Browsing by Subject "FEEDBACK"

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  • Pihajoki, Pauli (2017)
    We propose a new mathematical model for n - k-dimensional non-linear correlations with intrinsic scatter in n-dimensional data. The model is based on Riemannian geometry and is naturally symmetric with respect to the measured variables and invariant under coordinate transformations. We combine the model with a Bayesian approach for estimating the parameters of the correlation relation and the intrinsic scatter. A side benefit of the approach is that censored and truncated data sets and independent, arbitrary measurement errors can be incorporated. We also derive analytic likelihoods for the typical astrophysical use case of linear relations in n-dimensional Euclidean space. We pay particular attention to the case of linear regression in two dimensions and compare our results to existing methods. Finally, we apply our methodology to the well-known MBH-s correlation between the mass of a supermassive black hole in the centre of a galactic bulge and the corresponding bulge velocity dispersion. The main result of our analysis is that the most likely slope of this correlation is similar to 6 for the data sets used, rather than the values in the range of similar to 4-5 typically quoted in the literature for these data.
  • Räisänen, Jouni (2017)
    An energy balance decomposition of temperature changes is conducted for idealized transient CO2-only simulations in the fifth phase of the Coupled Model Intercomparison Project. The multimodel global mean warming is dominated by enhanced clear-sky greenhouse effect due to increased CO2 and water vapour, but other components of the energy balance substantially modify the geographical and seasonal patterns of the change. Changes in the net surface energy flux are important over the oceans, being especially crucial for the muted warming over the northern North Atlantic and for the seasonal cycle of warming over the Arctic Ocean. Changes in atmospheric energy flux convergence tend to smooth the gradients of temperature change and reduce its land-sea contrast, but they also amplify the seasonal cycle of warming in northern North America and Eurasia. The three most important terms for intermodel differences in warming are the changes in the clear-sky greenhouse effect, clouds, and the net surface energy flux, making the largest contribution to the standard deviation of annual mean temperature change in 34, 29 and 20 % of the world, respectively. Changes in atmospheric energy flux convergence mostly damp intermodel variations of temperature change especially over the oceans. However, the opposite is true for example in Greenland and Antarctica, where the warming appears to be substantially controlled by heat transport from the surrounding sea areas.
  • Sainio, Marko; Sutton, Robert M.; Huhtala, Heini; Eilevstjonn, Joar; Tenhunen, Jyrki; Olkkola, Klaus T.; Nadkarni, Vinay M.; Hoppu, Sanna (2013)
    A 2-year-old boy found in cardiac arrest secondary to drowning received standard CPR for 35 minutes and was transported to a tertiary hospital for rewarming from hypothermia. Chest compressions in hospital were started using two-thumb encircling hands technique. Subsequently two-thumbs direct sternal compression technique and after sternal force/depth sensor placement, chest compression with classic one-hand technique were done. By using CPR recording/feedback defibrillator, quantitative CPR quality data and invasive arterial pressures were available for analyses for 5 hours and 35 minutes. 316 compressions with the two-thumb encircling hands technique provided a mean (SD) systolic arterial pressure (SAP) of 24 (4) mmHg, mean arterial pressure (MAP) 18 (3) and diastolic arterial pressure (DAP) of 15 (3) mmHg. similar to 6000 compressions with the two thumbs direct compression technique created a mean SAP of 45 (7) mmHg, MAP 35 (4) mmHg and DAP of 30 (3) mmHg. similar to 20,000 compressions with the sternal accelerometer in place produced SAP 50 (10) mmHg, MAP 32 (5) mmHg and DAP 24 (4) mmHg. Restoration of spontaneous circulation (ROSC) was achieved at the point when the child achieved normothermia by using peritoneal dialysis. Unfortunately, the child died ten hours after ROSC without any signs of neurological recovery. This case demonstrates improved hemodynamic parameters with classic one-handed technique with real-time quantitative quality of CPR feedback compared to either the two-thumbs encircling hands or two-thumbs direct sternal compression techniques. We speculate that the improved arterial pressures were related to improved chest compression depth when a real-time CPR recording/feedback device was deployed.
