the horse. Infiltration of inflammatory or neoplastic cells into the intestinal wall and intestinal fibrosis cause changes in the integrity of the intestinal wall. This may lead to altered intestinal permeability which can be measured using the contrast medium iohexol. To determine if iohexol intestinal permeability, as evaluated by serum iohexol concentration, could be used to differentiate between healthy horses and horses with infiltrative disease of the large colon. Prospective non-randomised controlled clinical trial. Six healthy adult horses and 4 horses with chronic infiltrative disease of the large colon were used in the study. Infiltrative disease was confirmed on post mortem in all cases, and included alimentary lymphoma and mycobacterial granulomatous enterocolitis. Following a 16-h fast, each horse was dosed with 1.0 ml/kg bwt of iohexol as a 10% solution via nasogastric intubation. Blood samples were collected at 0, 30, 60, 120, 180, 240, 300, 360, 420 and 480 min after dosing. Iohexol concentration was determined using HPLC-UV and the differences between the groups were analysed with a repeated measures ANOVA. There was a statistically significant difference in iohexol serum concentration between the diseased and nondiseased horses (P = 0.001). The overall difference in the mean iohexol concentration between the 2 groups was 6.07 (95% CI 3.19-8.96) μg/ml, however there appeared to be a trend towards increasing difference at later time points (240, 300, 360 min). The iohexol permeability test has potential as a diagnostic tool for estimation of intestinal permeability in horses with infiltrative intestinal disease. Further studies are warranted to determine whether the test can be used to determine the site of intestinal pathology, predict the prognosis and potentially evaluate the response to treatment. The authors thank Professor Riitta-Mari Tulamo and Professor Thomas Spillmann and the staff of Equine College Ypäjä and the University of Helsinki Equine Teaching Hospital. The cooperation of horse owners is gratefully acknowledged. Ethical animal research: The study protocol was approved by the National Animal Experiment Board of Finland (Eläinkoelautakunta ELLA, Request for Animal Experiments, ref. no. ESAVI-2010-06567/Ym-23). For client-owned animals, owner informed consent was obtained. This study was funded by the Faculty of Veterinary Medicine, University of Helsinki, Finland. Competing interests: None declared. © 2015 The Author(s). Equine Veterinary Journal © 2015 EVJ Ltd.
CTC Sentinel. Volume 7, Issue 3
2014-03-01
foreign fighting, including Finland . In March 2014, the Finnish Security and Intelligence Service (FSIS) stated that over 30 individuals had...hardened jihadists returning to Finland from Syria.5 This article examines the factors that may have contributed to Finnish Muslim participation...Violent Extremism in Finland – Situation Overview 2/2013,” Finland Ministry of the Interior, August 26, 2013. The reports do not clarify whether
Raggi, Alberto; Corso, Barbara; Minicuci, Nadia; Quintas, Rui; Sattin, Davide; De Torres, Laura; Chatterji, Somnath; Frisoni, Giovanni Battista; Haro, Josep Maria; Koskinen, Seppo; Martinuzzi, Andrea; Miret, Marta; Tobiasz-Adamczyk, Beata; Leonardi, Matilde
2016-01-01
To comprehensively identify the determinants of quality of life (QoL) in a population study sample of persons aged 18-50 and 50+. In this observational, cross-sectional study, QoL was measured with the WHOQOL-AGE, a brief instrument designed to measure QoL in older adults. Eight hierarchical regression models were performed to identify determinants of QoL. Variables were entered in the following order: Sociodemographic; Health Habits; Chronic Conditions; Health State description; Vision and Hearing; Social Networks; Built Environment. In the final model, significant variables were retained. The final model was re-run using data from the three countries separately. Complete data were available for 5639 participants, mean age 46.3 (SD 18.4). The final model accounted for 45% of QoL variation and the most relevant contribution was given by sociodemographic data (particularly age, education level and living in Finland: 17.9% explained QoL variation), chronic conditions (particularly depression: 4.6%) and a wide and rich social network (4.6%). Other determinants were presence of disabling pain, learning difficulties and visual problems, and living in usable house that is perceived as non-risky. Some variables were specifically associated to QoL in single countries: age in Poland, alcohol consumption in Spain, angina in Finland, depression in Spain, and self-reported sadness both in Finland and Poland, but not in Spain. Other were commonly associated to QoL: smoking status, bodily aches, being emotionally affected by health problems, good social network and home characteristics. Our results highlight the importance of modifiable determinants of QoL, and provide public health indications that could support concrete actions at country level. In particular, smoking cessation, increasing the level of physical activity, improving social network ties and applying universal design approach to houses and environmental infrastructures could potentially increase QoL of ageing population.
Towards a healthier Gulf of Finland - results of the International Gulf of Finland Year 2014
NASA Astrophysics Data System (ADS)
Myrberg, Kai; Lips, Urmas; Orlova, Marina
2017-07-01
The international collaboration to protect the marine environment of the Gulf of Finland (GoF) dates back to 1968. Since then, Finland and the Soviet Union, and later on, Estonia, Finland, and Russia have collaborated trilaterally in the environmental front with a vision of a healthier GoF. The first Gulf of Finland Year organized in 1996 was a major step forward in trilateral cooperation and GoF research. It produced comprehensive scientific reports on different aspects of the GoF environment (Sarkkula, 1997), including an updated review of the physical oceanography of the Gulf (Alenius et al., 1998; Soomere et al., 2008) and recognition of the internal nutrient fluxes as a factor counteracting the decrease in external load (Pitkänen et al., 2001).
Assessing worldwide research activity on probiotics in pediatrics using Scopus database: 1994-2014.
Sweileh, Waleed M; Shraim, Naser Y; Al-Jabi, Samah W; Sawalha, Ansam F; Rahhal, Belal; Khayyat, Rasha A; Zyoud, Sa'ed H
2016-01-01
A wide variety of probiotic products has been introduced into the market in the past decade. Research trends and activity on probiotics help understand how these products were evolved and their potential future role in medicine. The objective of this study was to assess the research activity on probiotics in pediatrics using bibliometric indicators and network visualization. Original and review articles on probiotics in pediatrics published worldwide were retrieved from SciVerse, Scopus (1994-2014) and analyzed. VOSviewer was used for network visualization. The total number of documents published on probiotics in pediatrics was 2817. Research activity on probiotics in pediatrics showed approximately 90- fold increase during the study period. Approximately 22 % of published articles originated from USA and has the greatest share, however, Finland ranked first when data were stratified by population or income. The most productive institution in this field was Turku University in Finland with 82 (2.91 %) articles. Half of the prolific authors were also from Finland. Most of the published research activity appeared in Journal of Pediatric Gastroenterology and Nutrition. Most frequently encountered title terms include nutrition, infant formula, necrotizing enetrocolitis, allergy, and diarrhea. The total number of citations for the retreived documents documents was 70991, and the average citation per article was 25.20. Interest in probiotic research and its potential benefits in pediatric ailments is relatively recent but significantly increasing. Bibliometric analysis can be used as an indicator of the importance and growth of probiotic use in pediatrics.
Halmesmäki, Esa; Pasternack, Iris; Roine, Risto
2016-04-05
This study examines, as a part of the European Union funded Adopting Hospital Based Health Technology Assessment (AdHopHTA) project, the results and barriers of collaboration between Finnish hospitals and the national health technology assessment (HTA) agency, Finohta. A joint collaborative HTA program has existed since 2006 between the Finnish hospitals and the national agency. A case study method was used. Information about the collaboration between Finnish hospitals and Finohta was retrieved from interviews and publications, and categorised per theme. Hypotheses and indicators of successful collaboration were determined beforehand and reflected on the observations from the interviews and literature. Overall, 48 collaborative HTA reports have been performed during 7 years of collaboration. However, there were no clear indications that the use of HTA information or the transparency of decision-making regarding new technologies would have increased in hospitals. The managerial commitment to incorporate HTAs into the decision-making processes in hospitals was still low. The quality of the collaborative HTA reports was considered good, but their applicability in the hospital setting limited. There were differing expectations about the timing and relevance of the content. Signs of role conflict and mistrust were observed. Despite collaborative efforts to produce HTAs for hospitals, the impact of HTA information on hospital decision-making appears to remain low. The difficulties identified in this case study, such as lack of managerial commitment in hospitals, can hopefully be better addressed in the future with the guidance and tools having been developed in the AdHopHTA project. Collaboration between hospitals and national HTA agencies remains important for the efficient sharing of skills and resources.
Lower limb amputations: differences between the genders and long-term survival.
Heikkinen, M; Saarinen, J; Suominen, V P; Virkkunen, J; Salenius, J
2007-09-01
The purpose of the study was to evaluate possible differences between genders in amputation incidence, revascularization activity before and survival after amputation. This population-based study was carried out in a well-defined geographical area, where all vascular surgical consultations and reconstructions are performed in one university hospital. All amputations performed in the region during 1990 - 1999 were identified from the hospital central registers. According to patient's identity codes, the Cause of Death Registry of Statistics Finland provided death data. Amputation data were cross-linked with the local vascular registry using identity codes. Women were found to be 8 years older than men (p < 0.0001). Major amputations comprised 73.4% in males and 77.7% in females. The age-standardized amputation incidence among males was 338 and among females 226 (per 10(6) inhabitants/year) (p < 0.001). The most prominent difference was seen in amputations due to trauma, where the age-adjusted major amputation incidence was over three-fold among males compared to females. The proportion of patients who had undergone vascular procedure before amputation was 23% in both genders. Median survival after amputation was 943 days in men and 716 in women (p = 0.01). When the higher age of women was considered, there was no significant difference between the genders. Survival was poorer among diabetics in both genders and the difference was significant in males. The amputation incidence was found to be higher in men compared to women in all etiologic subgroups except malignant tumour. Almost one in 4 patients had undergone vascular surgical reconstruction before amputation in both genders. There was no significant difference between the genders in survival after amputation. Subjects with diabetes had a poorer survival after major amputation than those without diabetes.
Saunders, Hannele
2015-07-01
To describe quantitative and qualitative best evidence as sources for practical interventions usable in daily care delivery in order to integrate best evidence into clinical decision-making at local practice settings. To illustrate the development, implementation and evaluation of a pain management nursing care bundle based on a clinical practice guideline via a real-world clinical exemplar. Successful implementation of evidence-based practice requires consistent integration of best evidence into daily clinical decision-making. Best evidence comprises high-quality knowledge summarised in systematic reviews and translated into guidelines. However, consistent integration of guidelines into care delivery remains challenging, partly due to guidelines not being in a usable form for daily practice or relevant for the local context. A position paper with a clinical exemplar of a nurse-led, evidence-based quality improvement project to design, implement and evaluate a pain management care bundle translated from a national nursing guideline. A pragmatic approach to integrating guidelines into daily practice is presented. Best evidence from a national nursing guideline was translated into a pain management care bundle and integrated into daily practice in 15 medical-surgical (med-surg) units of nine hospitals of a large university hospital system in Finland. Translation of best evidence from guidelines into usable form as care bundles adapted to the local setting may increase implementation and uptake of guidelines and improve quality and consistency of care delivery. A pragmatic approach to translating a nursing guideline into a pain management care bundle to incorporate best evidence into daily practice may help achieve more consistent and equitable integration of guidelines into care delivery, and better quality of pain management and patient outcomes. © 2015 John Wiley & Sons Ltd.
Leivo, Tiina; Sarikkola, Anna-Ulrika; Uusitalo, Risto J; Hellstedt, Timo; Ess, Sirje-Linda; Kivelä, Tero
2011-06-01
To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Helsinki University Eye Hospital, Helsinki, Finland. Economic analysis. Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Banzuzi, Kukka
2013-03-01
The representation of women in physics and related fields of study in Finland, career advancement of female physicists in Finland, and the actions carried out in recent years to improve the situation are summarized.
Peltola, H; Heinonen, O P; Valle, M; Paunio, M; Virtanen, M; Karanko, V; Cantell, K
1994-11-24
In the 1970s measles, mumps, and rubella were rampant in Finland, and rates of immunization were inadequate. In 1982 a comprehensive national vaccination program began in which two doses of a combined live-virus vaccine were used. Public health nurses at 1036 child health centers administered the vaccine to children at 14 to 18 months of age and again at 6 years, and also to selected groups of older children and young adults. Vaccination was voluntary and free of charge. In follow-up studies, we focused on rates of vaccination, reasons for noncompliance, adverse reactions, immunogenicity, persistence of antibody, and incidence of the three diseases. Since 1987, paired serum samples have been collected from all patients with suspected cases of measles, mumps, or rubella. Over a period of 12 years, 1.5 million of the 5 million people in Finland were vaccinated. Coverage now exceeds 95 percent. The vaccine was efficient and safe, even in those with a history of severe allergy. No deaths or persistent sequelae were attributable to vaccination. The most frequent complication requiring hospitalization was acute thrombocytopenic purpura, which occurred at a rate of 3.3 per 100,000 vaccinated persons. The 99 percent decrease in the incidence of the three diseases was accompanied by an increasing rate of false positive clinical diagnoses. In 655 vaccinated patients with clinically diagnosed disease, serologic studies confirmed the presence of measles in only 0.8 percent, mumps in 2.0 percent, and rubella in 1.2 percent. The few localized outbreaks were confined to patients in the partially vaccinated age groups. There are now fewer than 30 sporadic cases of each of the three diseases per year, and those are probably imported. Over a 12-year period, an immunization program using two doses of combined live-virus vaccine has eliminated indigenous measles, mumps, and rubella from Finland. Serologic studies show that most reported sporadic cases are now due to other causes, but a continued high rate of vaccination coverage is essential to prevent outbreaks resulting from exposure to imported disease.
Benchmarking antibiotic use in Finnish acute care hospitals using patient case-mix adjustment.
Kanerva, Mari; Ollgren, Jukka; Lyytikäinen, Outi
2011-11-01
It is difficult to draw conclusions about the prudence of antibiotic use in different hospitals by directly comparing usage figures. We present a patient case-mix adjustment model of antibiotic use to rank hospitals while taking patient characteristics into account. Data on antibiotic use were collected during the national healthcare-associated infection (HAI) prevalence survey in 2005 in Finland in all 5 tertiary care, all 15 secondary care and 10 (25% of 40) other acute care hospitals. The use of antibiotics was measured using use-days/100 patient-days during a 7day period and the prevalence of patients receiving at least two antimicrobials during the study day. Case-mix-adjusted antibiotic use was calculated by using multivariate models and an indirect standardization method. Parameters in the model included age, sex, severity of underlying diseases, intensive care, haematology, preceding surgery, respirator, central venous and urinary catheters, community-associated infection, HAI and contact isolation due to methicillin-resistant Staphylococcus aureus. The ranking order changed one position in 12 (40%) hospitals and more than two positions in 13 (43%) hospitals when the case-mix-adjusted figures were compared with those observed. In 24 hospitals (80%), the antibiotic use density observed was lower than expected by the case-mix-adjusted use density. The patient case-mix adjustment of antibiotic use ranked the hospitals differently from the ranking according to observed use, and may be a useful tool for benchmarking hospital antibiotic use. However, the best set of easily and widely available parameters that would describe both patient material and hospital activities remains to be determined.
KAMEDO report no. 87: bomb attack in Finnish shopping center, 2002.
Deverell, Edward; Ortenwall, Per; Almgren, Ola; Riddez, Louis
2007-01-01
The detonation of a bomb in a shopping center in Vantaa, Finland, took place on 11 October 2002. Seven people died as a result and > 160 people required medical attention. Because the rescue teams were inadequately trained to respond to terrorist attacks, the event was handled according to protocol. A number of problems arose, including: people from different rescue agencies were difficult to distinguish from each other; there was inadequate communication between the incident site and the main hospital; relatives of victims were not kept informed; and psychiatric problems in the wake of the disaster were not addressed sufficiently.
de Fine Licht, Sofie; Rugbjerg, Kathrine; Gudmundsdottir, Thorgerdur; Bonnesen, Trine G; Asdahl, Peter Haubjerg; Holmqvist, Anna Sällfors; Madanat-Harjuoja, Laura; Tryggvadottir, Laufey; Wesenberg, Finn; Hasle, Henrik; Winther, Jeanette F; Olsen, Jørgen H
2017-05-01
Survivors of childhood cancer are at increased risk for a wide range of late effects. However, no large population-based studies have included the whole range of somatic diagnoses including subgroup diagnoses and all main types of childhood cancers. Therefore, we aimed to provide the most detailed overview of the long-term risk of hospitalisation in survivors of childhood cancer. From the national cancer registers of Denmark, Finland, Iceland, and Sweden, we identified 21,297 5-year survivors of childhood cancer diagnosed with cancer before the age of 20 years in the periods 1943-2008 in Denmark, 1971-2008 in Finland, 1955-2008 in Iceland, and 1958-2008 in Sweden. We randomly selected 152,231 population comparison individuals matched by age, sex, year, and country (or municipality in Sweden) from the national population registers. Using a cohort design, study participants were followed in the national hospital registers in Denmark, 1977-2010; Finland, 1975-2012; Iceland, 1999-2008; and Sweden, 1968-2009. Disease-specific hospitalisation rates in survivors and comparison individuals were used to calculate survivors' standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and standardised bed day ratios (SBDRs) based on length of stay in hospital. We adjusted for sex, age, and year by indirect standardisation. During 336,554 person-years of follow-up (mean: 16 years; range: 0-42 years), childhood cancer survivors experienced 21,325 first hospitalisations for diseases in one or more of 120 disease categories (cancer recurrence not included), when 10,999 were expected, yielding an overall RR of 1.94 (95% confidence interval [95% CI] 1.91-1.97). The AER was 3,068 (2,980-3,156) per 100,000 person-years, meaning that for each additional year of follow-up, an average of 3 of 100 survivors were hospitalised for a new excess disease beyond the background rates. Approximately 50% of the excess hospitalisations were for diseases of the nervous system (19.1% of all excess hospitalisations), endocrine system (11.1%), digestive organs (10.5%), and respiratory system (10.0%). Survivors of all types of childhood cancer were at increased, persistent risk for subsequent hospitalisation, the highest risks being those of survivors of neuroblastoma (RR: 2.6 [2.4-2.8]; n = 876), hepatic tumours (RR: 2.5 [2.0-3.1]; n = 92), central nervous system tumours (RR: 2.4 [2.3-2.5]; n = 6,175), and Hodgkin lymphoma (RR: 2.4 [2.3-2.5]; n = 2,027). Survivors spent on average five times as many days in hospital as comparison individuals (SBDR: 4.96 [4.94-4.98]; n = 422,218). The analyses of bed days in hospital included new primary cancers and recurrences. Of the total 422,218 days survivors spent in hospital, 47% (197,596 bed days) were for new primary cancers and recurrences. Our study is likely to underestimate the absolute overall disease burden experienced by survivors, as less severe late effects are missed if they are treated sufficiently in the outpatient setting or in the primary health care system. Childhood cancer survivors were at increased long-term risk for diseases requiring inpatient treatment even decades after their initial cancer. Health care providers who do not work in the area of late effects, especially those in primary health care, should be aware of this highly challenged group of patients in order to avoid or postpone hospitalisations by prevention, early detection, and appropriate treatments.
Kuusi, Markku; Lahti, Elina; Virolainen, Anni; Hatakka, Maija; Vuento, Risto; Rantala, Leila; Vuopio-Varkila, Jaana; Seuna, Eija; Karppelin, Matti; Hakkinen, Marjaana; Takkinen, Johanna; Gindonis, Veera; Siponen, Kyosti; Huotari, Kaisa
2006-01-01
Background Streptococcus equi subspecies zooepidemicus is a rare infection in humans associated with contact with horses or consumption of unpasteurized milk products. On October 23, 2003, the National Public Health Institute was alerted that within one week three persons had been admitted to Tampere University Central Hospital (TaYS) because of S. equi subsp. zooepidemicus septicaemia. All had consumed fresh goat cheese produced in a small-scale dairy located on a farm. We conducted an investigation to determine the source and the extent of the outbreak. Methods Cases were identified from the National Infectious Disease Register. Cases were persons with S. equi subsp. zooepidemicus isolated from a normally sterile site who had illness onset 15.9-31.10.2003. All cases were telephone interviewed by using a standard questionnaire and clinical information was extracted from patient charts. Environmental and food specimens included throat swabs from two persons working in the dairy, milk from goats and raw milk tank, cheeses made of unpasteurized milk, vaginal samples of goats, and borehole well water. The isolates were characterized by ribotyping and pulsed-field gel electrophoresis (PFGE). Results Seven persons met the case definition; six had septicaemia and one had purulent arthritis. Five were women; the median age was 70 years (range 54–93). None of the cases were immunocompromized and none died. Six cases were identified in TaYS, and one in another university hospital in southern Finland. All had eaten goat cheese produced on the implicated farm. S. equi subsp. zooepidemicus was isolated from throat swabs, fresh goat cheese, milk tank, and vaginal samples of one goat. All human and environmental strains were indistinguishable by ribotyping and PFGE. Conclusion The outbreak was caused by goat cheese produced from unpasteurized milk. Outbreaks caused by S. equi subsp. zooepidemicus may not be detected if streptococcal strains are only typed to the group level. S. equi subsp. zooepidemicus may be a re-emerging disease if unpasteurized milk is increasingly used for food production. Facilities using unpasteurized milk should be carefully monitored to prevent this type of outbreaks. PMID:16504158
The Serpent Monte Carlo Code: Status, Development and Applications in 2013
NASA Astrophysics Data System (ADS)
Leppänen, Jaakko; Pusa, Maria; Viitanen, Tuomas; Valtavirta, Ville; Kaltiaisenaho, Toni
2014-06-01
The Serpent Monte Carlo reactor physics burnup calculation code has been developed at VTT Technical Research Centre of Finland since 2004, and is currently used in 100 universities and research organizations around the world. This paper presents the brief history of the project, together with the currently available methods and capabilities and plans for future work. Typical user applications are introduced in the form of a summary review on Serpent-related publications over the past few years.
Howard University Hospital finds partner in helping children succeed.
Botvin, Judith D
2005-01-01
Howard University Hospital, Washington, D.C., becomes the site for the launch of a national ad campaign by the nonprofit youth education organization, Communities in Schools. The hospital and university share the organization's mission of supporting young people in the community.
The Impact of Information Culture on Patient Safety Outcomes
Mikkonen, Santtu; Saranto, Kaija; Bates, David W.
2017-01-01
Summary Background An organization’s information culture and information management practices create conditions for processing patient information in hospitals. Information management incidents are failures that could lead to adverse events for the patient if they are not detected. Objectives To test a theoretical model that links information culture in acute care hospitals to information management incidents and patient safety outcomes. Methods Reason’s model for the stages of development of organizational accidents was applied. Study data were collected from a cross-sectional survey of 909 RNs who work in medical or surgical units at 32 acute care hospitals in Finland. Structural equation modeling was used to assess how well the hypothesized model fit the study data. Results Fit indices indicated a good fit for the model. In total, 18 of the 32 paths tested were statistically significant. Documentation errors had the strongest total effect on patient safety outcomes. Organizational guidance positively affected information availability and utilization of electronic patient records, whereas the latter had the strongest total effect on the reduction of information delays. Conclusions Patient safety outcomes are associated with information management incidents and information culture. Further, the dimensions of the information culture create work conditions that generate errors in hospitals. PMID:28272647
Jylhä, Virpi; Mikkonen, Santtu; Saranto, Kaija; Bates, David W
2017-03-08
An organization's information culture and information management practices create conditions for processing patient information in hospitals. Information management incidents are failures that could lead to adverse events for the patient if they are not detected. To test a theoretical model that links information culture in acute care hospitals to information management incidents and patient safety outcomes. Reason's model for the stages of development of organizational accidents was applied. Study data were collected from a cross-sectional survey of 909 RNs who work in medical or surgical units at 32 acute care hospitals in Finland. Structural equation modeling was used to assess how well the hypothesized model fit the study data. Fit indices indicated a good fit for the model. In total, 18 of the 32 paths tested were statistically significant. Documentation errors had the strongest total effect on patient safety outcomes. Organizational guidance positively affected information availability and utilization of electronic patient records, whereas the latter had the strongest total effect on the reduction of information delays. Patient safety outcomes are associated with information management incidents and information culture. Further, the dimensions of the information culture create work conditions that generate errors in hospitals.
NASA Astrophysics Data System (ADS)
2004-02-01
Finland will become the eleventh member state of the European Southern Observatory (ESO) [1]. Today, during a ceremony at the ESO Headquarters in Garching (Germany), a corresponding Agreement was signed by the Finnish Minister of Education and Science, Ms. Tuula Haatainen and the ESO Director General, Dr. Catherine Cesarsky, in the presence of other high officials from Finland and the ESO member states (see Video Clip 02/04 below). Following subsequent ratification by the Finnish Parliament of the ESO Convention and the associated protocols [2], it is foreseen that Finland will formally join ESO on July 1, 2004. Uniting European Astronomy ESO PR Photo 03/04 ESO PR Photo 03/04 Caption : Signing of the Finland-ESO Agreement on February 9, 2004, at the ESO Headquarters in Garching (Germany). At the table, the ESO Director General, Dr. Catherine Cesarsky, and the Finnish Minister of Education and Science, Ms. Tuula Haatainen . [Preview - JPEG: 400 x 499 pix - 52k] [Normal - JPEG: 800 x 997 pix - 720k] [Full Res - JPEG: 2126 x 2649 pix - 2.9M] The Finnish Minister of Education and Science, Ms. Tuula Haatainen, began her speech with these words: "On behalf of Finland, I am happy and proud that we are now joining the European Southern Observatory, one of the most successful megaprojects of European science. ESO is an excellent example of the potential of European cooperation in science, and along with the ALMA project, more and more of global cooperation as well." She also mentioned that besides science ESO offers many technological challenges and opportunities. And she added: "In Finland we will try to promote also technological and industrial cooperation with ESO, and we hope that the ESO side will help us to create good working relations. I am confident that Finland's membership in ESO will be beneficial to both sides." Dr. Catherine Cesarsky, ESO Director General, warmly welcomed the Finnish intention to join ESO. "With the accession of their country to ESO, Finnish astronomers, renowned for their expertise in many frontline areas, will have new, exciting opportunities for working on research programmes at the frontiers of modern astrophysics." "This is indeed the right time to join ESO", she added. "The four 8.2-m VLT Unit Telescopes with their many first-class instruments are working with unsurpassed efficiency at Paranal, probing the near and distant Universe and providing European astronomers with a goldmine of unique astronomical data. The implementation of the VLT Interferometer is progressing well and last year we entered into the construction phase of the intercontinental millimetre- and submillimetre-band Atacama Large Millimeter Array. And the continued design studies for gigantic optical/infrared telescopes like OWL are progressing fast. Wonderful horizons are indeed opening for the coming generations of European astronomers!" She was seconded by the President of the ESO Council, Professor Piet van der Kruit, "This is a most important step in the continuing evolution of ESO. By having Finland become a member of ESO, we welcome a country that has put in place a highly efficient and competitive innovation system with one of the fastest growths of research investment in the EU area. I have no doubt that the Finnish astronomers will not only make the best scientific use of ESO facilities but that they will also greatly contribute through their high quality R&D to technological developments which will benefit the whole ESO community. " Notes [1]: Current ESO member countries are Belgium, Denmark, France, Germany, Italy, the Netherlands, Portugal, Sweden, Switzerland and the United Kindgdom. [2]: The ESO Convention was established in 1962 and specifies the goals of ESO and the means to achieve these, e.g., "The Governments of the States parties to this convention... desirous of jointly creating an observatory equipped with powerful instruments in the Southern hemisphere and accordingly promoting and organizing co-operation in astronomical research..." (from the Preamble to the ESO Convention).
Heinänen, M; Brinck, T; Handolin, L; Mattila, V M; Söderlund, T
2017-09-01
The Finnish Hospital Discharge Register data are frequently used for research purposes. The Finnish Hospital Discharge Register has shown excellent validity in single injuries or disease groups, but no studies have assessed patients with multiple trauma diagnoses. We aimed to evaluate the accuracy and coverage of the Finnish Hospital Discharge Register but at the same time validate the data of the trauma registry of the Helsinki University Hospital's Trauma Unit. We assessed the accuracy and coverage of the Finnish Hospital Discharge Register data by comparing them to the original patient files and trauma registry files from the trauma registry of the Helsinki University Hospital's Trauma Unit. We identified a baseline cohort of patients with severe thorax injury from the trauma registry of the Helsinki University Hospital's Trauma Unit of 2013 (sample of 107 patients). We hypothesized that the Finnish Hospital Discharge Register would lack valuable information about these patients. Using patient files, we identified 965 trauma diagnoses in these 107 patients. From the Finnish Hospital Discharge Register, we identified 632 (65.5%) diagnoses and from the trauma registry of the Helsinki University Hospital's Trauma Unit, 924 (95.8%) diagnoses. A total of 170 (17.6%) trauma diagnoses were missing from the Finnish Hospital Discharge Register data and 41 (4.2%) from the trauma registry of the Helsinki University Hospital's Trauma Unit data. The coverage and accuracy of diagnoses in the Finnish Hospital Discharge Register were 65.5% (95% confidence interval: 62.5%-68.5%) and 73.8% (95% confidence interval: 70.4%-77.2%), respectively, and for the trauma registry of the Helsinki University Hospital's Trauma Unit, 95.8% (95% confidence interval: 94.5%-97.0%) and 97.6% (95% confidence interval: 96.7%-98.6%), respectively. According to patient records, these patients were subjects in 249 operations. We identified 40 (16.1%) missing operation codes from the Finnish Hospital Discharge Register and 19 (7.6%) from the trauma registry of the Helsinki University Hospital's Trauma Unit. The validity of the Finnish Hospital Discharge Register data is unsatisfactory in terms of the accuracy and coverage of diagnoses in patients with multiple trauma diagnoses. Procedural codes provide greater accuracy. We found the coverage and accuracy of the trauma registry of the Helsinki University Hospital's Trauma Unit to be excellent. Therefore, a special trauma registry, such as the trauma registry of the Helsinki University Hospital's Trauma Unit, provides much more accurate data and should be the preferred registry when extracting data for research or for administrative use, such as resource prioritizing.
