Browsing by Subject "CENTERS"

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  • Nikander, Kirsi; Kosola, Silja; Vahlberg, Tero; Kaila, Minna; Hermanson, Elina (2022)
    Background The benefits of school doctor interventions conducted at routine general health checks remain insufficiently studied. This study explored the associations of school doctor interventions with the doctor-evaluated and parent-evaluated benefits of routine health checks. Methods Between August 2017 and August 2018, we recruited a random sample of 1341 children from grades 1 and 5 from 21 Finnish elementary schools in 4 municipalities. Doctors routinely examined all children, who were accompanied by parents. The doctor-reported interventions were categorised into six groups: instructions and/or significant discussions, prescriptions, laboratory tests and/or medical imaging, scheduling of follow-up appointments, referrals to other professionals and referrals to specialised care. Doctors evaluated the benefit of the appointment using predetermined criteria, and parents provided their subjective perceptions of benefit. Interventions and reported benefit were compared using multilevel logistic regression. Results Doctors reported 52% and parents 87% of the appointments with interventions beneficial. All interventions were independently associated with doctor-evaluated benefit (ORs: 1.91-17.26). Receiving any intervention during the appointment was associated with parent-evaluated benefit (OR: 3.25, 95% CI 2.22 to 4.75). In analyses of different interventions, instructions and/or significant discussions (OR: 1.71, 95% CI 1.20 to 2.44), prescriptions (OR: 7.44, 95% CI 2.32 to 23.91) and laboratory tests and/or medical imaging (OR: 3.38, 95% CI 1.34 to 8.55) were associated with parent-evaluated benefit. Scheduled follow-up appointments and referrals to other professionals showed no significant association with parent-evaluated benefit. Conclusions Doctors and parents valued the appointments with interventions. Parents especially appreciated immediate help and testing from the doctor.
  • Weckström, Elina; Karlsson, Liisa; Pöllänen, Sinikka; Lastikka, Anna-Leena (2021)
    This study reports on critical participatory research in an early childhood education and care centre in Finland. The objective was to study which elements are critical in the development and construction of a culture of participation. The data comprise conversations, team meetings and educators' diaries. Data were analysed using thematic analysis. The results indicated that a culture of participation requires four elements: (a) a shared understanding of the image of the child, (b) a shared understanding of professional development, (c) leadership and (d) a shared we-narrative that enables the comprehensive understanding, promotion and maintenance of a culture of participation.
  • Wahlin, Rebecka Rubenson; Ponzer, Sari; Skrifvars, Markus B.; Lossius, Hans Morten; Castren, Maaret (2016)
    Background: Trauma systems and regionalized trauma care have been shown to improve outcome in severely injured trauma patients. The aim of this study was to evaluate the implementation of a prehospital trauma care protocol and transport directive, and to determine its effects on the number of primary admissions and secondary trauma transfers in a large Scandinavian city. Methods: We performed a retrospective observational study based on local trauma registries and hospital and ambulance records in Stockholm County; patients > 15 years of age with an Injury Severity Score (ISS) > 15 transported to any emergency care hospitals in the Stockholm area were included for the years 2006 and 2008. We also included secondary transferred patients to the regional trauma center during 2006, 2008, and 2013. Results: A total of 693 primarily admitted trauma patients were included for the years 2006 and 2008. For the years 2006, 2008 and 2013, we included 114 secondarily transported trauma patients. The number of primary patient transports to the trauma center increased during the years by 20.2 %, (p <0.001); patients primarily transported to the trauma center had a significantly higher Injury Severity Score in 2008 than in 2006, and the number of patients transported secondarily to the trauma center in 2006 was higher compared to 2008 and to 2013 (p <0.001, all 3 years). Discussion: Our data indicate that implementation of a prehospital trauma care protocol may have an effect on transportation of severely injured trauma patients. A decrease in secondarily transported trauma patients to the regional trauma center was noted after 1 year and persisted at 7 years after the organizational change. Patients primarily admitted to the trauma center after the change had more severe injuries than patients transported to other emergency hospitals in the area even if 20 % of patients were not admitted primarily to a trauma center. This does not imply that the transport directives or the criteria were not followed but rather reveals the difficulties and uncertainties of field triage. Conclusions: With the introduction of a prehospital trauma transport directive in a large urban city, an increase in patients transported to the regional trauma center and a decrease in secondary transfers were detected, but a considerable number of severely injured patients were still transported to local hospitals.