  • Presseau, Justin; Mackintosh, Joan; Hawthorne, Gillian; Francis, Jill J.; Johnston, Marie; Grimshaw, Jeremy M.; Steen, Nick; Coulthard, Tom; Brown, Heather; Kaner, Eileen; Elovainio, Marko; Sniehotta, Falko F. (2018)
    Background: National diabetes audits in the UK show room for improvement in the quality of care delivered to people with type 2 diabetes in primary care. Systematic reviews of quality improvement interventions show that such approaches can be effective but there is wide variability between trials and little understanding concerning what explains this variability. A national cohort study of primary care across 99 UK practices identified modifiable predictors of healthcare professionals' prescribing, advising and foot examination. Our objective was to evaluate the effectiveness of an implementation intervention to improve six guideline-recommended health professional behaviours in managing type 2 diabetes in primary care: prescribing for blood pressure and glycaemic control, providing physical activity and nutrition advice and providing updated diabetes education and foot examination. Methods: Two-armed cluster randomised trial involving 44 general practices. Primary outcomes (at 12 months follow-up): from electronic medical records, the proportion of patients receiving additional prescriptions for blood pressure and insulin initiation for glycaemic control and having a foot examination; and from a patient survey of a random sample of 100 patients per practice, reported receipt of updated diabetes education and physical activity and nutrition advice. Results: The implementation intervention did not lead to statistically significant improvement on any of the six clinical behaviours. 1,138,105 prescriptions were assessed. Intervention (29% to 37% patients) and control arms (31% to 35%) increased insulin initiation relative to baseline but were not statistically significantly different at follow-up (IRR 1.18, 95% CI 0.95-1.48). Intervention (45% to 53%) and control practices (45% to 50%) increased blood pressure prescription from baseline to follow-up but were not statistically significantly different at follow-up (IRR 1.05, 95% CI 0.96 to 1.16). Intervention (75 to 78%) and control practices (74 to 79%) increased foot examination relative to baseline; control practices increased statistically significantly more (OR 0.84, 95% CI 0.75-0.94). Fewer patients in intervention (33%) than control practices (40%) reported receiving updated diabetes education (OR = 0.74, 95% CI 0.57-0.97). No statistically significant differences were observed in patient reports of having had a discussion about nutrition (intervention = 73%; control = 72%; OR = 0.98, 95% CI 0.59-1.64) or physical activity (intervention = 57%; control = 62%; OR = 0.79, 95% CI 0. 56-1.11). Development and delivery of the intervention cost 1191 pound per practice. Conclusions: There was no measurable benefit to practices' participation in this intervention. Despite widespread use of outreach interventions worldwide, there is a need to better understand which techniques at which intensity are optimally suited to address the multiple clinical behaviours involved in improving care for type 2 diabetes.
  • Huhtamäki, Martina; Grahn, Inga-Lill (2022)
    This paper examines explicit positive assessments (EPAs) in personal training, that is, the personal trainer's positive evaluations of the client's physical performance, including comments such as bra ('good'). The data consist of video-recorded training-sessions in Swedish from Finland and Sweden. The methodological framework is interactional linguistics, and the study explores the actions that EPAs perform as well as their linguistic design and embodied and sequential environment. The main actions performed by EPAs in personal training include transitioning between activities, encouraging the client, and making positive evaluations. The personal trainer (PT) may vary the lexical, syntactic, prosodic, and embodied features of the EPA to emphasize any of these actions or a combination of them. Overall, EPAs are a central resource for fulfilling the institutional goals of personal training by guiding the clients through the training-program and motivating them. In addition to their use as feedback on actions in the present moment, EPAs also include forward-focusing aspects aimed at guiding clients' future behavior. (c) 2021 Elsevier B.V. All rights reserved.