The risk of childhood autism among second-generation migrants in Finland: a case-control study.
Lehti, Venla; Hinkka-Yli-Salomäki, Susanna; Cheslack-Postava, Keely; Gissler, Mika; Brown, Alan S; Sourander, Andre
2013-10-19
Studying second-generation immigrants can help in identifying genetic or environmental risk factors for childhood autism. Most previous studies have focused on maternal region of birth and showed inconsistent results. No previous study has been conducted in Finland. The study was a nested case-control study based on a national birth cohort. Children born in 1987-2005 and diagnosed with childhood autism by the year 2007 were identified from the Finnish Hospital Discharge Register. Controls were selected from the Finnish Medical Birth Register. Information on maternal and paternal country of birth and mother tongue was collected from the Finnish Central Population Register. There were 1132 cases and 4515 matched controls. The statistical test used was conditional logistic regression analysis. Compared with children with two Finnish parents, the risk of childhood autism was increased for those whose parents are both immigrants (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI] 1.2-2.7) and for those with only an immigrant mother (aOR 1.8, 95% CI 1.2-2.7), but not for those with only an immigrant father. The risk was increased for those with a mother born in the former Soviet Union or Yugoslavia and for those with a mother or a father born in Asia. Specific parental countries of birth associated with an increased risk were the former Soviet Union, the former Yugoslavia and Vietnam. In Finland, children who are born to immigrant mothers with or without an immigrant partner, have an increased risk of childhood autism. The risk varies with immigrant parents' region of birth. The findings may help in identifying possible risk factors, which can be examined in future studies.
A substantial number of scientific publications originate from non-university hospitals.
Fedder, Jens; Nielsen, Gunnar Lauge; Petersen, Lars J; Rasmussen, Claus; Lauszus, Finn F; Frost, Lars; Hornung, Nete; Lederballe, Ole; Andersen, Jens Peter
2011-11-01
As we found no recent published reports on the amount and kind of research published from Danish hospitals without university affiliation, we have found it relevant to conduct a bibliometric survey disclosing these research activities. We retrieved all scientific papers published in the period 2000-2009 emanating from all seven Danish non-university hospitals in two regions, comprising 1.8 million inhabitants, and which were registered in a minimum of one of the three databases: PubMed MEDLINE, Thomson Reuters Web of Science and Elsevier's Scopus. In 878 of 1,252 papers, the first and/or last author was affiliated to a non-university hospital. Original papers made up 69% of these publications versus 86% of publications with university affiliation on first or last place. Case reports and reviews most frequently had authors from regional hospitals as first and/or last authors. The total number of publications from regional hospitals increased by 48% over the 10-year period. Publications were cited more often if the first or last author was from a university hospital and even more so if they were affiliated to foreign institutions. Cardiology, gynaecology and obstetrics, and environmental medicine were the three specialities with the largest number of regional hospital publications. A substantial number of scientific publications originate from non-university hospitals. Almost two thirds of the publications were original research published in international journals. Variations between specialities may reflect local conditions. not relevant. not relevant.
Pharmaco-economics of levosimendan in cardiology: a European perspective.
Nieminen, M S; Buerke, M; Parissis, J; Ben-Gal, T; Pollesello, P; Kivikko, M; Karavidas, A; Severino, P; Comín-Colet, J; Wikström, G; Fedele, F
2015-11-15
Heart failure places a significant economic burden on health care. Acute heart failure requires hospitalization and often frequent re-hospitalization in expensive wards where vasoactive rescue therapy is often added on top of standard medications. In these lean times, there is a growing need for cost-effective therapeutic options that supply superior support and in addition shorten the length of stay in hospital and reduce re-hospitalization rates. The inodilator levosimendan represents the latest addition to the vasoactive treatments of acute heart failure patients, and it appears to meet these expectations. Our aim was to answer the question whether the treatment efficacy of levosimendan - when selected as therapy for patients hospitalized for acute heart failure - brings savings to hospitals in various European countries representing different economies. We took a conservative approach and selected some a fortiori arguments to simplify the calculations. We selected seven European countries to represent different economies: Italy, Spain, Greece, Germany, Sweden, Finland and Israel. Data on the costs of medications and on the cost per day were collected and fed in a simple algorithm to detect savings. These saving varied from country to country, from a minimum of €0.50 in Germany to a maximum of €354.64 in Sweden. The use of levosimendan as a therapy for patients hospitalized for acute heart failure provides a net saving to hospitals driven by a reduction in the length of hospital stay. This finding is true in each of the countries considered in this study. Copyright © 2015. Published by Elsevier Ireland Ltd.
Atmospheric inorganic trace contaminants in Finland, especially in the Gulf of Finland area
NASA Astrophysics Data System (ADS)
Jalkanen, Liisa Maria
Atmospheric aerosol samples were collected at Utö and Virolahti in the Gulf of Finland area and Ähtäri in Central Finland using a filter pack. The samples were analysed by instrumental neutron activation analysis (INAA) and inductively coupled plasma mass-spectrometry (ICP-MS) for 34 elements including halogens and heavy metals. A very simple and quantitative acid digestion method was developed for the dissolution of the aerosol samples for ICP-MS analysis. Analysis of the elemental data is given using trajectories, principal component analysis and long-range transport modelling. The average total (fine + coarse) atmospheric concentrations range at Utö from 0.083 ng m -3 for Cd to 730 ng m-3 for Na. The sea areas (Utö, Virolahti, Hailuoto) have most of the heavy metal air pollution in Finland, as witnessed by the aerosol concentration and wet deposition data. There is a clear decreasing gradient in the deposition of As, Cd, Cr, Pb, and V from South to North in Finland. In general, the trace element concentrations and deposition are lower in Finland than in Central Europe. The effect of large particulate emission sources in Estonia can be seen in the elemental concentrations of atmospheric particles and in the deposition around the eastern Gulf of Finland region. There has been a remarkable decrease in heavy metal emissions in Finland during the 1990s. However, due to long-range transport, the decrease in deposition as witnessed by analysis of these concentrations in precipitation and moss is much less than would be expected.
Small Particles, Big Science: The International LBNF/DUNE Project
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
Neutrinos are the most abundant matter particles in the universe, yet very little is known about them. This animation shows how the Department of Energy’s Long-Baseline Neutrino Facility will power the Deep Underground Neutrino Experiment to help scientists understand the role neutrinos play in the universe. DUNE will also look for the birth of neutron stars and black holes by catching neutrinos from exploding stars. More than 800 scientists from 150 institutions in 27 countries are working on the LBNF/DUNE project, including Armenia, Belgium, Brazil, Bulgaria, Canada, Colombia, Czech Republic, Finland, France, Greece, India, Iran, Italy, Japan, Madagascar, Mexico, Netherlands,more » Peru, Poland, Romania, Russia, Spain, Switzerland, Turkey, Ukraine, United Kingdom, USA.« less
Learning From Iraq: A Final Report From the Special Inspector General for Iraq Reconstruction
2013-03-01
organizations that benefit Iraqi refugees, internally displaced persons, and other conflict victims; funding is also pro - vided to non-governmental...corrupt countries in the world. 0 2 4 6 8 10 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Finland Finland Iceland Finland Iceland New Zealand Denmark... Finland New Zealand Denmark New Zealand Sweden New ZealandNew Zealand Denmark New Zealand Singapore (113) (129) (137) (160) (133) Bangladesh (145
Selin, Jani; Hakkarainen, Pekka; Partanen, Airi; Tammi, Tuukka; Tigerstedt, Christoffer
2013-11-01
The aim of the article is to analyze changes in opioid substitution treatments (OST) in Finland. OST spread in Finland in the late 1990s and early 2000s (Phase 1). Since then, OST has become an integrated part of Finnish drug policy and is provided in various substance abuse treatment units as well as in municipal health centers (Phase 2). The paper analyses the policy around the implementation of opioid substitution treatment in Finland, focusing on identifying the key factors and the relations between them that have contributed to the implementation of OST in Finland. OST has become accepted in Finland during the past ten years as a crucial element of a harm reduction strategy. Present incentives behind this development are not as clearly related to drug-specific policies as in the late 1990s; rather, they stem from both the restructuring of health care services (e.g. cost-effectiveness) and the strengthening of the medical or technico-administrative approach to the development of OST. Since the early 2000s, the development of substitution treatment in Finland has not taken place under explicit drug-political guidance, but largely as a result of many differing intended and unintended effects. One of the unintended effects is the fact that buprenorphine has replaced heroin as the most commonly misused opioid in Finland. Copyright © 2013 Elsevier B.V. All rights reserved.
Opioid abuse and hospitalization rates in patients with schizophrenia.
Kivimies, Kristiina; Repo-Tiihonen, Eila; Kautiainen, Hannu; Maaranen, Päivi; Muhonen, Leea H; Heikkinen, Martti; Tiihonen, Jari
2016-01-01
Substance abuse worsens the course of schizophrenia, but it is not known whether or not there are differences between specific substances concerning their association with the hospitalizations of patients with schizophrenia. The primary aims of this study were to examine the possible associations between amphetamine, cannabis, and opioid abuse, and the risk of hospitalizations among patients with schizophrenia. The study population consisted of 146 patients with ICD-defined schizophrenia from two different geographical sites in Finland, and it included both inpatients and outpatients. Data were collected retrospectively from the patients' medical files. Substance abuse was defined as either harmful use or dependence according to ICD-10. The cumulative prevalence of substance abuse was 10.9% (16/146) for cannabis, 8.9% (13/146) for amphetamine, and 4.1% (6/146) for opioids. Among patients with schizophrenia and abuse of any substance, the number of hospitalizations was about 1.5-fold when compared to those without substance abuse. The incidence rate ratio for hospitalizations was 2.9 (95% CI 2.47-3.63) for opioids, 2.0 (1.71-2.41) for amphetamine, and 1.6 (1.33-1.84) for cannabis, when compared with no abuse of each substance. The risk of hospitalizations was significantly higher for opioids when compared with amphetamine (p < 0.001) or cannabis (p < 0.001). Harmful use or dependence of opioids among patients with schizophrenia is associated with significantly higher risk of hospitalizations than either harmful use or dependence of amphetamine or cannabis.
Taanila, A; Rantakallio, P; Koiranen, M; von Wendt, L; Järvelin, M-R
2005-03-01
The aim was to study how many of the individuals with intellectual disability (ID; IQ < or = 70) in an age cohort were not receiving a disability pension by the age of 34 years and what their life situation was like in terms of employment, education and morbidity. In 2000, the Northern Finland 1966 Birth Cohort (n=12,058 live-born) included 129 individuals with ID. The outcome data on employment, education, pensions and morbidity were obtained from national registers. A total of 85.3% (n=110) of all the individuals with ID were on pension, and 66 of them had severe ID (IQ <50) and 44 had mild ID (IQ 50-70). Altogether 99 were drawing a pension because of ID, and 11 had a main diagnosis other than ID in the register of Social Insurance Institution. Nineteen individuals with mild ID were not on disability pension. The educational level of those without pension was low, and all whose occupation was known worked in low-level manual trades in the open labour market. During the past 8 years (1993-2000), their employment rate had been lower and unemployment rate correspondingly higher and unemployment periods longer than those of the reference group (IQ >85 or not measured). As to the morbidity, they had been hospitalized twice more often than those in the reference group and the mean of their hospitalization days was over fourfold. More attention should be paid to the vocational education and supported employment services of individuals with ID to help them to manage as independently as possible.
Barriers to climate-friendly food choices among young adults in Finland.
Mäkiniemi, Jaana-Piia; Vainio, Annukka
2014-03-01
The aim of the study was to examine how young adults in Finland perceive barriers to climate-friendly food choices and how these barriers are associated with their choices. The participants were 350 university students of the social and behavioral sciences who completed a questionnaire during class. The study found that the barriers the participants perceived as being the most relevant were different from those that were associated with the omission of climate-friendly food choices. High prices were perceived as the most relevant barrier, but were only weakly associated with the participants' food choices. Instead, habit and disbelief in the effects of food consumption on the climate were found to be the barriers that had the greatest association with climate-friendly choices. Moreover, women considered high prices and poor supply more important compared to men, whereas men considered disbelief and habit more important. In addition, vegetarians perceived fewer barriers than those who followed other diets. The findings increase our understanding of young adults' perceptions of barriers to climate-friendly food choices, as well as their effects. Copyright © 2013 Elsevier Ltd. All rights reserved.
Experiential health from an ageing and migration perspective: the case of older Finland-Swedes.
Kulla, Gunilla; Ekman, Sirkka-Liisa; Sarvimäki, Anneli
2010-02-01
Research has shown that immigrants and minority groups tend to have a lower health status compared to the majority population. The Finnish immigrants in Sweden are no exception. The Finland-Swedes, i.e., persons living in Finland who have Swedish as their mother language, seem to be an exception, however. They have been found to have better health and longer life expectancy compared to the Finnish majority. Research on health among migrated Finland-Swedes is scarce. The aim of this study was to describe and deepen the understanding of how older Finland-Swedes living as immigrants in Sweden, as well as re-migrants in Finland, experienced their health. Data was collected through 39 qualitative interviews with 29 older Finland-Swedes aged 65 or more. Data was analysed through qualitative thematic content analysis. The analysis resulted in five themes: Ageing means becoming frail and closer to death; Despite frailty and old age it is possible to feel well and experience peace; Being grateful for health as a source of life; Health comes from inner strength and external sources; Migration meant a mental and physical burden to health. Overall, both ageing and migration were experienced as jeopardising health.
Small-scale cannabis growers in Denmark and Finland.
Hakkarainen, Pekka; Frank, Vibeke Asmussen; Perälä, Jussi; Dahl, Helle Vibeke
2011-01-01
To compare domestic cannabis cultivation in Denmark and Finland to describe national characteristics in small-scale cannabis growing. A Web survey conducted among small-scale cannabis growers in Denmark (June to November 2008) and Finland (May to June 2009). Current cannabis growers (Denmark, 401; Finland, 1,054). Comparisons in regard to social background, growing history, practices, purposes and motives of growing, and perceptions of risks. Cannabis was cultivated primarily for own use, but sharing with friends and avoiding criminal circles also were significant motives for growing. Finnish growers prioritized indoor cultivation, whereas the Danes were more in favor of open-air plantations. Risks of getting caught by the police were observed to be greater in Finland. Growing for medical purposes was twice as prevalent in Finland as in Denmark. Cannabis growing is a stronger and more novel phenomenon in Finland than in Denmark, but both countries have been influenced by international trends. Finnish and Danish small-scale cannabis cultivators can be considered to be ideologically oriented lifestyle growers. Differences in the magnitude of the phenomenon may reflect differences in the availability and quality of cannabis in national drug markets. The Internet had promoted the spreading of the trend. Copyright © 2011 S. Karger AG, Basel.
Contemporary Issues of Occupational Education in Finland.
ERIC Educational Resources Information Center
Lasonen, Johanna, Ed.; Stenstrom, Marja-Leena, Ed.
This book contains 28 papers about the current status of occupational education in Finland, with special emphasis on context factors, structural and pedagogical reform, and quality management. The following papers are included: "Introduction of Educational Structure in Finland" (Johanna Lasonen, Marja-Leena Stenstrom); "Vocational…
Mortensen, Laust H; Lauridsen, Jørgen T; Diderichsen, Finn; Kaplan, George A; Gissler, Mika; Andersen, Anne-Marie N
2010-02-01
In this paper, we examine income- and education-related inequality in small-for-gestational age (SGA) and preterm birth in Denmark and Finland from 1987 to 2003 using concentration indexes (CIXs). From the national medical birth registries we gathered information on all births from 1987 to 2003. Information on highest completed maternal education and household income in the year preceding birth of the offspring was obtained for 1,012,400 births in Denmark and 499,390 in Finland. We then calculated CIXs for income- and education-related inequality in SGA and preterm birth. The mean household income-related inequality in SGA was -0.04 (95% confidence interval: -0.05, -0.04) in Denmark and -0.03 (-0.04, -0.02) in Finland. The maternal education-related inequality in SGA was -0.08 (-0.10, -0.06) in Denmark and -0.07 (-0.08, -0.06) in Finland. The income-related inequality in preterm birth was -0.03 (-0.03, -0.02) in Denmark and -0.03 (-0.04, -0.02) in Finland. The education-related inequality in preterm birth was -0.05 (-0.07, -0.04) in Denmark and -0.04 (-0.05, -0.03) in Finland. In Denmark, the income-related and education-related inequity in SGA increased over time. In Finland, the income-related inequality in SGA birth increased slightly, while education-related inequalities remained stable. Inequalities in preterm birth decreased over time in both countries. Denmark and Finland are examples of nations with free prenatal care and publicly financed obstetric care of high quality. During the period of study there were macroeconomic shocks affecting both countries. However, only small income- and education-related inequalities in SGA and preterm births during the period were observed.
Virtanen, P; Koivisto, A
2001-01-01
STUDY OBJECTIVE—Knowledge about changes in wellbeing during the passage from professional studies to working life is scarce and controversial. This study examined these changes among university graduates with good and poor employment prospects. DESIGN—A longitudinal study with four postal questionnaire surveys of a closed cohort. SETTING—Cohorts of graduating Finnish physicians and architects were followed up from 1994 to 1998. In 1994 Finland's national economy was still struggling to break loose from a period of severe recession, and unemployment rates were high even among educated professionals. As economic growth eventually got under way the unemployment situation began to ease for physicians but not for architects. PARTICIPANTS—Architecture students (n = 189) from Finland's three technical universities and medical students (n = 638) from Finland's five medical faculties. Both had started their studies in 1989. RESULTS—In the first questionnaire survey there were no differences between the professions in strain resistance resources, as indicated by Sense of Coherence (SOC), or in psychological distress, as indicated by General Health Questionnaire (GHQ). Profession emerged as a significant between subject factor in analysis of variance for repeated measures of both SOC and GHQ. Physicians' scores on the 13 item SOC questionnaire improved during the follow up from 62.6 to 67.5 and on the 12 item GHQ questionnaire from 24.2 to 22.2. Among architects the corresponding scores remained unchanged (62.5-62.2 and 23.1-22.6). The significance of profession remained unchanged when gender and individuals' graduation and total work experience were introduced to the statistical models as between subject factors. CONCLUSIONS—Improved SOC in physicians but not in architects supports the hypothesis that good employment prospects are important to employee wellbeing. Although less consistent, indicating fluctuations in day to day psychological distress, GHQ findings are also in line with the hypothesis. In both professions the indicators studied were independent of individuals' graduation and career. It is concluded that rather than individually, the mechanisms that connect employment prospects with wellbeing operate collectively within the whole profession. Highly educated professionals do not complete their studies until almost 30, and if for reasons of insecure employment they are unable to develop their SOC to the optimum level at that age, their resources for resisting health endangering strain may remain permanently poor. Keywords: university graduates; employment insecurity; sense of coherence; general health questionnaire PMID:11604440
El Ansari, Walid; Suominen, Sakari; Samara, Anastasia
2015-12-01
Poor eating habits among young adults are a public health concern. This survey examined the eating habits of undergraduate university students in Finland. We assessed students' dietary intake of a variety of food groups, their adherence to international dietary guidelines (whole sample and by gender), and the associations between importance of eating healthy and dietary guidelines adherence (whole sample and by gender). During the 2013-2014 academic year, 1,189 undergraduate students enrolled at the University of Turku in southwestern Finland completed an online self-administered questionnaire. Students reported their eating habits of 12 food groups, the number of daily servings of fruits/vegetables they consume and how important it is for them to eat healthy. For dietary adherence recommendations, we employed WHO guidelines. Chi-square statistic tested the differences in dietary guidelines adherence between males and females and also the associations between the gradients of importance of healthy eating and the self reported eating habits for each of the food groups, for the whole sample and by gender. We observed high levels of dietary adherence (>70%) for most of the 'unhealthy food' items (cake/cookies, snacks, fast food/canned food, and lemonade/soft drinks), and moderate adherence for most of the 'healthy food' items (>50%) (dairy/dairy products, fruit/vegetables servings/day, fresh fruit, salads/raw vegetables and cereal/cereal products). Fish/seafood, meat/sausage products and cooked vegetables had levels <50% for adherence to the guidelines. Women had better adherence for meat/sausage products, fast food/canned food and for most 'healthy food' items (p≤0.001), whereas men had better adherence for sweets (difference=12.8%, p≤0.001), lemonade/soft drinks (difference=16.7%, p≤0.001) and fish/seafood (difference=6.6%, p=0.040) compared to women. Most students considered important to eat healthy (78.8%). The importance of eating healthy was significantly associated with adherence for all food groups besides sweets and cake/cookies. These associations remained significant for women but some of them not for men (cereal/cereal products, snacks and sweets). The results suggest high adherence to the guidelines mainly for 'unhealthy food' groups, and moderate adherence for healthier food groups. There was also accordance between regarding eating healthy as important and actually eating healthy. However, there are improvements to be considered for specific food groups, as well as gender differences when implementing public health strategies related to food intake. Copyright© by the National Institute of Public Health, Prague 2015.
López-Valcárcel, Beatriz G; González-Martel, Christian; Peiro, Salvador
2018-01-01
Objective Newcomb-Benford’s Law (NBL) proposes a regular distribution for first digits, second digits and digit combinations applicable to many different naturally occurring sources of data. Testing deviations from NBL is used in many datasets as a screening tool for identifying data trustworthiness problems. This study aims to compare public available waiting lists (WL) data from Finland and Spain for testing NBL as an instrument to flag up potential manipulation in WLs. Design Analysis of the frequency of Finnish and Spanish WLs first digits to determine if their distribution is similar to the pattern documented by NBL. Deviations from the expected first digit frequency were analysed using Pearson’s χ2, mean absolute deviation and Kuiper tests. Setting/participants Publicly available WL data from Finland and Spain, two countries with universal health insurance and National Health Systems but characterised by different levels of transparency and good governance standards. Main outcome measures Adjustment of the observed distribution of the numbers reported in Finnish and Spanish WL data to the expected distribution according to NBL. Results WL data reported by the Finnish health system fits first digit NBL according to all statistical tests used (p=0.6519 in χ2 test). For Spanish data, this hypothesis was rejected in all tests (p<0.0001 in χ2 test). Conclusions Testing deviations from NBL distribution can be a useful tool to identify problems with WL data trustworthiness and signalling the need for further testing. PMID:29743333
Jensen, Magnus T; Pereira, Marta; Araujo, Carla; Malmivaara, Anti; Ferrieres, Jean; Degano, Irene R; Kirchberger, Inge; Farmakis, Dimitrios; Garel, Pascal; Torre, Marina; Marrugat, Jaume; Azevedo, Ana
2018-03-01
The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Consecutive ACS patients admitted in 2008-2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain). Cardiogenic shock patients were excluded. Associations between heart rate at admission in categories of 10 beats per min (bpm) and in-hospital mortality were estimated by logistic regression in crude models and adjusting for age, sex, obesity, smoking, hypertension, diabetes, known heart failure, renal failure, previous stroke and ischaemic heart disease. In total 10,374 patients were included. In both STEMI and NSTE-ACS patients, a U-shaped relationship between admission heart rate and in-hospital mortality was found. The lowest risk was observed for heart rates between 70-79 bpm in STEMI and 60-69 bpm in NSTE-ACS; risk of mortality progressively increased with lower or higher heart rates. In multivariable models, the relationship persisted but was significant only for heart rates >80 bpm. A similar relationship was present in both patients with or without diabetes, above or below age 75 years, and irrespective of the presence of atrial fibrillation or use of beta-blockers. Heart rate at admission is significantly associated with in-hospital mortality in patients with both STEMI and NSTE-ACS. ACS patients with admission heart rate above 80 bpm are at highest risk of in-hospital mortality.
Interhospital differences and case-mix in a nationwide prevalence survey.
Kanerva, M; Ollgren, J; Lyytikäinen, O
2010-10-01
A prevalence survey is a time-saving and useful tool for obtaining an overview of healthcare-associated infection (HCAI) either in a single hospital or nationally. Direct comparison of prevalence rates is difficult. We evaluated the impact of case-mix adjustment on hospital-specific prevalences. All five tertiary care, all 15 secondary care and 10 (25% of 40) other acute care hospitals took part in the first national prevalence survey in Finland in 2005. US Centers for Disease Control and Prevention criteria served to define HCAI. The information collected included demographic characteristics, severity of the underlying disease, use of catheters and a respirator, and previous surgery. Patients with HCAI related to another hospital were excluded. Case-mix-adjusted HCAI prevalences were calculated by using a multivariate logistic regression model for HCAI risk and an indirect standardisation method. Altogether, 587 (7.2%) of 8118 adult patients had at least one infection; hospital-specific prevalences ranged between 1.9% and 12.6%. Risk factors for HCAI that were previously known or identified by univariate analysis (age, male gender, intensive care, high Charlson comorbidity and McCabe indices, respirator, central venous or urinary catheters, and surgery during stay) were included in the multivariate analysis for standardisation. Case-mix-adjusted prevalences varied between 2.6% and 17.0%, and ranked the hospitals differently from the observed rates. In 11 (38%) hospitals, the observed prevalence rank was lower than predicted by the case-mix-adjusted figure. Case-mix should be taken into consideration in the interhospital comparison of prevalence rates. Copyright 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.
Tähtinen, Paula A; Boonacker, Chantal W B; Rovers, Maroeska M; Schilder, Anne G M; Huovinen, Pentti; Liuksila, Pirjo-Riitta; Ruuskanen, Olli; Ruohola, Aino
2009-12-01
Both treatment guidelines and the amount of antibiotics used for acute otitis media (AOM) vary across western countries. Parental expectations and their awareness of antimicrobial use and resistance, which may also be influenced by the guidelines, are not yet completely known. To compare parental experiences and opinions regarding the management of AOM in children with AOM in Finland and The Netherlands. We sent the questionnaires via public day care in Turku, Finland, and Utrecht, The Netherlands. We asked about family background, child's history of AOM and parental experiences and attitudes about AOM treatment and antimicrobial resistance. Of 1151 participants, 83% in Finland and 49% in The Netherlands had had at least one episode of AOM. Antibiotics were used more frequently in Finland than in The Netherlands, 99% versus 78%, respectively. More Finnish parents reported to believe that antibiotics are necessary in the treatment of AOM as compared to Dutch parents. Use of analgesics for AOM was similar (80% in Finland and 86% in The Netherlands). One-third of the parents had discussed resistance with their doctor. According to parental experiences, antimicrobial resistance had caused more problems in Finland than in The Netherlands (20% versus 2%). Finally, 88% of parents in Finland and 65% in The Netherlands were worried that bacteria could become resistant to antibiotics. Treatment practices and parental expectations seem to interact with each other. Therefore, if we aim to change AOM treatment practices, we have to modify both guidelines and parental expectations.
