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Oman rahan käyttäminen luokanopettajan työssä
No full textLuokanopettajat käyttävät työhönsä omaa rahaa. Ilmiö tunnistetaan ympäri maailmaa, ja aiheesta keskustellaan niin keskustelupalstoilla, lehdissä kuin myös opettajanhuoneissa. Keskustelu ilmiön ympärillä jakaakin opettajia puolesta ja vastaan. Vaikka opettajat tunnistavat ilmiön laajasti, ei ilmiötä ole tutkittu Suomessa. Tämän tutkimuksen tarkoituksena on ymmärtää ilmiötä ja luoda yleiskuvaa ilmiöstä Suomessa. Tutkimuksen tavoitteena on selvittää, mitkä tekijät saavat luokanopettajat käyttämään työhönsä omaa rahaa ja miten luokanopettajat suhtautuvat työhön liittyvään oman rahan käyttämiseen.
Toteutin tutkielmani kvalitatiivisena eli laadullisena tutkimuksena. Keräsin tutkimusaineiston joulukuussa 2024 kyselylomakkeella, joka sisälsi pääosin avoimia kysymyksiä. Kysely jaettiin Facebookissa Alakoulun aarreaitta -ryhmään, jonka kautta uskoin tavoittavani tutkimuksen kohderyhmää eli luokanopettajia. Tutkimusaineisto koostuu 316 luokanopettajan vastauksesta. Analysoin tutkimusaineiston aineistolähtöisellä sisällönanalyysilla.
Tutkimuksessa selvisi, että vastaajista 91 prosenttia ilmoitti käyttävänsä omaa rahaa luokanopettajan työhön vähintään kerran lukuvuoden aikana. Kaikkien vastaajien ilmoittamien summien keskiarvo oli noin 74 euroa lukuvuodessa. Luokanopettajat käyttivät omaa rahaa opetusmateriaaleihin ja -välineisiin, luokkahuoneen sisustukseen, oppilaiden tukemiseen, opettajan työvälineisiin ja toimistotarvikkeisiin sekä koulutuksiin ja ammatilliseen kehittymiseen. Oman rahan käyttämisen taustalla vaikuttavia tekijöitä olivat riittämättömät tai puutteelliset resurssit, rajoitukset hankintakäytännöissä, helppous ja vaivattomuus, kynnys pyytää rahaa, hyväntahtoisuus ja halu tukea oppilaita, opetuksen monipuolistaminen, opettajan motivaatio ja työssä viihtyminen, oman työn helpottaminen ja oman materiaalipankin kartuttaminen. Opettajat suhtautuivat oman rahan käyttämiseen kielteisesti ja myönteisesti sekä osa koki sen jokaisen omaksi valinnaksi. Kaikissa työyhteisöissä aiheesta ei ollut keskusteltu julkisesti.
Suurin osa luokanopettajista käytti omaa rahaa, vaikka he suhtautuivatkin oman rahan käyttämiseen kielteisesti. Monet opettajat olivat kokeneet painetta käyttää omaa rahaa tai painetta olla käyttämättä omaa rahaa. Oman rahan käyttäminen kuuluu osaksi epävirallista koulua, ja se vaikuttaa olevan opettajien yksityisasia, josta ei ole lupaa puhua
Adult obstructive sleep apnea treated with tonsillectomy: a randomized controlled clinical trial
No full textPeer reviewe
Accuracy of EEG Slow Wave Activity in Predicting Favorable Outcome in Patients With Hypoxic Brain Injury—A Protocol for a Substudy of the STEPCARE Trial
No full textBackground: Early restitution of electroencephalogram (EEG) slow wave activity (SWA) may be able to predict favorable functional outcome after cardiac arrest. SWA can be monitored using the C-Trend Index, a recently developed dynamic numerical index computed using commercially available medical device software. Methods: This is a pre-planned prospective substudy of the randomized controlled Sedation, TEmperature and Pressure after Cardiac Arrest and REsuscitation (STEPCARE) trial. With a factorial design, the STEPCARE trial evaluates the effects of three different interventions (sedation, temperature management, and mean arterial blood pressure) on functional outcomes in adult out-of-hospital cardiac arrest (OHCA) patients. We will record continuous EEG (cEEG) starting as early as possible after ICU admission. We will compare the accuracy (the proportion of correct predictions of all predictions) of C-Trend Index with that of blinded retrospective visual analysis of cEEG at 12 h after return of spontaneous circulation in predicting favorable functional outcome (modified Rankin Scale 0–3) 6 months after cardiac arrest. We aim to recruit 300 patients to show noninferiority in prognostic accuracy of the C-Trend Index compared with the visual analysis of cEEG, using a 2% limit for noninferiority. Furthermore, we will assess whether the therapeutic intervention related to sedation, carried out as a part of the STEPCARE trial modifies the performance of the EEG-based predictors. Conclusion: The study will compare the accuracy of SWA measured using C-Trend Index with the gold standard, visual analysis of cEEG, in predicting favorable functional outcome after OHCA. The study will also assess the effect of the sedation intervention of the STEPCARE trial on the predictive accuracy of C-Trend Index. If the accuracy of the C-Trend Index is non-inferior to the comparator's, it may provide a feasible and easy-to-learn bedside method, especially in hospitals with limited availability of neurophysiology expertise. Trial Registration: ClinicalTrials.gov identifier: NCT06564675.Peer reviewe
Anti-beta2-glycoprotein I IgG antibodies are associated with early-onset cryptogenic ischemic stroke