  • Rimpelä, Jenni M.; Pörsti, Ilkka H.; Jula, Antti; Lehtimäki, Terho; Niiranen, Teemu J.; Oikarinen, Lasse; Porthan, Kimmo; Tikkakoski, Antti; Virolainen, Juha; Kontula, Kimmo K.; Hiltunen, Timo P. (2018)
    Background: Reduced nocturnal fall (non-dipping) of blood pressure (BP) is a predictor of cardiovascular target organ damage. No genome-wide association studies (GWAS) on BP dipping have been previously reported. Methods: To study genetic variation affecting BP dipping, we conducted a GWAS in Genetics of Drug Responsiveness in Essential Hypertension (GENRES) cohort (n = 204) using the mean night-to-day BP ratio from up to four ambulatory BP recordings conducted on placebo. Associations with P<1 x 10(-5) were further tested in two independent cohorts: Haemodynamics in Primary and Secondary Hypertension (DYNAMIC) (n = 183) and Dietary, Lifestyle and Genetic determinants of Obesity and Metabolic Syndrome (DILGOM) (n = 180). We also tested the genome-wide significant single nucleotide polymorphism (SNP) for association with left ventricular hypertrophy in GENRES. Results: In GENRES GWAS, rs4905794 near BCL11B achieved genome-wide significance (beta = - 4.8%, P = 9.6 x 10(-9) for systolic and beta = - 4.3%, P = 2.2 x 10(-6) for diastolic night-to-day BP ratio). Seven additional SNPs in five loci had P values <1 x 10(-5). The association of rs4905794 did not significantly replicate, even though in DYNAMIC the effect was in the same direction (beta = - 0.8%, P = 0.4 for systolic and beta = - 1.6%, P = 0.13 for diastolic night-to-day BP ratio). In GENRES, the associations remained significant even during administration of four different antihypertensive drugs. In separate analysis in GENRES, rs4905794 was associated with echocardiographic left ventricular mass (beta = -7.6 g/m(2), P = 0.02). Conclusions: rs4905794 near BCL11B showed evidence for association with nocturnal BP dipping. It also associated with left ventricular mass in GENRES. Combined with earlier data, our results provide support to the idea that BCL11B could play a role in cardiovascular pathophysiology.
  • Partanen, Lauri (2020)
    This paper represents the second contribution from an action research study on a bachelor-level quantum chemistry and spectroscopy course. In the proposed instructional model, active learning principles are extended outside lectures to form a student-centred course structure. The new model resulted in superior learning outcomes compared to a class where active learning elements were limited to course lectures, as demonstrated by previous research. In this article, I try to understand this improvement through an analysis of student motivation and experiences in the framework of self-determination theory. Based on my analysis of student feedback data and interviews, tasks that facilitated direct interaction with peers or course staff were seen as key factors in enhancing learning and motivation. In addition, the presence of various interconnected course components that supported students at different stages of the learning process was experienced as central to learning. Together, these two publications demonstrate that the incorporation of active learning principles outside lectures can substantially improve both learning and motivation.
  • Kivimäki, Ville; Romanoff, Jani; Remes, Heikki (EasyChair Publications, 2021)
    EPiC Series in Computing
    Due to the rapid shift to online learning, it has become increasingly difficult for teachers to monitor students’ learning experiences. This paper analyzes teachers’ experiences with an online tool for monitoring students’ metacognitive states during the learning process. Through an open-ended questionnaire, we collected teachers’ aims for starting to use the tool and experienced benefits. Our results show that teachers use this tool to understand the learning status of students in greater depth and to adjust their teaching according to feedback collected during the course. Moreover, teachers reported receiving better quality summative course feedback after starting to use the tool.