Kollanus, Virpi; Tiittanen, Pekka; Niemi, Jarkko V; Lanki, Timo
2016-11-01
Fine particulate matter (PM 2.5 ) emissions from vegetation fires can be transported over long distances and may cause significant air pollution episodes far from the fires. However, epidemiological evidence on health effects of vegetation-fire originated air pollution is limited, particularly for mortality and cardiovascular outcomes. We examined association between short-term exposure to long-range transported PM 2.5 from vegetation fires and daily mortality due to non-accidental, cardiovascular, and respiratory causes and daily hospital admissions due to cardiovascular and respiratory causes in the Helsinki metropolitan area, Finland. Days significantly affected by smoke from vegetation fires between 2001 and 2010 were identified using air quality measurements at an urban background and a regional background monitoring station, and modelled data on surface concentrations of vegetation-fire smoke. Associations between daily PM 2.5 concentration and health outcomes on i) smoke-affected days and ii) all other days (i.e. non-smoke days) were analysed using Poisson time series regression. All statistical models were adjusted for daily temperature and relative humidity, influenza, pollen, and public holidays. On smoke-affected days, 10µg/m 3 increase in PM 2.5 was associated with a borderline statistically significant increase in cardiovascular mortality among total population at a lag of three days (12.4%, 95% CI -0.2% to 26.5%), and among the elderly (≥65 years) following same-day exposure (13.8%, 95% CI -0.6% to 30.4%) and at a lag of three days (11.8%, 95% CI -2.2% to 27.7%). Smoke day PM 2.5 was not associated with non-accidental mortality or hospital admissions due to cardiovascular causes. However, there was an indication of a positive association with hospital admissions due to respiratory causes among the elderly, and admissions due to chronic obstructive pulmonary disease or asthma among the total population. In contrast, on non-smoke days PM 2.5 was generally not associated with the health outcomes, apart from suggestive small positive effects on non-accidental mortality at a lag of one day among the elderly and hospital admissions due to all respiratory causes following same-day exposure among the total population. Our research provides suggestive evidence for an association of exposure to long-range transported PM 2.5 from vegetation fires with increased cardiovascular mortality, and to a lesser extent with increased hospital admissions due to respiratory causes. Hence, vegetation-fire originated air pollution may have adverse effects on public health over a distance of hundreds to thousands of kilometres from the fires. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
F-cell world drive 2011: are tactical medicine principles applicable to a civilian scenario?
Burkert, Manuel G
2012-01-01
In 2011, a Mercedes Benz (MB) conducted the F-Cell World Drive tour around the globe in 125 days. While crossing Asia from Shanghai (China) to Helsinki (Finland) by car, en route medical care was provided by embedded emergency physicians. The designated route crossed four different countries, multiple climate zones, and challenging road conditions. There was only limited information provided about hospitals and emergency medical services within different host nations in the planning phase, so we adopted tactical medical principles for mission planning and execution, as we were facing remote conditions and limitations to equipment, staffing, and patient transport. 2012.
Dykes, Patricia C; Hurley, Ann C; Brown, Suzanne; Carr, Robyn; Cashen, Margaret; Collins, Rita; Cook, Robyn; Currie, Leanne; Docherty, Charles; Ensio, Anneli; Foster, Joanne; Hardiker, Nicholas R; Honey, Michelle L L; Killalea, Rosaleen; Murphy, Judy; Saranto, Kaija; Sensmeier, Joyce; Weaver, Charlotte
2009-01-01
In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the I-HIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the I-HIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative's validation of the I-HIT Scale completed to date.
SATO, Toyotaka; YOKOTA, Shin-ichi; ICHIHASHI, Risa; MIYAUCHI, Tomoka; OKUBO, Torahiko; USUI, Masaru; FUJII, Nobuhiro; TAMURA, Yutaka
2014-01-01
ABSTRACT Understanding the prevalence of antimicrobial-resistance and the relationship between emergence of resistant bacteria and clinical treatment can facilitate design of effective treatment strategies. We here examined antimicrobial susceptibilities of Escherichia coli isolated from dogs admitted to a university hospital (University hospital) and companion animal clinics (Community clinics) in the same city and investigated underlying multidrug-resistance mechanisms. The prevalence of E. coli with intermediate and resistant interpretations to ampicillin (AMP), enrofloxacin (ENR) and chloramphenicol (CHL) was higher in the University hospital than in the Community clinics cases. Use of antimicrobials, including fluoroquinolone, was also significantly higher in the University hospital than in the Community clinics cases. Upon isolation using ENR-supplemented agar plates, all ENR-resistant isolates had 3–4 nucleotide mutations that accompanied by amino acid substitutions in the quinolone-resistance-determining regions of gyrA, parC and parE, and 94.7% of all isolates derived from the University hospital showed AMP and/or CHL resistance and possessed blaTEM and/or catA1. The average mRNA expression levels of acrA, acrB and tolC and the prevalence of organic solvent tolerance, in isolates derived from ENR-supplemented agar plates were significantly higher in the University hospital than in the Community clinics isolates. Thus, E. coli derived from the University hospital cases more often showed concomitant decreased susceptibilities to aminopenicillins, fluoroquinolones and CHL than did those derived from the Community clinics; this was related to an active AcrAB–TolC efflux pump, in addition to acquisition of specific resistance genes and genetic mutations. PMID:24646457
Ervasti, Mari; Sankilampi, Ulla; Heinonen, Seppo; Punnonen, Kari
2009-01-01
To investigate the associations between maternal iron status, pregnancy outcome and newborn iron status using sensitive and specific red blood cell indices reflecting iron-deficient erythropoiesis. Cross-sectional study in Kuopio University Hospital, Finland. One hundred and ninety-two pregnant women and their full-term newborns (cord blood). Quartile analysis and Spearman correlations were used to investigate the associations of the iron status of pregnant women with that of their newborns, and with pregnancy outcome. Maternal and cord blood analysis including indices reflecting the hemoglobin (Hb) content of red blood cells as well as serum iron, transferrin saturation, transferrin receptor and ferritin. Gestational age, birthweight and placental weight. The highest quartile of the maternal percentage of hypochromic red blood cells (%HYPOm) indicating the lowest iron status was associated with a high birthweight and a long duration of pregnancy. The newborns in this group did not show any signs of iron deficiency even though the maternal %HYPOm was elevated. In a well-nourished maternal population, lower maternal iron status did not affect the iron accumulation on the fetal side. However, longer duration of pregnancy and growth of the fetus appeared to be associated with a lower amount of iron for Hb synthesis in maternal red blood cells, as reflected by the increased maternal %HYPOm, birthweight and length of gestation.
Anttila, L; Koskinen, P; Kaihola, H L; Erkkola, R; Irjala, K; Ruutiainen, K
1992-10-01
To examine the effect of short-term progestogen treatment on androgen, gonadotropin, and sex hormone-binding globulin (SHBG) levels in oligomenorrheic women. Comparative study of changes in hormonal parameters in patients with or without ultrasonographically diagnosed polycystic ovarian disease (PCOD). Open patient clinic of reproductive endocrinology at University Central Hospital of Turku, Finland. Seventy-five oligomenorrheic women with (n = 51) or without (n = 24) PCOD. Serum concentrations of testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and SHBG. The levels of T, A, LH, and the LH:FSH ratios decreased significantly after oral treatment with medroxyprogesterone acetate (10 mg/d for 10 days) in non-PCOD women and in women with PCOD decreasing the frequencies of pathological laboratory findings, in particular elevated levels of LH:FSH ratio and A in PCOD women and of LH:FSH ratio in non-PCOD women. The levels of T, A, and LH as well as the LH:FSH ratio were significantly higher in women with PCOD. Obesity was associated with high free androgen indices, low LH:FSH ratios, and low concentrations of LH, A, and SHBG. The serum samples for hormonal analyses used as an aid in diagnosing PCOD should be obtained without pretreatment with progestogen because it masks the biochemical findings of PCOD.
Intraocular lens bioactivity tested using rabbit corneal tissue cultures.
Linnola, R J; Salonen, J I; Happonen, R P
1999-11-01
To evaluate the effects of different intraocular lens (IOL) materials on epithelial cell growth to test the sandwich theory; i.e., a bioactivity-based explanation of posterior capsule opacification (PCO) after cataract surgery. Central Hospital, Vaasa, and Institute of Dentistry and Turku Center for Biomaterials, University of Turku, Finland. Rabbit corneal tissue cultures were set up on poly(methyl methacrylate) (PMMA), heparin-surface-modified (HSM) PMMA, silicone, acrylate, and hydrogel IOLs for 1 week. The tissue consisted of intact epithelium and half the thickness of the corneal stroma, which was placed against the IOL. The growth of the epithelium was examined by light microscopy to evaluate the attachment of the corneal explant to the IOL surface. All tissue samples grew well under the culture conditions. When grown on PMMA, HSM PMMA, silicone, and hydrogel, the tissue did not attach to the IOL or the epithelium grew around the explant, suggesting that the attachment of the stroma to the IOL was poor or nonexistent. Some explants on acrylate IOLs attached directly to the IOL surface with no epithelial ingrowth between the stroma and the IOL. This tissue culture method can be used to examine the behavior of corneal tissue in contact with different IOL materials. The results suggest that the acrylate IOL may have bioactive properties. This, with the lens optic's square edge, may hinder lens epithelial cell proliferation and thus prevent PCO.
Salmivesi, Susanna; Paassilta, Marita; Huhtala, Heini; Nieminen, Riina; Moilanen, Eeva; Korppi, Matti
2018-02-01
This study evaluated whether 15 allergy, immunology or inflammatory markers predicted the long-term use of cows' milk or milk products seven years after the start of oral immunotherapy (OIT) for cows' milk allergy in children. The following laboratory parameters were measured before the OIT at Tampere University Hospital, Finland, and after the six-month escalation phase: serum total immunoglobulin (Ig) E, milk-specific IgG and IgG4, eosinophil cationic protein, eosinophil-derived neurotoxin, interleukins 4, 5, 6, 10 and 12p70 and serum adipokines adiponectin, adipsin, leptin and resistin. Follow-up data from a seven-year phone questionnaire in 2015 were available for 24 children: 14 successful and 10 unsuccessful milk users. There were no significant differences in any of the 15 markers measured at the start of the study between the subjects who later formed the successful and unsuccessful groups. At the end of the six-month escalation phase of OIT, serum adipsin was higher in the group who were unsuccessful milk users at the seven-year follow-up study. None of the 15 allergy, immunology or inflammatory markers were useful in predicting the outcome of OIT. Preliminary evidence was found that high serum adipsin after the six-month escalation phase of OIT might predict unsuccessful outcome. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Permanent tensions in organization.
Jansson, Noora
2015-01-01
The purpose of this paper is to investigate the relationship between permanent tensions and organizational change. This study used paradox theory and a case study. The case organization is a public university hospital in Finland involving several stakeholders. The analysis suggests that the relationship between permanent tensions and organizational change is a paradox that is part of organizational reality. As an organization learns to live with its permanent tensions, the renewal paradox settles into equilibrium. When tensions are provoked, the paradox is disturbed until it finds a new balance. This flexible nature of the paradox is the force that keeps the different stakeholders simultaneously empowered to maintain their unique missions and cohesive in order to benefit from the larger synergy. This research suggests that identification and evaluation of each permanent tension within an organization is important when executing organizational change. The fact that certain tensions are permanent and cannot be solved may have an influence on how planned change initiatives are executed. The results show that permanent tensions may be harnessed for the benefit of an organizational change. This research demonstrates originality by offering an alternative view of tensions, a view which emphasizes not only their permanent and plural nature but their importance for enabling the organization to change at its own, non-disruptive pace. The research also proposes a new concept, the "renewal paradox", to enhance understanding of the relationship between permanent tensions and organizational change.
Dental caries is common in Finnish children infected with Helicobacter pylori.
Kolho, K L; Hölttä, P; Alaluusua, S; Lindahl, H; Savilahti, E; Rautelin, H
2001-01-01
Childhood factors such as low socioeconomic status are risk factors for Helicobacter pylori infection and Streptococcus mutans-related dental caries. We examined whether H. pylori infection and dental caries are present today in the same group of children examined previously. We reviewed the public dental health service files of 21 H. pylori-positive children (upper gastrointestinal endoscopy at a median age of 13.5 y) and 27 H. pylori-negative children (endoscopy at a median age of 12.5 y) examined during 1995-98 at the Helsinki University Central Hospital, Finland. All H. pylori-positive children had experienced dental caries in their primary or permanent teeth or in both whereas among H. pylori-negative children the respective proportion was 70% (p < 0.01). At the age of 7 y, 18% (3/17) of the H. pylori-positive children had experienced caries in permanent teeth as compared to 0% among H. pylori-negative children (0/24; p < 0.05). At the age of 12 y, H. pylori-positive children had more decayed, missing or filled permanent teeth than H. pylori-negative children (80% vs. 38%; p < 0.05). Although a causal relationship between H. pylori and dental caries is unlikely, it is possible that H. pylori-infected children have an increased risk of other health problems, such as dental caries, for which proper treatment is needed.
Axelin, Anna; Outinen, Jyri; Lainema, Kirsi; Lehtonen, Liisa; Franck, Linda S
2018-05-03
We explored the dynamics of neonatologist-parent communication and decision-making during medical rounds in a level three neonatal intensive care unit. This was a qualitative study, with an ethnographic approach, that was conducted at Turku University Hospital, Finland, from 2013-2014. We recruited eight mothers and seven couples, their 11 singletons and four sets of twins and two neonatologists and observed and video recorded 15 medical rounds. The infants were born at 23+5 to 40+1 weeks and the parents were aged 24-47. The neonatologists and parents were interviewed separately after the rounds. Four patterns of interaction emerged. The collaborative pattern was most consistent, with the ideal of shared decision-making, as the parents' preferences were genuinely and visibly integrated into the treatment decisions. In the neonatologist-led interactional pattern, the decision-making process was only somewhat inclusive of the parents' observations and preferences. The remaining two patterns, emergency and disconnected, were characterised by a paternalistic decision-making model where the parents' observations and preferences had minimal to no influence on the communication or decision-making. The neonatologists played a central role in facilitating parental participation and their interaction during medical rounds were characterised by the level of parent participation in decision-making. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Tuomikoski, Anna-Maria; Ruotsalainen, Heidi; Mikkonen, Kristina; Miettunen, Jouko; Kääriäinen, Maria
2018-06-05
Mentors require competence at a diverse array of skills to mentor students during clinical practice. According to the latest evidence, competence at mentoring includes: knowledge, skills and attributes of individual students' learning objectives, core elements of nursing, learning processes, a reciprocal and trustful relationship, feedback, evaluation, cooperation with stakeholders, and the mentor's personal qualities. The purpose of the study was to test psychometric properties of a mentor's competence instrument developed to self-evaluate mentors' competence at mentoring nursing students in clinical practice. A cross-sectional, descriptive, explorative study design was used. Data were collected from mentors at five university hospitals in Finland in 2016. A total of 576 mentors participated in this study. The instrument was developed through systematic review, experts' evaluations, and pilot versions of the instrument tested in previous studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis (EFA) with promax rotation and Cronbach's alpha. A 10-factor model showed that the instrument has acceptable construct validity. Cronbach's alpha values for the subscales observed ranged from 0.76 to 0.90. The instrument exhibited acceptable psychometric properties, thereby proving itself a valuable tool for evaluating mentors' competence at mentoring students. Further assessments of its reliability, validity and generality for measuring mentor's competence for mentoring students in different contexts and cultures are recommended. Copyright © 2018 Elsevier Ltd. All rights reserved.
Poikkeus, Tarja; Leino-Kilpi, Helena; Katajisto, Jouko
2014-09-01
The aim of this study was to analyse how nurse leaders support the ethical competence of nurses during recruitment and performance reviews. Ethical competence of nurses refers to ethical behaviour and action requiring ethical knowledge and reflection. Nurse leaders have a key role in supporting the ethical competence of nurses, but little is known about just how this should be done. The data were collected using a structured questionnaire and analysed statistically. The target sample consisted of nurse leaders (n = 198) from two university hospitals in two healthcare districts in Finland. Nurse leaders support the ethical competence of nurses more often during performance reviews than during recruitment. During recruitment, nurse leaders ensure the ethical behaviour and knowledge of nurses to varying degrees. During performance reviews, nurse leaders ensure that nurses meet the requirements for collegiality and comply with ethical guidelines and that they do so according to nursing values and principles. There seems to be a need to examine and improve support for the ethical competence of nurses, both during recruitment and performance reviews. Future priorities should include a focus on supporting the ethical knowledge, reflection and behaviour of nurses. An important aspect in terms of supporting the ethical competence of nurses has to do with the ethical knowledge and education of nurse leaders and organisational policies or recommendations for ethical support. © 2013 John Wiley & Sons Ltd.
Trump, Donald
2016-05-01
Patient-reported outcomes may help inform treatment choice in advanced/metastatic renal cell carcinoma (RCC), particularly between approved targeted therapies with similar efficacy. This double-blind crossover study evaluated patient preference for pazopanib or sunitinib and the influence of health-related quality of life (HRQoL) and safety factors on their stated preference. Patients with metastatic renal cell carcinoma were randomly assigned to pazopanib 800mg per day for 10 weeks, a 2-week washout, and then sunitinib 50mg per day (4 weeks on, 2 weeks off, 4weeks on) for 10 weeks, or the reverse sequence. The primary end point, patient preference for a specific treatment, was assessed by questionnaire at the end of the two treatment periods. Other end points and analyses included reasons for preference, physician preference, safety, and HRQoL. Of 169 randomly assigned patients, 114 met the following prespecified modified intent-to-treat criteria for the primary analysis: exposure to both treatments, no disease progression before cross over, and completion of the preference questionnaire. Significantly more patients preferred pazopanib (70%) over sunitinib (22%); 8% expressed no preference (P<.001). All preplanned sensitivity analyses, including the intent-to-treat population, statistically favored pazopanib. Less fatigue and better overall quality of life were the main reasons for preferring pazopanib, with less diarrhea being the most cited reason for preferring sunitinib. Physicians also preferred pazopanib (61%) over sunitinib (22%); 17% expressed no preference. Adverse events were consistent with each drug׳s known profile. Pazopanib was superior to sunitinib in HRQoL measures evaluating fatigue, hand/foot soreness, and mouth/throat soreness. This innovative crossover trial demonstrated a significant patient preference for pazopanib over sunitinib, with HRQoL and safety as key influencing factors. Copyright © 2016 Elsevier Inc. All rights reserved.
[Postgraduate training program in neurology at the regional hospitals in Hokkaido area].
Matsumoto, Akihisa
2007-11-01
In the new post graduate training system, the 55% of interns in the Hokkaido area choosed the post graduate training at the general hospitals and 45% of them choosed the medical universities (Hokkaido university, Asahikawa medical university, Sapporo medical university). Furthermore, 23% of interns in Hokkaido area choosed the general hospitals and medical universities in Sapporo city. As to the post graduate training system in neurology, 5 hospitals included the neurology for at least 1 month to 3 months. On the other hand, in one general hospital in Sapporo city, the clinical training of neurology was not included in the post graduate training system. During 2 years of the new post graduate training system, only 25% of the interns could rotate the neurological department. Since the neurology training course is necessary for the post graduate training system, it is suggested to need to support the opportunity to rotate the neurology for the interns.
A Comparative Analysis of Primary Teacher Professionalism in England and Finland
ERIC Educational Resources Information Center
Webb, Rosemary; Vulliamy, Graham; Hamalainen, Seppo; Sarja, Anneli; Kimonen, Eija; Nevalainen, Raimo
2004-01-01
Policy-makers' conceptions of teacher professionalism currently differ markedly in England and Finland. In England they are shaped by agendas associated with the drive to raise standards and "commercialized professionalism" whilst in Finland they are influenced by notions of "teacher empowerment". This article analyses findings…
ADHD in Finland and Types of Scandinavian Cooperation.
ERIC Educational Resources Information Center
Tapper, Marie-Louise; Michelsson, Katarina
This paper reviews the history and current status of services to children with attention deficit hyperactivity disorder in Finland. It notes the availability of free or almost free health services in Finland and the resulting very low infant mortality rate. The history of attention deficit hyperactivity disorders (ADHD), termed "minimal brain…
ESO Welcomes Finland as Eleventh Member State
NASA Astrophysics Data System (ADS)
Cesarsky, C.
2004-09-01
In early July, Finland joined ESO as the eleventh member state, following the completion of the formal accession procedure. Before this event, however, Finland and ESO had been in contact for a long time. Under an agreement with Sweden, Finnish astronomers had for quite a while enjoyed access to the SEST at La Silla. Finland had also been a very active participant in ESO's educational activities since they began in 1993. It became clear, that science and technology, as well as education, were priority areas for the Finnish government.
Putkonen, Hanna; Amon, Sabine; Almiron, Maria P; Cederwall, Jenny Yourstone; Eronen, Markku; Klier, Claudia; Kjelsberg, Ellen; Weizmann-Henelius, Ghitta
2009-11-21
Filicide is the tragic crime of murdering one's own child. Previous research has found that the offending parents are commonly depressed and that suicide is often associated as an actual act or an intention. Yet, filicide is an underreported crime and previous studies have been strained with methodological problems. No comprehensive international studies on filicide have been presented in the literature until now. This was a descriptive, comprehensive, register-based study of all filicides in Austria and Finland during 1995-2005. Filicide-suicide cases were also included. Most of the perpetrators were the biological mothers; in Austria 72%, in Finland 52%. Suicide followed filicide either as an attempt or a fulfilled act in 32% and 54% of the cases in Austria and Finland, respectively. Psychotic mood disorders were diagnosed for 10% of the living perpetrators in Austria, and 12% in Finland. Non-psychotic depression was diagnosed in 9% of surviving perpetrators in Austria, 35% in Finland. The data from the two countries demonstrated that filicide is such a multifaceted and rare phenomenon that national data from individual countries seldom offer sufficient scope for its thorough study. Further analyses are needed to produce a complete picture of filicide.
2009-01-01
Background Filicide is the tragic crime of murdering one's own child. Previous research has found that the offending parents are commonly depressed and that suicide is often associated as an actual act or an intention. Yet, filicide is an underreported crime and previous studies have been strained with methodological problems. No comprehensive international studies on filicide have been presented in the literature until now. Methods This was a descriptive, comprehensive, register-based study of all filicides in Austria and Finland during 1995-2005. Filicide-suicide cases were also included. Results Most of the perpetrators were the biological mothers; in Austria 72%, in Finland 52%. Suicide followed filicide either as an attempt or a fulfilled act in 32% and 54% of the cases in Austria and Finland, respectively. Psychotic mood disorders were diagnosed for 10% of the living perpetrators in Austria, and 12% in Finland. Non-psychotic depression was diagnosed in 9% of surviving perpetrators in Austria, 35% in Finland. Conclusion The data from the two countries demonstrated that filicide is such a multifaceted and rare phenomenon that national data from individual countries seldom offer sufficient scope for its thorough study. Further analyses are needed to produce a complete picture of filicide. PMID:19930581
ERIC Educational Resources Information Center
Goulart, Aurea Maria Paes Leme; de Moraes, Silvia Pereira Gonzaga
2000-01-01
Describes experiences with hospitalized children through the extension project "Writing and Reading at the University Hospital", State University of Maringa Hospital (Brazil). States the initial project proposal provided educational assistance to the children separated from school due to being in the hospital. Used play and games as an…
Which Implant Is Best After Failed Treatment for Pathologic Femur Fractures?
2012-01-01
performed at the Karolinska University Hospital, Stockholm, Sweden. J. A. Forsberg (&) Regenerative Medicine, Naval Medical Research Center, Silver...Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden 123 Clin Orthop Relat Res DOI 10.1007/s11999-012-2558-2...NAME(S) AND ADDRESS(ES) Karolinska Institute, Karolinska University Hospital,Section of Orthopaedics and Sports Medicine, Department,of Molecular
Muhsen, Khitam; Rubenstein, Uri; Kassem, Eias; Goren, Sophy; Schachter, Yaakov; Kremer, Adi; Shulman, Lester M; Ephros, Moshe; Cohen, Dani
2015-01-01
Universal rotavirus vaccination with RotaTeq was introduced in Israel in December 2010. We examined hospitalization rates of children under 5 years of age due to all-cause and rotavirus gastroenteritis, both before and 3 years after universal introduction of the vaccination. An ongoing hospital-based surveillance network that was established in November 2007, accessed information regarding hospitalization of children due to gastroenteritis (n = 6205) in 3 hospitals in northern Israel, with an annual average of about 60,000 children under 5 years of age living in the catchment area of these hospitals. Stool samples were tested for rotavirus by immunochromatography. Compared to the period preceding implementation of the universal rotavirus vaccination (2008-2010), hospitalizations due to rotavirus gastroenteritis in children <5 years of age decreased significantly, by 55% (95% CI 43%-67%) during the period of universal vaccination (2011-2013), a decrease that was sustained throughout the 3 year period. This reduction was greater in children aged 0-23 months (60-61%) than in toddlers aged 24-59 months (36%). A 32% (95% CI 21%-45%) decrease in the incidence of all-cause gastroenteritis was also observed. During the period preceding universal vaccination, rotavirus diarrhea showed typical winter seasonality, with highest incidence in December. However, the winter peak was substantially blunted during the period of universal immunization. Surveillance of rotavirus gastroenteritis should continue to assess the long-term impact of such a program. Our findings are of relevance to high and middle-income countries considering the introduction of a universal rotavirus immunization program.
Excess mortality in winter in Finnish intensive care.
Reinikainen, M; Uusaro, A; Ruokonen, E; Niskanen, M
2006-07-01
In the general population, mortality from acute myocardial infarctions, strokes and respiratory causes is increased in winter. The winter climate in Finland is harsh. The aim of this study was to find out whether there are seasonal variations in mortality rates in Finnish intensive care units (ICUs). We analysed data on 31,040 patients treated in 18 Finnish ICUs. We measured severity of illness with acute physiology and chronic health evaluation II (APACHE II) scores and intensity of care with therapeutic intervention scoring system (TISS) scores. We assessed mortality rates in different months and seasons and used logistic regression analysis to test the independent effect of various seasons on hospital mortality. We defined 'winter' as the period from December to February, inclusive. The crude hospital mortality rate was 17.9% in winter and 16.4% in non-winter, P = 0.003. Even after adjustment for case mix, winter season was an independent risk factor for increased hospital mortality (adjusted odds ratio 1.13, 95% confidence interval 1.04-1.22, P = 0.005). In particular, the risk of respiratory failure was increased in winter. Crude hospital mortality was increased during the main holiday season in July. However, the severity of illness-adjusted risk of death was not higher in July than in other months. An increase in the mean daily TISS score was an independent predictor of increased hospital mortality. Severity of illness-adjusted hospital mortality for Finnish ICU patients is higher in winter than in other seasons.
Coastal seas as resource for Blue Growth - SmartSea project
NASA Astrophysics Data System (ADS)
Kotilainen, Aarno; Alvi, Kimmo; Boman, Anton; Hämäläinen, Jyrki; Kaskela, Anu; Rantataro, Jyrki; Vallius, Henry; Virtasalo, Joonas
2017-04-01
Blue growth is a long term strategy of the European Union (EU) to enhance the sustainable growth of the maritime sector. Our surrounding seas have been drivers for the European economy for a long time, but still they have great potential for further exploiting of natural resources and economic growth. Especially if the growth can be achieved in an environmentally sustainable way, benefits are obvious. It has been estimated that improvement of the state of the Baltic Sea would until 2030 create 900 000 jobs in the whole Baltic Sea area, mainly in Blue Tech, tourism, real estate and building businesses (Dahlgren et al. 2015). However, coastal seas already experience multiple stressors like off-shore construction, pollution, eutrophication, shipping, over-fishing, and climate change. In order to obtain sustainable Blue Growth, it is necessary to localize and assess the current maritime activities, estimate their growth potential, and investigate their present and future effects on each other and on the marine environment. The purpose of the SmartSea project is to support the growth of commercial marine activities in the Gulf of Bothnia region, in the northern Baltic Sea. The Gulf of Bothnia is an essential resource in terms of fish farming and wind power, for example, and it is also possible to make use of the geological resources of the gulf. Moreover, the rapid growth of the commercial marine activities and the consequences of the climate change may lead to conflicts between the different activities and harm the marine ecosystem of the Gulf of Bothnia. The SmartSea project aims to identify these risks and find solutions for the sustainable use of the sea. SmartSea project is funded by the Strategic Research Council of Academy of Finland, grant No: 292 985. The project will last for six years (2015-2020) and its funding totals nearly 8 million euros. The project involves close to 40 researchers from eight different institutions: the Finnish Meteorological Institute (coordinator), the Finnish Environment Institute, Natural Resources Institute Finland, Geological Survey of Finland (GTK), VTT Technical Research Centre of Finland, the Universities of Helsinki and Turku, and the Swedish Meteorological and Hydrological Institute (SMHI).
Tobacco industry strategy to undermine tobacco control in Finland
Hiilamo, H
2003-01-01
Objective: To identify and explain tobacco industry strategy in undermining tobacco control measures in Finland and results of these interferences in tobacco policy development during the 1980s and early 1990s. Methods: Tobacco industry documents, which have been publicly available on the internet as a result of litigation in the USA, were analysed. Documents were sought by Finland and by names of organisations and tobacco control activists. Documents were accessed and assessed between September 2000 and November 2002. Tactics of the tobacco industry activities were categorised as presented by Saloojee and Dagli. Results: The international tobacco companies utilised similar strategies in Finland as in other industrial markets to fight tobacco control and legislation, the health advocacy movement, and litigation. These activities slowed down the development and implementation of the Tobacco Act in Finland. However, despite the extensive pressure, the industry was not able to prevent the most progressive tobacco legislation in Europe from being passed and coming into force in Finland in 1977 and in 1995. Conclusion: Denying the health hazards caused by tobacco—despite indisputable scientific evidence—decreased the credibility of the tobacco industry. Strategy of denial was falsely chosen, as health advocacy groups were active both in society and the parliamentary system. The strong influence of the tobacco industry may have in fact increased the visibility of tobacco control in Finland as the litigation process was also drawing attention to negative health effects of tobacco. Therefore the tobacco industry did not manage to convince public opinion. However, the tobacco industry did obtain experience in Finland in how to object to tobacco control measures. PMID:14660780
The OJ287 observing campaign hots up
NASA Astrophysics Data System (ADS)
Poyner, G.
