1,245 research outputs found
Helicobacter pylori : resistance and treatment results in Finland
No full textBackground: Helicobacter pylori infection is usually acquired in early childhood and is rarely resolved spontaneously. Eradication therapy is currently recommended virtually to all patients. While the first and second therapies are prescribed without knowing the antibiotic resistance of the bacteria, it is important to know the primary resistance in the population.
Aim: This study evaluates the primary resistance of H. pylori among patients in primary health care throughout Finland, the efficacy of three eradication regimens, the symptomatic response to successful therapy, and the effect of smoking on gastric histology and humoral response in H. pylori-positive patients.
Patients and methods: A total of 23 endoscopy referral centres located throughout Finland recruited 342 adult patients with positive rapid urease test results, who were referred to upper gastrointestinal endoscopy from primary health care. Gastric histology, H. pylori resistance and H. pylori serology were evaluated. The patients were randomized to receive a seven-day regimen, comprising 1) lansoprazole 30 mg b.d., amoxicillin 1 g b.d. and metronidazole 400 mg t.d. (LAM), 2) lansoprazole 30 mg b.d., amoxicillin 1 g b.d. and clarithromycin 500 mg b.d. (LAC) or 3) ranitidine bismuth citrate 400 mg b.d., metronidazole 400 mg t.d. and tetracycline 500 mg q.d. (RMT). The eradication results were assessed, using the 13C-urea breath test 4 weeks after therapy. The patients completed a symptom questionnaire before and a year after the therapy.
Results: Primary resistance of H. pylori to metronidazole was 48% among women and 25% among men. In women, metronidazole resistance correlated with previous use of antibiotics for gynaecologic infections and alcohol consumption. Resistance rate to clarithromycin was only 2%.
Intention-to-treat cure rates of LAM, LAC, and RMT were 78%, 91% and 81%. While in metronidazole-sensitive cases the cure rates with LAM, LAC and RMT were similar, in metronidazole resistance LAM and RMT were inferior to LAC (53%, 67% and 84%). Previous antibiotic therapies reduced the efficacy of LAC, to the level of RMT.
Dyspeptic symptoms in the Gastrointestinal Symptoms Rating Scale (GSRS) were decreased by 30.5%. In logistic regression analysis, duodenal ulcer, gastric antral neutrophilic inflammation and age from 50 to 59 years independently predicted greater decrease in dyspeptic symptoms.
In the gastric body, smokers had milder inflammation and less atrophy and in the antrum denser H. pylori load. Smokers also had lower IgG antibody titres against H. pylori and a smaller proportional decrease in antibodies after successful eradication. Smoking tripled the risk of duodenal ulcers.
Conclusions: in Finland H. pylori resistance to clarithromycin is low, but metronidazole resistance among women is high making metronidazole-based therapies unfavourable. Thus, LAC is the best choice for first-line eradication therapy. The effect of eradication on dyspeptic symptoms was only modest. Smoking slows the progression of atrophy in the gastric body.Antibioottien käytön rajoittaminen on helpottanut helikobakteerin hoitoa Suomessa
Helikobakteerin hoito on helpompaa Suomessa kuin monissa muissa maissa, koska tärkeintä bakteerin häätämiseen tarvittavaa antibioottia käytetään maltillisesti muiden sairauksien hoidoissa. Toiseksi yleisin antibiootti tehoaa bakteeriin melko huonosti erityisesti naisilla, koska antibioottia käytetään myös gynekologisten infektioiden hoitoon.
Yleensä jo lapsuudessa tarttunut helikobakteeri aiheuttaa 10 20 prosentille kantajistaan maha- ja pohjukaissuolihaavan, joillekin jopa mahasyöpää. Vain muutamat antibiootit tehoavat helikobakteerin häädössä, ja näitä lääkkeitä käyttäneillä bakteeri voi olla vastustuskykyinen, jolloin hoito voi epäonnistua.
Tässä tutkimuksessa selvitettiin helikobakteerin vastustuskykyä ja herkkyyttä tavallisimmin käytetyille antibiooteille 23 paikkakunnalla eri puolilla Suomea. Tutkimuksessa oli mukana 342 potilasta.
