Inclusive Education in the diversifying environments of Finland, Iceland, and the Netherlands : A multilingual systematic review

This review investigates how the scholarly fields, themes and concepts of 'inclusive education' are applied in the research and educational contexts of Finland, Iceland and the Netherlands. It identifies and outlines which thematic areas of research and sub-fields of study are referenced in each country by applying a systematic, multilingual approach. We reviewed literature in the local languages of each of these countries over the past decade, from 2007 to 2018, paying particular attention to (a) micro-level, in-depth, classroom interactions; (b) social and political contexts; and (c) social categories. Results of this review emphasise that across all three countries (a) there are similar conceptualisations of inclusive education dominated by categories of disability and special needs, and (b) there is a similar lack of attention to modes of exclusion based on social class, gender, ethnicity and geography as well as to how these can be addressed by more advanced research on inclusive education in these local spheres.Peer reviewe

Successful Curriculum Change in Health Management and Leadership Studies for the Specialist Training Programs in Medicine in Finland

In Finland, the specialization programs in Medicine and Dentistry can be undertaken at all five university medical faculties in 50 specialization programs and in five programs for Dentistry. The specialist training requires 5 or 6 years (300-360 ECTS credits) of medical practice including 9 months of service in primary health care centers, theoretical substance specific education, management studies, and passing a national written exam. The renovation of the national curriculum for the specialization programs was implemented, first in 2008 and officially in August 2009, when theoretical multi-professional social, health management and leadership studies (10-30 ECTS credits) were added to the curriculum. According to European Credit Transfer and Accumulation System (ECTS), 1 ECTS credit (henceforth, simply "ECTS") means 27-30 h of academic work(1) National guidelines for the multi-professional leadership training include the basics of organizational management and leadership, the social and healthcare system, human resources (HR) management, leadership interaction and organizational communication, healthcare economy, legislation (HR) and data management. Each medical faculty has implemented management studies autonomously but according to national guidelines. This paper will describe how the compulsory management studies (10 ECTS) have been executed at the Universities of Tampere and Turku. In Tampere, the 10 ECTS management studies follow a flexible design of six academic modules. Versatile modern teaching methods such as technology-assisted and student orientated learning are used. Advanced supplementary management studies (20 ECTS) are also available. In Turku, the 10 ECTS studies consist of academic lectures, portfolio and project work. Attendees select contact studies (4-6 ECTS) from yearly available 20 ECTS and proceed at their own pace. Portfolio and project comprise 2-5 ECTS each. The renovation of medical specializing physicians' management and leadership education has been a successful reform. It has been observed that positive attitudes and interest toward management overall are increasing among younger doctors. In addition, management and leadership education will presumably facilitate medical doctors' work as managers also. Continuous development of medical doctors' management and leadership education for physicians and dentists is needed while the changing and complex healthcare environment requires both professional and leadership expertise

Calibration of dosemeters used in mammography with different X ray qualities: Euromet Project No. 526

The effect of different X ray radiation qualities on the calibration of mammographic dosemeters was investigated within the framework of a EUROMET (European Collaboration in Measurement Standards) project. The calibration coefficients for two ionization chambers and two semiconductor detectors were established in 13 dosimetry calibration laboratories for radiation qualities used in mammography. They were compared with coefficients for other radiation qualities, including those defined in ISO 4037-1, with first half value layers in the mammographic range. The results indicate that the choice of the radiation quality is not crucial for instruments with a small energy dependence of the response. However, the radiation quality has to be chosen carefully if instruments with a marked dependence of their response to the radiation energy are calibrate

Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts

BACKGROUND: The magnitude of the association between Helicobacter pylori and incidence of gastric cancer is unclear. H pylori infection and the circulating antibody response can be lost with development of cancer; thus retrospective studies are subject to bias resulting from classifi- cation of cases as H pylori negative when they were infected in the past. AIMS: To combine data from all case control studies nested within prospective cohorts to assess more reliably the relative risk of gastric cancer associated with H pylori infection.To investigate variation in relative risk by age, sex, cancer type and subsite, and interval between blood sampling and cancer diagnosis. METHODS: Studies were eligible if blood samples for H pylori serology were collected before diagnosis of gastric cancer in cases. Identified published studies and two unpublished studies were included. Individual subject data were obtained for each. Matched odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for the association between H pylori and gastric cancer. RESULTS: Twelve studies with 1228 gastric cancer cases were considered. The association with H pylori was restricted to noncardia cancers (OR 3.0; 95% CI 2.3–3.8) and was stronger when blood samples for H pylori serology were collected 10+ years before cancer diagnosis (5.9; 3.4–10.3). H pylori infection was not associated with an altered overall risk of cardia cancer (1.0; 0.7–1.4). CONCLUSIONS: These results suggest that 5.9 is the best estimate of the relative risk of non-cardia cancer associated with H pylori infection and that H pylori does not increase the risk of cardia cancer. They also support the idea that when H pylori status is assessed close to cancer diagnosis, the magnitude of the non-cardia association may be underestimated

Centralized repeated resectability assessment of patients with colorectalliver metastases during first-line treatment : prospective study