2006-12-01
In the August 2006 issue of the Journal [116(4), 163-164] I gave details of the BAAVSS observing campaign to monitor the binary black hole OJ287. The campaign is now once again in full swing for the 2006/2007 season, now that solar conjunction is finally over. During the summer break, new analysis was done on the BAAVSS & TA data by Dr Mauri Valtonen (Dept of Physics and Tuorla Observatory, University of Turku, Finland & Dept of Physics, University of the West Indies, Trinidad) and Dr Mark Kidger (Herschel Science Centre, European Space Astronomy centre, Villafranca del Castillo Satellite Tracking Station, Madrid, Spain, & INSA) and Dr Harry Lehto (NORDITA, Copenhagen, Denmark). A detailed examination of these data from the past 15 years, and especially the last 12 months, has led to some interesting conclusions.
A Model Lesson: Finland Shows Us What Equal Opportunity Looks Like
ERIC Educational Resources Information Center
Sahlberg, Pasi
2012-01-01
International indicators show that Finland has one of the most educated citizenries in the world, provides educational opportunities in an egalitarian manner, and makes efficient use of resources. But at the beginning of the 1990s, education in Finland was nothing special in international terms. The performance of Finnish students on international…
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-20
... antidumping duty orders on purified carboxymethylcellulose from Finland and the Netherlands would likely lead... Netherlands would likely lead to continuation or recurrence of dumping and, therefore, notified the U.S... revocation of the antidumping duty orders on purified CMC from Finland and the Netherlands would likely lead...
The Quality and Effectiveness of Confirmation Classes in Finland
ERIC Educational Resources Information Center
Niemela, Kati
2006-01-01
Every year some 90% of 15-year-olds in Finland attend confirmation classes in the Evangelical Lutheran Church of Finland, which is greater than the percentage of that age group belonging to the Church. What is behind the popularity of Finnish confirmation classes? This article scrutinizes the quality and effectiveness of confirmation classes.…
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-13
... DEPARTMENT OF COMMERCE International Trade Administration [A-405-803, A-421-811] Purified Carboxymethylcellulose From Finland and the Netherlands: Extension of Time Limit for Preliminary Results of Antidumping... carboxymethylcellulose from Finland and the Netherlands covering the period July 1, 2010, through June 30, 2011. See...
ERIC Educational Resources Information Center
Ahola, Sakari
This report studies the matching of educational and occupational structures in Sweden and Finland by using classifications that include all educational and occupational groups. By using comprehensive databases available in Finland and Sweden, it aims to develop the methodological and theoretical perspectives of the research on education and…
Sims, Alison
2016-10-07
The Children's Hospitals Network (CHN) was formed in 2012 following a review of national specialist services. Oxford University Hospitals NHS Foundation Trust (OUH) and the University Hospital Southampton NHS Foundation Trust (UHS) collaborated in its formation, with the CHN hosting clinical and operational networks across more than 20 district general hospitals in the Thames Valley and Wessex regions.
[Efforts of gender equality at Kinki University School of Medicine].
Miyamoto, Katsuichi
2013-01-01
In recent years, medical doctors are in short supply in many university hospitals. Retirement of female doctor after delivery is one of the reasons. Although they want to return to work after giving birth, they quit unavoidable because the working conditions do not match. Then, Kinki university hospital established the "provisions for special work arrangements". This work arrangement is the wage less, but the working hours is less than the regular. This work arrangement increased returner to the university hospital after delivery.
Haddad, J; Kalbacher, E; Piccard, M; Aubry, S; Chaigneau, L; Pauchot, J
2017-02-01
A multidisciplinary meeting (RCP) dedicated to the treatment of sarcoma was established in Franche-Comte in 2010. The goals of the study are: (a) To evaluate the treatment of sarcomas by confrontation with the existing literature; (b) To evaluate the influence of the multidisciplinary meeting on the management of sarcomas by hospitals at the regional level. This is a retrospective single center study from 2010 to 2015 on patients with sarcoma and peripheral soft tissue drawn from a Netsarc database (National Network of sarcomas) and communicating cancer record. A database Cleanweb especially dedicated is created. Forty-seven patients were included: ten sarcomas at the upper member 26 to the lower limbs, 11 on the trunk. Forty patients were operated on: ten out of the university hospital, 28 at the university hospital and two in a coordinating center. Ninety percent of patients treated at the university hospital were in accordance with the recommandations. None of the patients operated out of the university hospital benefited from medical care in accordance to the recommendations. There is an increase in the number of files sent by the hospitals out of the university hospital discussed in multidisciplinary meeting, before treatment. The creation of a dedicated multidisciplinary meeting sarcoma improves the medical management of these tumors and decreases inappropriate medical managements thanks to a better education of the regional physicians. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Role of Winter Weather Conditions and Slipperiness on Tourists' Accidents in Finland.
Lépy, Élise; Rantala, Sinikka; Huusko, Antti; Nieminen, Pentti; Hippi, Marjo; Rautio, Arja
2016-08-15
(1) BACKGROUND: In Finland, slippery snowy or icy ground surface conditions can be quite hazardous to human health during wintertime. We focused on the impacts of the variability in weather conditions on tourists' health via documented accidents during the winter season in the Sotkamo area. We attempted to estimate the slipping hazard in a specific context of space and time focusing on the weather and other possible parameters, responsible for fluctuations in the numbers of injuries/accidents; (2) METHODS: We used statistical distributions with graphical illustrations to examine the distribution of visits to Kainuu Hospital by non-local patients and their characteristics/causes; graphs to illustrate the distribution of the different characteristics of weather conditions; questionnaires and interviews conducted among health care and safety personnel in Sotkamo and Kuusamo; (3) RESULTS: There was a clear seasonal distribution in the numbers and types of extremity injuries of non-local patients. While the risk of slipping is emphasized, other factors leading to injuries are evaluated; and (4) CONCLUSIONS: The study highlighted the clear role of wintery weather conditions as a cause of extremity injuries even though other aspects must also be considered. Future scenarios, challenges and adaptive strategies are also discussed from the viewpoint of climate change.
Vainio, Anni; Lyytikäinen, Outi; Sihvonen, Reetta; Kaijalainen, Tarja; Teirilä, Laura; Rantala, Merja; Lehtinen, Pirkko; Ruuska, Pekka; Virolainen, Anni
2009-07-01
Streptococcus pneumoniae is a well-known cause of community-acquired bacterial pneumonia. The purpose of this study was to assess the cause and extent of the outbreak of pneumonia which occurred among military recruits following a 1-week hard encampment in Finland. We also assessed the carriage rate and molecular characteristics of the S. pneumoniae isolates. All pneumococcal isolates were studied for antibiotic susceptibility, serotyped, genotyped by multilocus sequence typing (MLST), and the presence of pneumococcal rlrA pilus islet was detected. The genotype results defined by MLST corresponded with the serotype results. S. pneumoniae serotype 7F, ST2331, seemed to be associated with an outbreak of pneumonia and nasopharyngeal carriage among 43 military recruits. Of the 43 military recruits, five (12%) were hospitalized with pneumonia and two (40%) of them were positive for S. pneumoniae serotype 7F, ST2331 by blood culture. Eighteen (42%) of the 43 men were found to be positive for S. pneumoniae by nasopharyngeal culture, and nine (50%) of them carried pneumococcal serotype 7F, ST2331. The outbreak strain covered 55% of all the pneumococcal findings. Outbreaks of invasive pneumococcal disease seem to occur in a crowded environment such as a military training facility even among previously healthy young men.
Role of Winter Weather Conditions and Slipperiness on Tourists’ Accidents in Finland
Lépy, Élise; Rantala, Sinikka; Huusko, Antti; Nieminen, Pentti; Hippi, Marjo; Rautio, Arja
2016-01-01
(1) Background: In Finland, slippery snowy or icy ground surface conditions can be quite hazardous to human health during wintertime. We focused on the impacts of the variability in weather conditions on tourists’ health via documented accidents during the winter season in the Sotkamo area. We attempted to estimate the slipping hazard in a specific context of space and time focusing on the weather and other possible parameters, responsible for fluctuations in the numbers of injuries/accidents; (2) Methods: We used statistical distributions with graphical illustrations to examine the distribution of visits to Kainuu Hospital by non-local patients and their characteristics/causes; graphs to illustrate the distribution of the different characteristics of weather conditions; questionnaires and interviews conducted among health care and safety personnel in Sotkamo and Kuusamo; (3) Results: There was a clear seasonal distribution in the numbers and types of extremity injuries of non-local patients. While the risk of slipping is emphasized, other factors leading to injuries are evaluated; and (4) Conclusions: The study highlighted the clear role of wintery weather conditions as a cause of extremity injuries even though other aspects must also be considered. Future scenarios, challenges and adaptive strategies are also discussed from the viewpoint of climate change. PMID:27537899
Bellanger, Martine M; Quentin, Wilm; Tan, Siok Swan
2013-05-01
The study compares how Diagnosis-Related Group (DRG) based hospital payment systems in eleven European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) deal with women giving birth in hospitals. It aims to assist gynaecologists and national authorities in optimizing their DRG systems. National or regional databases were used to identify childbirth cases. DRG grouping algorithms and indicators of resource consumption were compared for those DRGs which account for at least 1% of all childbirth cases in the respective database. Five standardized case vignettes were defined and quasi prices (i.e. administrative prices or tariffs) of hospital deliveries according to national DRG-based hospital payment systems were ascertained. European DRG systems classify childbirth cases according to different sets of variables (between one and eight variables) into diverging numbers of DRGs (between three and eight DRGs). The most complex DRG is valued 3.5 times more resource intensive than an index case in Ireland but only 1.1 times more resource intensive than an index case in The Netherlands. Comparisons of quasi prices for the vignettes show that hypothetical payments for the most complex case amount to only € 479 in Poland but to € 5532 in Ireland. Differences in the classification of hospital childbirth cases into DRGs raise concerns whether European systems rely on the most appropriate classification variables. Physicians, hospitals and national DRG authorities should consider how other countries' DRG systems classify cases to optimize their system and to ensure fair and appropriate reimbursement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Information sources in science and technology in Finland
NASA Technical Reports Server (NTRS)
Haarala, Arja-Riitta
1994-01-01
Finland poses some problems to be overcome in the field of scientific and technical information: a small user community which makes domestic systems costly; great distances within the country between users and suppliers of information; great distances to international data systems and large libraries abroad; and inadequate collections of scientific and technical information. The national bibliography Fennica includes all books and journals published in Finland. Data base services available in Finland include: reference data bases in science and technology; data banks for decision making such as statistical time series or legal proceedings; national bibliographies; and library catalogs.
Maisch, Bernhard
2005-03-01
1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state government, may be unrealistic, when the 4th biggest university hospital in Germany will be created by the merger. University hospitals recrute the patients for high end medicine beyond their region because of the specialized academic competence and advanced technical possibilities. Additional recruitment of patients for routine hospital can hardly be expected.d) A private management will have to consider primarily the "shareholder value", even when investing in infrastructure and buildings, as it can be expected for one partner. On the longterm this will not be possible without a substantial reduction of employees in both institutions. There are, however, also substantial efforts of some private hospital chains in clinical research, e. g. by Helios in Berlin and Rhön Gmbh at the Leipzig Heart Center.e) There is a yet underestimated but very substantial risk because of the taxation for the private owner when academic staff is transferred from the university to hospital care in their dual function as academic teachers and doctors. This risk also applies for the university if the transfer should come from hospital to the university. These costs would add to the financial burden, which has to be carried in addition to the DRGs.
State-Based Curriculum-Making: Approaches to Local Curriculum Work in Norway and Finland
ERIC Educational Resources Information Center
Mølstad, Christina Elde
2015-01-01
This article investigates how state authorities in Norway and Finland design national curriculum to provide different policy conditions for local curriculum work in municipalities and schools. The topic is explored by comparing how national authorities in Norway and Finland create a scope for local curriculum. The data consist of interviews with…
ERIC Educational Resources Information Center
Sivesind, Kirsten; Afsar, Azita; Bachmann, Kari E.
2016-01-01
This article examines how three national curricula for basic education in Finland reflect transnational policy perspectives from 1994 to the present. By developing a conceptual apparatus for curriculum analysis, we examine how national curricula in Finland can be interpreted as modifications of transnational policy transfers shaped by…
PISA in Finland: An Education Miracle or an Obstacle to Change?
ERIC Educational Resources Information Center
Sahlberg, Pasi
2011-01-01
The present article discusses the role and impact of the Programme for International Student Assessment (PISA) in Finland. PISA has created a new geography of education policies and reforms by shifting global interest away from Anglo-Saxon education systems to Asian countries, as well as to Finland and Canada in the West. The article describes how…
Youth Suicide Trends in Finland, 1969-2008
ERIC Educational Resources Information Center
Lahti, Anniina; Rasanen, Pirkko; Riala, Kaisa; Keranen, Sirpa; Hakko, Helina
2011-01-01
Background: There are only a few recent studies on secular trends in child and adolescent suicides. We examine here trends in rates and methods of suicide among young people in Finland, where suicide rates at these ages are among the highest in the world. Methods: The data, obtained from Statistics Finland, consisted of all suicides (n = 901)…
European Linguistic Diversity--For Whom? The Cases of Finland and Sweden. Mercator Working Papers.
ERIC Educational Resources Information Center
Lainio, Jarmo
Linguistic diversity in the Nordic countries has several dimensions. One main division is between what the majority group thinks it is about versus what the minority group thinks it is about. This paper examines the situation in Finland and Sweden, noting implications for linguistic diversity. Finland and Sweden contain five main varieties of…
Hospitality Major Vocational High School Students' Expectations on University Education
ERIC Educational Resources Information Center
Chung, Ya-Ting; Yang, Cheng-Cheng
2013-01-01
Hospitality is not a new industry in Asia, but high quality hospitality industry has become more and more important in the trend of questing service-based economy and the increasing number of tourists in Asia. Thus there are more universities opened hospitality degree programs in Asia, Taiwan is no exception. In this context, why high school…
ERIC Educational Resources Information Center
Pongpirul, Krit
2011-01-01
In the Thai Universal Coverage scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group (DRG) reimbursement. Questionable quality of the submitted DRG codes has been of concern whereas knowledge about hospital coding practice has been lacking. The objectives of this thesis are (1) To explore hospital coding…
Pinilla, Jaime; López-Valcárcel, Beatriz G; González-Martel, Christian; Peiro, Salvador
2018-05-09
Newcomb-Benford's Law (NBL) proposes a regular distribution for first digits, second digits and digit combinations applicable to many different naturally occurring sources of data. Testing deviations from NBL is used in many datasets as a screening tool for identifying data trustworthiness problems. This study aims to compare public available waiting lists (WL) data from Finland and Spain for testing NBL as an instrument to flag up potential manipulation in WLs. Analysis of the frequency of Finnish and Spanish WLs first digits to determine if their distribution is similar to the pattern documented by NBL. Deviations from the expected first digit frequency were analysed using Pearson's χ 2 , mean absolute deviation and Kuiper tests. Publicly available WL data from Finland and Spain, two countries with universal health insurance and National Health Systems but characterised by different levels of transparency and good governance standards. Adjustment of the observed distribution of the numbers reported in Finnish and Spanish WL data to the expected distribution according to NBL. WL data reported by the Finnish health system fits first digit NBL according to all statistical tests used (p=0.6519 in χ 2 test). For Spanish data, this hypothesis was rejected in all tests (p<0.0001 in χ 2 test). Testing deviations from NBL distribution can be a useful tool to identify problems with WL data trustworthiness and signalling the need for further testing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
El Ansari, Walid; Suominen, Sakari; Berg-Beckhoff, Gabriele
2015-01-01
We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189). For nutrition behaviour, we computed two composite food intake pattern scores (sweets, cakes and snacks; and fruits and vegetables), a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students’ nutrition behaviour with three levels of self-reported health, controlling for many potential confounders (age, sex, living with partner, economic situation, moderate physical activity, Faculty and BMI). Factor analysis of the 20 health complaints revealed three components (psychological, pains/aches and circulatory/breathing symptoms). Multiple linear regression tested the association of students’ eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health, exhibiting a decreasing trend for those individuals with poor/fair self-reported health. High levels of psychological symptoms were associated with decreased consumption of fruits and vegetables, less dietary guideline adherence and less subjective importance of healthy eating. Pain/aches symptoms were associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary guideline adherence index was the best indicator and exhibited the most consistent associations with self-reported health and health complaints. PMID:26473918
Health promotion by stealth: active transportation success in Helsinki, Finland.
Saidla, Karl
2017-02-03
The promotion of active transportation (AT-utilitarian trips including walking, cycling, and public transit use), represents a well-recognized opportunity for increasing physical activity. This study examines the strong AT success achieved in Helsinki, Finland (in 2013, the share of daily trips in Helsinki completed by AT was 77 per cent) from a political perspective. Helsinki represents a noteworthy example of AT success given important challenges including the region's relatively low population density, its difficult winter climate, and Finland's high driving rate. This research applied the advocacy coalition framework (ACF), a formal policy process theory from political science. Interviews were conducted with 23 AT experts in Helsinki. Document review was employed as a secondary method. Overall, the research indicates that Helsinki's success may be attributed to the long-term dominance of municipal transportation policy by a pro-AT advocacy coalition. When viewed from the perspective of health promotion, it is striking that this success is not strongly attributable to health considerations or efforts from health-related fields. Rather, the data suggest that the coalition, comprised of members from a variety of non-health fields, was most strongly motivated by a desire to protect a high degree of livability. Importantly, a number of significant historical events and background-level factors greatly facilitated success. Overall, these results suggest that health promotion advocates may have very useful allies in non-health sectors, and that awareness of the importance of political factors is likely to contribute to stronger health promotion efforts. Finally, several possibilities for related and further research are suggested. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
What affects local community hospitals' survival in turbulent times?
Chiang, Hung-Che; Wang, Shiow-Ing
2015-06-01
Hospital closures became a prevalent phenomenon in Taiwan after the implementation of a national health insurance program. A wide range of causes contributes to the viability of hospitals, but little is known about the situation under universal coverage health systems. The purpose of present study is to recognize the factors that may contribute to hospital survival under the universal coverage health system. This is a retrospective case-control study. Local community hospitals that contracted with the Bureau of National Health Insurance in 1998 and remained open during the period 1998-2011 are the designated cases. Controls are local community hospitals that closed during the same period. Using longitudinal representative health claim data, 209 local community hospitals that closed during 1998-2011 were compared with 165 that remained open. Variables related to institutional characteristics, degree of competition, characteristics of patients and financial performance were analyzed by logistic regression models. Hospitals' survival was positively related to specialty hospital, the number of respiratory care beds, the physician to population ratio, the number of clinics in the same region, a highly competitive market and the occupancy rate of elderly patients in the hospital. Teaching hospitals, investor-owned hospitals, the provision of obstetrics services or home care, and the number of medical centers or other local community hospitals may jeopardize the chance of survival. Factors-enhanced local hospitals to survive under the universal coverage health system have been identified. Hospital managers could manipulate these findings and adapt strategies for subsistence. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Standardized spider (Arachnida, Araneae) inventory of Hankoniemi, Finland.
Cardoso, Pedro; Heikkinen, Lea; Jalkanen, Joel; Kohonen, Minna; Leponiemi, Matti; Mattila, Laura; Ollonen, Joni; Ranki, Jukka-Pekka; Virolainen, Anni; Zhou, Xuan; Pajunen, Timo
2017-01-01
During a field course on spider taxonomy and ecology at the University of Helsinki, the authors had the opportunity to sample four plots with a dual objective of both teaching on field methods, spider identification and behaviour and uncovering the spider diversity patterns found in the southern coastal forests of Hankoniemi, Finland. As an ultimate goal, this field course intended to contribute to a global project that intends to uncover spider diversity patterns worldwide. With that purpose, a set of standardised methods and procedures was followed that allow the comparability of obtained data with numerous other projects being conducted across all continents. A total of 104 species and 1997 adults was collected. Of these, 41 species (39%) were Linyphiidae and 13 (12%) Theridiidae. All other families had 6 or less species represented. Linyphiidae were also dominant in terms of adult individuals captured, with 1015 (51%), followed by 428 (21%) Lycosidae, 158 (8%) Tetragnathidae and 145 (7%) Theridiidae. All other families had less than 100 individuals. The most abundant species were Neriene peltata , Alopecosa taeniata , Piratula hygrophila and Dismodicus elevatus , all with more than 100 individuals. All sites had between 56 and 62 species and between 445 and 569 individuals.
ERIC Educational Resources Information Center
Webb, Rosemary; Vulliamy, Graham; Sarja, Anneli; Hamalainen, Seppo
2006-01-01
This article analyses the impact of processes of globalization on both policy and practice in relation to primary school leadership and management in England and Finland. Data are drawn from case study research carried out from 1994-1996 in six schools in Finland and six schools in England and a follow-up study on teacher professionalism…
NASA Astrophysics Data System (ADS)
2004-03-01
Finland will become the eleventh member state of the European Southern Observatory. In a ceremony at the ESO Headquarters in Garching on 9 February 2004, an Agreement to this effect was signed by the Finnish Minister of Education and Science, Ms. Tuula Haatainen and the ESO Director General, Dr. Catherine Cesarsky, in the presence of other high officials from Finland and the ESO member states.
ERIC Educational Resources Information Center
Rasmussen, Jens; Bayer, Martin
2014-01-01
This article presents the results of a comparative study of the content in selected teacher education programmes for primary and lower secondary teachers in Canada, Denmark, Finland and Singapore. First and foremost, the study is a comparison between teacher education programmes in, on the one hand, Canada, Finland and Singapore, all of which…
ERIC Educational Resources Information Center
Schatz, Monika
2015-01-01
Since the first publication of the Organization for Economic Co-Operation and Development (OECD) PISA (Programme for International Student Assessment) results in 2000, the Finnish education system has received much praise both in Finland and abroad. In recent years, Finland started to build up its own education export sector with the aim of…
ERIC Educational Resources Information Center
Kikas, Eve; Poikonen, Pirjo-Liisa; Kontoniemi, Marita; Lyyra, Anna-Liisa; Lerkkanen, Marja-Kristiina; Niilo, Airi
2011-01-01
Mutual trust between mothers and kindergarten teachers along with its relation to mother's educational level and child's gender was studied in two neighboring countries--Estonia and Finland. From Estonia 543 ratings of mothers and 232 ratings of teachers were collected, and, from Finland, 712 ratings of mothers and 712 ratings of teachers. Trust…
ERIC Educational Resources Information Center
Hansen, Sven-Erik
2004-01-01
This paper presents an historical overview of issues around the language of instruction and the curriculum of mother-tongue education for the Swedish-speaking minority in Finland during the half-century after the establishment of the public school in 1866. In a linguistic- and culturally-diverse society like that of Finland it has not been…
Klemetti, Seija; Leino-Kilpi, Helena; Cabrera, Esther; Copanitsanou, Panagiota; Ingadottir, Brynja; Istomina, Natalja; Katajisto, Jouko; Papastavrou, Evridiki; Unosson, Mitra; Valkeapää, Kirsi
2015-12-01
The purpose of the study was to examine received and expected knowledge of patients with knee/hip arthroplasty in seven European countries. The goal was to obtain information for developing empowering patient education. The data were collected (during 2009-2012) from patients (n = 943) with hip/knee arthroplasty prior to scheduled preoperative education and before discharge with the Received Knowledge of hospital patient scale (RKhp) and Expected Knowledge of hospital patient scale (EKhp). Patients' knowledge expectations were high but the level of received knowledge did not correspond to expectations. The difference between received and expected knowledge was higher in Greece and Sweden compared with Finland (p < .0001, p < .0001), Spain (p < .0001, p = .001), and Lithuania (p = .005, p = .003), respectively. Patients' knowledge expectations are important in tailoring patient education. To achieve high standards in the future, scientific research collaboration on empowering patient education is needed between European countries. © The Author(s) 2014.
Scheller-Kreinsen, David; Quentin, Wilm; Geissler, Alexander; Busse, Reinhard
2013-10-01
Researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) compared how their DRG systems deal with breast cancer surgery patients. DRG algorithms and indicators of resource consumption were assessed for those DRGs that individually contain at least 1% of all breast cancer surgery patients. Six standardised case vignettes were defined and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems classify breast cancer surgery patients according to different sets of classification variables into three to seven DRGs. Quasi prices for an index case treated with partial mastectomy range from €577 in Poland to €5780 in the Netherlands. Countries award their highest payments for very different kinds of patients. Breast cancer specialists and national DRG authorities should consider how other countries' DRG systems classify breast cancer patients in order to identify potential scope for improvement and to ensure fair and appropriate reimbursement. Copyright © 2012 Elsevier Ltd. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tauriainen, S.; Ahola, P.; Hallikainen, M.
1996-10-01
The typical airborne remote sensing measurements conducted by the Helsinki University of Technology laboratory of space technology require very precise navigation over the selected measurement sites. This means that both system performance as far as positioning is concerned and the actual flight track of the aircraft has to be within 10 meters. To meet these requirements, a custom made navigation system was designed and installed in the SHORT SC7 Skyvan research aircraft of the Helsinki University of Technology. The system is based on the Finnish national Differential GPS network providing positioning accuracy within a few meters within Finland. For pilotmore » guidance, a graphical user interface with mission specific software is used to give the pilots an overview of the relative position and orientation to the measurement target. In addition, the system is used to synchronize the scientific instruments and record the actual flight track. 2 refs., 2 figs.« less
Nordic databases to evaluate medications in pregnancy.
Kieler, Helle
2014-01-01
The objective of this review is to describe the possibilities to assess drugs used in pregnancy by means of the Nordic health registers. The Nordic countries comprise five countries: Denmark, Finland, Iceland, Norway and Sweden and have a total population of 25 million. All five countries have in their national health registers for many years recorded information concerning all births, cancer diagnoses, hospital contacts, causes of death and dispensed drugs. The registers can be used for studying drugs dispensed during pregnancy and though most previous studies focused on risks of congenital abnormalities, other health consequences of maternal medication can also be assessed. © 2014 Société Française de Pharmacologie et de Thérapeutique.
Virtanen, P; Koivisto, A M
2001-11-01
Knowledge about changes in wellbeing during the passage from professional studies to working life is scarce and controversial. This study examined these changes among university graduates with good and poor employment prospects. A longitudinal study with four postal questionnaire surveys of a closed cohort. Cohorts of graduating Finnish physicians and architects were followed up from 1994 to 1998. In 1994 Finland's national economy was still struggling to break loose from a period of severe recession, and unemployment rates were high even among educated professionals. As economic growth eventually got under way the unemployment situation began to ease for physicians but not for architects. Architecture students (n = 189) from Finland's three technical universities and medical students (n = 638) from Finland's five medical faculties. Both had started their studies in 1989. In the first questionnaire survey there were no differences between the professions in strain resistance resources, as indicated by Sense of Coherence (SOC), or in psychological distress, as indicated by General Health Questionnaire (GHQ). Profession emerged as a significant between subject factor in analysis of variance for repeated measures of both SOC and GHQ. Physicians' scores on the 13 item SOC questionnaire improved during the follow up from 62.6 to 67.5 and on the 12 item GHQ questionnaire from 24.2 to 22.2. Among architects the corresponding scores remained unchanged (62.5-62.2 and 23.1-22.6). The significance of profession remained unchanged when gender and individuals' graduation and total work experience were introduced to the statistical models as between subject factors. Improved SOC in physicians but not in architects supports the hypothesis that good employment prospects are important to employee wellbeing. Although less consistent, indicating fluctuations in day to day psychological distress, GHQ findings are also in line with the hypothesis. In both professions the indicators studied were independent of individuals' graduation and career. It is concluded that rather than individually, the mechanisms that connect employment prospects with wellbeing operate collectively within the whole profession. Highly educated professionals do not complete their studies until almost 30, and if for reasons of insecure employment they are unable to develop their SOC to the optimum level at that age, their resources for resisting health endangering strain may remain permanently poor.
Environmental Education in Finland--A Case Study of Environmental Education in Nature Schools
ERIC Educational Resources Information Center
Jeronen, Eila; Jeronen, Juha; Raustia, Hanna
2009-01-01
The article aims to introduce Environmental Education (EE) in Finland and to discuss how it has been taken into account in Finnish nature schools. Firstly, we present EE models used in Finland. Thereafter we describe a qualitative case study on EE in nature schools (NS). The aim of the study was to get information for the development of EE. The…
An autochthonous case of cystic echinococcosis in Finland, 2015.