  • Lu, Peng; Leppäranta, Matti; Cheng, Bin; Li, Zhijun (2016)
    Solar radiation drives the melting of Arctic sea ice in summer, but its parameterization in thermodynamic modeling is difficult due to the large variability of the optical properties of sea ice in space and time. Here, a two-stream radiative transfer model was developed for the propagation of solar radiation in ponded sea ice to investigate the dependence of apparent optical properties (AOPs), particularly albedo and transmittance, on sky conditions, pond depth, ice thickness, and the inherent optical properties (IOPs) of ice and water. The results of numerical experiments revealed that decrease in melt-pond albedo during melting results not only from increase in pond depth but also from decrease in underlying ice thickness, and the latter is more important for thin ice with thickness less than 1.5 m. Hence, a parameterized pond albedo as a function of both pond depth and ice thickness is more suitable for thinning Arctic sea ice than the previously used exponential function of pond depth, which is valid for thicker ice. The increase in broadband transmittance during melting can be explained by the decrease in underlying ice thickness, because its dependence on ice thickness is nearly three times stronger than on pond depth. The spectral dependence of the pond albedo on depth is significant only in the 600-900-nm band, while it depends clearly on ice thickness in the 350-600-nm band. The uncertainty resulting from the absorption coefficient of ice is limited, while the effect of scattering in ice is more important, as determined by a sensitivity study on the influence of the IOPs on the AOPs of sea ice. The two-stream model provides a time-efficient parameterization of the AOPs for ponded sea ice, accounting for both absorption and scattering, and has potential for implementation into sea-ice thermodynamic models to explain the role of melt ponds in the summer decay of Arctic sea ice. (C) 2016 Elsevier B.V. All rights reserved.
  • Mäkipää, Toni; Ouakrim-Soivio, Najat (2020)
    The paper addresses Finnish students’ perceptions of assessment practices in upper secondary school. We study what experiences students have about assessment, and how they assess their ability to use and understand teachers’ feedback. The data were gathered on a web-based questionnaire to 918 students in four upper secondary schools. The questionnaire contained both closed-ended and open-ended questions. According to students’ responses, most students consider that they are able to use and understand their teachers’ feedback, and that teachers are prone to apply traditional assessment methods. The results pave the way for enhancing versatility in assessment practices. At the end of this paper, we will discuss the important role of assessment in teaching and how teachers’ assessment literacy could be enhanced and made more visible. We also ponder whether alongside teachers’ assessment literacy we should also consider students’ assessment literacy.
  • Guo, Qingxue; Yan, Lijuan; Korpelainen, Helena; Niinemets, Ülo; Li, Chunyang (2019)
    The impact of conspecific and heterospecific neighboring plants on soil bacterial and fungal communities has never been explored in a forest ecosystem. In the present study, we first investigated soil microbial communities in three plantations: Larix kaempferi monoculture, L. olgensis monoculture and their mixture. Then, a two-year growth experiment was conducted to investigate the effects of intra- and inter-specific interactions of L. kaempferi and L. olgensis on rhizosphere microbial communities at two different nitrogen levels. The results demonstrated clear differences in the beta-diversity and composition of bacteria and fungi among the three plantations, which implied the presence of different effects of plant-plant interactions on soil microbial communities. The results of the pot experiment showed that L. kaempferi suffered from greater neighbor effects from its conspecific neighbor regardless of N fertilization, although the effect declined when L. kaempferi was grown with L. olgensis under N fertilization. Changes in intra- and inter-specific plant interactions significantly impacted the chemical and biological properties of soil under N fertilization, with lower concentrations of NH4+, and lower soil microbial biomass (C-Mic) and soil carbon nitrogen biomass (N-Mic) under intra-specific plant interactions of L. kaempferi (KK) compared to inter-specific interactions of L. kaempferi and L. olgensis (KO). N fertilization increased bacterial and fungal alpha diversities in the rhizosphere soil of KO. For the beta diversity, the PERMANOVA results demonstrated that there was a significant impact of intra- and inter-specific plant interactions on soil microbial communities, with KK significantly differing from intra-specific plant interactions of L. olgensis (OO) and KO. The two plant species and N fertilization showed specific effects on the soil microbial composition, particularly on the fungal community. Both L. olgensis and N fertilization increased the abundance of Ascomycota but reduced that of Basidiomycota, and even shifted the dominance from Basidiomycota to Ascomycota under KO combined with N fertilization.
