222 research outputs found

    Evaluation of early childhood education quality across Europe

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    The aim of the current study was to present the initial results of the evaluation of early childhood education (ECE) quality in six European countries. This study discusses various aspects of the ECE quality in different educational systems. Such comparisons can create a fertile ground for communication and collaboration among the educational communities of different European countries and promote open education. Implications and future recommendations are also discussed

    Simulation of Subject-Specific Progression of Knee Osteoarthritis and Comparison to Experimental Follow-up Data : Data from the Osteoarthritis Initiative

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    Economic costs of osteoarthritis (OA) are considerable. However, there are no clinical tools to predict the progression of OA or guide patients to a correct treatment for preventing OA. We tested the ability of our cartilage degeneration algorithm to predict the subject-specific development of OA and separate groups with different OA levels. The algorithm was able to predict OA progression similarly with the experimental follow-up data and separate subjects with radiographical OA (Kellgren-Lawrence (KL) grade 2 and 3) from healthy subjects (KL0). Maximum degeneration and degenerated volumes within cartilage were significantly higher (p <0.05) in OA compared to healthy subjects, KL3 group showing the highest degeneration values. Presented algorithm shows a great potential to predict subjectspecific progression of knee OA and has a clinical potential by simulating the effect of interventions on the progression of OA, thus helping decision making in an attempt to delay or prevent further OA symptoms.Peer reviewe

    Comparing Aspects Of The Process Quality In Six European Early Childhood Educational Settings

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    The European project ‘Early Change’ (http://earlychange.teithe.gr) attempts to evaluate the quality of early childhood education (ECE) environments of six European countries, Greece, Portugal, Finland, Denmark, Cyprus and Romania. The purpose of this paper is to compare the level of two dimensions of the process quality of these environments a) Space & Furnishings, and b) Personal Care Routines. Theorists, practitioners and researchers agree that in order to provide qualitative education to young children, one of the basic needs of all children must be met; that need is the protection of their health and their safety. A high quality early childhood education program must contain a safe and stimulating environment for the child (Lindsey, 1998). Such an environment includes indoor space, outdoor space, furniture, and room arrangement, and it is considered an integral part of a high quality early childhood program. 117 early educators from the six participating countries attended the training seminars about the evaluation of ECE quality using the Early Childhood Environmental Rating Scale-R (ECERS-R). The trained educators evaluated the 8 indicators of the subscale ‘space & furnishings’ and the six indicators of the subscale ‘personal care routines’ in approximately 600 early childhood classrooms from six European countries. The results of this study highlight the similarities and differences concerning the specific dimensions of the process quality of ECE environments in six European countries, and reflect the diversity of ECE environment across these countries. The findings of this study may provide a valuable insight to researchers and educational policy makers for an enhanced understanding of the cultural diversities and the strengthening of the common values and targets of the European Union

    Status report of the JYFL-ECR ion sources

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    "Ion beam cocktails" are mixtures of ions with near-identical charge-to-mass ratios. In conjunction with the JYFL-ECRIS, the K130-cyclotron acts as a mass analyzer: the switch from one ion to another within the same cocktail is simple and fast. In the case of the first ion beam cocktail, the oxygen and argon gases were mixed into the gas feed line. At the same time the magnesium and iron ion beams were produced using the MIVOC method. Magnesocene and ferrocene compounds were both mixed into the MIVOC chamber. This capability is especially useful in the study of single event effects (SEE) in space electronics. All gaseous elements from H to Xe can be produced. The non-gaseous elements produced so far are C, Mg, Al, Si, S, Ca, Ti, Cr, Fe, Co, Ni, Cu, Zn and Ge. A major technical modification since the construction (in 1990) of the JYFL-ECRIS was made in January 98: a negatively biased disc replaces now the first plasma stage. After a couple of months experience with the modified source the change was found to be towards a correct direction. The source is now much easier to use and the good operating conditions are well repeated. A real advantage is the new magnetic field settings which are practically the same for all kind of beams, gaseous and solids. Due to the requirements of ion beams with higher charges and heavier elements than the present JYFL-ECRIS can produce, JYFL decided to begin a design and construction project of a new ECR ion source, called as ECRIS 2. The project aims to a source that is based mainly on the design of the 14 GHz AECR-U source at the LBNL. Some modifications made into the similar source under construction at the NSCL/MSU will be utilized here. The new source will be installed horizontally in the basement of the ECRIS laboratory. It requires a new beam-line from the source to the cyclotron injection line, since the old vertically located JYFL-ECRIS will be preserved in operation. The new source is planned to be operational during the year 2000

