Browsing by Subject "AWARENESS"

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  • Sever, Mehmet Sukru; Jager, Kitty J.; Vanholder, Raymond; Stengel, Benedicte; Harambat, Jerome; Finne, Patrik; Tesar, Vladimir; Barbullushi, Myftar; Bumblyte, Inga A.; Zakharova, Elena; Spasovski, Goce; Resic, Halima; Wiecek, Andrzej; Blankestijn, Peter J.; Bruchfeld, Annette; Cozzolino, Mario; Goumenos, Dimitris; Soler, Maria Jose; Rychlik, Ivan; Stevens, Kate; Wanner, Christoph; Zoccali, Carmine; Massy, Ziad A. (2021)
    Chronic kidney disease (CKD) is a major health problem because of its high prevalence, associated complications and high treatment costs. Several aspects of CKD differ significantly in the Eastern European nephrology community compared with Western Europe because of different geographic, socio-economic, infrastructure, cultural and educational features. The two most frequent aetiologies of CKD, DM and hypertension, and many other predisposing factors, are more frequent in the Eastern region, resulting in more prevalent CKD Stages 3-5. Interventions may minimize the potential drawbacks of the high prevalence of CKD in Eastern Europe, which include several options at various stages of the disease, such as raising public, medical personnel and healthcare authorities awareness; early detection by screening high-risk populations; preventing progression and CKD-related complications by training health professionals and patients; promoting transplantation or home dialysis as the preferred modality; disseminating and implementing guidelines and guided therapy and encouraging/supporting country-specific observational research as well as international collaborative projects. Specific ways to significantly impact CKD-related problems in every region of Europe through education, science and networking are collaboration with non-nephrology European societies who have a common interest in CKD and its associated complications, representation through an advisory role within nephrology via national nephrology societies, contributing to the training of local nephrologists and stimulating patient-oriented research. The latter is mandatory to identify country-specific kidney disease-related priorities. Active involvement of patients in this research via collaboration with the European Kidney Patient Federation or national patient federations is imperative to ensure that projects reflect specific patient needs.
  • Gholami, Mahdia; Pakdaman, Afsaneh; Montazeri, Ali; Jafari, Ahmad; Virtanen, Jorma I. (2014)
  • Smith, Drew H.; Grewal, Jaskaran; Mehboob, Saba; Mohan, Shiva; Pombo, Luisa F.; Rodriguez, Pura; Gonzalez, Juan Carlos; Zevallos, Juan; Barengo, Noel C. (2022)
    Background Studies in the United States have shown a genetic predisposition to hypertension in individuals of African descent. However, studies on the associations between ethnic groups and hypertension in Latin America are lacking and the limited results have been inconsistent. The objective of this study is to determine whether Afro-Colombian ethnicity increases the risk of hypertension. Methods This study is a secondary data analysis of a cross sectional study from five provinces in Northern Colombia. Randomly selected individuals (N = 2613; age-range 18-74 years) enrolled in a health care insurance company underwent physical examinations and completed questionnaires regarding ethnicity, lifestyle, and other risk factors. Hypertension in these patients was determined. Unadjusted and adjusted logistic regression analysis were calculated to determine the association between ethnicity and hypertension. Results No association between Afro-Colombian ethnicity and hypertension was found (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.66-1.09). As expected, people with a body mass index (BMI) of 30 or higher were at a greater risk of having hypertension (OR, 3.12; 95% CI, 2.35-4.16) compared with those with a normal BMI. Conclusions Findings from this study suggest no independent association between Afro-Colombian ethnicity and hypertension. Further research should focus on genotyping or socioeconomic factors such as income level.