  • Savela-Huovinen, Ulriikka; Muukkonen, Hanni; Toom, Auli (2018)
    The aim of this study was to identify competencies and learning contexts that are central when a standardized sensory expert assessor conducts food sensory evaluations in an authentic professional context. The aim was to answer the following questions: first, according to accessors, what competencies does sensory evaluation require? Second, what contexts of sensory evaluation do assessors report on? Thirteen assessors from three Finnish food companies were interviewed using semi-structured thematic interviews to map competencies and development intentions and explain established practices. In the study, 42% of analysis units described individual evaluation contexts, 53% described collaborative interactional contexts, and 5% described collaborative knowledge creation contexts. The findings contribute to the explanation of how assessors learn extensively from each other in collaborative interactional and knowledge creation contexts. Assessors' learning practices and abilities to work collaboratively in interactional and knowledge creation contexts need to be ensured for the development of expertise. Practical applicationsOur findings suggest that an important aspect of enhancing learning and achieving consistent results in assessors' work is to increase collaborative and knowledge creating practices in sensory training, in addition to training individual skills. Such practices are embedded in daily practices, especially the cases when product defects were sought and discussed. Advanced practices included: learning, sharing, and reviewing both external and in-house consumer panel feedback, developing methods to moderate small-panel evaluations and developing a product vocabulary collectively between the assessors. These practices supported sensory expert assessors in developing their personal and collective expertise in the workplace.
  • Mannerkoski, Matias; Johansson, Peter H.; Rantala, Antti; Naab, Thorsten; Liao, Shihong; Rawlings, Alexander (2022)
    We model here the merger histories of the supermassive black hole (SMBH) population in the late stages of a cosmological simulation of a similar to 2 x 10(13) M (circle dot) galaxy group. The gravitational dynamics around the several tens of SMBHs (M (center dot) > 7.5 x 10(7) M (circle dot)) hosted by the galaxies in the group is computed at high accuracy using regularized integration with the KETJU code. The 11 SMBHs that form binaries and a hierarchical triplet eventually merge after hardening through dynamical friction, stellar scattering, and gravitational wave (GW) emission. The binaries form at eccentricities of e similar to 0.3-0.9, with one system evolving to a very high eccentricity of e = 0.998, and merge on timescales of a few tens to several hundred megayears. During the simulation, the merger-induced GW recoil kicks eject one SMBH remnant from the central host galaxy. This temporarily drives the galaxy off the M (center dot)-sigma relation; however, the galaxy returns to the relation due to subsequent galaxy mergers, which bring in new SMBHs. This showcases a possible mechanism contributing to the observed scatter of the M (center dot)-sigma relation. Finally, we show that pulsar timing arrays and LISA would be able to detect parts of the GW signals from the SMBH mergers that occur during the similar to 4 Gyr time span simulated with KETJU.
  • Padoan, Paolo; Juvela, Mika; Pan, Liubin; Haugbolle, Troels; Nordlund, Åke (2016)
    We present a comparison of molecular clouds (MCs) from a simulation of supernova (SN) driven interstellar medium (ISM) turbulence with real MCs from the Outer Galaxy Survey. The radiative transfer calculations to compute synthetic CO spectra are carried out assuming that the CO relative abundance depends only on gas density, according to four different models. Synthetic MCs are selected above a threshold brightness temperature value, T-B,T-min = 1.4 K, of the J = 1 - 0 (CO)-C-12 line, generating 16 synthetic catalogs (four different spatial resolutions and four CO abundance models), each containing up to several thousands MCs. The comparison with the observations focuses on the mass and size distributions and on the velocity-size and mass-size Larson relations. The mass and size distributions are found to be consistent with the observations, with no significant variations with spatial resolution or chemical model, except in the case of the unrealistic model with constant CO abundance. The velocity-size relation is slightly too steep for some of the models, while the mass-size relation is a bit too shallow for all models only at a spatial resolution dx approximate to 1 pc. The normalizations of the Larson relations show a clear dependence on spatial resolution, for both the synthetic and the real MCs. The comparison of the velocity-size normalization suggests that the SN rate in the Perseus arm is approximately 70% or less of the rate adopted in the simulation. Overall, the realistic properties of the synthetic clouds confirm that SN-driven turbulence can explain the origin and dynamics of MCs.