No full textBackground: Previously undetected antiphospholipid antibodies (aPLs) potentially provide explanations for early-onset cryptogenic ischemic stroke (CIS). Prior association studies conducted over a decade ago were inconclusive and not focused on patients with CIS. Methods: SECRETO is a multi-center case-control study enrolling patients aged 18–49 years with imaging-positive acute CIS and 1:1 matched stroke-free controls. Lupus anticoagulant (LA), anticardiolipin (aCL), and anti-beta2-glycoprotein I (aβ2GPI) IgG antibodies were assessed from blood samples taken at two time points (baseline and 12-weeks) from patients and at a single time point from controls. Conditional logistic regression models assessed the association of aPLs, adjusted for age, level of education, and vascular risk factors. Results: A total of 503 patient-control pairs were analyzed. At either time-point, compared to healthy controls, patients had more frequently positive aβ2GPI (patients 11.9% vs controls 2.0%, p < 0.001). There was no significant difference in the presence of positive LA between patients and controls. In the logistic regression model, at either time-point positive aB2GI and aCL were associated with CIS (odds ratio [OR] 11.22, 95% confidence interval [CI] 4.35–28.95 and OR 20.85, 95% CI 204–213.16, respectively). The frequency of patients with positive aβ2GPI or aCL increased from baseline to 12 weeks (p < 0.001), whereas frequency of positive LA results decreased (p < 0.001). Conclusions: Positive aβ2GPI and aCL, but not LA, detected either shortly after stroke or after 12 weeks were associated with early-onset CIS. Notably, after the acute phase, frequencies of positive aβ2GPI and aCL increased, whereas LA showed a reverse trend.Peer reviewe
Late-Onset Asthma Phenotypes by Onset Age: A Cluster Analysis in Swedish Population-Based Cohorts
No full textNon peer reviewe
Behavioural and social drivers of routine childhood immunization in selected low coverage areas in the Philippines
No full textBackground: Routine childhood vaccination coverage under the National Immunization Program of the Philippines is well below the target of 95% with a high number of zero-dose children. Declining immunization rates led to outbreaks of vaccine-preventable diseases such as measles, polio, and pertussis. This study aimed to identify the factors affecting childhood vaccine uptake by exploring the perspectives of community members, program managers, and coordinators. Methods: Three regions with low vaccine coverage in the Philippines were selected as study sites. We conducted focus groups with adult caregivers of vaccinated and unvaccinated children aged 0–11 years recruited by barangay (community) health workers. Key informant interviews were also conducted with immunization program managers and coordinators from different administrative levels. Focus group and interview guides were informed by the World Health Organization’s Behavioural and Social Drivers (BeSD) of Vaccination framework. Transcripts were analysed by themes and deductive axial coding was used to categorize themes into BeSD domains and socioecological levels. Results: Twelve focus groups (n = 143) and 57 key informant interviews were done. Various behavioural and social drivers of vaccination present at different levels of the socioecological model affect vaccine decisions both positively and negatively. Under the ‘Thinking and feeling’ domain of the BeSD, at the intrapersonal level, the perception of benefits and negative side effects of routine vaccines were clear drivers of vaccination. In the ‘Social processes’ domain, factors at multiple socioecological levels such as the influence of family, barangay health workers, and community leaders were identified. Practical issues such as the availability of vaccines and accessibility of vaccination sites remain a barrier to vaccination. Conclusions: Availability of routine vaccines and accessibility to vaccination sites are major challenges in the Philippines. Acceptability of routine vaccines continue to be affected by previous controversies around the Dengue vaccine and the recent COVID-19 pandemic. Findings suggest that enhancing advocacy for immunization through continuing communication training for health care workers on health promotion and education regarding vaccination may contribute to increased vaccine uptake. Integration of immunization with other population-based health programs could be explored.Peer reviewe
Purcell Effect in Epsilon-Near-Zero Microcavities
No full textEpsilon-near-zero (ENZ) photonics offers a compelling platform for integrated photonic systems, enabling a range of novel and extraordinary functionalities. However, the practical deployment of ENZ-based devices is constrained by high material losses and severe impedance mismatch, which are detrimental to applications requiring coherent light manipulation and efficient light-matter interaction. To address these challenges, we demonstrate that all-dielectric Bragg-reflection microcavities operated near their cutoff frequency, offer an ultralow-loss platform for enhancing light-matter interaction and exploring emission processes in the ENZ regime. While Bragg cavities are well-established, their potential as ENZ resonant microcavities remains largely unexplored. We investigate the Purcell effect and quality factor in these structures, comparing their performance with those of the perfect-electric-conductor and metallic counterparts. Through analytical derivations based on Fermi’s golden rule and field quantization in lossless dispersive media, we establish scaling laws that distinguish these ENZ cavities from conventional resonators. Frequency domain simulations validate our counterintuitive findings, demonstrating that in all-dielectric ENZ Bragg-reflection microcavities, the Purcell and quality factors scale as L/λ0and (L/λ0)3, respectively, where L is the cavity length and λ0is the resonance wavelength. Our results offer key insights into the design of ENZ-based photonic systems, paving the way for enhanced light-matter interactions in nonlinear optics and quantum photonics.Peer reviewe
Return to work within 2 years of lumbar fusion: a prospective cohort study