Tutkimuksessa todettiin, että jopa 98 prosenttia helikobakteereista oli herkkiä tärkeimmälle antibiootille klaritromysiinille. Sen varaan rakennettu hoito onnistui yli yhdeksässä tapauksessa kymmenestä. Tämä johtuu siitä, että Suomessa antibioottien käyttö on suhteellisen pidättyväistä, ja 1991 Suomessa annettiin yleinen ohje välttää klaritromysiinin sukuisten antibioottien käyttöä hengitystieinfektioissa. Etelä-Euroopassa näitä antibiootteja määrätään löyhemmin: Ranskassa käyttö on kolminkertaista, ja siellä jopa 20 prosenttia helikobakteereista on vastustuskykyisiä klaritromysiinille.
Metronidatsoli on toinen tärkeä antibiootti. Miesten helikobakteereista 25 prosenttia oli sille vastustuskykyisiä, mikä on yleinen taso länsimaissa. Sen sijaan naisilla 48 prosenttia helikobakteereista oli vastustuskykyisiä, mikä on poikkeuksellisen paljon. Ilmeisin syy on aiempi gynekologisten infektioiden hoito metronidatsolilla. Siten metronidatsolipohjainen häätöhoito onnistui kaikkiaan 80 prosentissa, mutta vastustuskykyisten bakteerien kohdalla vain 53 67 prosentissa tapauksista.
Potilaiden ylävatsaoireet vähenivät 30 prosenttia bakteerin häätämisen jälkeen. Ne vatsaoireet, joilla ei ollut mitään tekemistä helikobakteerin kanssa, vähenivät 20 prosenttia. Häätöhoidon nettohyödyksi jää siis vain 10 prosenttia.
Tupakointi kolminkertaisti pohjukaisuolihaavan riskin näillä potilailla.ei saavutettav
Book Reviews
No full textPäivi Koivisto
A Tribute to a Great Author
Worldview under assemblage. The individual, solitude and community in
Ulla-Lena Lundberg’s writings.
Lea Rojola
The Golden Days of Everyday Life in Finnish Literature
Le naturalisme Finlandais. Une conception entropique du quotidien.
Rita Paqvalén
Voices on Finnish Feminist Literature and Research
Women’s Voices. Female Authors and Feminist Criticism in the Finnish Literary Tradition.
Tuulia Toivanen
A Spectrum of Voices and Otherness
Toiset ambivalentit äänet. Essays in Feminine Poetics in Nordic Countries
Remembering Spaces of Work
No full textThis chapter examines how the experience of work is embedded in multiple ways in place and places of work. Drawing on two research projects it looks in detail and the affect of work. It draws on and contributes to literature on the place of work, nostalgia and memory
Rakkaudella rakkautta tutkimassa
No full textPäivi Koivisto
Rakkaudella rakkautta tutkimassa
Eva Maria Korsisaari: Tule rakkaani!
Minna Maijala
Kansallisrunoilija, pedofiili ja homoseksuaali?
Panu Rajala: Runoilijan sydän. J. H. Erkon täyttymätön elämä.
Holger Lillqvist
Edith Södergran och Rudolf Steiner
Jan Häll: Vägen till landet som icke är.
Karoliina Lummaa
Kuulumisia Espanjan Mannerilta
Tuula Hökkä (toim.): Kirjoittamisen aika.
Markku Soikkeli
Fanikohtaisia luentoja rock-sanoituksista
Toni Lahtinen ja Markku Lehtimäki (toim.): Ääniä äänien takaa
Response Letter to Koivisto et al. 'Evaluating the Theoretical Background of STOFFENMANAGER® and the Advanced REACH Tool'
No full textIn this article, we have responded to the key statements in the article by Koivisto et al. (2022) that were incorrect and considered to be a biased critique on a subset of the exposure models used in Europe (i.e. ART and Stoffenmanager®) used for regulatory exposure assessment. We welcome scientific discussions on exposure modelling (as was done during the ISES Europe workshop) and criticism based on scientific evidence to contribute to the advancement of occupational exposure estimation tools. The tiered approach to risk assessment allows various exposure assessment models from screening tools (control/hazard banding) through to higher-tiered approaches. There is a place for every type of model, but we do need to recognize the cost and data requirements of highly bespoke assessments. That is why model developers have taken pragmatic approaches to develop tools for exposure assessments based on imperfect data. We encourage Koivisto et al. to focus on further scientifically robust work to develop mass-balance models and by independent external validations studies, compare these models with alternative model tools such as ART and Stoffenmanager®.</p
Glycogen depletion during prolonged exercise: influence of glucose, fructose, or placebo.