Hämäläinen, Sari; Kantele, Anu; Arvonen, Miika; Hakala, Tapio; Karhukorpi, Jari; Heikkinen, Jukka; Berg, Ensio; Vanamo, Kari; Tyrväinen, Erja; Heiskanen-Kosma, Tarja; Oksanen, Antti; Lavikainen, Antti
2015-01-01
We report a case of pulmonary cystic echinococcosis in a child from eastern Finland with no history of travelling abroad. The cyst was surgically removed and the organism molecularly identified as Echinococcus canadensis genotype G10. This parasite is maintained in eastern Finland in a sylvatic life cycle involving wolves and moose; in the present case, the infection was presumably transmitted by hunting dogs.
ERIC Educational Resources Information Center
Tanriverdi, Belgin; Apak, Ozlem
2010-01-01
The purpose of this study is to evaluate the implications of Media Literacy Education (MLE) in Turkey by analyzing the Primary School Curricula in terms of MLE comparatively in Turkey, Ireland and Finland. In this study, the selection of Finland and Ireland curricula is related with those countries' being the pioneering countries in MLE and the…
ERIC Educational Resources Information Center
Jaatinen, Riitta; Saarivirta, Toni
2014-01-01
This study describes the evolution of English language teaching in Finland and looks into the connections of the societal and educational changes in the country as explanatory factors in the process. The results of the study show that the language teaching methodology and the status of foreign languages in Finland are clearly connected to the…
Data Farming in Support of NATO
2014-03-01
What are your national/international experiences on data farming ? • Finland : Technology forecasting, indirect fire studies (19,000 different...from the military bringing their questions to the data farming community. • Which simulation systems have been used in the past? • Finland : SANDIS...sponsors. • Do you have standardized procedures to conduct a data farming experiment? • Finland : No standard procedure (ad hoc at the moment, still
Kokkinen, Lauri; Muntaner, Carles; Kouvonen, Anne; Koskinen, Aki; Varje, Pekka; Väänänen, Ari
2015-01-01
Objectives Epidemiological studies have shown an association between educational credentials and mental disorders, but have not offered any explanation for the varying strength of this association in different historical contexts. In this study, we investigate the education-specific trends in hospitalisation due to psychiatric disorders in Finnish working-age men and women between 1976 and 2010, and offer a welfare state explanation for the secular trends found. Setting Population-based setting with a 25% random sample of the population aged 30–65 years in 7 independent consecutive cohorts (1976–1980, 1981–1985, 1986–1990, 1991–1995, 1996–2000, 2001–2005, 2006–2010). Participants Participants were randomly selected from the Statistics Finland population database (n=2 865 746). These data were linked to diagnosis-specific records on hospitalisations, drawn from the National Hospital Discharge Registry using personal identification numbers. Employment rates by educational credentials were drawn from the Statistics Finland employment database. Primary and secondary outcome measures Hospitalisation and employment. Results We found an increasing trend in psychiatric hospitalisation rates among the population with only an elementary school education, and a decreasing trend in those with higher educational credentials. The employment rate of the population with only an elementary school education decreased more than that of those with higher educational credentials. Conclusions We propose that restricted employment opportunities are the main mechanism behind the increased educational inequality in hospitalisation for psychiatric disorders, while several secondary mechanisms (lack of outpatient healthcare services, welfare cuts, decreased alcohol duty) further accelerated the diverging long-term trends. All of these inequality-increasing mechanisms were activated by welfare state retrenchment, which included the liberalisation of financial markets and labour markets, severe austerity measures and narrowing down of public sector employment commitment. PMID:26041491
NASA Astrophysics Data System (ADS)
Holmberg, Peter
. I trace the origins of teaching and research in physics and astronomy during the 17th and 18th centuries at the Academy of Turku (Åbo), which was relocated to Helsinki in 1827 and renamed as the Imperial Alexander University of Finland, and which in turn in 1917 became the University of Helsinki. I discuss the growth of physics in Helsinki during the 19th century, which culminated in the opening of a large new Physical Institute in 1911, pointing out the individuals responsible for these developments and the sites associated with them. I also discuss related events, such as the founding of a new astronomical observatory and a new magnetic observatory and the development of technical education in Helsinki. I conclude by discussing the construction of an accelerator laboratory and other important developments in physics in Helsinki after 1945.
Freeware eLearning Flash-ECG for learning electrocardiography.
Romanov, Kalle; Kuusi, Timo
2009-06-01
Electrocardiographic (ECG) analysis can be taught in eLearning programmes with suitable software that permits the effective use of basic tools such as a ruler and a magnifier, required for measurements. The Flash-ECG (Research & Development Unit for Medical Education, University of Helsinki, Finland) was developed to enable teachers and students to use scanned and archived ECGs on computer screens and classroom projectors. The software requires only a standard web browser with a Flash plug-in and can be integrated with learning environments (Blackboard/WebCT, Moodle). The Flash-ECG is freeware and is available to medical teachers worldwide.
12th European Conference on Accelerators in Applied Research and Technology
NASA Astrophysics Data System (ADS)
Sajavaara, Timo; Tarvainen, Olli; Javanainen, Arto; Räisänen, Jyrki
2017-09-01
The 12th European Conference on Accelerators in Applied Research and Technology was organized by Department of Physics on the 3rd -8th July 2016 in the Agora building of the University of Jyväskylä in Finland. This was the first time ECAART was held in Nordic countries. There were in total 141 participants from 31 countries and six industrial exhibitors. The largest foreign delegation was from Japan with 25 participants. The scientific programme included 13 invited lectures, 29 oral and 112 poster presentations. There were altogether 14 exhibitors and sponsors.
The Nordic concept of reactive psychosis--a multicenter reliability study.
Hansen, H; Dahl, A A; Bertelsen, A; Birket-Smith, M; von Knorring, L; Ottosson, J O; Pakaslahti, A; Retterstøl, N; Salvesen, C; Thorsteinsson, G
1992-07-01
Reactive psychosis is a common diagnosis in the Nordic countries (Norway, Sweden, Denmark, Finland and Iceland) and in several other parts of the world. In ICD-9 and DSM-III-R, the concept is defined more narrowly than in the Nordic tradition. In this study we examined the interrater reliability of the Nordic concept by the case-summary method between clinicians from 9 university departments in the Nordic countries. The results show that Nordic psychiatrists have a reasonably reliable concept of reactive psychosis, and that this psychosis can be diagnosed as reliably as schizophrenia and affective psychosis.
Radio advertising increases hospital call center volume by 48%.
2006-01-01
Since the fall of 2005, call volume at University of Southern California University Hospital of Los Angeles' call center has increased by nearly 50%. How? The hospital embarked on a long-term radio campaign to promote its presence as a premier academic medical center and to increase patient volume.
Aggressive television ad campaign for Cooper University Hospital features hometown celebrity.
2006-01-01
Cooper University Hospital in Camden, NJ, features an extensive ambulatory care network that includes practice sites across eight counties of Southern New Jersey. Recently, the hospital worked with Willing Strategic Advertising to produce an award-winning television advertising campaign endorsed by New Jersey-born TV personality, Kelly Ripa.
Kuisma, Markku; Salo, Ari; Puolakka, Jyrki; Nurmi, Jouni; Kirves, Hetti; Väyrynen, Taneli; Boyd, James
2017-09-01
The delayed return of spontaneous circulation (ROSC) after cessation of cardiopulmonary resuscitation (CPR), also known as the Lazarus phenomenon, is a rare event described in several case reports. This study aims to determine the incidence and the time of occurrence of the Lazarus phenomenon after cessation of out-of-hospital CPR. This prospective observational cohort study was conducted in the Helsinki Emergency Medical Service in Finland from 1 January 2011 through 31 December 2016. All out-of-hospital CPR attempts were carefully monitored for 10min after the cessation of CPR in order to detect delayed ROSC. Altogether, 2102 out-of-hospital cardiac arrests occurred during the six-year study period. CPR was attempted in 1376 (65.5%) cases. In 840 cases (61.0% of all attempts) CPR attempts were terminated on site. The Lazarus phenomenon occurred five times, with an incidence of 5.95/1000 (95% CI 2.10-14.30) in field-terminated CPR attempts. Time to delayed ROSC from the cessation of CPR varied from 3 to 8min. Three of the five patients with delayed ROSC died at the scene within 2-15min while two died later in hospital within 1.5 and 26h, respectively. We observed that the Lazarus phenomenon is a real albeit rare event and can occur a few minutes after the cessation of out-of-hospital CPR. We suggest a 10-min monitoring period before diagnosing death. CPR guidelines should be updated to include information of the Lazarus phenomenon and appropriate monitoring for it. Copyright © 2017 Elsevier B.V. All rights reserved.
Rugbjerg, Kathrine; Bonnesen, Trine G.; Holmqvist, Anna Sällfors; Madanat-Harjuoja, Laura; Wesenberg, Finn; Winther, Jeanette F.
2017-01-01
Background Survivors of childhood cancer are at increased risk for a wide range of late effects. However, no large population-based studies have included the whole range of somatic diagnoses including subgroup diagnoses and all main types of childhood cancers. Therefore, we aimed to provide the most detailed overview of the long-term risk of hospitalisation in survivors of childhood cancer. Methods and findings From the national cancer registers of Denmark, Finland, Iceland, and Sweden, we identified 21,297 5-year survivors of childhood cancer diagnosed with cancer before the age of 20 years in the periods 1943–2008 in Denmark, 1971–2008 in Finland, 1955–2008 in Iceland, and 1958–2008 in Sweden. We randomly selected 152,231 population comparison individuals matched by age, sex, year, and country (or municipality in Sweden) from the national population registers. Using a cohort design, study participants were followed in the national hospital registers in Denmark, 1977–2010; Finland, 1975–2012; Iceland, 1999–2008; and Sweden, 1968–2009. Disease-specific hospitalisation rates in survivors and comparison individuals were used to calculate survivors’ standardised hospitalisation rate ratios (RRs), absolute excess risks (AERs), and standardised bed day ratios (SBDRs) based on length of stay in hospital. We adjusted for sex, age, and year by indirect standardisation. During 336,554 person-years of follow-up (mean: 16 years; range: 0–42 years), childhood cancer survivors experienced 21,325 first hospitalisations for diseases in one or more of 120 disease categories (cancer recurrence not included), when 10,999 were expected, yielding an overall RR of 1.94 (95% confidence interval [95% CI] 1.91–1.97). The AER was 3,068 (2,980–3,156) per 100,000 person-years, meaning that for each additional year of follow-up, an average of 3 of 100 survivors were hospitalised for a new excess disease beyond the background rates. Approximately 50% of the excess hospitalisations were for diseases of the nervous system (19.1% of all excess hospitalisations), endocrine system (11.1%), digestive organs (10.5%), and respiratory system (10.0%). Survivors of all types of childhood cancer were at increased, persistent risk for subsequent hospitalisation, the highest risks being those of survivors of neuroblastoma (RR: 2.6 [2.4–2.8]; n = 876), hepatic tumours (RR: 2.5 [2.0–3.1]; n = 92), central nervous system tumours (RR: 2.4 [2.3–2.5]; n = 6,175), and Hodgkin lymphoma (RR: 2.4 [2.3–2.5]; n = 2,027). Survivors spent on average five times as many days in hospital as comparison individuals (SBDR: 4.96 [4.94–4.98]; n = 422,218). The analyses of bed days in hospital included new primary cancers and recurrences. Of the total 422,218 days survivors spent in hospital, 47% (197,596 bed days) were for new primary cancers and recurrences. Our study is likely to underestimate the absolute overall disease burden experienced by survivors, as less severe late effects are missed if they are treated sufficiently in the outpatient setting or in the primary health care system. Conclusions Childhood cancer survivors were at increased long-term risk for diseases requiring inpatient treatment even decades after their initial cancer. Health care providers who do not work in the area of late effects, especially those in primary health care, should be aware of this highly challenged group of patients in order to avoid or postpone hospitalisations by prevention, early detection, and appropriate treatments. PMID:28486495
Lewicki, G
1999-01-01
University Hospital, Denver, has started its University Seniors Assn. to promote health and wellness to people 50 and older. Within four months the organization had 500 members. Now the association is 3,500 members strong.
Adverse Events in Affiliated Hospitals of Mazandaran University of Medical Sciences
Saravi, Benyamin Mohseni; Siamian, Hasan; Nezhad, Ayyob Barzegar; Asghari, Zoleleykha; Kabirzadeh, Azar
2014-01-01
Due to the complexity of the hospital environment, its structure faces with multiple hazards. The risks whether by providing the care and whether by hospital environment endanger patients, relatives and care providers. Therefore, a more accurate reporting and analysis of the report by focusing on access to preventative methods is essential. In this study, hospitals' adverse event that has sent by affiliated hospitals of Mazandaran University of Medical Sciences to deputy for treatment has studied. PMID:24944536
Mattila, Ville M; Sihvonen, Raine; Paloneva, Juha; Felländer-Tsai, Li
2016-01-01
Background and purpose Knee arthroscopy is commonly performed to treat degenerative knee disease symptoms and traumatic meniscal tears. We evaluated whether the recent high-quality randomized control trials not favoring arthroscopic surgery for degenerative knee disease affected the procedure incidence and trends in Finland and Sweden. Patients and methods We conducted a bi-national registry-based study including all adult (aged ≥18 years) inpatient and outpatient arthroscopic surgeries performed for degenerative knee disease (osteoarthritis (OA) and degenerative meniscal tears) and traumatic meniscal tears in Finland between 1997 and 2012, and in Sweden between 2001 and 2012. Results In Finland, the annual number of operations was 16,389 in 1997, reached 20,432 in 2007, and declined to 15,018 in 2012. In Sweden, the number of operations was 9,944 in 2001, reached 11,711 in 2008, and declined to 8,114 in 2012. The knee arthroscopy incidence for OA was 124 per 105 person-years in 2012 in Finland and it was 51 in Sweden. The incidence of knee arthroscopies for meniscal tears coded as traumatic steadily increased in Finland from 64 per 105 person-years in 1997 to 97 per 105 person-years in 2012, but not in Sweden. Interpretation The incidence of arthroscopies for degenerative knee disease declined after 2008 in both countries. Remarkably, the incidence of arthroscopy for degenerative knee disease and traumatic meniscal tears is 2 to 4 times higher in Finland than in Sweden. Efficient implementation of new high-quality evidence in clinical practice could reduce the number of ineffective surgeries. PMID:26122621
Zaninelli, M; Campagnoli, A; Reyes, M; Rojas, V
2012-11-01
In order to improve the hospital information system of the Chilean University Hospital, the Veterinary Medicine School of Universidad de Chile made a research cooperation with Università San Raffaele Roma to develop and test a new release of the O3-Vet software application. O3-Vet was selected by the Chilean University mainly for two reasons: (1) it uses human medicine standardized technologies such as "Health Level 7" (HL7) and "Integrating the Healthcare Enterprise" (IHE), which allow a good level of data sharing and hospital management; (2) it is open source, which means it can be adapted to specific hospital needs. In the new release, a subset of diagnostic terms was added from the "Systematized Nomenclature of Medicine Clinical Terms" (SNOMED CT), selected by the "American Animal Hospital Association" (AAHA) to standardize the filing of clinical data and its retrieval. Results from a limited survey of veterinarians of the University (n=9) show that the new release improved the management of the Chilean University Hospital and the ability to retrieve useful clinical data. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Jameson, W J; Pierce, K; Martin, D K
1998-05-01
California's county hospitals train 45% of the state's graduate medical residents, including 33% of residents in the University of California system. This paper describes the interrelationships of California's county hospitals and the University of California (UC) graduate medical education (GME) programs, highlighting key challenges facing both systems. The mission of California's county health care systems is to serve all who need health care services regardless of ability to pay. Locating UC GME programs in county hospitals helps serve the public missions of both institutions. Such partnerships enhance the GME experience of UC residents, provide key primary care training opportunities, and ensure continued health care access for indigent and uninsured populations. Only through affiliation with university training programs have county hospitals been able to run the cost-effective, quality programs that constitute an acceptable safety net for the poor. Financial stress, however, has led county hospitals and UC's GME programs to advocate for reform in both GME financing and indigent care funding. County hospitals must participate in constructing strategies for GME reform to assure that GME funding mechanisms provide for equitable compensation of county hospitals' essential role. Joint advocacy will also be essential in achieving significant indigent care policy reform.
Assessing Governance Alternatives for University-Owned Public Teaching Hospitals.
ERIC Educational Resources Information Center
Whitley, Evangeline L.
The governance options matrix is provided to offer a way for state and university policymakers to examine the functioning environments of specific university-owned public teaching hospitals. With it, they can consider the benefits and problems involved with different options for governance. The issues related to the environmental factors affecting…
Korjamo, Riina; Heikinheimo, Oskari; Mentula, Maarit
2018-04-01
To analyse the post-abortion effect of long-acting reversible contraception (LARC) plans and initiation on the risk of subsequent unwanted pregnancy and abortion. retrospective cohort study of 666 women who underwent medical abortion between January-May 2013 at Helsinki University Hospital, Finland. Altogether 159 (23.8%) women planning post-abortion use of levonorgestrel-releasing intrauterine system (LNG-IUS) participated in a randomized study and had an opportunity to receive the LNG-IUS free-of-charge from the hospital. The other 507 (76.2%) women planned and obtained their contraception according to clinical routine. Demographics, planned contraception, and LARC initiation at the time of the index abortion were collected. Data on subsequent abortions were retrieved from the Finnish Abortion Register and electronic patient files until the end of 2014. During the 21 months ([median], IQR 20-22) follow-up, 54(8.1%) women requested subsequent abortions. When adjusted for age, previous pregnancies, deliveries, induced abortions and gestational-age, planning LARC for post-abortion contraception failed to prevent subsequent abortion (33 abortions/360 women, 9.2%) compared to other contraceptive plans (21/306, 6.9%) (HR 1.22, 95% CI 0.68-2.17). However, verified LARC initiation decreased the abortion rate (4 abortions/177 women, 2.3%) compared to women with uncertain LARC initiation status (50/489, 10.2%) (HR 0.17, 95% CI 0.06-0.48). When adjusted for LARC initiation status, age <25 years was a risk factor for subsequent abortion (27 abortions/283 women, 9.5%) compared to women ≥25 years (27/383, 7.0%, HR1.95, 95% CI 1.04-3.67). Initiation of LARC as part of abortion service at the time of medical abortion is an important means to prevent subsequent abortion, especially among young women.
Ryödi, Essi; Metso, Saara; Jaatinen, Pia; Huhtala, Heini; Saaristo, Rauni; Välimäki, Matti; Auvinen, Anssi
2015-10-01
Some previous studies have suggested increased cancer risk in hyperthyroid patients treated with radioactive iodine (RAI). It is unclear whether the excess cancer risk is attributable to hyperthyroidism, its treatment, or the shared risk factors of the two diseases. The objective was to assess cancer morbidity and mortality in hyperthyroid patients treated with either RAI or surgery. We identified 4334 patients treated surgically for hyperthyroidism in Finland during 1986-2007 from the Hospital Discharge Registry and 1814 patients treated with RAI for hyperthyroidism at Tampere University Hospital. For each patient, three age- and gender-matched controls were chosen. Information on cancer diagnoses was obtained from the Cancer Registry. The follow-up began 3 months after the treatment and ended at cancer diagnosis, death, emigration, or the common closing date (December 31, 2009). The overall cancer incidence was not increased among the hyperthyroid patients compared to their controls (rate ratio [RR], 1.05; 95% confidence interval [CI], 0.96-1.15). However, the risk of cancers of the respiratory tract (RR, 1.46; 95% CI, 1.05-2.02) and the stomach (RR, 1.64; 95% CI, 1.01-2.68) was increased among the patients. The overall cancer mortality did not differ between the patients and the controls (RR, 1.08; 95% CI, 0.94-1.25). The type of treatment did not affect the overall risk of cancer (hazard ratio for RAI vs thyroidectomy, 1.03; 95% CI, 0.86-1.23) or cancer mortality (hazard ratio, 1.04; 95% CI, 0.91-1.21). In this cohort of Finnish patients with hyperthyroidism treated with thyroidectomy or RAI, the overall risk of cancer was not increased, although an increased risk of gastric and respiratory tract cancers was seen in hyperthyroid patients. Based on this large-scale, long-term follow-up study, the increased cancer risk in hyperthyroid patients is attributable to hyperthyroidism and shared risk factors, not the treatment modality.
Historical development of the renal histopathology services in Malaysia.
Looi, Lai-Meng; Cheah, Phaik-Leng
2009-06-01
Western-style medicine was introduced to Malaya by the Portuguese, Dutch and British between the 1500s and 1800s. Although the earliest pathology laboratories were developed within hospitals towards the end of the 19th Century, histopathology emerged much later than the biochemistry and bacteriology services. The University Departments of Pathology were the pioneers of the renal histopathology diagnostic services. The Department of Pathology, University of Malaya (UM) received its first renal biopsy on 19 May 1968. Hospital Universiti Kebangsaan Malaysia (HUKM) and Hospital Universiti Sains Malaysia (HUSM) started their services in 1979 and 1987 respectively. It is notable that the early services in these University centres caterred for both the university hospitals and the Ministry of Health (MOH) until the mid-1990s when MOH began to develop its own services, pivoted on renal pathologists trained through Fellowship programmes. Currently, key centres in the MOH are Kuala Lumpur Hospital, Sultanah Aminah Hospital Johor Bahru and Malacca Hospital. With the inclusion of renal biopsy interpretation in the Master of Pathology programmes, basic renal histopathology services became widely available throughout the country from 2000. This subsequently filtered out to the private sector as more histopathologists embraced private practice. There is now active continuing professional development in renal histopathology through clinicopathological dicussions, seminars and workshops. Renal research on amyloid nephropathy, minimal change disease, IgA nephropathy, fibrillary glomerulonephritis, lupus nephritis and microwave technology have provided an insight into the patterns of renal pathology and changing criteria for biopsy. More recently, there has been increasing involvement of renal teams in clinical trials, particularly for lupus nephritis and renal transplant modulation.
Paat-Ahi, Gerli; Aaviksoo, Ain; Swiderek, Maria
2014-12-01
As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries' DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement.
Regional Correlates of Psychiatric Inpatient Treatment.
Ala-Nikkola, Taina; Pirkola, Sami; Kaila, Minna; Saarni, Samuli I; Joffe, Grigori; Kontio, Raija; Oranta, Olli; Sadeniemi, Minna; Wahlbeck, Kristian
2016-12-05
Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components.
Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare
Choi, Jinwook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-Sun; Kim, Young-Ah; Yang, Seung Hoon; Jo, Eun Mi; Hwang, Min-A; Kim, Wan Suk; Lee, Eun Hye; Choi, Su Hi
2010-01-01
Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system. PMID:21818449
Hospitable Gestures in the University Lecture: Analysing Derrida's Pedagogy
ERIC Educational Resources Information Center
Ruitenberg, Claudia
2014-01-01
Based on archival research, this article analyses the pedagogical gestures in Derrida's (largely unpublished) lectures on hospitality (1995/96), with particular attention to the enactment of hospitality in these gestures. The motivation for this analysis is twofold. First, since the large-group university lecture has been widely critiqued as…
Gallini, Adeline; Juillard-Condat, Blandine; Saux, Marie-Claude; Taboulet, Florence
2011-11-01
To give a panorama of the selectivity and agreement of French university hospitals' drug formularies (HDF) for nine competitive classes. All university hospitals were asked to send their HDF and selection criteria as of January 2009 for nine competitive pharmacological classes (proton pump inhibitors, serotonin antagonists, low molecular weight heparins, erythropoietins, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, statins, α-adrenoreceptor antagonists and selective serotonin re-uptake inhibitors). Selectivity of HDF was estimated by the percentage of drug entities selected by the hospital within the pharmacological class. Agreement between hospitals was assessed with modified kappa coefficients for multi-raters. Twenty-one out of the 29 hospitals agreed to participate. These hospitals selected between 34% and 63% of the drug entities available for the nine classes, which represented 18 to 35 agents. Regarding the nature of chosen drug entities, the overall level of agreement was 'fair' and varied with pharmacological classes. Selection criteria were sent by only 12 hospitals. The technical component was the most important element in all hospitals. The weight of the economic component varied between 20% and 40% in the tender's grade. Large variations were seen in the number and nature of drugs selected by university hospitals which can be attributable to two successive decision-making processes (evaluation by the Drug and Therapeutics Committee followed by the purchasing process). © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.
Cohort profile: the Finnish Genetics of Pre-eclampsia Consortium (FINNPEC).
Jääskeläinen, Tiina; Heinonen, Seppo; Kajantie, Eero; Kere, Juha; Kivinen, Katja; Pouta, Anneli; Laivuori, Hannele
2016-11-10
The Finnish Genetics of Pre-eclampsia Consortium (FINNPEC) Study was established to set up a nationwide clinical and DNA database on women with and without pre-eclampsia (PE), including their partners and infants, in order to identify genetic risk factors for PE. FINNPEC is a cross-sectional case-control cohort collected from 5 university hospitals in Finland during 2008-2011. A total of 1450 patients with PE and 1065 pregnant control women without PE (aged 18-47 years) were recruited. Altogether, there were 1377 full triads (625 PE and 752 control triads). The established cohort holds both clinical and genetic information of mother-infant-father triads representing a valuable resource for studying the pathogenesis of the disease. Furthermore, maternal biological samples (first and third trimester serum and placenta) will provide additional information for PE research. Until now, research has encompassed studies on candidate genes, Sanger and next-generation sequencing, and various studies on the placenta. FINNPEC has also participated in the InterPregGen study, which is the largest investigation on maternal and fetal genetic factors underlying PE until now. Ongoing studies focus on elucidating the role of immunogenetic and metabolic factors in PE. Data on morbidity and mortality will be collected from mothers and fathers through links to the nationwide health registers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Epilepsy-associated long-term mortality after aneurysmal subarachnoid hemorrhage.
Huttunen, Jukka; Lindgren, Antti; Kurki, Mitja I; Huttunen, Terhi; Frösen, Juhana; Koivisto, Timo; von Und Zu Fraunberg, Mikael; Immonen, Arto; Jääskeläinen, Juha E; Kälviäinen, Reetta
2017-07-18
To elucidate the epilepsy-associated causes of death and subsequent excess long-term mortality among 12-month survivors of subarachnoid hemorrhage from saccular intracranial aneurysm (SIA-SAH). The Kuopio SIA Database (kuopioneurosurgery.fi) includes all SIA-SAH patients admitted to the Kuopio University Hospital from its defined catchment population in Eastern Finland. The study cohort consists of 779 patients, admitted from 1995 to 2007, who were alive at 12 months after SIA-SAH. Their use of reimbursable antiepileptic drugs and the causes of death (ICD-10) were fused from the Finnish national registries from 1994 to 2014. The 779 12-month survivors were followed up until death (n = 197) or December 31, 2014, a median of 12.0 years after SIA-SAH. Epilepsy had been diagnosed in 121 (15%) patients after SIA-SAH, and 34/121 (28%) had died at the end of follow-up, with epilepsy as the immediate cause of death in 7/34 (21%). In the 779 patients alive at 12 months after SIA-SAH, epilepsy was an independent risk factor for mortality (hazard ratio 1.8, 95% confidence interval 1.1-3.0). Comorbid epilepsy in 12-month survivors of SIA-SAH is associated with increased risk of death in long-term follow-up. Survivors of SIA-SAH require long-term dedicated follow-up, including identification and effective treatment of comorbid epilepsy to prevent avoidable deaths. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
Kiviniemi, Annukka Auni Inkeri; Wasz-Höckert, Ole; Seitamo, Leila Kaarina; Joskitt, Leena Orvokki; Heikkinen, Hanna Pauliina; Moilanen, Irma Kaarina; Ebeling, Hanna Elina
2011-04-01
Experiences in one's family of origin, especially the relationship to one's parents, supposedly form the basis of relationships in adulthood. The connection between traumatic childhood events and later life has been studied intensively, whereas average childhood growth experiences have been given less attention. The aim of this study was to find out the association between images of the mother and father and the psychosocial well-being of young adults from the perspective of satisfaction in intimate relationships. Cross-sectional study. The research is a part of the Oulu University Hospital Mother-Child Follow-up Study 1971-1972. The follow-up data were collected from the young adults (n=337) in 2000 by way of mailed questionnaires, which included 17 questions about the participants' images of their parents and 18 questions about their intimate relationship satisfaction. In this study we used attachment theory as a theoretical frame of reference. Mental images of dominating parents were associated with quarrelsome intimate relationships, and the image of a dominating father, with repressive/submissive and less balanced relationships. Mental images of diligent and sociable parents were associated with a loving and balanced relationship, and the image of supportive parents, with a balanced relationship. Parental diligence was associated with a less quarrelsome relationship. The young adults' mental images of their parents were associated with their intimate relationship satisfaction. Positive mental images of the father, in particular, seemed to protect young adults from a quarrelsome and repressive/submissive intimate relationship.