  • Karjalainen, A.; Weiser, P. M.; Makkonen, I.; Reinertsen, V. M.; Vines, L.; Tuomisto, F. (2021)
    Positron annihilation spectroscopy, Fourier transform-infrared absorption spectroscopy, and secondary ion mass spectrometry have been used to study the behavior of gallium vacancy-related defects and hydrogen in deuterium (D) implanted and subsequently annealed beta-Ga2O3 single crystals. The data suggest the implantation generates a plethora of V-Ga-related species, including V-Ga1- and V-Ga2-type defects. The latter's contribution to the positron signal was enhanced after an anneal at 300 degrees C, which is driven by the passivation of Vib Ga by hydrogen as seen from infrared measurements. Subsequent annealing near 600 degrees C returns the positron signal to levels similar to those in the as-received samples, which suggests that split V-Ga-like defects are still present in the sample. The almost complete removal of the V(Ga)(ib-)2D vibrational line, the appearance of new weak O-D lines in the same spectral region, and the lack of D outdiffusion from the samples suggest that the 600 degrees C anneal promotes the formation of either D-containing, IR-inactive complexes or defect complexes between V-Ga(ib)-2D and other implantation-induced defects. The degree of electrical compensation is found to be governed by the interactions between the Ga vacancies and hydrogen.Published under an exclusive license by AIP Publishing.
  • Salmi, Hannu; Thuneberg, Helena; Vainikainen, Mari-Pauliina (2017)
    The aim of the study was to analyse learning using Augmented Reality (AR) technology and the motivational and cognitive aspects related to it in an informal learning context. The 146 participants were 11- to 13-year-old Finnish pupils visiting a science centre exhibition. The data, which consisted of both cognitive tasks and self-report questionnaires, were collected using a pre- post-test design and were analysed by SEM path-analysis. The results showed that AR-technology experience was beneficial for all, but especially for the lowest-achieving group and for the girls. In general, pre-knowledge skills predicted post-knowledge test results. As expected, school achievement had an effect on pre-knowledge results. In addition, motivation turned out to be an alternative key route for learning. Being a boy predicted directly or indirectly all other motivational variables, enjoyment and interest, but girls had a higher relative autonomy experience (RAI). Situation motivation and attitude towards learning in the science exhibition were much more strongly inter-connected among boys than girls, and attitude predicted post-knowledge only for boys. AR seems to be a promising method by which to learn abstract phenomena using a concrete manner.
  • Lehto, Reetta; Lehto, Elviira; Konttinen, Hanna; Vepsalainen, Henna; Nislin, Mari; Nissinen, Kaija; Vepsalainen, Ciara; Koivusilta, Leena; Erkkola, Maijaliisa; Roos, Eva; Ray, Carola (2019)
    Aims: Certain feeding practices, such as role modeling healthy eating and encouragement are recommended to be used in preschools. Little is known about whether preschool characteristics are associated with the use of these feeding practices. Our aim was to examine whether the socioeconomic status (SES) of the preschool neighborhood is associated with the feeding practices in preschools. Methods: This study was part of the cross-sectional DAGIS study. We studied 66 municipal preschools and 378 early childhood educators (ECEs). Preschool neighborhood SES was assessed with map grid data. Feeding practices were assessed by questionnaires and lunchtime observation. Associations between preschool neighborhood SES and feeding practices were tested with logistic regression analyses adjusted for ECEs' educational level and municipal policies on ECEs' lunch prices, and on birthday foods. Results: The crude model showed that in high-SES neighborhood preschools ECEs were more likely to eat the same lunch as the children (OR 2.46, 95% CI 1.42-4.24) and to reward children with other food for eating vegetables (OR 2.48, 95% CI 1.40-4.41). Furthermore, in high-SES preschools it was less likely that birthday foods outside of the normal menu were available on birthdays (OR 0.29, 95% CI 0.12-0.71). In the adjusted model, rewarding with other food remained associated with preschool neighborhood SES (OR 2.13, 95% CI 1.12-4.07). Conclusions: After adjustments, preschool neighborhood SES was mostly unassociated with the feeding practices in preschools. Municipal policies may have a significant impact on feeding practices and ultimately on young children's food intake in Finland where most children attend municipal preschools.
  • Mäkitie, Antti A.; Keski-Säntti, Harri; Markkanen-Leppänen, Mari; Bäck, Leif; Koivunen, Petri; Ekberg, Tomas; Sandström, Karl; Laurell, Göran; von Beckerath, Mathias; Nilsson, Johan S.; Wahlberg, Peter; Greiff, Lennart; Spaak, Lena Norberg; Kjaergaard, Thomas; Godballe, Christian; Rikardsen, Oddveig; Channir, Hani Ibrahim; Rubek, Niclas; von Buchwald, Christian (2018)
    Background: The five Nordic countries with a population of 27 M people form a rather homogenous region in terms of health care. The management of head and neck cancer is centralized to the 21 university hospitals in these countries. Our aim was to gain an overview of the volume and role of transoral robotic surgery (TORS) and to evaluate the need to centralize it in this area as the field is rapidly developing. Materials and Methods: A structured questionnaire was sent to all 10 Departments of Otorhinolaryngology-Head and Neck Surgery in the Nordic countries having an active programme for TORS in December 2017. Results: The total cumulative number of performed robotic surgeries at these 10 Nordic centers was 528 and varied between 5 and 240 per center. The median annual number of robotic surgeries was 38 (range, 5-60). The observed number of annually operated cases remained fairly low ( Conclusions: The present results showing a limited volume of performed surgeries call for considerations to further centralize TORS in the Nordic countries.