No full textGamified apps for sustainable consumption: A systematic review
No full textMobile apps are ubiquitous, affecting our everyday practices because “there is always an app for that”. In this vein, there have been a significant number of apps devised to support people’s lifestyles to make them more sustainable. This study aims to draw an overview of gamified mobile apps for sustainable consumption. Following a systematic process, this study analyzes 67 gamified apps’ sustainability approaches and gamification concepts. It was found that (1) sustainable consumption is generally presented as the efficient use of resources to impact the environment positively, rarely addressing societal impacts or economic gains from shifting consumption practices. Other findings include (2) a lack of diversity in gamification characteristics, given the prevalence of direct communication with the user, the absence of virtual identities, and most apps targeting behavior change without attitude change. A potentially problematic design choice is (3) the presence, in some cases, of external rewards that are often contradictory to the message of sustainable consumption as they lead to more consumption. Nonetheless, based on most apps embedding sustainable consumption activities in the gamification concept and having a large number of users, it is possible to conclude that gamification has the potential to motivate shifts in their users’ lifestyles.Energy and Industr
Ore pass design and placement
No full textA current trend in mining is towards lower grade deposits when easy to access mineral deposits are depleted in the world. Therefore, to make the current deposits accessible, a cost of mining need to be economic. Costs can be decreased in equipment and mine planning to maximize the availability and utilization of equipment for example by decreasing travelling and hauling distances in daily production. Ore passes are one of the possibilities to decrease hauling costs when mine is evolving the greater depths.
Ore pass design and placement is conducted using modified Bieniawski’s design strategy for rock structures. Thesis studies in detail all parameters affecting to the ore pass design and placement. With the strategy and data available from mine and literature, a case study for Kittilä Mine had been carried out.
Data collection from literature review and data acquired from the mine site was made and applied in the Bieniawski’s design strategy. Production related factors were weighted more in the design process in order of mining to assess the ore pass design and placement. The location and design of the ore pass were optimized using a state-of-the-art technology and best practices in combination with mathematically optimized location.
Via strategy it was possible to identify the project risks, technical viability and feasibility of the ore pass project. Case study shows that via applying the design strategy it is possible to show that mine can benefit from using ore passes in its operations and that ore passes are financially viable solution if ore passes can be operated the way presented in this study
Taaperoimetys : Äitien kokemuksia taaperoimetyksestä sekä läheisten ja terveydenhoitajien suhtautumisesta siihen
No full textKoulutusyksikkö: Sosiaali- ja terveysalan yksikkö
Koulutusohjelma: Hoitotyön koulutusohjelma
Suuntautumisvaihtoehto: Terveydenhoitotyön suuntautumisvaihtoehto
Tekijä: Koivisto Henna-Maija ja Tuohisaari Liisa
Työn nimi: Taaperoimetys – äitien kokemuksia taaperoimetyksestä sekä läheisten ja terveydenhoitajien suhtautumisesta siihen
Ohjaajat: Vierre Else TtM, lehtori ja Mäki-Kojola Tiina THM, lehtori
Vuosi: Syksy 2013 Sivumäärä: 39 Liitteiden lukumäärä: 3
Taaperoimetyksellä tarkoitetaan yli 1-vuotiaan imetystä. Imetyksen edut eivät katoa lapsen kasvaessa ja sillä on ennen kaikkea emotionaalinen merkitys. Taaperoimetys on äidille ja lapselle merkityksellinen asia, mutta ympäristö suhtautuu siihen usein negatiivisesti ja painostaa vieroitukseen. Terveydenhoitajan tulisi tukea ja kannustaa äitejä myös isomman lapsen imetykseen perheen valintoja kunnioittaen. Terveydenhoitajat tarvitsevat ajantasaista tietoa imetyksestä myös vauvaiän jälkeen.
Tutkimuksen tavoitteena oli imetystietouden lisääminen ja terveydenhoitajien positiivisen suhtautumisen edistäminen taaperoimetystä kohtaan. Tarkoituksena oli kuvailla äitien kokemuksia taaperoimetyksestä sekä kuvata millaisena äidit kokevat terveydenhoitajien suhtautumisen taaperoimetykseen ja miten se vaikuttaa äitien haluun jatkaa imetystä. Tutkimusmenetelmänä käytettiin kvalitatiivista tutkimusotetta ja tutkimus toteutettiin sähköpostitse lähetetyllä kyselyllä. Tutkimukseen osallistui seitsemän noin 2-vuotiasta lastaan imettävää äitiä. Vastaukset analysoitiin sisällön analyysin avulla.