Huhtala, Mira; Korja, Riikka; Lehtonen, Liisa; Haataja, Leena; Lapinleimu, Helena; Rautava, Päivi
2014-03-01
Preterm children are at risk for developing behavioral and emotional problems, as well as being less socially competent. Premature birth causes chronic distress in the parents. The aim of the paper is to discover whether parental psychological well-being is associated with the social, behavioral, and functional development of very low birth weight (VLBW, ≤1500g) children at 5years of age. A longitudinal prospective cohort study. A cohort of 201 VLBW infants (≤1500g, <37weeks of gestation) born during 2001-2006 in Turku University Hospital, Finland was studied. At 4-year chronological age of their child, parents independently completed validated questionnaires (Beck Depression Inventory, Parenting Stress Index and Sense of Coherence Scale). At 5years, parents and day-care providers evaluated the development of the child by completing the Five to Fifteen questionnaire. The parents of VLBW children reported significantly more problems in child development compared to the Finnish normative data. Depressive symptoms and weaker sense of coherence in mothers, but not in fathers, were associated with more problems in child development. Parenting stress, for both mothers and fathers, was associated with developmental problems in their child at 5years of age. Maternal depressive symptoms and parenting stress of both parents may be risk factors for the social, behavioral, and functional development of 5-year-old preterm children. On the other hand, stronger maternal sense of coherence may be a protective factor. Copyright © 2013 Elsevier Ltd. All rights reserved.
Antila-Långsjö, Riitta; Mäenpää, Johanna U; Huhtala, Heini; Tomás, Eija; Staff, Synnöve
2018-05-12
The aim of this study was to investigate the prevalence of post-cesarean isthmocele and to measure agreement between transvaginal ultrasonography and saline contrast sonohysterography in assessment of isthmocele. Prospective observational cohort study was carried out at Tampere University Hospital, Finland. Non-pregnant women delivered by cesarean section (n=371) were examined with transvaginal ultrasonography (TVUS) and sonohysterography (SHG) six months after cesarean section. The main outcome measure was the prevalence of isthmocele using TVUS and SHG. Secondary outcome measures were characteristics of isthmocele. Three hundred and seventy-one women were included. The prevalence of isthmocele was 22.4% based on TVUS and 45.6% based on SHG. Sensitivity and specificity for TVUS was 49.1 and 100% when compared to SHG. Therefore, half of the defects (50.9%) diagnosed with SHG remained undiagnosed with TVUS. Bland-Altman analysis showed an underestimation of 1.1 mm (range 0.00 to 7.90) for TVUS compared to SHG, with 95% limits of agreement from -1.9 to 4.1 mm. This methodological study provides confirmatory data that TVUS and SHG are not in good agreement in the isthmocele diagnostics and the use of only TVUS may lead to an underestimation of the prevalence of isthmocele. Thus, SHG should be considered as a method of choice in diagnostics of isthmocele. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
ERIC Educational Resources Information Center
Organisation for Economic Cooperation and Development, Paris (France).
This document presents statistical data from the countries of France, Finland, the Netherlands, Japan, Italy, and Norway regarding the flows of graduates from higher education and their entry into the workforce. Among the statistical data presented are the trends and current situation in each country for such areas as college enrollments and…
Recent PCB accidents in Finland.
Elo, O; Vuojolahti, P; Janhunen, H; Rantanen, J
1985-01-01
Twenty-eight polychlorinated biphenyl (PCB) accidents were recorded during a 1-year period in Finland. They comprised leaks, fires or explosions of capacitors. Some of the explosions and fires gave rise to high concentrations of PCBs in air and of PCBs and tetrachlorodibenzofurans (TCDFs), including 2,3,7,8-TCDF, on surfaces. One large explosion is described in detail, and biomedical data and findings of this case are compared with those of smaller accidents in Finland. PMID:3928359
1 to 3-Year-Old Children in Day Care Centres in Finland: An Overview of Eight Doctoral Dissertations
ERIC Educational Resources Information Center
Hannikainen, Maritta
2010-01-01
This article gives a general picture of the policy and main structural features of early childhood education services for the younger children in Finland. It also provides an overview of the research on 1 to 3-year-old children in day care centres carried out in Finland during the last 15 years, the focus being on a review of all the eight…
Suominen, Sakari
2014-01-01
The health differences between Swedish and Finnish speakers in Finland Swedish-speaking people in Finland (circa 5 %) are somewhat healthier than Finnish-speaking people. This systematic review presents research results on this topic, mostly published in international journals. The differences apply more to men, and although not great, they can be observed on many levels, such as mortality, disability pensions and perceived health. The differences cannot be attributed to mere socioeconomic factors. Concomitant long-term social, cultural and biomedical mechanisms have probably been involved in the formation of the health differences. The significance of the findings would be higher if they could be applied in health promotion in a more general manner.
Mehra, Tarun; Moos, Rudolf M; Seifert, Burkhardt; Bopp, Matthias; Senn, Oliver; Simmen, Hans-Peter; Neuhaus, Valentin; Ciritsis, Bernhard
2017-12-01
The assessment of structural and potentially economic factors determining cost, treatment type, and inpatient mortality of traumatic hip fractures are important health policy issues. We showed that insurance status and treatment in university hospitals were significantly associated with treatment type (i.e., primary hip replacement), cost, and lower inpatient mortality respectively. The purpose of this study was to determine the influence of the structural level of hospital care and patient insurance type on treatment, hospitalization cost, and inpatient mortality in cases with traumatic hip fractures in Switzerland. The Swiss national medical statistic 2011-2012 was screened for adults with hip fracture as primary diagnosis. Gender, age, insurance type, year of discharge, hospital infrastructure level, length-of-stay, case weight, reason for discharge, and all coded diagnoses and procedures were extracted. Descriptive statistics and multivariate logistic regression with treatment by primary hip replacement as well as inpatient mortality as dependent variables were performed. We obtained 24,678 inpatient case records from the medical statistic. Hospitalization costs were calculated from a second dataset, the Swiss national cost statistic (7528 cases with hip fractures, discharged in 2012). Average inpatient costs per case were the highest for discharges from university hospitals (US$21,471, SD US$17,015) and the lowest in basic coverage hospitals (US$18,291, SD US$12,635). Controlling for other variables, higher costs for hip fracture treatment at university hospitals were significant in multivariate regression (p < 0.001). University hospitals had a lower inpatient mortality rate than full and basic care providers (2.8% vs. both 4.0%); results confirmed in our multivariate logistic regression analysis (odds ratio (OR) 1.434, 95% CI 1.127-1.824 and OR 1.459, 95% confidence interval (CI) 1.139-1.870 for full and basic coverage hospitals vs. university hospitals respectively). The proportion of privately insured varied between 16.0% in university hospitals and 38.9% in specialized hospitals. Private insurance had an OR of 1.419 (95% CI 1.306-1.542) in predicting treatment of a hip fracture with primary hip replacement. The seeming importance of insurance type on hip fracture treatment and the large inequity in the distribution of privately insured between provider types would be worth a closer look by the regulatory authorities. Better outcomes, i.e., lower mortality rates for hip fracture treatment in hospitals with a higher structural care level advocate centralization of care.
Saunders, Hannele; Vehviläinen-Julkunen, Katri; Stevens, Kathleen R
2016-08-01
Nurses' lack of readiness for evidence-based practice slows down the uptake, adoption, and implementation of evidence-based practice which is of international concern as it impedes attainment of the highest quality of care and best patient outcomes. There is limited evidence about the most effective approaches to strengthen nurses' readiness for evidence-based practice. To evaluate the effectiveness of an Advanced Practice Nurse-delivered education program to strengthen nurses' readiness for evidence-based practice at a university hospital. A single-blind randomized controlled trial with repeated measures design, with measures completed during spring and fall 2015, before the education program (T0), within 1week after (T1), 8weeks after (T2), and 4months after completion of education interventions (T3). One large university hospital system in Finland, consisting of 15 acute care hospitals. The required sample size, calculated by a priori power analysis and including a 20% estimated attrition rate, called for 85 nurse participants to be recruited. Nurses working in different professional nursing roles and care settings were randomly allocated into two groups: intervention (evidence-based practice education, N=43) and control (research utilization education, N=34). The nurse participants received live 4-h education sessions on the basic principles of evidence-based practice (intervention group) and on the principles of research utilization (control group). The intervention group also received a web-based interactive evidence-based practice education module with a booster mentoring intervention. Readiness for evidence-based practice data, previous experience with evidence-based practice, and participant demographics were collected using the Stevens' EBP Readiness Inventory. Nurses' confidence in employing evidence-based practice and actual evidence-based practice knowledge were lower at T0, compared with the post-education scores, specifically at T1. The improvement in the confidence or actual evidence-based practice knowledge levels did not differ between the intervention and control groups. Confidence in employing evidence-based practice was directly correlated with level of education and inversely correlated with age. Actual evidence-based practice knowledge was lowest among nurses who had no previous knowledge or experience of evidence-based practice. Both the evidence-based practice and research utilization education interventions improved nurses' confidence in employing evidence-based practice and actual evidence-based practice knowledge, strengthening their evidence-based practice readiness at least in the short-term. Most of the variation in the confidence in employing evidence-based practice and actual evidence-based practice knowledge levels was due to background factors, such as primary role and education level, which emphasize differences in educational needs between nurses with diverse backgrounds. Copyright © 2016 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Vogl, Raimund
2001-08-01
In 1997, a large PACS was first introduced at Innsbruck University Hospital in the context of a new traumatology centre. In the subsequent years, this initial PACS setting covering only one department was expanded to most of the hospital campus, with currently some 250 viewing stations attached. Constantly connecting new modalities and viewing stations created the demand for several redesigns from the original PACS configuration to cope with the increasing data load. We give an account of these changes necessary to develop a multi hospital PACS and the considerations that lead us there. Issues of personnel for running a large scale PACS are discussed and we give an outlook to the new information systems currently under development for archiving and communication of general medical imaging data and for simple telemedicine networking between several large university hospitals.
Hsiao, Yu-Yu; Cheng, Shou-Hsia
2013-07-01
To analyze the disparity in hospital care among people of various socio-economic status (SES) under a universal health insurance scheme. A survey questionnaire was mailed to discharged patients in October 2010. This study included 183 large-scale hospitals in Taiwan. A total of 3015 patients/caregivers completed the questionnaires, which yielded a response rate of 58%. Three variables were included. The two access-to-care variables were admission route and accreditation level of the hospital in which the patient stayed. A structured questionnaire, the patient-reported hospital quality (PRHQ), was included to characterize patient's experience of hospital stay. Patients with lower education were less likely to be admitted to a hospital according to a planned schedule, or to choose an Medical Center Hospital. However, SES was not associated with the PRHQ scores. Furthermore, patients with unplanned admission were associated with lower PRHQ scores than those with planned admission to the hospital. Under the universal health insurance system in Taiwan, lower education is associated with unplanned admission to a hospital, which might result in poorer perceived quality of care. Reducing unplanned admission is a challenge for health authorities in the future.
Finland Becomes Eleventh ESO Member State
NASA Astrophysics Data System (ADS)
2004-07-01
Finland has become the eleventh member state of the European Southern Observatory (ESO) [1]. The formal accession procedure was carried through as planned and has now been completed. Following the signing of the corresponding Agreement earlier this year (ESO PR 02/04), acceptance by the Finnish Parliament and ratification by the Finnish President of the Agreement as well as the ESO Convention and the associated protocols in June [2] and the deposit of the instruments of accession today, Finland has now officially joined ESO. ESO warmly welcomes the new member country and its scientific community that is renowned for their expertise in many frontline areas. The related opportunities will contribute to strenghtening of pioneering research with the powerful facilities at ESO's observatories, to the benefit of Astronomy and Astrophysics as well as European science in general. ESO also looks forward to collaboration with the Finnish high-tech industry. For Finland, the membership in ESO is motivated by scientific and technological objectives as well as by the objective of improving the public understanding of science. The Finnish Government is committed to increasing the public research funding in order to improve the quality, impact and internationalisation of research. Membership in ESO offers unique facilities for astronomical research which would not otherwise be available for Finnish astronomers. Finland is also very interested in taking part in technological development projects in fields like ICT, optics and instrumentation. For young scientists and engineers, ESO is a challenging, international working and learning environment. Finland has already taken part in the educational programmes of ESO, and as a member this activity will be broadened and intensified. In Finland there are also several science journalists and a large community of amateur astronomers who will be very happy to take part in ESO's outreach activities.
International Quit and Win 1996: comparative evaluation study in China and Finland
Sun, S.; Korhonen, T.; Uutela, A.; Korhonen, H.; Puska, P.; Jun, Y.; Chonghua, Y.; Zeyu, G.; Yonghao, W.; Wenqing, X.
2000-01-01
OBJECTIVES—To compare background and process variables, as well as follow up status, of the participants in the International Quit and Win '96 contests of China and Finland, and analyse factors contributing to sustained maintenance. DESIGN—A standardised 12 month follow up was conducted in both countries with random samples of participants. The sample sizes were 3119 in China and 1448 in Finland, with response rates of 91.2% and 65.2%, respectively. INTERVENTIONS—The International Quit and Win '96 contest was the second coordinated, multinational smoking cessation campaign targeted at adult daily smokers. Altogether 25 countries participated, including China with 15 000 and Finland with 6000 smokers registered. MAIN OUTCOME MEASURES—Conservative (considering all non-respondents relapsed) and non-conservative (based on respondents only) estimates were calculated for one month abstinence, 12 month continuous abstinence, and point abstinence at the time point of follow up. RESULTS—Great differences were found in the background and process variables, as well as in the outcome measures. At one year follow up, the conservative continuous abstinence rates show that the Chinese participants maintained their abstinence better (38%) compared to the Finnish ones (12%). In China women reached higher abstinence rate (50%) than men (36%), whereas in Finland men achieved a better result (14%) than women (9%). CONCLUSIONS—The Quit and Win contest is a mass smoking cessation method feasible in countries showing great variance in smoking habits and rates. However, in countries with different stages of anti-smoking development, such as China and Finland, different practical implementation strategies may be needed. Keywords: smoking cessation; Quit and Win; China; Finland PMID:10982574
Hedlund, Ebba; Kaprio, Jaakko; Lange, Anders; Koskenvuo, Markku; Jartti, Laura; Rönnemaa, Tapani; Hammar, Niklas
2007-01-01
Finland and Sweden are neighbouring countries with a substantially higher incidence and mortality from coronary heart disease (CHD) in Finland. Migration from Finland to Sweden has resulted in a population of about 187,000 Finnish immigrants, with a higher risk of CHD than Swedes. The aim of the present study was to analyse the prevalence of CHD in migrants to Sweden compared with co-twins remaining in Finland. The study population consisted of twin pairs of the Finnish Twin Cohort Study where at least one twin had lived one year or more in Sweden, including 1,534 subjects and 251 complete twin pairs discordant regarding residency in Sweden. Emigrant twins were compared with nonmigrant co-twins regarding prevalence of CHD in 1998. CHD prevalence was assessed by self-reported questionnaires validated using information from a clinical examination. Self-reported CHD showed a good correspondence with clinical diagnosis. Differences in social and behavioural risk factors for CHD among men were small but emigrants were more physically active than non-migrants. Female emigrants had less overweight and better education, but were more often working class than non-migrants. Intra-pair comparisons restricted to migration discordant pairs showed a tendency towards a reduced prevalence of CHD in the migrant co-twins (0.6; 0.3-1.4). In analyses of all subjects disregarding pair status, emigrants showed a reduced prevalence of CHD compared with subjects always living in Finland (0.6; 0.4-0.9). Emigration from Finland to Sweden may be associated with a reduced prevalence of CHD. The causes are most likely multifactorial and may involve changes in dietary habits, physical activity, psychosocial factors, and inflammation.
Predictors for Unplanned Hospitalization of New Home Care Clients.
Rönneikkö, Jukka K; Mäkelä, Matti; Jämsen, Esa R; Huhtala, Heini; Finne-Soveri, Harriet; Noro, Anja; Valvanne, Jaakko N
2017-02-01
To identify factors predicting unplanned hospitalization of new home care clients using the Resident Assessment Instrument for Home Care (RAI-HC). A register-based study based on RAI-HC assessments and nationwide hospital discharge records. Municipal home care services in Finland. New Finnish home care clients aged 63 and older (N = 15,700). Information from home care clients' first RAI-HC assessment was connected to information regarding their first hospitalization over 1 year of follow-up. Multivariate regression analyses were used to evaluate the independent risk factors for hospitalization. Forty-three percent (n = 6,812) of participants were hospitalized at least once. The strongest independent risk factors were hospitalization during the year preceding the RAI-HC assessment (odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.87-2.16), aged 90 and older (OR = 1.69, 95% CI = 1.48-1.92), renal insufficiency (OR = 1.44, 95% CI = 1.22-1.69) and using 10 or more drugs (OR = 1.41, 95% CI = 1.26-1.58). Other independent risk factors were male sex, previous emergency department visits or other acute outpatient care use, daily urinary incontinence, fecal incontinence, history of falls, cognitive impairment, chronic skin ulcer, pain, unstable health status, housing-related problems, and poor self-rated health. Parkinson's disease, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, and cancer were independent prognostic indicators. A body mass index of 24 kg/m 2 or greater and the client's own belief that functional capacity could improve had a protective role. Assessing new home care clients using the RAI-HC reveals modifiable risk factors for unplanned hospitalization. Systematic assessment by a multidisciplinary team at the beginning of the service and targeting modifiable risk factors could reduce the risk of unplanned hospitalization. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
Berlin, Claudia; Panczak, Radoslaw; Hasler, Rebecca; Zwahlen, Marcel
2016-11-01
Switzerland has mountains and valleys complicating the access to a hospital and critical care in case of emergencies. Treatment success for acute myocardial infarction (AMI) or stroke depends on timely treatment. We examined the relationship between distance to different hospital types and mortality from AMI or stroke in the Swiss National Cohort (SNC) Study. The SNC is a longitudinal mortality study of the census 2000 population of Switzerland. For 4.5 million Swiss residents not living in a nursing home and older than 30 years in the year 2000, we calculated driving time and straight-line distance from their home to the nearest acute, acute with emergency room, central and university hospital (in total 173 hospitals). On the basis of quintiles, we used multivariable Cox proportional hazard models to estimate HRs of AMI and stroke mortality for driving time distance groups compared to the closest distance group. Over 8 years, 19 301 AMI and 21 931 stroke deaths occurred. Mean driving time to the nearest acute hospital was 6.5 min (29.7 min to a university hospital). For AMI mortality, driving time to a university hospital showed the strongest association among the four types of hospitals with a hazard ratio (HR) of 1.19 (95% CI 1.10 to 1.30) and 1.10 (95% CI 1.01 to 1.20) for men and women aged 65+ years when comparing the highest quintile with the lowest quintile of driving time. For stroke mortality, the association with university hospital driving time was less pronounced than for AMI mortality and did not show a clear incremental pattern with increasing driving time. There was no association with driving time to the nearest hospital. The increasing AMI mortality with increasing driving time to the nearest university hospital but not to any nearest hospital reflects a complex interplay of many factors along the care pathway. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
ERIC Educational Resources Information Center
Kalliopuska, Mirja, Ed.
This publication reports the proceedings of the Fenno-Hungarian Conference on Recent Family Types, which was held in Lahti, Finland, in July, 1989. The purpose of the conference was to discuss the effect of changing social conditions on the family, family types, and home education in Hungary and Finland. A series of papers was presented. Topics…
Irita, Kazuo; Tsuzaki, Koichi; Sawa, Tomohiro; Sanuki, Michiyoshi; Nakatsuka, Hideki; Makita, Koshi; Morita, Kiyoshi
2007-01-01
The Japanese Society of Anesthesiologists (JSA) survey of critical incidents in the operating room and other reports have shown that pediatric patients undergoing anesthesia are at an increased risk. Purpose was to examine the state of pediatric anesthesia in Japan. This might clarify the role of children's hospitals for pediatric anesthesia, and the relationship between critical incidents and volume of pediatric anesthetic procedures. The JSA has conducted annual surveys of critical incidents in the operating room by sending to and collecting confidential questionnaires from all JSA Certified Training Hospitals. From 1999 to 2003, 342,840 pediatric (0-5 yr) anesthetic procedures were registered. During this period, only 15 cardiac arrests and 3 deaths within 7 postoperative days totally attributable to anesthetic management were reported. Therefore, we analyzed cardiac arrests and deaths due to all etiologies. The hospitals were classified as children's hospitals, university hospitals, and other hospitals, and the incidence of cardiac arrest, the recovery rate from cardiac arrest without any sequelae, and the mortality rate were compared according to types of the hospitals. The relationship between death due to intraoperative critical incidents and the volume of pediatric anesthetic procedures was examined using data from the 2003 survey, the recovery rate of which was 85.7%. In 2003, 739 JSA Certified Training Hospitals responded to the survey: 7 children's hospitals, 109 university hospitals, and 623 other hospitals. Among these hospitals, 707 and 270 hospitals conducted pediatric and newborn (<1 mo) anesthesia, respectively. In 2003, 4,630 newborn, 17,890 infant (<1 yr), and 60,524 child (1-5 yr) anesthetic procedures were registered. Odds ratios were determined to compare the risks among the hospital groups, and the 95% confidential interval (CI) was shown. The Chi square test was used to compare the background of patients with cardiac arrest. P values less than 0.05 were considered significant. In 2003, 95.7% and 36.5% of JSA Certified Training Hospitals which responded to the survey had conducted pediatric and newborn anesthesia, respectively. Children's hospitals, university hospitals, and other hospitals were responsible for 10.7%, 31.0%, and 58.3% of pediatric anesthetic procedures, respectively. Seven children's hospitals (100.0%), 54 university hospitals (50.5%), and 54 other hospitals (9.1%) conducted more than 201 annual pediatric anesthetic procedures, respectively, and these 115 hospitals conducted 62.5% of all pediatric anesthetic procedures in Japan. There was no significant difference between the overall mortality rate in hospitals with an annual pediatric anesthetic volume of less than 200 and that in hospitals with an annual pediatric anesthetic volume of more than 201 (5.46 versus 7.12/10,000 anesthetic procedures). However, the overall mortality rate was 4.87 times higher (95% confidential interval: 1.53-15.66) in hospitals with an annual pediatric anesthetic volume of more than 101 (7.91/10,000 anesthetic procedures) than in those with an annual pediatric anesthetic volume of less than 100 (1.62/10,000 anesthetic procedures). The situation was quite different when we focused on newborn anesthetic procedures : the overall mortality was 2.63 times higher (95% confidential interval : 1.19-5.84) in hospitals with an annual newborn anesthetic volume of less than 12 (126.6/ 10,000 anesthetic procedures) than those with an annual newborn anesthetic volume of more than 13 (48.5/10,000 anesthetic procedures). Between 1999 and 2003, the incidences of cardiac arrest in children's hospitals, university hospitals, and other hospitals were 9.54 (1.89 times higher than the other hospitals; CI 1.31-2.67), 10.30, and 5.11/10,000 anesthetic procedures, respectively. Among the children who developed cardiac arrest, the ratio of poor preoperative conditions with an American Society of Anesthesiologists physical status classification of more than 3 was significantly lower in the children's hospitals (68.9%) than the university hospitals (84.3%) and the other hospitals (84.0%). The recovery rate from cardiac arrest was 51.1% (2.49 times higher than the university hospitals; CI 1.23-5.06, and 3.05 times higher than the other hospitals ; CI 1.45-6.43), 29.6%, and 25.5%, respectively. The mortality rate was 9.54 (1.77 times higher than the other hospitals; CI 1.25-2.52), 8.87, and 5.38/10,000 anesthetic procedures in children's hospitals, university hospitals and other hospitals, respectively. Almost all JSA Certified Training Hospitals conducted pediatric anesthesia, although only 15.6% of them had an annual pediatric anesthetic volume of more than 200. It was suggested that general pediatric anesthesia was conduced safely in JSA Certified Training Hospitals, even if they had a low annual pediatric anesthetic volume. The exception was newborn anesthetic procedures : the mortality was high in hospitals with an annual newborn anesthetic volume of less than 12. Analysis of critical incidents in the operating room failed to show the superiority of children's hospitals in comparison with the university hospitals and other hospitals. Collecting and analyzing data including the patients without critical incidents are required for further analysis.
A study to promote breast feeding in the Helsinki Metropolitan area in Finland.
Hannula, Leena S; Kaunonen, Marja E; Puukka, Pauli J
2014-06-01
the aim of this study was to assess the impact of providing intensified support for breast feeding during the perinatal period. a quasi-experimental design with non-equivalent control group. three public maternity hospitals (two study, one control) in the Helsinki Metropolitan area in Finland. a convenience sample of 705 mothers (431 in the intervention group, 274 in the control group). in this study, families in the intervention group had access to intensified breast feeding support from midpregnancy, whereas those in the control group had access to normal care. Intensified support included lectures and workshops to health professionals, and families in the intervention group had access to more intensive support and counselling for breast feeding and a breast feeding outpatient clinic. Additionally, an internet-based intervention was only used in the intervention group, but not in the control group. Mothers in the control group received normal care from the midwifery and nursing professionals who were to continue their work normally. The data were analysed statistically. altogether 705 women participated in the study. In the intervention group (n=431), 76% of the women breast fed exclusively throughout the hospital stay, compared to 66% of the mothers in the control group (n=274). In multivariate analysis, the likelihood of exclusive breast feeding at the time of responding (at hospital discharge or after that at home) was increased by the mother not being treated for an underlying illness or medical problem during pregnancy, being in the intervention group, having normal vaginal childbirth, high breast feeding confidence, positive attitude towards breast feeding, good coping with breast feeding, and 24-hour presence of the infant's father in the ward. the low exclusive breast feeding rates of newborns could be increased by using intensified breast feeding support. Mothers' health problems during pregnancy can decrease exclusive breast feeding. Mothers with health problems or other than normal childbirth should receive extra breast feeding support, and the presence of fathers in the ward should be encouraged. Intensified breast feeding counselling and support helps mothers to breast feed exclusively. This support should be available in a variety of forms, so that mothers can choose the type of support they need. As breast feeding counselling and support is intensified, more mothers succeed with exclusive breast feeding. © 2013 Published by Elsevier Ltd.
Peltola, Mikko; Quentin, Wilm
2013-01-01
Diagnosis-related groups (DRGs) are increasingly being used for various purposes in many countries. However, there are no studies comparing different DRG systems in the care of stroke. As part of the EuroDRG project, researchers from 11 countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Sweden and Spain) compared how their DRG systems deal with stroke patients. The study aims to assist clinicians and national authorities to optimize their DRG systems. National or regional databases were used to identify hospital cases with a diagnosis of stroke. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually represent at least 1% of stroke cases. In addition, standardized case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained. European DRG systems vary widely: they classify stroke patients according to different sets of variables (between 1 and 7 classification variables) into diverging numbers of DRGs (between 1 and 10 DRGs). In 6 of the countries more than half of the patients are concentrated within a single DRG. The countries' systems also vary with respect to the evaluation of different kinds of stroke patients. The most complex DRG is considered 3.8 times more resource intensive than an index case in Finland. By contrast, in England, the DRG system does not account for complex cases. Comparisons of quasi prices for the case vignettes show that hypothetical payments for the index case amount to only EUR 907 in Poland but to EUR 7,881 in Ireland. Large variations in the classification of stroke patients raise concerns whether all systems rely on the most appropriate classification variables and whether the DRGs adequately reflect differences in the complexity of treating different groups of patients. Learning from other DRG systems may help in improving the national systems. Clinicians and national DRG authorities should consider how other countries' DRG systems classify stroke patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement. In future, quantitative research is needed to verify whether the most important determinants of cost are considered in different patient classification systems, and whether differences between systems reflect country-specific differences in treatment patterns and, most importantly, what influence they have on patient outcomes. Copyright © 2013 S. Karger AG, Basel.
The professional competence profile of Finnish nurses practising in a forensic setting.
Koskinen, L; Likitalo, H; Aho, J; Vuorio, O; Meretoja, R
2014-05-01
Forensic nurses in Finland work in the two state-maintained forensic hospitals. The main function of these hospitals is to perform forensic psychiatric evaluation and provide treatment for two groups of patients: violent offenders found not guilty by reason of insanity, and those too dangerous or difficult to be treated in regional hospitals. Although the forensic nurses work with the most challenging psychiatric patients, they do not have any preparatory special education for the work. This paper describes the development of nurses who participated in a 1-year further education programme that was tailored to them. The nurses experienced that the 1-year education had a significant impact on their overall competence level. They found that their skills for observing, helping, teaching and caring for their patients had increased during the education. Conversely, it was found that the nurses collaborated little with their patients' family members. They were also not familiar with utilizing research findings in improving their care of patients. Forensic nursing is a global and relatively young profession that combines nursing care and juridical processes. There are, however, significant differences in the qualifications of forensic nurses internationally. The aim of the study was to describe the professional competence profile of practising forensic nurses in Finland and to explore the effects of a 1-year further education programme on that competence profile. The data were collected in 2011-2012 using the Nurse Competence Scale comprising seven competence categories, and analysed using the software package SPSS version 19.0 (SPSS, Inc., Armonk, NY, USA). The participants were 19 forensic nurses and their 15 head nurses. The assessed overall scores from both informant groups indicated a high level of competence across the seven categories. The nurses felt that the overall competence level had increased during the education programme. The increase seen by the head nurses was smaller. The less frequent competence items included utilization of research and involvement of family in care. It can be stated that the 1-year further education programme was effective in developing the nurses' competence profile and, in particular, affected their professional self-confidence. It will, however, be essential to strengthen their skills for working with families and their awareness of evidence-based forensic nursing. © 2013 John Wiley & Sons Ltd.