  • Mattila, Tiina; Hasala, Hannele; Kreivi, Hanna-Riikka; Avellan-Hietanen, Heidi; Bachour, Adel; Herse, Fredrik; Leskelä, Riikka-Leena; Toppila-Salmi, Sanna; Erhola, Marina; Haahtela, Tari; Vasankari, Tuula (2022)
    Background In the current century, sleep apnoea has become a significant public health problem due to the obesity epidemic. To increase awareness, improve diagnostics, and improve treatment, Finland implemented a national sleep apnoea programme from 2002 to 2010. Here, we present changes in the societal burden caused by sleep apnoea from 1996 to 2018. Methods National register data were collected from the Care Register for Health Care, Statistics Finland, the Social Insurance Institution of Finland, and the Finnish Centre for Pensions. Disease prevalence, use of healthcare and social services, and societal costs were estimated. Findings The number of sleep apnoea patients increased in secondary care from 8 600 in 1996 to 61 000 in 2018. There was a continuous increase in outpatient visits in secondary care from 9 700 in 1996 to 122 000 in 2018 (1 160%) and in primary care from 10 000 in 2015 to 29 000 in 2018 (190%). Accordingly, the cumulative annual number of days off work for sleep apnoea increased from 1 100 to 46 000. However, disability pensions for sleep apnoea decreased from 820 to 550 (33%) during the observation period. Societal costs per patient decreased over 50% during the observation period ((sic) 2 800 to (sic)1 200). Interpretation The number of sleep apnoea patients in Finland increased remarkably during the observation period. To control this burden, diagnostic methods and treatment were revised and follow up was reorganised. Consequently, there was a significant decrease in societal costs per patient. The decrease in disability pensions suggests earlier diagnosis and improved treatment. The national sleep apnoea programme was one of the initiators for these improved outcomes. Funding The Finnish Institute for Health and Welfare and the Hospital District of Helsinki and Uusimaa (HUH), Helsinki, Finland. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (
  • Tammeleht, Anu; Rodriguez-Triana, Maria Jesus; Koort, Kairi; Lofstrom, Erika (2019)
    The increasing concern about ethics and integrity in research communities has brought attention to how students and junior academics can be trained on this regard. Moreover, it is known that ethical behaviour and integrity not only involve individual but also group norms and considerations. Thus, through action research and participant observation, this research investigates the learning processes through which 64 students collaboratively develop research ethics and integrity competencies. The aim was to understand how bachelor, master and PhD students approach ethical dilemma cases through a collaborative process. The data consisted of recorded group work on ethics cases, student group reports, and post-training questionnaires. Later, the analyses considered groups as the unit of analysis. These data were analysed through content analysis utilizing the SOLO taxonomy to identify levels of understanding and assess evolvement of ethical sensitivity during a casebased training session. The results show that all groups reached the level of understanding where the groups demonstrated that concepts had been understood appropriately, but occasionally struggled to make connections between them. Students perceived working collaboratively as beneficial. The results help teachers of research ethics and integrity to make pedagogically justified choices in their teaching. Drawing on the results of this study, we propose a tool for the formative assessment of student learning of research ethics and integrity.
  • Villarreal, Sanna; Linnavuo, Matti; Sepponen, Raimo; Vuori, Outi; Bonato, Mario; Jokinen, Hanna; Hietanen, Marja (2022)
    Objective: Traditionally, asymmetric spatial processing (i.e., hemispatial neglect) has been assessed with paper-and-pencil tasks, but growing evidence indicates that computer-based methods are a more sensitive assessment modality. It is not known, however, whether simply converting well-established paper-and-pencil methods into a digital format is the best option. The aim of the present study was to compare sensitivity in detecting contralesional omissions of two different computer-based methods: a “digitally converted” cancellation task was compared with a computer-based Visual and Auditory dual-tasking approach, which has already proved to be very sensitive. Methods: Participants included 40 patients with chronic unilateral stroke in either the right hemisphere (RH patients, N = 20) or the left hemisphere (LH patients, N = 20) and 20 age-matched healthy controls. The cancellation task was implemented on a very large format (173 cm × 277 cm) or in a smaller (A4) paper-and-pencil version. The computer-based dual-tasks were implemented on a 15′′ monitor and required the detection of unilateral and bilateral briefly presented lateralized targets. Results: Neither version of the cancellation task was able to show spatial bias in RH patients. In contrast, in the Visual dual-task RH patients missed significantly more left-sided targets than controls in both unilateral and bilateral trials. They also missed significantly more left-sided than right-sided targets only in the bilateral trials of the Auditory dual-task. Conclusion: The dual-task setting outperforms the cancellation task approach even when the latter is implemented on a (large) screen. Attentionally demanding methods are useful for revealing mild forms of contralesional visuospatial deficits.