  • Fuller, Richard; Goddard, Viktoria C. T.; Nadarajah, Vishna D.; Treasure-Jones, Tamsin; Yeates, Peter; Scott, Karen; Webb, Alexandra; Valter, Krisztina; Pyörälä, Eeva (2022)
    INTRODUCTION In 2011, a consensus report was produced on technology-enhanced assessment (TEA), its good practices, and future perspectives. Since then, technological advances have enabled innovative practices and tools that have revolutionised how learners are assessed. In this updated consensus, we bring together the potential of technology and the ultimate goals of assessment on learner attainment, faculty development, and improved healthcare practices. METHODS As a material for the report, we used the scholarly publications on TEA in both HPE and general higher education, feedback from 2020 Ottawa Conference workshops, and scholarly publications on assessment technology practices during the Covid-19 pandemic. RESULTS AND CONCLUSION The group identified areas of consensus that remained to be resolved and issues that arose in the evolution of TEA. We adopted a three-stage approach (readiness to adopt technology, application of assessment technology, and evaluation/dissemination). The application stage adopted an assessment ‘lifecycle’ approach and targeted five key foci: (1) Advancing authenticity of assessment, (2) Engaging learners with assessment, (3) Enhancing design and scheduling, (4) Optimising assessment delivery and recording learner achievement, and (5) Tracking learner progress and faculty activity and thereby supporting longitudinal learning and continuous assessment.
  • Hislop, Jessica M.; Naab, Thorsten; Steinwandel, Ulrich P.; Lahén, Natalia; Irodotou, Dimitrios; Johansson, Peter; Walch, Stefanie (2022)
    We present results on the star cluster properties from a series of high resolution smoothed particles hydrodynamics (SPH) simulations of isolated dwarf galaxies as part of the GRIFFIN project. The simulations at sub-parsec spatial resolution and a minimum particle mass of 4 M-circle dot incorporate non-equilibrium heating, cooling, and chemistry processes, and realize individual massive stars. The simulations follow feedback channels of massive stars that include the interstellar-radiation field variable in space and time, the radiation input by photo-ionization and supernova explosions. Varying the star formation efficiency per free-fall time in the range epsilon(ff) = 0.2-50 per cent neither changes the star formation rates nor the outflow rates. While the environmental densities at star formation change significantly with epsilon(ff), the ambient densities of supernovae are independent of epsilon(ff) indicating a decoupling of the two processes. At low epsilon(ff), gas is allowed to collapse more before star formation, resulting in more massive, and increasingly more bound star clusters are formed, which are typically not destroyed. With increasing epsilon(ff), there is a trend for shallower cluster mass functions and the cluster formation efficiency Gamma for young bound clusters decreases from 50 per cent to similar to 1 per cent showing evidence for cluster disruption. However, none of our simulations form low mass (
  • Genina, Anna; Benitez-Llambay, Alejandro; Frenk, Carlos S.; Cole, Shaun; Fattahi, Azadeh; Navarro, Julio F.; Oman, Kyle A.; Sawala, Till; Theuns, Tom (2018)
    The existence of two kinematically and chemically distinct stellar subpopulations in the Sculptor and Fornax dwarf galaxies offers the opportunity to constrain the density profile of their matter haloes by measuring the mass contained within the well-separated half-light radii of the two metallicity subpopulations. Walker and Penarrubia have used this approach to argue that data for these galaxies are consistent with constant-density 'cores' in their inner regions and rule out 'cuspy' Navarro-Frenk-White (NFW) profiles with high statistical significance, particularly in the case of Sculptor. We test the validity of these claims using dwarf galaxies in the APOSTLE (A Project Of Simulating The Local Environment) Lambda cold dark matter cosmological hydrodynamic simulations of analogues of the Local Group. These galaxies all have NFW dark matter density profiles and a subset of them develop two distinct metallicity subpopulations reminiscent of Sculptor and Fornax. We apply a method analogous to that of Walker and Penarrubia to a sample of 50 simulated dwarfs and find that this procedure often leads to a statistically significant detection of a core in the profile when in reality there is a cusp. Although multiple factors contribute to these failures, the main cause is a violation of the assumption of spherical symmetry upon which the mass estimators are based. The stellar populations of the simulated dwarfs tend to be significantly elongated and, in several cases, the two metallicity populations have different asphericity and are misaligned. As a result, a wide range of slopes of the density profile are inferred depending on the angle from which the galaxy is viewed.