    Treatment of electrical status epilepticus in sleep : A pooled analysis of 575 cases

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    OBJECTIVE: Epileptic encephalopathy with electrical status epilepticus in sleep (ESES) is a pediatric epilepsy syndrome with sleep-induced epileptic discharges and acquired impairment of cognition or behavior. Treatment of ESES is assumed to improve cognitive outcome. The aim of this study is to create an overview of the current evidence for different treatment regimens in children with ESES syndrome. METHODS: A literature search using PubMed and Embase was performed. Articles were selected that contain original treatment data of patients with ESES syndrome. Authors were contacted for additional information. Individual patient data were collected, coded, and analyzed using logistic regression analysis. The three predefined main outcome measures were improvement in cognitive function, electroencephalography (EEG) pattern, and any improvement (cognition or EEG). RESULTS: The literature search yielded 1,766 articles. After applying inclusion and exclusion criteria, 112 articles and 950 treatments in 575 patients could be analyzed. Antiepileptic drugs (AEDs, n = 495) were associated with improvement (i.e., cognition or EEG) in 49% of patients, benzodiazepines (n = 171) in 68%, and steroids (n = 166) in 81%. Surgery (n = 62) resulted in improvement in 90% of patients. In a subgroup analysis of patients who were consecutively reported (585 treatments in 282 patients), we found improvement in a smaller proportion treated with AEDs (34%), benzodiazepines (59%), and steroids (75%), whereas the improvement percentage after surgery was preserved (93%). Possible predictors of improved outcome were treatment category, normal development before ESES onset, and the absence of structural abnormalities. SIGNIFICANCE: Although most included studies were small and retrospective and their heterogeneity allowed analysis of only qualitative outcome data, this pooled analysis suggests superior efficacy of steroids and surgery in encephalopathy with ESES

    Treatment response of colorectal cancer liver metastases to neoadjuvant or conversion therapy : a prospective multicentre follow-up study using MRI, diffusion-weighted imaging and H-1-MR spectroscopy compared with histology (subgroup in the RAXO trial)

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    Background: Colorectal cancer liver metastases respond to chemotherapy and targeted agents not only by shrinking, but also by morphologic and metabolic changes. The aim of this study was to evaluate the value of advanced magnetic resonance imaging (MRI) methods in predicting treatment response and survival. Patients and methods: We investigated contrast-enhanced MRI, apparent diffusion coefficient (ADC) in diffusionweighted imaging and H-1-magnetic resonance spectroscopy (1H-MRS) in detecting early morphologic and metabolic changes in borderline or resectable liver metastases, as a response to first-line neoadjuvant or conversion therapy in a prospective substudy of the RAXO trial (NCT01531621, EudraCT2011-003158-24). MRI findings were compared with histology of resected liver metastases and KaplaneMeier estimates of overall survival (OS). Results: In 2012-2018, 52 patients at four Finnish university hospitals were recruited. Forty-seven patients received neoadjuvant or conversion chemotherapy and 40 liver resections were carried out. Low ADC values (below median) of the representative liver metastases, at baseline and after systemic therapy, were associated with partial response according to RECIST criteria, but not with morphologic MRI changes or histology. Decreasing ADC values following systemic therapy were associated with improved OS compared to unchanged or increasing ADC, both in the liver resected subgroup (5-year OS rate 100% and 34%, respectively, P = 0.022) and systemic therapy subgroup (5-year OS rate 62% and 23%, P = 0.049). H-1-MRS revealed steatohepatosis induced by systemic therapy. Conclusions: Low ADC values at baseline or during systemic therapy were associated with treatment response by RECIST but not with histology, morphologic or detectable metabolic changes. A decreasing ADC during systemic therapy is associated with improved OS both in all patients receiving systemic therapy and in the resected subgroup.Peer reviewe

    Treatment response of colorectal cancer liver metastases to neoadjuvant or conversion therapy : a prospective multicentre follow-up study using MRI, diffusion-weighted imaging and H-1-MR spectroscopy compared with histology (subgroup in the RAXO trial)