  • Haller-Kikkatalo, Kadri; Alnek, Kristi; Metspalu, Andres; Mihailov, Evelin; Metskula, Kaja; Kisand, Kalle; Pisarev, Heti; Salumets, Andres; Uibo, Raivo (2017)
    The presence of autoantibodies usually precedes autoimmune disease, but is sometimes considered an incidental finding with no clinical relevance. The prevalence of immune-mediated diseases was studied in a group of individuals from the Estonian Genome Project (n = 51,862), and 6 clinically significant autoantibodies were detected in a subgroup of 994 (auto) immune-mediated disease-free individuals. The overall prevalence of individuals with immune-mediated diseases in the primary cohort was 30.1%. Similarly, 23.6% of the participants in the disease-free subgroup were seropositive for at least one autoantibody. Several phenotypic parameters were associated with autoantibodies. The results suggest that (i) immune-mediated diseases are diagnosed in nearly one-third of a random European population, (ii) 6 common autoantibodies are detectable in almost one-third of individuals without diagnosed autoimmune diseases, (iii) tissue non-specific autoantibodies, especially at high levels, may reflect preclinical disease in symptom-free individuals, and (iv) the incidental positivity of anti-TPO in men with positive familial anamnesis of maternal autoimmune disease deserves further medical attention. These results encourage physicians to evaluate autoantibodies in addition to treating a variety of patient health complaints to detect autoimmune-mediated disease early.
  • Löfström, Erika; Pyhältö, Kirsi (2017)
    This study explored the perceptions of ethical issues in supervision among doctoral students and supervisors. The nature of ethical issues identified by doctoral students (n = 28) and their supervisors (n = 14) is explored and the degree of fit and misfit between their perceptions in two cases representing the natural and behavioural sciences is analysed. Supervisors and students identified different ethical issues, which suggest that there are aspects in the supervisory relationship about which there is no shared understanding. There were also differences between the ethical issues emphasised in the natural sciences from those emphasised in the behavioural sciences, suggesting differences between the domains.
  • Virtanen, Niia; Tiippana, Kaisa; Tervaniemi, Mari; Poikonen, Hanna; Anttila, Eeva; Kaseva, Kaisa (2022)
    Body consciousness is associated with kinetic skills and various aspects of wellbeing. Physical activities have been shown to contribute to the development of body consciousness. Methodological studies are needed in improving the assessment of body consciousness in adults with distinct physical activity backgrounds. This study (1) examined whether dancers, athletes, and lightly physically active individuals differed regarding the level of their body consciousness, and (2) evaluated the usability of different methods in assessing body consciousness. Fifty-seven healthy adults (aged 20-37) were included in the study. Three experimental methods (aperture task, endpoint matching, and posture copying) and two self-report questionnaires (the Private Body Consciousness Scale, PBCS, and the Body Awareness Questionnaire, BAQ) were used in assessing body consciousness. Athletes outperformed the lightly physically active participants in the posture copying task with the aid of vision when copying leg postures. Dancers performed better than the athletes without the aid of vision when their back and upper body were involved, and better than the lightly active participants when copying leg postures. Dancers and athletes had higher self-reported cognitive and perceptual knowledge of their body than lightly physically active participants. To examine the role of different physical activities in developing body consciousness, experimental methods involving the use of the whole body might be most suitable. Subjective measures may provide complementary evidence for experimental testing.