  • Lahen, Natalia; Naab, Thorsten; Johansson, Peter H.; Elmegreen, Bruce; Hu, Chia-Yu; Walch, Stefanie (2019)
    We present a hydrodynamical simulation at sub-parsec and few-solar-mass resolution of a merger between two gas-rich dwarf galaxies. Our simulation includes a detailed model for the multi-phase interstellar medium and is able to follow the entire formation history of spatially resolved star clusters, including feedback from individual massive stars. Shortly after the merger we find a population of similar to 900 stellar clusters with masses above 10(2.5) M-circle dot and a cluster mass function (CMF), which is well fitted with a power law with a slope of alpha = -1.70 +/- 0.08. We describe here in detail the formation of the three most massive clusters (M-* greater than or similar to 10(5) M-circle dot), which populate the high-mass end of the CMF. The simulated clusters form rapidly on a timescale of 6-8 Myr in converging flows of dense gas. The embedded merger phase has extremely high star formation rate surface densities of Sigma(SFR) > 10 M-circle dot yr(-1) kpc(-2) and thermal gas pressures in excess of Pth similar to 10(7) K-B cm(-3))(-1). The formation process is terminated by rapid gas expulsion driven by the first generation of supernovae, after which the cluster centers relax and both their structure and kinematics become indistinguishable from observed local globular clusters (GCs). The simulation presented here provides a general model for the formation of metal-poor GCs in chemically unevolved starbursting environments of low-mass dwarf galaxies, which are common at high redshifts.
  • Chen, An; Väyrynen, Kirsi; Schmidt, Alexandra; Leskelä, Riikka-Leena; Torkki, Paulus; Heinonen, Seppo; Tekay, Aydin; Acharya, Ganesh (2022)
    Introduction While there is growing interest in applying patient-reported measures (PRMs) in clinical routine, limited collective evidence of the impact of PRMs hinder their widespread use in specific contexts, such as maternity care. Our objective was to synthesize existing empirical evidence on the impact of implementing PRMs in routine maternity care. Material and methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (version 2020). We electronically searched six databases for the literature on the implementation of PRMs in maternity care. A multi-level (woman, clinical, organizational, national and societal) analytic framework for analyzing and synthesizing empirically proven impacts of PRMs was developed. Quality was assessed using the Mixed Method Appraisal Tool. The GRADE-CERQual approach was used to assess the confidence in the review findings and arguments. The protocol was registered in PROSPERO (CRD42021234501). Results Overall, 4971 articles were screened. The empirical evidence, collected from 11 relevant studies, showed that the use of PRMs in routine maternity care could produce positive effects on clinical process (assessment and detection of health problems, clinical visit preparation, resource use, woman-professional communication, decision-making, woman-professional relationship, and care quality), and health behavior and outcomes (women's health and wellbeing, quality of life, health behavior, experiences and satisfaction with healthcare services), awareness, engagement and self-management of own health, and disclosure of health issues. The confidence in the review findings was low to moderate due to a limited number of studies, inadequate data and methodological limitations of included studies. Conclusions The limited empirical evidence available suggested that the use of PRMs may have positive effects at the individual health level and clinical process level. However, the evidence was not strong enough to provide policy recommendations on the use of PRMs in routine maternity care. This review revealed limitations of currently available research, such as lack of generalizability and narrow scopes in investigating impact. Efforts are needed to improve the quality of research on the use of PRMs in routine maternity care by widening the study population, including different types of PRMs, and considering the effects of PRMs at different levels and domains of healthcare.