Y Background: Metastasectomy is probably underused in metastatic colorectal cancer. The aim of this study was to investigate the effect of centralized repeated assessment on resectability rate of liver metastases. Methods: The prospective RAXO study was a nationwide study in Finland. Patients with treatable metastatic colorectal cancer at any site were eligible. This planned substudy included patients with baseline liver metastases between 2012 and 2018. Resectability was reassessed by the multidisciplinary team at Helsinki tertiary referral centre upfront and twice during first-line systemic therapy. Outcomes were resectability rates, management changes, and survival. Results: Of 812 patients included, 301 (37.1 per cent) had liver-only metastases. Of these, tumours were categorized as upfront resectable in 161 (53.5 per cent), and became amenable to surgery during systemic treatment in 63 (20.9 per cent). Some 207 patients (68.7 per cent) eventually underwent liver resection or ablation. At baseline, a discrepancy in resectability between central and local judgement was noted for 102 patients (33.9 per cent). Median disease-free survival (DFS) after first resection was 20 months and overall survival (OS) 79 months. Median OS after diagnosis of metastatic colorectal cancer was 80, 32, and 21 months in R0-1 resection, R2/ablation, and non-resected groups, and 5-year OS rates were 68, 37, and 9 per cent, respectively. Liver and extrahepatic metastases were present in 511 patients. Of these, tumours in 72 patients (14.1 per cent) were categorized as upfront resectable, and 53 patients (10.4 per cent) became eligible for surgery. Eventually 110 patients (21.5 per cent) underwent liver resection or ablation. At baseline, a discrepancy between local and central resectability was noted for 116 patients (22.7 per cent). Median DFS from first resection was 7 months and median OS 55 months. Median OS after diagnosis of metastatic colorectal cancer was 79, 42, and 17 months in R0-1 resection, R2/ablation, and non-resected groups, with 5-year OS rates of 65, 39, and 2 per cent, respectively. Conclusion: Repeated centralized resectability assessment in patients with colorectal liver metastases improved resection and survival rates.Peer reviewe

Nordic calibration comparison for radiotherapy dosemeters : Cylindrical and plane-parallel ionization chambers

Raportissa kuvataan pohjoismaisena yhteistyönä tehty mittausvertailu. Mittausvertailussa oli mukana viisi laboratoriota Pohjoismaista (Suomi, Ruotsi, Norja ja kaksi laboratoriota Tanskasta). Vertailussa käytettiin kahta erilaista sädehoidon annosmittauksissa käytettävää ionisaatiokammiota (sylinteri ja tasolevykammiot) sekä näihin liittyvää elektrometriä. Osallistuvat laboratoriota määrittivät kalibrointikertoimen veteen absorboituneelle annokselle näille ionisaatiokammioille Co-60 –säteilyllä. Lisäksi laboratoriot määrittivät joitakin ionisaatiokammioiden korjauskertoimia sekä elektrometrin herkkyyskorjauskertoimen, mikäli mittaukset oli mahdollista toteuttaa kyseissä laboratoriossa. Kaikki mittaustulokset ovat erittäin lähellä toisiaan epävarmuusarvioiden puitteissa ja ne tukevat hyvin kaikkien laboratorioiden mittauskykyä

Extracting Relevance and Affect Information from Physiological Text Annotation

We present physiological text annotation, which refers to the practice of associating physiological responses to text content in order to infer characteristics of the user information needs and affective responses. Text annotation is a laborious task, and implicit feedback has been studied as a way to collect annotations without requiring any explicit action from the user. Previous work has explored behavioral signals, such as clicks or dwell time to automatically infer annotations, and physiological signals have mostly been explored for image or video content. We report on two experiments in which physiological text annotation is studied first to 1) indicate perceived relevance and then to 2) indicate affective responses of the users. The first experiment tackles the user’s perception of relevance of an information item, which is fundamental towards revealing the user’s information needs. The second experiment is then aimed at revealing the user’s affective responses towards a -relevant- text document. Results show that physiological user signals are associated with relevance and affect. In particular, electrodermal activity (EDA) was found to be different when users read relevant content than when they read irrelevant content and was found to be lower when reading texts with negative emotional content than when reading texts with neutral content. Together, the experiments show that physiological text annotation can provide valuable implicit inputs for personalized systems. We discuss how our findings help design personalized systems that can annotate digital content using human physiology without the need for any explicit user interaction

Reduced clinical and postmortem measures of cardiac pathology in subjects with advanced Alzheimer's Disease

Background. Epidemiological studies indicate a statistical linkage between atherosclerotic vascular disease (ATH) and Alzheimer\u27s disease (AD). Autopsy studies of cardiac disease in AD have been few and inconclusive. In this report, clinical and gross anatomic measures of cardiac disease were compared in deceased human subjects with and without AD. Methods. Clinically documented cardiovascular conditions from AD (n = 35) and elderly non-demented control subjects (n = 22) were obtained by review of medical records. Coronary artery stenosis and other gross anatomical measures, including heart weight, ventricular wall thickness, valvular circumferences, valvular calcifications and myocardial infarct number and volume were determined at autopsy. Results. Compared to non-demented age-similar control subjects, those with AD had significantly fewer total diagnosed clinical conditions (2.91 vs 4.18), decreased coronary artery stenosis (70.8 vs 74.8%), heart weight (402 vs 489 g for males; 319 vs 412 g for females) and valvular circumferences. Carriage of the Apolipoprotein E-ε4 allele did not influence the degree of coronary stenosis. Group differences in heart weight remained significant after adjustment for age, gender, body mass index and apolipoprotein E genotype while differences in coronary artery stenosis were significantly associated with body mass index alone. Conclusions. The results are in agreement with an emerging understanding that, while midlife risk factors for ATH increase the risk for the later development of AD, once dementia begins, both risk factors and manifest disease diminish, possibly due to progressive weight loss with increasing dementia as well as disease involvement of the brain\u27s vasomotor centers. © 2011 Beach et al; licensee BioMed Central Ltd