  • Kristensen, Peter L.; Pedersen-Bjergaard, Ulrik; Due-Andersen, Rikke; Hoi-Hansen, Thomas; Grimmeshave, Lise; Lyssenko, Valeriya; Groop, Leif; Holst, Jens J.; Vaag, Allan A.; Thorsteinsson, Birger (2016)
    Introduction: In healthy carriers of the T allele of the transcription factor 7-like 2 (TCF7L2), fasting plasma glucagon concentrations are lower compared with those with the C allele. We hypothesised that presence of the T allele is associated with a diminished glucagon response during hypoglycaemia and a higher frequency of severe hypoglycaemia (SH) in type 1 diabetes (T1DM). Material and methods: This is a post hoc study of an earlier prospective observational study of SH and four mechanistic studies of physiological responses to hypoglycaemia. 269 patients with T1DM were followed in a one-year observational study. A log-linear negative binomial model was applied with events of SH as dependent variable and TCF7L2 alleles as explanatory variable. In four experimental studies including 65 people, TCF7L2 genotyping was done and plasma glucagon concentration during experimental hypoglycaemia was determined. Results: Incidences of SH were TT 0.54, TC 0.98 and CC 1.01 episodes per patient-year with no significant difference between groups. During experimental hypoglycaemia, the TCF7L2 polymorphism did not influence glucagon secretion. Discussion: Patients with T1DM carrying the T allele of the TCF7L2 polymorphism do not exhibit diminished glucagon response during hypoglycaemia and are not at increased risk of severe hypoglycaemia compared with carriers of the C allele.
  • Pehrsson, Minja; Heikkinen, Hanna; Wartiovaara-Kautto, Ulla; Mäntylahti, Sampo; Bäckström, Pia; Lassenius, Mariann I.; Uusi-Rauva, Kristiina; Carpen, Olli; Elomaa, Kaisa (2022)
    Background: Autosomal recessive Gaucher disease (GD) is likely underdiagnosed in many countries. Because the number of diagnosed GD patients in Finland is relatively low, and the true prevalence is currently not known, it was hypothesized that undiagnosed GD patients may exist in Finland. Our previous study demonstrated the applicability of Gaucher Earlier Diagnosis Consensus point-scoring system (GED-C PSS; Mehta et al., 2019) and Finnish biobank data and specimens in the automated point scoring of large populations. An indicative point -score range for Finnish GD patients was determined, but undiagnosed patients were not identified partly due to high number of high-score subjects in combination with a lack of suitable samples for diagnostics in the assessed biobank population. The current study extended the screening to another biobank and evaluated the feasibility of utilising the automated GED-C PSS in conjunction with small nucleotide polymorphism (SNP) chip genotype data from the FinnGen study of biobank sample donors in the identification of undiagnosed GD patients in Finland. Furthermore, the applicability of FFPE tissues and DNA restoration in the next-generation sequencing (NGS) of the GBA gene were tested. Methods: Previously diagnosed Finnish GD patients eligible to the study, and up to 45,100 sample donors in Helsinki Biobank (HBB) were point scored. The GED-C point scoring, adjusted to local data, was automated, but also partly manually verified for GD patients. The SNP chip genotype data for rare GBA variants was visually assessed. FFPE tissues of GD patients were obtained from HBB and Biobank Borealis of Northern Finland (BB). Results: Three previously diagnosed GD patients and one patient previously treated for GD-related features were included. A genetic diagnosis was confirmed for the patient treated for GD-related features. The GED-C point score of the GD patients was 12.5-22.5 in the current study. The score in eight Finnish GD patients of the previous and the current study is thus 6-22.5 points per patient. In the automated point scoring of the HBB
  • Perander, Katarina; Londen, Monica; Holm, Gunilla (2021)
    Purpose - The purpose of this study was to investigate how a workshop can enhance first-year university students' understanding of their study strategies and self-regulated learning. Design/methodology/approach - Aqualitative content analysis was done of 190 reflective journals written by first-year university students. Findings - The main findings confirmed that starting studies in higher education is challenging for many students. New insights were provided on how these challenges can be addressed, especially regarding selfregulated learning. Students perceived that they gained several insights from the workshop that they believed could benefit their studying and thereby enhance motivation. Practical implications - This study showed that even small measures promote both good study habits and specifically self-regulated learning skills. Interventions like the workshop described in this study ease first-year students' transition to the university and foster successful studies for all students. Originality/value - This study contributes to research on supporting students' transition to higher education by investigating how students perceive early study skill interventions. It adds to a holistic perspective of students' challenges and coping strategies during their first semester in higher education.