1986-10-01
In 1985, Finland's population stood at 4,913,300, with an annual growth rate of 0.35%. The 1984 infant mortality rate was 6.6/1000 and life expectancy was 70.4 years for males and 78.8 years for females. Finland's literacy rate approaches 100%. Of the labor force of 2,437,000, 11.5% are engaged in agriculture; 45.5% are employed in industry, commerce, and finance; 28% are in the service sector; 5.1% work for the government; and 7.6% work in the transport sector. The gross domestic product (GDP) was US$54 billion in 1985, with an annual growth rate of 2.8% and a per capita income of $1,007. Industry accounts for 28% of the GDP. An extensive social welfare system, comprising 20% of the national income, includes a variety of pension and assistance programs and a comprehensive health insurance program covering the entire Finnish population. Finland's proportional representation system of government encourages a multitude of political parties and has resulted in several coalition governments. Finland's industrial economy is based on capital investment and new technology.
University Hospital Struck Deaf and Silent by Lightning: Lessons to Learn.
Dami, Fabrice; Carron, Pierre-Nicolas; Yersin, Bertrand; Hugli, Olivier
2015-08-01
We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident.
Schmidt, C; Möller, J; Hardt, F; Gabbert, T; Bauer, M
2007-12-01
The German hospital market is in a state of transition due to the introduction of diagnosis-related groups (DRGs) and a constant change of the reimbursement, demographic, economical and technical framework. To date mainly public hospitals were bought by private hospital chains, but this trend has currently reached university hospitals. During recent months a consolidation within the market of private hospitals took place, while new market players such as foreign hospital chains, US universities and private equity firms emerged on the scene. The target of the privatisation process, however, turns more and more to larger hospitals. Central key values remain the cluster formation and centralisation of key competences such as food supply, purchasing and pharmacy. Within a network of clinics the representation of different care components (basic, regular and maximum care provider) and care levels (low, normal, intermediate and intensive care) remain important elements of efficient hospital management. Today, successful hospital operation is based on the successful competition for patients and even more for qualified staff. In this aspect, university hospitals could play a decisive role, because of their combination of maximum acute care provision and educational mandate. No such network has yet been formed due to the different interests of the owners, however, given the new market situation this alternative concept could become more attractive.
Workshop on wave-ice interaction
NASA Astrophysics Data System (ADS)
Wadhams, Peter; Squire, Vernon; Rottier, Philip; Liu, Antony; Dugan, John; Czipott, Peter; Shen, Hayley
The subject of wave-ice interaction has been advanced in recent years by small groups of researchers working on a similar range of topics in widely separated geographic locations. Their recent studies inspired a workshop on wave-ice interaction held at the Scott Polar Research Institute, University of Cambridge, England, December 16-18, 1991, where theories in all aspects of the physics of wave-ice interaction were compared.Conveners of the workshop hoped that plans for future observational and theoretical work dealing with outstanding issues in a collaborative way would emerge. The workshop, organized by the Commission on Sea Ice of the International Association for Physical Sciences of the Ocean (IAPSO), was co-chaired by Vernon Squire, professor of mathematics and statistics at the University of Otago, New Zealand, and Peter Wadhams, director of the Scott Polar Research Institute. Participants attended from Britain, Finland, New Zealand, Norway, and the United States.
KAMEDO report No. 93-the power failure at Karolinska University Hospital, Huddinge, 07 April 2007.
Angantyr, Lars-Göran; Häggström, Eskil; Kulling, Per
2009-01-01
A sudden and extensive power failure occurred at Karolinska University Hospital in Huddinge on Easter Saturday, 07 April 2007. The power failure lasted one hour and 22 minutes, but it took a longer time for activities to return to normal. It put many patients at great risk, particularly in the intensive care unit and other departments with critically ill patients. This report details the conditions and response at Karolinska University Hospital during the power failure and provides lessons learned for future events.
Single and double sexual standards in Finland, Estonia, and St. Petersburg.
Haavio-Mannila, Elina; Kontula, Osmo
2003-02-01
The sexual revolution and fight for gender equality began in the West during the 1960s but did not reach the Soviet Union until the late 1980s. Using survey data from nationally representative samples from Finland in 1971, 1992, and 1999 and from two former Soviet areas, Estonia in 2000 and St. Petersburg in 1996, we investigated the following: (a) differences across decades and countries in acceptance of the sexual double standard (SDS) in attitudes toward marital infidelity and women's initiating sex; and (b) the relationship between the SDS and sexual satisfaction. Results show that Finland in the 1990s was more egalitarian than Finland in 1971, St. Petersburg in 1996, or Estonia in 2000. Egalitarian sexual attitudes were positively related to sexual satisfaction.
Activity-based costing and its application in a Turkish university hospital.
Yereli, Ayşe Necef
2009-03-01
Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. Copyright (c) AORN, Inc, 2009.
2 CFR 176.90 - Non-application to acquisitions covered under international agreements.
Code of Federal Regulations, 2010 CFR
2010-01-01
..., Bulgaria, Canada, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong..., Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg...
Polycystic kidney disease at Howard University Hospital.
Hosten, A O; Cummings, Y
1977-08-01
Adult polycystic kidney disease treatment at Howard University Hospital is summarized. The cases are taken from autopsies performed between January 1955 and November 1975 and from the Hospital's dialysis population. Polycystic kidney disease was identified in six adults and four infants. Only two dialysis patients were clinically thought to have the disease. A review of the major clinical features of the disease is presented.
1991-07-01
Chairman for the Clinic of Anaesthesiology University Hospital Mainz, Germany Vice-President, European Academy of Anaesthesiology Medical Director...Consultant Anesthetist Department of Anaesthesiology Frenchay Hospital President, Association of Anaesthetists of Great Britain and Ireland President...of the Institute for Anaesthesiology University Hospital-Nijmegen Member of the National Health Council (Gezondheidsraad) Vice-President, National
Miller, Catherine; Lanham, Amy; Welsh, Christopher; Ramanadhan, Shaalini; Terplan, Mishka
2014-01-01
Recent amendments to the Child Abuse Prevention and Treatment Act tie the receipt of federal block grants to mandatory reporting of substance-exposed newborns. To determine rates of screening, testing, and reporting of drug and alcohol use at the time of delivery, we administered a telephone survey of nursing managers and perinatal social workers at Maryland birthing hospitals. Of the 34 hospitals, 31 responded (response rate 91%). Although 97% of hospitals reported universal screening, only 6% used a validated instrument. Testing was reported by 94% with 45% reporting universal maternal testing and 7% universal newborn testing. Only 32% reported obtaining maternal consent prior to testing. There is significant heterogeneity in screening and testing for substance use in birthing hospitals. Given federal reporting mandates, state-level practices need to be standardized.
Saxén, Salla
2018-03-01
This qualitative social scientific study explores professional texts of healthcare ethics to understand the ways in which ethical professionalism in medicine and nursing are culturally constructed in Finland. Two books in ethics, published by Finnish national professional organizations-one for nurses and one for physicians-were analyzed with the method of critical discourse analysis. Codes of ethics for each profession were also scrutinized. Analysis of the texts sought to reveal what is taken for granted in the texts as well as to speculate what appeared to be relegated to the margins of the texts or left entirely invisible. Physicians' ethics was discovered to emphasize objectivity and strong group membership as a basis for ethical professionalism. The discourses identified in the physicians' ethics guidebook were universal ethics, reductionism, non-subjectivity, and threat. Nursing ethics was discovered to highlight reflectivity as its central focus. This idea of reflectivity was echoed in the identified discourses: local ethics, enlightenment, and moral agency. The analysis exposes a cultural gap between the ethics discourses of medicine and nursing. More work is needed to bridge ethics discourses in Finland in a way that can support healthcare professionals to find common ground and to foster inclusivity in ethical dialogue. Further development of bioethical practices is suggested as a potential way forward.
Update on women in physics in Finland
NASA Astrophysics Data System (ADS)
Miikkulainen, Kukka; Vapaavuori, Jaana
2015-12-01
Despite Finland's role as a forerunner in many areas of gender equality, in the field of physics, the advancement of females to reach the full gender equality has been stagnated for the past decade, and no significant improvements since 2011 can be reported. However, a few interesting PhD theses have focused on gaining a better understanding of the phenomena, and a few seminars on the topic have been organized. However, good, systematically collected statistics on the numbers and salaries of female researches in Finland are still lacking.
Control of typhus fever in Finland during World War II.
Laurent, Helene
2009-12-01
The article describes the measures taken against the threat of typhus epidemic in Finland during the Second World War. Comparisons between countries at war and their different typhus prevention methods are made. The main method of typhus prevention in Finland consisted of regular sauna bathing, which was culturally acceptable and very efficient when combined with heating of the clothing. The Finnish troops remained virtually louse-free by ecological and traditional methods, and thus the spread of typhus fever in the army could be prevented.
Aiken, Linda H; Sloane, Douglas; Griffiths, Peter; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter
2017-07-01
To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80
Aiken, Linda H; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter
2017-01-01
Objectives To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Design Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Setting Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Participants Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Main outcome measures Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Results Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80
The impact of varicella vaccination on varicella-related hospitalization rates: global data review
Hirose, Maki; Gilio, Alfredo Elias; Ferronato, Angela Esposito; Ragazzi, Selma Lopes Betta
2016-01-01
Abstract Objective: To describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease. Data source: We identified countries that implemented universal vaccination against varicella at the http://apps.who.int/immunization_monitoring/globalsummary/schedules site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination) in the varicella-related hospitalization rates in these countries, using the Keywords "varicella", "vaccination/vaccine" and "children" (or) "hospitalization". Publications in English published between January 1995 and May 2015 were included. Data synthesis: 24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4%–99.2% reduction in hospitalization rates in children younger than four years, 6–14 years after the onset of universal vaccination (1995), with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1–4 years) in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1–4 years) in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1–4 years) in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1–4 years) in 5 years, coverage of 90%; Spain: 83.5% decrease (age <5 years) in four years, coverage of 77.2% and Italy 69.7%–73.8% decrease (general population), coverage of 60%–95%. Conclusions: The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between data. PMID:26965075
The impact of varicella vaccination on varicella-related hospitalization rates: global data review.
Hirose, Maki; Gilio, Alfredo Elias; Ferronato, Angela Esposito; Ragazzi, Selma Lopes Betta
2016-09-01
to describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease. we identified countries that implemented universal vaccination against varicella at the http://apps.who.int/immunization_monitoring/globalsummary/schedules site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination) in the varicella-related hospitalization rates in these countries, using the Keywords "varicella", "vaccination/vaccine" and "children" (or) "hospitalization". Publications in English published between January 1995 and May 2015 were included. 24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4% -99.2% reduction in hospitalization rates in children younger than four years after 6-14 years after the onset of universal vaccination (1995), with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1-4 years) in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1-4 years) in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1-4 years) in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1-4 years) in 5 years, coverage of 90%; Spain: 83.5% decrease (age <5 years) in four years, coverage of 77.2% and Italy 69.7% -73.8% decrease (general population), coverage of 60%-95%. The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between data. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Sex, timing, and depression among suicide victims with schizophrenia.
Karvonen, Kaisa; Sammela, Hanna-Lena; Rahikkala, Heidi; Hakko, Helinä; Särkioja, Terttu; Meyer-Rochow, V Benno; Räsänen, Pirkko; Timonen, Markku
2007-01-01
Schizophrenia and depression by themselves and especially in combination with each other are known to be important risk factors of suicide. An increased risk of suicide has also been reported for the period immediately after a psychiatric patient's discharge from the hospital. However, to the best of our knowledge, it remains unknown whether survival times differ between suicide victims with schizophrenia concomitantly with and those without depression. This study aimed to examine survival times from the discharge of last hospital treatment (irrespective of the kind of illness) to the day of death in suicide victims with schizophrenia with or without concomitant depression. A 16-year database of all suicides (1535 males, 342 females) committed during the years 1988-2003 in the province of Oulu in northern Finland, and information available from the national hospital discharge registers formed the basis of this study. In male suicide victims with schizophrenia, the median survival time after final hospitalization was approximately 1 day in those with a history of depression and 90 days in those without depression (P = .005). The corresponding times for females were 50 and 24 days, respectively (P = .396). Using Cox regression analysis after adjusting for confounders, we noticed a statistically significant difference in survival times from last hospitalization to suicide between depressive and nondepressive male patients with schizophrenia (hazard ratio, 1.80; 95% confidence interval, 1.04-3.11), but not females (hazard ratio, 0.72; 95% confidence interval, 0.34-1.53). Concomitant depression was markedly linked with shorter survival time in male suicide victims with schizophrenia after last hospitalization. Psychiatric inpatient facilities appear to be in a key position to establish suicide prevention programs for patients with schizophrenia, especially those with depression.
Impact of hospital atmosphere on perceived health care outcome.
Narang, Ritu; Polsa, Pia; Soneye, Alabi; Fuxiang, Wei
2015-01-01
Healthcare service quality studies primarily examine the relationships between patients' perceived quality and satisfaction with healthcare services, clinical effectiveness, service use, recommendations and value for money. These studies suggest that patient-independent quality dimensions (structure, process and outcome) are antecedents to quality. The purpose of this paper is to propose an alternative by looking at the relationship between hospital atmosphere and healthcare quality with perceived outcome. Data were collected from Finland, India, Nigeria and the People's Republic of China. Regression analysis used perceived outcome as the dependent variable and atmosphere and healthcare service quality as independent variables. Findings - Results showed that atmosphere and healthcare service quality have a statistically significant relationship with patient perceived outcomes. The sample size was small and the sampling units were selected on convenience; thus, caution must be exercised in generalizing the findings. The study determined that service quality and atmosphere are considered significant for developing and developed nations. This result could have significant implications for policy makers and service providers developing healthcare quality and hospital atmosphere. Studies concentrate on healthcare outcome primarily regarding population health status, mortality, morbidity, customer satisfaction, loyalty, quality of life, customer behavior and consumption. However, the study exposes how patients perceive their health after treatment. Furthermore, the authors develop the healthcare service literature by considering atmosphere and perceived outcome.
Review of thromboembolic prophylaxis in patients attending Cork University Hospital.
Byrne, Stephen; Weaver, Daniel Timothy
2013-06-01
Although preventable, venous thromboembolism remains a common cause of hospital acquired morbidity and mortality. Guidelines, such as the one produced by the American College of Chest Physicians (ACCP), are aimed at reducing hospital associated venous thromboemboli. Unfortunately the majority of studies have revealed inadequate adherence to these guidelines. The objective of this study was to evaluate the use of venous thromboembolism prophylaxis at Cork University Hospital. Cork University Hospital, Wilton, Cork, Ireland. Data from the patient's chart, drug kardex and laboratory results were recorded during April 2010. A Caprini score, a venous thromboembolism risk factor assessment tool, was subsequently calculated for each patient based on data collected. Appropriate prophylaxis was determined after examining data collected, Caprini score and prophylactic regime according to the ACCP 8th edition guidelines. Primary outcome was to analyse adherence to VTE prophylaxis guidelines. A total of 394 patients met the inclusion criteria and were reviewed, of which, 60% (n = 236) were medical and 37% (n = 146) were surgical patients. In total 63% of patients received some form of venous thromboembolism prophylaxis. Furthermore, 54% of medical and 76% of surgical patients received prophylaxis. However only 37% of the patients studied received appropriate thromboprophylaxis according to the ACCP 8th edition guidelines (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). Additionally 51% of surgical and 27% of medical patients received appropriate prophylaxis. Data collected from Cork University Hospital revealed poor adherence to international venous thromboembolism prophylaxis guidelines. As stated in the ACCP 8th edition guidelines, every hospital should develop a formal strategy for venous thromboembolism prevention (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). In order to improve adherence to guidelines, Cork University Hospital should develop, implement and re-evaluate a specific protocol for venous thromboembolism prophylaxis.
No association of moon phase with stroke occurrence.
Ruuskanen, Jori O; Sipilä, Jussi O T; Rautava, Päivi; Kytö, Ville
2018-05-23
Stroke occurrence shows strong correlations with sleep disorders and even subtle sleep disturbances have been shown to affect ischemic stroke (IS) occurrence. Chronobiology also exerts effects, like the morning surge in IS occurrence. Lunar cycles have also been shown to affect sleep and other physiological processes, but studies on moon phases and its possible association with occurrence of stroke are rare and nonconclusive. Therefore, we studied the effects of moon phases on stroke hospitalizations and in-hospital mortality nationwide in Finland in 2004-2014. All patients aged ≥18 years with IS or intracerebral hemorrhage (ICH) as primary discharge diagnosis were included. Daily number of admissions was treated as a response variable while moon phase, year and astronomical season were independent variables in Poisson regression modeling. We found no association between moon phases and stroke occurrence. The overall occurrence rates did not vary between different moon phases for IS or ICH (p = 0.61 or higher). There were no differences between moon phases in daily admission rates among men, women, young and old patients for any of the stroke subtypes. There was no difference in in-hospital mortality with regard to moon phase for IS or ICH overall (p = 0.19 or higher), nor in subgroup analyses. There were no significant interactions between moon phase and astronomical season for stroke occurrence or in-hospital mortality. To conclude, in this over a decade-long nationwide study including a total of 46 million person years of follow-up, we found no association between moon phases and occurrence or in-hospital mortality rates of IS or intracerebral hemorrhage.
Marušić, Srećko; Knežević, Aleksandar; Bačić Vrca, Vesna; Marinović, Ivana; Bačić, Julija; Obreli Neto, Paulo Roque; Amidžić Klarić, Daniela; Diklić, Dijaneta
2017-12-01
The aim of this study was to evaluate the implementation of the 9th edition of the American College of Chest Physicians (ACCP9) guidelines for prevention of venous thromboembolism in nonsurgical patients in clinical practice in one university and one general Croatian hospital. A retrospective study was conducted at Zadar General Hospital from Zadar and Dubrava University Hospital from Zagreb. Medical charts of all patients admitted to Medical Departments in two periods, before and after implementation of the ACCP9 guidelines, were analyzed. The ACCP9 guidelines were made available to all physicians through the hospital electronic information system immediately after the publication. The Hospital Drug Committees promoted implementation of the guidelines during their periodical clinical visits. Overall, 850 patients were included in the study in two periods. There was no statistically significant difference in the number of high-risk patients receiving thromboprophylaxis after the guidelines implementation in either hospital. In both periods, a signifi-cantly higher number of high-risk patients received thromboprophylaxis in Dubrava University Hos-pital in comparison with Zadar General Hospital (31.7% vs. 3.8% and 40.3% vs. 7.3%, respectively; p<0.001). This study revealed insufficient implementation of evidence-based thromboprophylaxis guidelines in clinical practice in two Croatian hospitals.
Income Analysis of University-Owned Teaching Hospitals.
ERIC Educational Resources Information Center
Isaacs, Joseph C.
1979-01-01
The annual survey, undertaken by the Association of American Medical Colleges, of income, expense and general operating information for university-owned teaching hospitals is discussed. Focus is on sources of income, including state funds, Medicare, and insurance companies. (JMD)
Using the New Scenarios Framework to Inform Climate Change Adaptation Policy in Finland
NASA Astrophysics Data System (ADS)
Carter, T. R.
2013-12-01
In 2005, Finland was among the first countries in the world to develop a national climate change adaptation strategy (Marttila et al., 2005). This included a characterization of future changes in climate and socioeconomic conditions using scenarios based on the IPCC Special Report on Emissions Scenarios (SRES - IPCC, 2000). Following a government evaluation of the strategy, completion of a national adaptation research programme, and in light of the recent European Union adaptation strategy, the Finnish strategy is now under revision. As part of this revision process, the New Scenario Framework (Moss et al., 2010) is being used to guide the mapping of future conditions in Finland out to the end of the 21st century. Future Finnish climate is being analysed using the CMIP5 climate model simulations (Taylor et al., 2012), including downscaled information based on regional climate model projections in the EURO-CORDEX project (Vautard et al., 2013). All projections are forced by the Representative Concentration Pathways (RCPs - van Vuuren et al., 2011). Socioeconomic scenarios are also being developed by outlining alternative pathways that reflect national social, economic, environmental and planning goals. These are designed according to the Shared Socioeconomic Pathway (SSP) framework of challenges to adaptation and mitigation (Kriegler et al., 2012). Work is in progress to characterize these pathways, mainly qualitatively, for different sectors in Finland. Preliminary results of the conceptual scenario development phase will be presented in this session. These initial ideas will be exchanged with representatives of ministries, regional government and key stakeholder groups. The eventual form and number of scenarios that appear in the revised strategy will be determined following a formal review of the draft document to be prepared in 2014. Future work could include quantification of scenarios, possibly mapping them onto the specific SSP worlds. This would then provide a firm basis for future climate change impact, adaptation and vulnerability assessments, offering RCP/SSP-based scenarios that are not only related to the global New Scenarios Framework, but are also recognised by national policy makers and key stakeholders, via the revised national climate change adaptation strategy. References IPCC (2000) Special Report on Emissions Scenarios: A Special Report of Working Group III of the Intergovernmental Panel on Climate Change. [Nakićenović, N. et al. (eds.)]. Cambridge University Press, 600 pp. Kriegler E et al. (2012) The need for and use of socio-economic scenarios for climate change analysis: A new approach based on shared socio-economic pathways. Glob. Envir. Change 22:807-822. Marttila V et al. (2005) Finland's National Strategy for Adaptation to Climate Change, MMM publications 1a/2005, Ministry of Agriculture and Forestry, Helsinki, Finland, 280 pp. Moss RH et al. (2010) The next generation of scenarios for climate change research and assessment. Nature 463:747-756. Taylor KE et al. (2012) A summary of the CMIP5 experiment design. BAMS 93:485-498. van Vuuren DP et al. (2011) The representative concentration pathways: an overview. Clim. Change 109:5-31. Vautard R et al. (2013) The simulation of European heat waves from an ensemble of regional climate models within the EURO-CORDEX project. Clim. Dyn. doi:10.1007/s00382-013-1714-z
ERIC Educational Resources Information Center
Environmental Science and Technology, 1975
1975-01-01
Finland has received a $20 million loan from the World Bank to attack its pollution problems, mainly water. Improved quality of life, as well as resource conservation are both motives and goals of that country's environmental programs. (BT)
The Rehabilitation of Visually Impaired Persons in Finland.
ERIC Educational Resources Information Center
Ojamo, M.; And Others
1990-01-01
A profile is presented of the gender, age, and diagnoses of individuals with visual impairments in Finland. Services provided, current legislative measures, rehabilitation courses, and orientation and mobility training are also described. (JDD)
Heiskanen, Kati; Ahonen, Riitta; Kanerva, Risto; Karttunen, Pekka; Timonen, Johanna
2017-01-01
The aim of this study was to explore the reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland. The study took the form of semi-structured interviews. Forty-one pharmaceutical companies and pharmaceutical wholesalers were invited to participate in the study. The pharmaceutical companies were the member organizations of Pharma Industry Finland (PIF) (N = 30) and the Finnish Generic Pharmaceutical Association (FGPA) (N = 7). One company which is a central player in the pharmaceutical market in Finland but does not belong to PIF or FGPA was also invited. The pharmaceutical wholesalers were those with a nationwide distribution network (N = 3). A total of 30 interviews were conducted between March and June 2016. The data were subjected to qualitative thematic analysis. The most common reasons behind medicine shortages in Finland were the small size of the pharmaceutical market (29/30), sudden or fluctuating demand (28/30), small stock sizes (25/30), long delivery time (23/30) and a long or complex production chain (23/30). The reasons for the medicine shortages were supply-related more often than demand-related. However, the reasons were often complex and there was more than one reason behind a shortage. Supply-related reasons behind shortages commonly interfaced with the country-specific characteristics of Finland, whereas demand-related reasons were commonly associated with the predictability and attractiveness of the market. Some reasons, such as raw material shortages, were considered global and thus had similar effects on other countries.
[Problems in career planning for novice medical technologists in Japanese national hospitals].
Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki
2012-12-01
Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs.
Building new university hospital--what citizens know and policy makers should be aware of.
Oresković, S; Letica, S; Mastilica, M; Babić-Bosanac, S; Civljak, M; Bozicević, I; Borovecki, A
2002-12-01
Survey of citizens' attitudes in the process of strategic decision making is one of the most important methods for determining health care priorities. We describe the results of a survey carried out in December 2001, with an aim to collect and analyze the attitudes of the citizens and health care professionals toward the possibilities and strategies of construction of the University Hospital in Blato, Zagreb. The first referendum on the construction of the new hospital was conducted among Zagreb citizens in 1982, when they agreed that the new University Hospital was much needed. Zagreb citizens confirmed once again their attitudes toward and opinions on the need to continue the construction of new hospital in the city outskirts. By 1992, when the construction of the hospital was halted due to insufficient financial means, Zagreb citizens had already invested over 150 epsilon million in the project. It is interesting that today, 89.4% of the citizens and 74.5% of physicians agree that the new hospital building should be completed. Also, 66.7% of the citizens and 88% of physicians think that this hospital should be a University hospital that could offer the most complex treatments and medical education. To finish the construction of the new hospital further 200 epsilon million needs to be invested. Survey showed that 71% of citizens and 82.2% of physicians think that funds should be raised from some form of credit or budget rather than by special local tax, additional tax or voluntary tax. This project will significantly determine the future of hospital and health care system in Croatia due to its capacities in terms of space, technology, and staff. Before the decision to continue with the new hospital construction be made, the expected future needs, demands, and supply of the health care services in hospital sector in Zagreb and Croatia should be provided using SWOT analysis for each of existing the facilities.
NASA Astrophysics Data System (ADS)
Raykova, Zh.; Mitrikova, R.; Nikolov, St.; Dimova, Y.; Valtonen, S.; Lampiselka, J.; Kyyronen, L.; Krikmann, Ott; Susi, J.; Przegietka, K.; Turlo, J.
2007-04-01
Recent research shows that students' interest in science is decreasing dramatically. This places urgent demands to making science teaching better so as to stimulate interest in it. Future teachers who are to cope with the problem are the main figures in this process. Teaching practice as a fundamental part of then-university education is essential for their successful preparation as teachers. Searching for possibilities in this area led to the launch of this international project with partners from University of Helsinki, University of Jyvaskyla (Finland), the University of Plovdiv (Bulgaria), Copernicus University in Torun (Poland) and the University of Tartu (Estonia). The main objective of the project is to present guidelines for unified initial training of science teachers in partner countries and the possibility for mobility of trainees during their studies. The present study has made a comparison of the teaching practice in partners' countries. It has identified certain main principles for a future unified curriculum for initial training of science teachers. The comparison aims to create suitable conditions for mobility of students from partners' countries during their studies and to set up the grounds for a future collaboration in developing common principles, requirements and educational standards for the practical training of science teachers.
Kujanpää, Tero; Ylisaukko-Oja, Tero; Jokelainen, Jari; Linna, Miika; Timonen, Markku
2014-07-01
Major depressive disorder (MDD) has shown to cause high costs to society. Earlier research indicates that generalized anxiety disorder (GAD) also causes high costs, but only limited data is available in varying settings. To analyse the secondary care costs of GAD compared with those of MDD. Retrospective database analysis from Finnish Hospital Discharge Registers (FHDR). All GAD and MDD patients diagnosed between 1 January 2007 and 31 December 2007 in FHDR were recorded and individual-level secondary care costs during a 48-month follow-up period were measured. The total mean cost of GAD with history of MDD or some other anxiety disorder was significantly higher than that of MDD with history of GAD or some other anxiety disorder during the 48-month follow-up period. The costs of pure GAD were comparable with those of pure MDD, but after adjusting for age and sex, the costs of pure MDD were higher than those of pure GAD. The economic burden of individual GAD patients is comparable with that of MDD patients in secondary care.
Participatory interaction design in user requirements specification in healthcare.