Tutkimuksen tulosten mukaan taaperoimetys koettiin arkea helpottavana tekijänä ja sillä nähtiin olevan suuri merkitys lapsen psyykkiselle ja fyysiselle hyvinvoinnille. Pitkä imetys voi olla joko tietoinen päätös tai siihen voidaan ajautua vähitellen. Läheiset suhtautuivat taaperoimetykseen vaihtelevasti. Äidit olivat kokeneet niin myönteistä kuin tuomitsevaakin suhtautumista. Terveydenhoitajien suhtautuminen taaperoimetykseen oli usein negatiivista tai imetystä ei otettu neuvolassa puheeksi lainkaan vauvaiän jälkeen. Keskustelu taaperoimetyksestä käytiin yleensä vain vieroitusnäkökulmasta. Terveydenhoitajien suhtautumisesta vain yhdellä äideistä oli positiivinen kokemus. Kuitenkaan terveydenhoitajien negatiivisella suhtautumisella ei ollut vaikutusta äitien halukkuuteen jatkaa imetystä, mutta he olisivat silti kaivanneet terveydenhoitajilta tukea ja kannustusta imetyksen jatkamiseen.Faculty: School of Health Care and Social Work
Degree programme: Degree Programme in Nursing
Specialisation: Public Health Nurse
Author/s: Koivisto Henna-Maija and Tuohisaari Liisa
Title of thesis: Toddler breastfeeding – Mothers’ experiences about toddler breast-feeding and what people close to them and public health nurses think about it
Supervisors: Vierre Else, MNSc, lecture and Mäki-Kojola Tiina, MNSc, lecture
Year: Autumn 2013 Number of pages: 39 Number of appendices: 3
Toddler breastfeeding means that the mother is breastfeeding a child that is over one year old. The benefits of lactation do not disappear when children grow up and, above all, it has an emotional meaning. Breastfeeding a toddler is meaningful for both the mother and the child, but often people have negative thoughts about it and pressurize to wean. Public health nurses should support and encourage mothers to breastfeed a toddler, but also respect the choices made by the family. Public health nurses need current information about lactation also after babyhood.
The aim of the study was to increase knowledge about lactation and support the idea of toddler breastfeeding among public health nurses. The purpose of the study was to describe how mothers experience the toddler breastfeeding, as well as encountering public health nurses about the matter, but also how the encounter affects the decision of continuing toddler breastfeeding. The research method was qualitative. The study was conducted as a mail survey. Seven mothers who breastfeed a toddler participated. The data was analyzed with content analysis method.
The main findings of the study indicated that toddler breastfeeding has a soothing effect on everyday life and it has a major significance to the child’s psychical and physical wellbeing. Extended breastfeeding might be a conscious decision or the mother can gradually drift into it. People who are close react to toddler breastfeed-ing differently. Mothers have experienced both positive and judgemental reactions. Usually, public health nurses had negative thoughts about toddler breastfeeding. Generally, lactation was a skipped topic after babyhood or the discussions were only about weaning. Only one of the mothers had good experiences about the en-counters with public health nurses. Despite the negative attitudes, mothers contin-ued breastfeeding. However, they would have wanted support and encouragement from public health nurses
The MIVOC method for the production of metal ion beams
No full textA fundamentally new MIVOC method (Metal Ions from VOlatile Compounds) for the production of metal ion beams at the ECR ion sources has been developed. With the MIVOC technique it has been found possible to operate the JYFL-ECR ion source with compounds of metals, either powders or liquids, that have vapour pressure of the order of lE-3 mbar, or higher at room temperature. Up to present time, 17 beams have been produced with the MIVOC method (C, Mg, Si, Cl, Ti, V, Cr, Fe, Co, Ni, Ge, Mo, Ru, Sn, I, W and Os). In every day use it has turned out to be both simple and reliable. Due to this property, the MIVOC method has been adopted at several laboratories.unknown accessibilityei tietoa saavutettavuudest
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