  • Hungarian Pancreatic Study Grp; Földi, Maria; Gede, Noemi; Kiss, Szabolcs; Sallinen, Ville; Szentesi, Andrea (2022)
    Introduction Pain is the most common symptom in acute pancreatitis (AP) and is among the diagnostic criteria. Therefore, we aimed to characterize acute abdominal pain in AP. Methods The Hungarian Pancreatic Study Group prospectively collected multicentre clinical data on 1435 adult AP patients between 2012 and 2017. Pain was characterized by its intensity (mild or intense), duration prior to admission (hours), localization (nine regions of the abdomen) and type (sharp, dull or cramping). Results 97.3% of patients (n = 1394) had pain on admission. Of the initial population with acute abdominal pain, 727 patients answered questions about pain intensity, 1148 about pain type, 1134 about pain localization and 1202 about pain duration. Pain was mostly intense (70%, n = 511/727), characterized by cramping (61%, n = 705/1148), mostly starting less than 24 h prior to admission (56.7%, n = 682/1202). Interestingly, 50.9% of the patients (n = 577/1134) had atypical pain, which means pain other than epigastric or belt-like upper abdominal pain. We observed a higher proportion of peripancreatic fluid collection (19.5% vs. 11.0%; p = 0.009) and oedematous pancreas (8.4% vs. 3.1%; p = 0.016) with intense pain. Sharp pain was associated with AP severity (OR = 2.481 95% CI: 1.550-3.969) and increased mortality (OR = 2.263, 95% CI: 1.199-4.059) compared to other types. Longstanding pain (>72 h) on admission was not associated with outcomes. Pain characteristics showed little association with the patient's baseline characteristics. Conclusion A comprehensive patient interview should include questions about pain characteristics, including pain type. Patients with sharp and intense pain might need special monitoring and tailored pain management. Significance Acute abdominal pain is the leading presenting symptom in acute pancreatitis; however, we currently lack specific guidelines for pain assessment and management. In our cohort analysis, intense and sharp pain on admission was associated with higher odds for severe AP and several systemic and local complications. Therefore, a comprehensive patient interview should include questions about pain characteristics and patients with intense and sharp pain might need closer monitoring.
  • Lundberg, Piia Kristiina; Vainio, Satu Annukka; MacMillan, Douglas Craig; Smith, Bob; Verissimo, Diogo; Arponen, Anni Katri Ilona (2019)
    Environmental non-governmental organizations (ENGOs) largely select flagship species for conservation marketing based on their aesthetic appeal. However, little is known about the fundraising effectiveness of this approach or how it compares to ecosystem conservation campaigns that use habitat types as flagships. By performing a willingness to donate (WTD) survey of potential online donors from Finland, we identified which motivations and donor characteristics influence their preferences for a range of different flagship species and ecosystems. Using the contingent valuation method and the payment card approach, we found the combined funding for eight mammal flagship species was 29% higher funding than for eight bird flagship species. Furthermore, the aesthetically more appealing species, as well as the species and ecosystems that are native to Finland, attracted the most funding. We then used ordinal logistic regression to identify the factors influencing a donor's WTD, finding that knowledge of biodiversity conservation and familiarity with the flagship was associated with an increased WTD to birds and ecosystems, and people with higher education levels had an increased WTD to ecosystems. Surprisingly, species aesthetic appeal was not related to an increased WTD, although "need of conservation" was, suggesting that highlighting the plight of these less appealing threatened species or ecosystems could raise money. Our results suggest that the factors driving donating to mammals, birds or ecosystems differ, and so underline the importance of considering the diverse motivations behind donation behaviour in fundraising campaigns. They also provide new evidence of the motivations of online donors, an under-studied group who are likely to become an increasingly important source of conservation funding.