Martikainen, Susanna; Ikävalko, Pauliina; Korpela, Mikko
2010-01-01
Healthcare information systems are accused of poor usability even in the popular media in Finland. Doctors especially have been very critical and actively expressed their opinions in public. User involvement and user-centered design methods are seen as the key solution to usability problems. In this paper we describe a research case where participatory methods were experimented within healthcare information systems development in medicinal care in a hospital. The study was part of a larger research project on Activity-driven Information Systems Development in healthcare. The study started by finding out about and modeling the present state of medicinal care in the hospital. After that it was important to define and model the goal state. The goal state, facilitated by the would-be software package, was modeled with the help of user interface drawings as one way of prototyping. Traditional usability methods were extended during the study. According to the health professionals' feedback, the use of participatory and user-centered interaction design methods, particularly user interface drawings enabled them to describe their requirements and create common understanding with the system developers.
Is family size related to adolescence mental hospitalization?
Kylmänen, Paula; Hakko, Helinä; Räsänen, Pirkko; Riala, Kaisa
2010-05-15
The aim of this study was to investigate the association between family size and psychiatric disorders of underage adolescent psychiatric inpatients. The study sample consisted of 508 adolescents (age 12-17) admitted to psychiatric impatient care between April 2001 and March 2006. Diagnostic and Statistical Manual of Mental Disorders, fourth edition-based psychiatric diagnoses and variables measuring family size were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL). The family size of the general Finnish population was used as a reference population. There was a significant difference between the family size of the inpatient adolescents and the general population: 17.0% of adolescents came from large families (with 6 or more children) while the percentage in the general population was 3.3. A girl from a large family had an about 4-fold risk of psychosis other than schizophrenia. However, large family size was not associated with a risk for schizophrenia. Large family size was overrepresented among underage adolescents admitted for psychiatric hospitalization in Northern Finland. Copyright 2009 Elsevier Ltd. All rights reserved.
Inequalities in health and gender.
Haavio-Mannila, E
1986-01-01
Gender inequalities in health are studied in Denmark, Finland, Norway and Sweden on the basis of survey data on morbidity and symptoms of anxiety, and of mental hospitalization statistics. Women have higher rates of illness than men in countries where, and in periods when, they have to a great extent stayed at home as full-time housewives. Participation in paid economic activity and the resulting economical independence thus seems to be beneficial to women's health on the macro-level of society. On the micro-level of individual families, inequality in morbidity by gender is smaller in families with two economical providers than in families where the wife stays at home. The anxiety rates of employed wives are, however, relatively high compared with those of men and non-employed wives. Only in Sweden is the mental health of employed wives good, perhaps because of supportive social policies favouring women's work outside the home. The strain involved in combining family and work among women thus becomes manifest in the appearance of symptoms of anxiety but not in physical morbidity nor mental hospitalization.
Information technology governance domains in hospitals: a case study in Iran.
Shahi, Mehraban; Sadoughi, Farahnaz; Ahmadi, Maryam
2014-11-30
IT governance is a set of organizational structures ensuring decision-making rights and responsibilities with regard to the organization's IT assets. This qualitative study was carried out to identify the IT governance domains in teaching hospitals affiliated to Iran University of Medical Sciences. There were 10 heads of IT departments and 10 hospital directors. Semi structured interviews used for data collection. To analyze the data content analysis was applied. All the interviewees (100%) believed that decisions upon hospital software needs could be made in a decentralized fashion by the IT department of the university. Most of the interviewees (90%) believed that there were policies for logistics and maintenance of networks, purchase and maintenance, standards and general policies in the direction of the policies of the ministry of health and medical education. About 80% of the interviewees believed that the current emphasis of the hospital's IT unit and the hospital management for outsourcing of services were in the format of specialized contracts and under supervision of the university Statistic and IT department. A hospital strategic committee is an official organizational group consisting of hospital executives, heads of IT and multiple functional areas and business units in a hospital. In this committee, "the head of hospital" acts as the director of IT activities and ensures that IT strategies are alignment with the hospital business strategies.
Papaevangelou, V; Alexopoulou, Z; Hadjichristodoulou, C; Kourlamba, G; Katsioulis, A; Theodoridou, K; Spoulou, V; Theodoridou, M
2016-07-02
Hepatitis A vaccine was introduced in the Greek National Immunization Program in 2008. To estimate possible impact of the universal vaccination implementation, time trends of hospitalizations for hepatitis A at the Infectious Diseases Unit of a Tertiary Pediatric Hospital in Athens during 1999-2013 were analyzed. Hepatitis A hospitalizations were recorded from the discharge database and were expressed as frequencies and rate of annual departmental hospitalizations. Time series analysis (ARIMA) was used to explore trends and the impact of the vaccination. Moreover, changes in patient age, population group distribution and the duration of hospitalization were also examined. Hepatitis A hospitalizations rate significantly decreased between pre-vaccination (1999-2008) and post-vaccination (2009-2013) era from 50.5 to 20.8/1000 hospitalizations (p = 0.005). A 3-year periodicity and a trend of reduction on hepatitis A hospitalizations rates across years were noted. Roma children had significant higher rates of hepatitis A hospitalization, followed by immigrant children. Importantly, possibly due to preceding vaccine availability with considerable uptake in private market and unvaccinated group/pockets of children (Roma), overall vaccination effect was less apparent when compared to data from other countries that implemented universal vaccination. No significant change in patient age, population group distribution, or duration of hospitalization was observed. High risk groups such as Roma children should be targeted for vaccination to reduce future outbreaks.
[Measures taken by a university hospital for the prevention and control of the 2009 H1N1 influenza].
Hayashi, Jun; Murata, Masayuki; Furusyo, Norihiro; Hoshina, Takayuki; Shimono, Nobuyuki
2010-09-01
After extensive discussion with the Fukuoka City government of measures for the prevention and control of the 2009 H1N1 influenza pandemic, Kyushu University Hospital organized the infection control teams of 39 hospitals in the Fukuoka City area in preparation for a possible outbreak. A facility was set up at Kyushu University Hospital for the screening of outpatients with fever, and those with influenza and an underlying disease or severe symptoms were admitted to the hospital. 37 (22%) of the 171 outpatients with fever were infected with the new strain of influenza, confirmed by rapid influenza antigen test and PCR: Of these 37 patients, 17 (45.9%) were negative by influenza antigen test. Other 37 patients (5 adults, 32 children) were admitted, all of whom were successfully treated with neuraminidase inhibitors and discharged with no aftereffects.
Drennan, Ian R.; Case, Erin; Verbeek, P. Richard; Reynolds, Joshua C.; Goldberger, Zachary D.; Jasti, Jamie; Charleston, Mark; Herren, Heather; Idris, Ahamed H.; Leslie, Paul R.; Austin, Michael A.; Xiong, Yan; Schmicker, Robert H.; Morrison, Laurie J.
2017-01-01
Introduction The Universal Termination of Resuscitation (TOR) Guideline accurately identifies potential out-of-hospital cardiac arrest (OHCA) survivors. However, implementation is inconsistent with some emergency medical service (EMS) agencies using absence of return of spontaneous circulation (ROSC) as sole criterion for termination. Objective To compare the performance of the Universal TOR Guideline with the single criterion of no prehospital ROSC. Second, to determine factors associated with survival for patients transported without a ROSC. Lastly, to compare the impact of time to ROSC as a marker of futility to the Universal TOR Guideline. Design Retrospective, observational cohort study Participants Non-traumatic, adult (≥18 years) OHCA patients of presumed cardiac etiology treated by EMS providers Setting ROC-PRIMED and ROC-Epistry post ROC-PRIMED databases between 2007 and 2011. Outcomes Primary outcome was survival to hospital discharge and the secondary outcome was functional survival. We used multivariable regression to evaluate factors associated with survival in patients transported without a ROSC. Results 36,543 treated OHCAs occurred of which 9,467 (26%) were transported to hospital without a ROSC. Patients transported without a ROSC who met the Universal TOR Guideline for transport had a survival of 3.0% (95% CI 2.5%–3.4%) compared to 0.7% (95% CI 0.4%–0.9%) in patients who met the Universal TOR Guideline for termination. The Universal TOR Guideline identified 99% of survivors requiring continued resuscitation and transportation to hospital including early identification of survivors who sustained a ROSC after extended durations of CPR. Conclusion Using absence of ROSC as a sole predictor of futility misses potential survivors. The Universal TOR Guideline remains a strong predictor of survival. PMID:27923115
Vasemägi, Anti; Nousiainen, Ilkka; Saura, Ari; Vähä, Juha-Pekka; Valjus, Jorma; Huusko, Ari
2017-06-19
The myxozoan endoparasite Tetracapsuloides bryosalmonae causes temperature-driven proliferative kidney disease (PKD) in salmonid fishes. Despite the economic and ecological importance of PKD, information about the distribution of the parasite is still scarce. Here, we report for the first time the occurrence of T. bryosalmonae in wild brown trout Salmo trutta and European grayling Thymallus thymallus populations in Finland. We detected T. bryosalmonae at high prevalence in both brown trout and European grayling from the transboundary Finnish-Russian River Koutajoki system (Rivers Oulankajoki, Kuusinkijoki, Kitkajoki, Maaninkajoki, and Juumajoki) in north-eastern Finland. In southern Finland, T. bryosalmonae was detected in River Siuntionjoki young-of-the-year brown trout collected both in 2015 and 2016 (100% prevalence), while the parasite was not observed in fish from 3 other rivers (Ingarskila, Mustajoki, and Vantaanjoki) flowing to the Gulf of Finland. Our results, together with those from recent studies of Atlantic salmon, indicate that T. bryosalmonae is distributed over much higher latitudes in northern Europe than previously appreciated. We expect that increasing water temperatures will likely cause new PKD outbreaks in these more northerly regions in the future.
Genetic markers and population history: Finland revisited.
Palo, Jukka U; Ulmanen, Ismo; Lukka, Matti; Ellonen, Pekka; Sajantila, Antti
2009-10-01
The Finnish population in Northern Europe has been a target of extensive genetic studies during the last decades. The population is considered as a homogeneous isolate, well suited for gene mapping studies because of its reduced diversity and homogeneity. However, several studies have shown substantial differences between the eastern and western parts of the country, especially in the male-mediated Y chromosome. This divergence is evident in non-neutral genetic variation also and it is usually explained to stem from founder effects occurring in the settlement of eastern Finland as late as in the 16th century. Here, we have reassessed this population historical scenario using Y-chromosomal, mitochondrial and autosomal markers and geographical sampling covering entire Finland. The obtained results suggest substantial Scandinavian gene flow into south-western, but not into the eastern, Finland. Male-biased Scandinavian gene flow into the south-western parts of the country would plausibly explain the large inter-regional differences observed in the Y-chromosome, and the relative homogeneity in the mitochondrial and autosomal data. On the basis of these results, we suggest that the expression of 'Finnish Disease Heritage' illnesses, more common in the eastern/north-eastern Finland, stems from long-term drift, rather than from relatively recent founder effects.
Phenological observations since the Linnean time in Finland
NASA Astrophysics Data System (ADS)
Kubin, E.; Poikolainen, J.; Karhu, J.; Terhivuo, J.
2012-04-01
The Finnish National Phenological Network was established in 1996 by the Finnish Forest Research Institute in collaboration with other research institutes and universities. The Network investigates the timing of phenological phases of forest plants in relation to climate factors, develops real time information to the internet and studies digital techniques as tools for monitoring. Monitoring is done troughout the growth period, focusing on nine forest tree species and two dwarf shrubs. The results can be followed in real time at: http://www.metla.fi/metinfo/fenologia/index-en.htm. The results indicate that spring phenophases usually advanced with respect to climatic conditions, but there were also differences between the years. The research period started in 1995 is relatively short and the results indicates that long-term monitoring is needed in order to detect true trends in the impacts of climate on plant phenology. The Finnish National Phenological Network has therefore collaborated with the Finnish Museum of Natural History and analysed historical phenological data based on voluntary monitoring. The oldest phenological observation series based on voluntary observers started in Finland in 1752. The long-term data shows an advancement in the timing of bud burst by five days per 100 years in Prunus padus. The onset of flowering in the rowan (Sorbus aucuparia) has become correspondingly earlier in Finland at the rate of three days per century. In the conference the focus is on a historical long-term dataset as well as on the newer Finnish National Phenological Network established for monitoring annual phenological events taking place in the same individual plants. The latest results of the network will be updated with the earlier presented historical data. Phenological monitoring is nowadays more important than ever especially in boreal regions, where spring temperatures are elevated. Compilation and documentation of observations on plant phenophases play a key role in working out the rate of global dimate change. The timing of spring phenolgy will be discussed in the conference.
Unemployment and mortality among Finnish men, 1981-5.
Martikainen, P T
1990-01-01
OBJECTIVE--To ascertain whether, after controlling for several relevant background variables simultaneously, unemployment is related to mortality and to assess whether this relation is causal or whether unhealthy people are more likely to become unemployed. DESIGN--Prospective study of mortality in Finland during 1981-5 based on 1980 census data on 30-54 year old wage earner men and with particular attention to unemployment in the year before the census. SETTING--Research project at the University of Helsinki. SUBJECTS--All wage earner men in Finland aged 30-54 at the 1980 census. MAIN OUTCOME MEASURES--Causes of death during 1981-5 and duration of unemployment in the year before the census. Background variables controlled for were age, socioeconomic state, marital state, and health. The data were analysed by log linear regression models. RESULTS--During the study period 1981-5, which covered almost 2.7 million person years, there were 9810 deaths. After controlling for all background variables relative total mortality among unemployed versus employed men was 1.93 (95% confidence interval 1.82 to 2.05). The excess mortality was highest in accidental and violent causes of death (relative mortality 2.51; 95% confidence interval 2.28 to 2.76). For circulatory diseases the relative death rate was 1.54 (95% confidence interval 1.40 to 1.70), but among neoplasms only lung cancer was associated with excess mortality. Selection for unemployment based on age, socioeconomic state, and marital state was evident but no such selection was detected based on health. Effects of unemployment on mortality were more pronounced with increasing duration of unemployment. CONCLUSIONS--The relative excess mortality of unemployed men in Finland cannot fully be explained by demographic, social, and health variables preceding unemployment. Unemployment therefore seems to have an independent causal effect on male mortality. Further studies are needed to elucidate the mechanisms between unemployment and mortality. PMID:2282395
Understanding space science under the northern lights
NASA Astrophysics Data System (ADS)
Koskinen, H.
What is space science? The answers to this question can be very variable indeed. In fact, space research is a field where science, technology, and applications are so closely tied together that it is often difficult to recognize the central role of science. However, as paradoxical as it may sound, it appears that the less-educated public often appreciates the value of space science better than highly educated policy makers and bureaucrats who tend to evaluate the importance of space activities in terms of economic and societal benefits only. In a country like Finland located below the zone, where auroras are visible during the long dark winter nights, the space is perhaps closer to the public than in countries where the visible objects are the Moon, planets and stars somewhere far away. This positive fact has been very useful, for example, in popularization of such an abstract concept as space weather. In Finland it is possible to see space weather and this rises the curiosity about the processes behind this magnificent phenomenon. Of course, also in Finland the beautiful SOHO images of the Sun and the Hubble Space Telescope pictures of the remote universe attract the attention of the large public. We also have an excellent vehicle in increasing the public understanding in the society of Finnish amateur astronomers Ursa. It is an organization for anyone interested in practically everything from visual phenomena in the air to the remote galaxies and the Big Bang. Ursa publishes a high-quality monthly magazine in Finnish and runs local amateur clubs. Last year its 80th birthday exhibition was one of the best-visited public events in Helsinki. It clearly gave a strong evidence of wide public interest in space in general and in space science in particular. Only curious people can grasp the beauty and importance of the underlying science. Thus, we should focus our public space science education and outreach primarily on waking up the curiosity of the public instead of providing ready answers from above.
Paat-Ahi, Gerli; Aaviksoo, Ain; Świderek, Maria
2014-01-01
Background: As part of the EuroDRG project, researchers from eleven countries (i.e. Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their Diagnosis-Related Groups (DRG) systems deal with cholecystectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. Methods: National or regional databases were used to identify hospital cases with a procedure of cholecystectomy. DRG classification algorithms and indicators of resource consumption were compared for those DRGs that individually contained at least 1% of cases. Six standardised case vignettes were defined, and quasi prices according to national DRG-based hospital payment systems were ascertained and compared to an index case. Results: European DRG systems vary widely: they classify cholecystectomy patients according to different sets of variables into diverging numbers of DRGs (between two DRGs in Austria and Poland to nine DRGs in England). The most complex DRG is valued at four times more resource intensive than the index case in Ireland but only 1.3 times more resource intensive than the index case in Austria. Conclusion: Large variations in the classification of cholecystectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons, hospital managers and national DRG authorities should consider how other countries’ DRG systems classify cholecystectomy patients in order to optimize their DRG systems and to ensure fair and appropriate reimbursement. PMID:25489596
210Po and 210Pb in Forest Soil and in Wild Berries in Finland
NASA Astrophysics Data System (ADS)
Vaaramaa, Kaisa; Solatie, Dina; Aro, Lasse; Lehto, Jukka
2008-08-01
The behaviour of 210Po and 210Pb was investigated in forests in the Southern Finland site and in the Northern Finland site. Sampling sites were in Scots pine (Pinus sylvestris) forests. Maximum activities of 210Po and 210Pb in soil columns were found in organic layers. According to preliminary results of wild berry samples, the lowest 210Po concentrations were found in berries. The highest concentration of 210Po was found in stems of the blueberry (Vaccinium myrtillus) and the lingonberry (Vaccinium vitis-idaea) samples.
ERIC Educational Resources Information Center
Farley, Eugene S.; Piemme, Thomas E.
1975-01-01
Eugene Farley describes the University of Rochester and Highland Hospital Family Medicine Program for teaching of primary care internists, primary care pediatricians, and family doctors. Thomas Piemme presents the George Washington University School of Medicine alternative, a 2-year program in an ambulatory setting leading to broad eligibility in…
Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott
2016-10-01
The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals and creates financial incentives for quality improvement and fosters increased transparency. Limited information is available comparing hospital performance across health care business models. The 2015 Hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Of 3,089 hospitals with total performance scores, categories of representative health care business models included 104 physician-owned surgical hospitals, 111 University HealthSystem Consortium, 14 US News & World Report Honor Roll hospitals, 33 Kaiser Permanente, and 124 Pioneer accountable care organization affiliated hospitals. Estimated mean total performance scores for physician-owned surgical hospitals (64.4; 95% CI, 61.83-66.38) and Kaiser Permanente (60.79; 95% CI, 56.56-65.03) were significantly higher compared with all remaining hospitals, and University HealthSystem Consortium members (36.8; 95% CI, 34.51-39.17) performed below the mean (p < 0.0001). Significant differences in mean hospital case mix index included physician-owned surgical hospitals (mean 2.32; p < 0.0001), US News & World Report honorees (mean 2.24; p = 0.0140), and University HealthSystem Consortium members (mean 1.99; p < 0.0001), and Kaiser Permanente hospitals had lower case mix value (mean 1.54; p < 0.0001). Re-estimation of total performance scores did not change the original results after adjustment for differences in hospital case mix index. The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals can guide value improvement and policy-making decisions for all Medicare Value-Based Purchasing Program Hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
A simulation model of hospital management based on cost accounting analysis according to disease.
Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki
2004-12-01
Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.
They use humor, off-beat images. These ads keep the consumers' minds OUT of the hospital.
Botvin, Judith D
2003-01-01
Limited budgets make it more important for a healthcare campaign to stand out. NeathawkDubuque, Richmond, Va., showcases television commercials for Washington Hospital Center and Georgetown University Hospital, both in Washington, D.C.; and print ads for the University of Virginia Health System, Charlottesville, Va. Additionally, Coil Counts Ford and Cheney, Chicago, provide a distinctive campaign for Advocate Illinois Masonic Medical Center, Chicago.
Enhanced surveillance for tuberculosis among foreign-born persons, Finland, 2014-2016.
Räisänen, Pirre E; Soini, Hanna; Turtiainen, Pirjo; Vasankari, Tuula; Ruutu, Petri; Nuorti, J Pekka; Lyytikäinen, Outi
2018-05-09
Tuberculosis (TB) in foreign-born residents is increasing in many European countries including Finland. We conducted enhanced TB surveillance to collect supplementary information on TB cases among recent immigrants and their children to provide data for revising TB control policies in Finland to take into account the decrease in native cases and increase in foreign-born cases. TB cases were identified from the National Infectious Diseases Register. Data on foreign-born (if not available, most recent nationality other than Finnish) TB cases notified during 2014-2016 (country of birth, date of arrival to Finland, participation in TB screening, date of first symptoms, and details of possible contact tracing) were requested from physicians responsible for regional communicable disease control through a web-based questionnaire. Questionnaires were returned for 203 (65%) of 314 foreign-born TB cases; 36 (18%) were paediatric cases TB was detected in arrival screening in 42 (21%) and during contact tracing of another TB case in 18 (9%); 143 (70%) cases sought care for symptoms or were identified by chance (e.g. chest x-ray because of an accident). Of cases with data available, 48 (24%) cases were diagnosed within 3 months of arrival to Finland, 55 (27%) cases between 3 months and 2 years from arrival, and 84 (42%) cases after 2 years from arrival. Of all the foreign-born cases, 17% had been in a reception centre in Finland and 15% had been in a refugee camp abroad. In addition to asylum seekers and refugees, TB screening should be considered for immigrants arriving from high TB incidence countries, since the majority of TB cases were detected among persons who immigrated to Finland due to other reasons, presumably work or study. Further evaluation of the target group and timing of TB screening is warranted to update national screening guidance.
West, S.; Lashen, H.; Bloigu, A.; Franks, S.; Puukka, K.; Ruokonen, A.; Järvelin, M.-R.; Tapanainen, J.S.; Morin-Papunen, L.
2014-01-01
STUDY QUESTION Do teenage girls with a history of menstrual irregularity and/or elevated androgen levels in adolescence exhibit an increased risk of polycystic ovary syndrome (PCOS) and/or infertility later on in adulthood? SUMMARY ANSWER Our results suggest that menstrual irregularity and/or elevated androgen levels at 16 years are still associated with symptoms of PCOS at 26 years as well as infertility problems at 26 years but not with decreased pregnancy or delivery rates at 26 years. WHAT IS KNOWN ALREADY Hyperandrogenaemia is associated with menstrual irregularity, hirsutism, acne and potentially higher risk for PCOS, but there are few follow-up studies investigating whether adolescent hyperandrogenaemia and/or menstrual irregularity are an early sign of PCOS. STUDY DESIGN, SIZE, DURATION A prospective population-based cohort study was conducted using two postal questionnaires targeting girls in the Northern Finland Birth Cohort 1986 (NFBC1986, n = 4567). The NFBC1986 comprises all expected births from the year 1986 in the two northernmost provinces of Finland. Collection of the database was performed at the age of 16 and 26. The 16-year and 26-year questionnaires included one question about the regularity and length of the menstrual cycle. The 26-year questionnaire also included questions about symptoms of PCOS, reproduction and infertility problems. PARTICIPANTS, SETTING, METHODS The response rates for the questionnaires were 80% (n = 3669) at 16 years and 50% (n = 2270) at 26 years. At 15–16 years, of 2448 girls, 709 (29%) girls reported menstrual irregularity (symptomatic girls) and 1739 (71%) had regular periods (non-symptomatic girls). After combining data from the two questionnaires a total of 2033 girls were included in the analyses. The χ2 and Student's t-test was used to compare reproductive outcome and prevalence of clinical hyperandrogenaemia, PCOS and infertility at 26 years between the study groups. Univariate and multivariate logistic regression models were employed to estimate the association of menstrual irregularity at 16 years with clinical hyperandrogenaemia, PCOS and infertility at 26 years. MAIN RESULTS AND THE ROLE OF CHANCE At follow-up, the proportion of symptomatic girls who had conceived at least once (68.0 versus 67.9%) and had delivered at least one child (25.7 versus 28.1%) was similar to the non-symptomatic women and the groups had similar miscarriage rates (11.6 versus 12.1%). Logistic regression analyses indicated that menstrual irregularity at 16 years was associated with an increased risk of menstrual irregularity [adjusted odds ratio (OR) 1.37, 95% confidence interval (CI) 1.00–1.88, P = 0.050], PCOS (adjusted OR 2.91, 95% CI 1.74–4.84, P < 0.001) and infertility problems (adjusted OR 2.07, 95% CI 1.16–3.76, P = 0.013) at 26 years. At 26 years, women with PCOS (P = 0.013), hirsutism (P = 0.001) and acne (P < 0.001) exhibited significantly higher values of free androgen index (FAI) at 16 years than control women. There was a significant linear trend in the higher FAI quartiles at 16 years towards higher prevalence of PCOS (P = 0.005), hirsutism (P < 0.001) and acne (P < 0.001) at 26 years. Only 10.5% of the girls with menstrual irregularity at 16 years had PCOS at 26 years. LIMITATIONS, REASONS FOR CAUTION The diagnosis of menstrual irregularity was based on a self-reported questionnaire, thus introducing a risk of information bias in reporting the symptoms. Moreover, ovarian ultrasonography was not available to aid the diagnosis of PCOS and there was no clinical evaluation of hyperandrogenism. The relatively low rate of participation to the questionnaire at 26 years may also have biased the results. WIDER IMPLICATIONS OF THE FINDINGS Our findings confirm that menstrual irregularity and/or elevated androgen levels are already present in adolescence in women with PCOS and infertility in later life, which strengthens the importance of early identification of menstrual irregularity. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by grants from the Finnish Medical Society Duodecim, the North Ostrobothnia Regional Fund, the Academy of Finland, the Sigrid Juselius Foundation, University Hospital Oulu and University of Oulu, the European Commission and the Medical Research Council, UK, Welcome Trust (089549/Z/09/Z). None of the authors have any conflict of interest. PMID:25085801
None
2018-05-18
The DG C. Rubbia and the vice president of the council of CERN gives a warm welcome to the membership of Finland, as the 15th member of CERN since January 1 1991 in the presence of the Secretary-General and the ambassador.
Closedure - Mine Closure Technologies Resource
NASA Astrophysics Data System (ADS)
Kauppila, Päivi; Kauppila, Tommi; Pasanen, Antti; Backnäs, Soile; Liisa Räisänen, Marja; Turunen, Kaisa; Karlsson, Teemu; Solismaa, Lauri; Hentinen, Kimmo
2015-04-01
Closure of mining operations is an essential part of the development of eco-efficient mining and the Green Mining concept in Finland to reduce the environmental footprint of mining. Closedure is a 2-year joint research project between Geological Survey of Finland and Technical Research Centre of Finland that aims at developing accessible tools and resources for planning, executing and monitoring mine closure. The main outcome of the Closedure project is an updatable wiki technology-based internet platform (http://mineclosure.gtk.fi) in which comprehensive guidance on the mine closure is provided and main methods and technologies related to mine closure are evaluated. Closedure also provides new data on the key issues of mine closure, such as performance of passive water treatment in Finland, applicability of test methods for evaluating cover structures for mining wastes, prediction of water effluents from mine wastes, and isotopic and geophysical methods to recognize contaminant transport paths in crystalline bedrock.
Kawano, Seiji
2014-12-01
As the 2nd Joint Symposium of the Japanese Society of Laboratory Medicine and the Japanese Association of Laboratory Pathologists, the symposium on clinical test out-sourcing and branch laboratories was held at the 60th General Meeting of the Japanese Society of Laboratory Medicine on November 2nd, 2013 in Kobe. For the symposium, we conducted a questionnaire survey on the usage of clinical test out-sourcing and the introduction of branch laboratories to clinical laboratories of Japanese university hospitals, both private and public, between July 25th and August 20th, 2013. Seventy-two hospitals responded to the questionnaire survey, consisting of 41 public medical school hospitals and 31 private ones. According to the survey, the selection of each clinical test for out-sourcing was mainly determined by the capacities of hospital clinical laboratories and their equipment, as well as the profitability of each test. The main concerns of clinical laboratory members of university hospitals involved the continuity of measurement principles, traceability, and standardization of reference values for each test. They strongly requested the interchangeability and computerization of test data between laboratory testing companies. A branch laboratory was introduced to six hospitals, all of which were private medical college hospitals, out of 72 university hospitals, and eight of the other hospitals were open to its introduction. The merits and demerits of introducing a branch laboratory were also discussed. (Review).
Analysis of Time-of-Day Energy Demand and Supply in University and Hospital
NASA Astrophysics Data System (ADS)
Shimazaki, Yoichi
The aim of this study was to estimate the time-of-day energy demand in University of Yamanashi. Our University consisted of Kofu campus (Faculty of Education & Human Sciences and Faculty of Engineering) and Faculty of Medicine campus (Faculty of Medicine and University Hospital). The energy data of 4 facilities were classified into hot water, heating, cooling and electric power demands based on electric power consumptions, city gas and heavy oil from 1996 to 2005. For 10 years, primary energy increased 1.2 times in the whole of the university. The amount of electric power consumption was 63% in the fuel classification. The amount of electric power consumption of faculty reacted to the change in temperature greatly. In 2005, it was found that thermoelectric-ratios for 4 facilities, i.e. Education, Engineering, Medicine and Hospital were 2.3, 1.5, 2.0 and 2.7 respectively. These data are very useful for the energy saving and energy management of university.