Removing the barriers to research engagement - teacher motivation for research-based teaching development in language centres

This article draws on several workshops we have held on teacher research engagement. These recent workshops have indicated that many language centre teachers in Finland identify the same barriers that prevent them from doing research. In the same vein, these teachers tend to agree on the factors that drive them to do research. Based on our workshop at the Language Centres in Higher Education: Sharing Innovations, Research, Methodology and Best Practices conference, European language centre teachers share similar thoughts about research engagement: they like the idea of doing research and they often do some research, but sometimes find the barriers in their professional lives too great. Using research findings as well as data collected in the Brno workshop, we aim to discuss 1) the motives of teachers to carry out or follow research in fields related to teaching and learning and 2) ways and methods that encourage or facilitate teacher research. To help us reach these aims, we present the story of Johanna, to exemplify a teacher's experiences in becoming research engaged while taking part in in-house pedagogical training that fostered research orientation.

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion A Double-Blinded, Placebo-Controlled, Randomized Clinical Trial

Background: Pregabalin as part of a multimodal pain-management regimen has been shown to reduce opioid consumption after spinal surgery in adults but it is unclear whether this is also true in adolescents. Pregabalin has been found to have neuroprotective effects and therefore could have a positive impact on pain after spinal deformity surgery. We conducted a randomized, double-blinded, placebo-controlled clinical trial of adolescent patients undergoing spinal fusion to evaluate the short-term effects of pregabalin on postoperative pain and opioid consumption. Methods: Adolescents with adolescent idiopathic scoliosis, Scheuermann kyphosis, or spondylolisthesis who were scheduled for posterior spinal fusion with all-pedicle-screw instrumentation were randomized to receive either pregabalin (2 mg/kg twice daily) or placebo preoperatively and for 5 days after surgery. The patients ranged from 10 to 21 years of age. The primary outcome was total opioid consumption as measured with use of patient-controlled analgesia. Postoperative pain scores and opioid-related adverse effects were evaluated. Results: Sixty-three of 77 eligible patients were included and analyzed. Cumulative oxycodone consumption per kilogram did not differ between the study groups during the first 48 hours postoperatively, with a median of 1.44 mg/kg (95% confidence interval [CI],1.32 to 1.67 mg/kg) in the pregabalin group and 1.50 mg/kg (95% CI, 1.39 to 1.79 mg/kg) in the placebo group (p = 0.433). A subgroup analysis of 51 patients with adolescent idiopathic scoliosis showed the same result, with a mean of 1.45 mg/kg (95% CI, 1.24 to 1.65 mg/kg) in the pregabalin group and 1.59 mg/kg (95% CI, 1.37 to 1.82 mg/kg) in the placebo group (p = 0.289). Total oxycodone consumption per hour (mg/kg/hr) was not different between the groups over the time points (p = 0.752). The postoperative pain scores did not differ significantly between the groups (p = 0.196). Conclusions: The use of perioperative pregabalin does not reduce the postoperative opioid consumption or pain scores in adolescents after posterior spinal fusion surgery.Peer reviewe

Pharmacokinetics and Sedative Effects of Intranasal Dexmedetomidine in Ambulatory Pediatric Patients

BACKGROUND: Our aim was to characterize the pharmacokinetics and sedative effects of intranasally (IN) administered dexmedetomidine used as an adjuvant in pediatric patients scheduled for magnetic resonance imaging (MRI) requiring sedation.METHODS: This was an open-label, single-period study without randomization. Pediatric patients from 5 months to 11 years of age scheduled for MRI and receiving IN dexmedetomidine for premedication as part of their care were included in this clinical trial. Single doses of 2-3 µg·kg of dexmedetomidine were applied IN approximately 1 hour before MRI. Five or 6 venous blood samples were collected over 4 hours for dexmedetomidine concentration analysis. Sedation was monitored with Comfort-B scores, and vital signs were recorded. Pharmacokinetic variables were calculated with noncompartmental methods and compared between 3 age groups (between 1 and 24 months, from 24 months to 6 years, and over 6-11 years).RESULTS: We evaluated 187 consecutive patients for suitability, of which 132 were excluded. Remaining 55 patients were recruited, of which 5 were excluded before the analysis. Data from 50 patients were analyzed. The average (standard deviation [SD]) dose-corrected peak plasma concentration (Cmax) was 0.011 liter (0.0051), and the median (interquartile range [IQR]) time to reach peak concentration (tmax) was 37 minutes (30-45 minutes). There was negative correlation with Cmax versus age (r = -0.58; 95% confidence interval [CI], -0.74 to -0.37; P CONCLUSIONS: Dexmedetomidine is relatively rapidly absorbed after IN administration and provides clinically meaningful but short-lasting sedation in pediatric patients.</p

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Hiki, ähky ja loikka - Osallistujien pedagogisia mietteitä ja ideoita hankkeen varrelta

DIGIJOUJOU-hankkeessa työskennelleet opettajat ovat hankkeen toimintavuosien 2017-2019 aikana pohtineet opetuksen ja oppimisen digitaalisuutta ja joustavuutta eri näkökulmista: mitä digitaalisuus ja joustavuus suomen ja ruotsin opiskelussa tarkoittaa, miten soveltaa, lisätä ja kehittää digitaalisuutta ja joustavuutta omassa opetuksessa ja opiskelijoiden oppimisessa. Hankelaisten blogikirjoituksissa näemme askeleita opettajien omasta ja yhdessä muiden kanssa oppimisesta hankkeen edetessä; epävarmuus muuttuu varmuudeksi, ajoittainen digiähky oman asiantuntijuuden kasvuksi ja joustavuus osaksi opettajan arkipedagogiikkaa. Antoisia ja inspiroivia lukuhetkiä! Lisätietoa: https://digijoujou.aalto.fi/Lärarna i DIGIJOUJOU-projektet har under projektets verksamhetsår 2017-2019 reflekterat över digitalisering och exibilitet från olika perspektiv; vad betyder digitalisering och exibilitet i lärandet av finska och svenska, hur ska man implementera, öka och utveckla dessa i den egna undervisningen och i hur studerande lär sig finska och svenska. I projektdeltagarnas bloginlägg får vi inblick i hur allas lärandeprocess i projektet framskrider; osäkerhet utvecklas till säkerhet, digikaoset får ordning och exibilitet blir en del av den egna sakkunnigheten och pedagogiken. Med önskan om givande och inspirerande läsning! Mer information: https://digijoujou.aalto.fi