No full textBackground and purpose — Return to work is an important objective and measure of treatment success in the working-age population. Many patient-related factors have been shown to be associated with failure to resume working postoperatively. The aim of this longitudinal database study was to determine return to work rates in a 24-month followup after lumbar fusion. We also evaluated whether return to work was affected by the physical demand of work or the preoperative dominance of leg or back pain. Methods — 348 consecutive patients available to the workforce underwent lumbar fusion. Return to work at 12 and 24 months was evaluated by patient questionnaires. Patients rated the physical demand of work into 3 categories: light, moderately demanding, or demanding. The surgeon identified the predominant symptom preoperatively, dividing patients into back and leg pain groups. Results — Return to work was 69% (95% confidence interval [CI] 64–73) and 76% (CI 71–81), at 12-and 24-month follow-ups, respectively. Patients in physically demanding work were less likely to resume working than patients in light work (63% vs 86% at 24 months, respectively). The predominant symptom did not affect return to work. Conclusion — In patients of working age, three-quarters of lumbar spine fusion patients returned to work within 2 years of surgery. Work absenteeism was higher in physically demanding occupations and only 60% of the patients with predominant leg pain returned to their physically heavy occupation in the first year following lumbar fusion.Peer reviewe
Psychometric properties and content of instruments for assessing penile cancer patients’ quality of life: A systematic review
No full textAim: To describe the psychometric properties and content of the instruments used for assessing penile cancer patients’ quality of life Design: A systematic review Method: A systematic literature search was conducted in October 2024 across four electronic databases: PubMed, CINAHL, PsycINFO, and the Cochrane Library. The systematic approach was adhered to when conducting the review, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to ensure explicit reporting. The search across the four databases generated 135 articles, out of which 16 were included in the review. Results: Eight instruments assessing the quality of life (QoL) among penile cancer patients were identified: four generic, two cancer-specific, and two penile cancer-specific. The content of these instruments fell into three main categories: physical functioning, psychosocial resilience, and overall life functions. However, none of the instruments covered all these aspects comprehensively. Additionally, no instrument was reported to be thoroughly valid or reliable. Conclusions: A psychometrically tested and validated QoL instrument that covers all aspects of penile cancer patients' well-being was not found. There is a need for holistic instruments tailored to evaluate and improve the QoL for these patients. Such instruments would enable the identification and comparison of individual care needs and factors influencing their QoL.Peer reviewe
Published Population Pharmacokinetic Models of Imatinib Perform Poorly on TDM Data from Pediatric Patients
No full textBackground: Population pharmacokinetic models can potentially provide suggestions for an initial dose and the magnitude of dose adjustment during therapeutic drug monitoring procedures of imatinib. Several population pharmacokinetic models for imatinib have been developed over the last two decades. However, their predictive performance is still unknown when extrapolated to different populations, especially children. Objective: This study aimed to evaluate the predictive performance of these published models on an external real-world dataset containing data from both adults and children. Methods: A real-world dataset was collected, containing observations from adult and pediatric patients with Philadelphia chromosome-positive/Philadelphia chromosome-like acute lymphoblastic leukemia and chronic myeloid leukemia (N = 39) treated with imatinib. A systematic review through PubMed was conducted to identify qualified population-pharmacokinetic models for external evaluation (i.e., prediction-based, simulation-based, and Bayesian forecasting diagnostics). Standard allometric scaling was used for models that were developed based on data from adults only. Results: Fifteen published models were found for evaluation, of which only two were based on data from both children and adults. Prediction-based diagnostics showed that some models had an acceptable level of bias. The model by Shriyan et al. (with allometric scaling) performed best with a median prediction error of 1.24%. However, no models performed well on precision even when allometric scaling was used, where the lowest median absolute prediction error was 37.66% using the model by Schmidli et al. The models by Golabchifar et al. and Schmidli et al. (both with allometric scaling) performed the best of all tested models, with a median prediction error ≤ 15%, median absolute prediction error ≤ 40%, fraction of prediction error within ± 20% (F20) ≥ 0.3, and within ± 30% (F30) nearly 0.4. Simulation-based diagnostics showed that most of the observations outside the 90% prediction interval were from children. Bayesian forecasting showed that the model prediction could be improved using one prior sample, particularly in adults. Conclusions: Current models fail to accurately predict imatinib plasma concentrations in our real-world dataset, especially for children. Future pharmacokinetic studies should focus on developing better models for pediatric populations.Peer reviewe