  • Loorits, Kristjan (2018)
    Despite the remarkable progress made in consciousness research during recent decades, there is still no sign of a general agreement about the location of its object. According to internalists, consciousness resides inside the brain. According to externalists, consciousness is partly constituted by elements or aspects of the environment. Internalism comports better with the existence of dreams, hallucinations and sensory imaging. Externalism seems to provide a more promising basis for understanding how we can experience the world and refer to the content of our consciousness. I argue that the framework of structural realism supports internalism and helps to reveal the reasons behind the apparent explanatory success of the externalist approach. More specifically, structural realism supports the view that the structure of our consciousness is always present in our neural processes and only sometimes (additionally) in an extended system that includes elements of the environment.
  • Sandberg, Andreas; Salminen, Veera; Heinonen, Susanna; Siven, Mia (2022)
    Background: Adverse drug reaction (ADR) reporting has been studied relatively extensively in all the Nordic countries besides Finland, but no definitive solution to decrease under-reporting has been found. Despite many similarities in reporting, the most notable difference compared to other Nordic countries is that ADR reporting is completely voluntary in Finland. Purpose: The purpose was to examine if voluntary reporting influences healthcare professional (HCP) ADR reporting, why HCPs do not report all suspected ADRs, how could reporting be enhanced, and do we need to develop the process for collecting ADR follow-up (F/U) information from HCPs. Methods: An open and anonymous questionnaire was developed and made available online at the e-form portal of the University of Helsinki. Trade and area unions distributed the questionnaire to their respective member physicians, nurses, and pharmacists. Two independent coders performed the content analysis of answers to open-ended questions. Results: A total of 149 responses was received. Two fifths (38%) of the HCPs confirmed that they had not always reported suspected ADRs. The main reason for not reporting was that the ADR was already known. HCPs who had no previous ADR reporting experience did not report ADRs mainly because it was not clear how to report them. Seriousness (chosen by 76%) and unexpectedness of the reaction (chosen by 64%) were the most actuating factors in reporting an ADR. Only 52% of the HCPs had received ADR reporting training and only 16% of the HCPs felt that they had enough information about reporting. Most HCPs felt that ADR F/U requests are justified, and these requests did not affect their ADR reporting willingness. Conclusions: As in other Nordic countries, ADR under-reporting occurs also in Finland despite differences in reporting guidance. ADR reporting rate could be enhanced by organizing recurring training, information campaigns, and including reporting reminders to the patient information systems that HCPs use. Training should primarily aid in recognizing ADRs, educate in how to report, and promote a reporting culture among HCPs.
  • Villarreal, Sanna; Linnavuo, Matti; Sepponen, Raimo; Vuori, Outi; Bonato, Mario; Jokinen, Hanna; Hietanen, Marja (2021)
    Objective: Patients with unilateral stroke commonly show hemispatial neglect or milder contralesional visuoattentive deficits, but spatially non-lateralized visuoattentive deficits have also been reported. The aim of the present study was to compare spatially lateralized (i.e., contralesional) and non-lateralized (i.e., general) visuoattentive deficits in left and right hemisphere stroke patients. Method: Participants included 40 patients with chronic unilateral stroke in either the left hemisphere (LH group, n = 20) or the right hemisphere (RH group, n = 20) and 20 healthy controls. To assess the contralesional deficits, we used a traditional paper-and-pencil cancellation task (the Bells Test) and a Lateralized Targets Computer Task. To assess the non-lateralized deficits, we developed a novel large-screen (173 x 277 cm) computer method, the Ball Rain task, with moving visual stimuli and fast-paced requirements for selective attention. Results: There were no contralesional visuoattentive deficits according to the cancellation task. However, in the Lateralized Targets Computer Task, RH patients missed significantly more left-sided than right-sided targets in bilateral trials. This omission distribution differed significantly from those of the controls and LH patients. In the assessment of non-lateralized attention, RH and LH patients missed significantly more Ball Rain targets than controls in both the left and right hemifields. Conclusions: Computer-based assessment sensitively reveals various aspects of visuoattentive deficits in unilateral stroke. Patients with either right or left hemisphere stroke demonstrate non-lateralized visual inattention. In right hemisphere stroke, these symptoms can be accompanied by subtle contralesional visuoattentive deficits that have remained unnoticed in cancellation task.