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    Background: Colorectal cancer liver metastases respond to chemotherapy and targeted agents not only by shrinking, but also by morphologic and metabolic changes. The aim of this study was to evaluate the value of advanced magnetic resonance imaging (MRI) methods in predicting treatment response and survival. Patients and methods: We investigated contrast-enhanced MRI, apparent diffusion coefficient (ADC) in diffusionweighted imaging and H-1-magnetic resonance spectroscopy (1H-MRS) in detecting early morphologic and metabolic changes in borderline or resectable liver metastases, as a response to first-line neoadjuvant or conversion therapy in a prospective substudy of the RAXO trial (NCT01531621, EudraCT2011-003158-24). MRI findings were compared with histology of resected liver metastases and KaplaneMeier estimates of overall survival (OS). Results: In 2012-2018, 52 patients at four Finnish university hospitals were recruited. Forty-seven patients received neoadjuvant or conversion chemotherapy and 40 liver resections were carried out. Low ADC values (below median) of the representative liver metastases, at baseline and after systemic therapy, were associated with partial response according to RECIST criteria, but not with morphologic MRI changes or histology. Decreasing ADC values following systemic therapy were associated with improved OS compared to unchanged or increasing ADC, both in the liver resected subgroup (5-year OS rate 100% and 34%, respectively, P = 0.022) and systemic therapy subgroup (5-year OS rate 62% and 23%, P = 0.049). H-1-MRS revealed steatohepatosis induced by systemic therapy. Conclusions: Low ADC values at baseline or during systemic therapy were associated with treatment response by RECIST but not with histology, morphologic or detectable metabolic changes. A decreasing ADC during systemic therapy is associated with improved OS both in all patients receiving systemic therapy and in the resected subgroup.Peer reviewe

    Symptoms and diagnostic delays in bladder cancer with high risk of recurrence: results from a prospective FinnBladder 9 trial

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    Purpose: To investigate the symptoms and delays in the clinical pathway of bladder cancer (BC).Methods: This is a substudy of a prospective, randomized, multicenter phase III study (FinnBladder 9, NCT01675219) where the efficacy of photodynamic diagnosis and 6 weekly optimized mitomycin C instillations are studied in pTa bladder cancer with high risk for recurrence. The data of presenting symptoms and critical time points were prospectively collected, and the effect of factors on delays was analyzed.Results: At the time of analysis, 245 patients were randomized. Analysis included 131 patients with primary bladder cancer and their complete data. Sixty-nine percent had smoking history and 67% presented with macroscopic hematuria. Median patient delay (from symptoms to health-care contact) was 7 days. The median general practice delay (from health-care contact to urology referral) was 8 days. Median time from urology referral to cystoscopy was 23 days and from cystoscopy to TUR-BT 21 days. Total time used in the clinical pathway (from symptom to TUR-BT) was 78 days. Current and former smokers had non-significantly shorter patient-related and general practice delays compared to never smokers. TUR-BT delay was significantly shorter in patients with malignant cytology (16 days) compared to patients with benign cytology (21 days, p = 0.03).Conclusions: Patient-derived delay was short and most of the delay occurred in the referral centers. The majority had macroscopic hematuria as the initial symptom. Surprisingly, current and past smokers were more prone to contact the health-care system compared to never smokers.</p

    Sense of coherence and attrition during four-year follow-up in cohorts of permanent and non-permanent Finnish employees

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    <p>Abstract</p> <p>Background</p> <p>We studied whether health resources, measured as sense of coherence (SOC), are associated with participation in a follow-up survey among permanent and non-permanent employees who responded at baseline.</p> <p>Methods</p> <p>Of a cohort of 5,981 permanent employees, those who after four years were still in the service of the same employer were asked to participate in a follow-up survey. Another cohort consisted of 2,194 fixed-term and 682 subsidised employees; among these the follow-up survey was posted to those whose addresses were found in the population register. Non-participation was divided into loss to follow-up (i.e., failure to locate the individual, death and, among permanent employees, turnover or exit from labour market) and non-response to the follow-up survey. Logistic regression analyses were used to examine whether the respondents differed from the non-respondents with respect to SOC and other characteristics at baseline.</p> <p>Results</p> <p>Among permanent employees the follow-up survey yielded 3,998 respondents, 1,051 were lost, and 932 did not reply. Among non-permanent employees the follow-up survey yielded 1,563 respondents on initially fixed-term and 467 on subsidised contracts, the corresponding figures for those lost were 145 and 38, and for the non-respondents 486 and 177. Low SOC was associated with lower response rate among fixed-term but not among permanent or subsidised employees. No association was found between SOC and loss to follow-up.</p> <p>Conclusion</p> <p>SOC is a potential source of non-random sample attrition and should be taken into account for when estimating bias due to non-participation in occupational cohorts that include fixed-term employees.</p
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