Physical fitness of paramedic students during vocational training - a follow-up study

Introduction: Paramedics’ work includes periods of physically light activity, but also involves short periods of relatively intense physical activity.  Even during their studies paramedic students’ days involve a lot of sitting, i.e. physically sedentary behaviour. We initiated a programme to motivate paramedic students to be physically active during their studies. In this study we report physical fitness among paramedic students who for one year participated in brief physical activity counselling consisting of both verbal and a written individually tailored exercise programMethods: A total of 40 paramedic students (26 female, 14 male) had participated voluntarily in a physical activity programme alongside their studies. Subjects’ maximal oxygen consumption and muscle strength were measured at baseline and at one-year follow-up. According to the results of the baseline tests all students were given an individual exercise programme, which included aerobic and muscle strength training.Results: Sixty-five percent (26/40) of the students participated in the follow-up examinations. At baseline male students had higher mean maximal oxygen consumption (VO2Max) and, as expected, greater absolute muscle strength than their female counterparts (all p-values <0.05). During the follow-up females had improved their VO2Max on average by 2.4 ml/kg/min. Furthermore, females on average improved the number of squats  by 4.2 [95% Confidence Interval (CI) 0.01 to 8.33] repetitions, and males improved the number of push-ups (mean improvement 4.8, 95% CI 1.93 to 7.57), and left arm grip strength (mean improvement 4.0 kg, 95% CI 1.39 to 6.53).Conclusions: It seems to be possible to maintain, and even slightly improve paramedic students’ physical fitness with a self-directed, guided, home exercise programme. This approach could enhance prospective paramedics’ willingness to develop the necessary physical qualities long-term throughout their clinical careers.

Niuvanniemen nuoriso-osastolle ohjautuneiden potilaiden kotikuntien mielenterveyttä tukevien palvelujen tarjonta ja menot

Tutkimuksessa arvioitiin vuosina 2004–2007 Niuvanniemen sairaalan nuoriso-osastolla olleiden (N = 52) potilaiden kotikuntien (N = 34) talouden tunnuslukuja ja palvelujen käyttöä vuosina 1994–2008 vertaamalla niitä samansuuruisten kuntien (n = 34) tunnuslukuihin. Tutkimuksessa verrattiin potilaiden kotikuntien alaikäisten palveluihin käytettyjä menoja/alaikäinen vertailukuntien ja koko Suomen kuntien menoihin. Aineisto kerättiin Tilasto- ja indikaattoripankki SOTKAnetistä. Tilastollisina menetelminä käytettiin keskiarvotestejä. Potilaiden kotikunnissa oli vertailukuntiin verrattuna enemmän sairastavuutta ja mielenterveyssyistä työkyvyttömyyseläkkeellä olevia työikäisiä. Nuoriso-osastolla olleiden potilaiden kotikunnissa oli erityiskorvattaviin lääkkeisiin oikeutettuja alle 16-vuotiaita ja psykiatrian erikoissairaanhoidon laitoshoidon päiviä alle 17-vuotiailla enemmän kuin vertailukunnissa. Alaikäisten suuremmasta sairastavuudesta huolimatta kotikuntien alaikäisten peruspalvelujen käyttö ei eronnut vertailukunnista. Tulosten mukaan erityisen vaikeahoitoisten alaikäisten kotikuntien mielenterveyspalvelujen tarjonta on viime vuosiin saakka painottunut laitoshoitoon avopalvelujen sijaan. Lasten mielenterveyspalveluihin kohdennettujen valtionosuuksien myötä koko Suomessa erikoissairaanhoidon palveluihin käytetyt menot alaikäistä kohden ovat ylittäneet kouluterveydenhuoltoon sekä kasvatus- ja perheneuvolapalveluihin käytetyt menot

Distinct fatty acid signatures in infrapatellar fat pad and synovial fluid of patients with osteoarthritis versus rheumatoid arthritis

Background: Infrapatellar fat pad (IFP) has recently emerged as a potential source of inflammation in knee arthropathies. It has been proposed to be one source of adipocytokines, fatty acids (FA), and FA-derived lipid mediators that could contribute to the pathophysiological processes in the knee joint. Alterations in synovial fluid (SF) lipid composition have been linked to both osteoarthritis (OA) and rheumatoid arthritis (RA). The aim of the present study was to compare the FA signatures in the IFP and SF of RA and OA patients. Methods: Pairs of IFP and SF samples were collected from the same knees of RA (n=10) and OA patients (n=10) undergoing total joint replacement surgery. Control SF samples (n=6) were harvested during diagnostic or therapeutic arthroscopic knee surgery unrelated to RA or OA. The FA composition in the total lipids of IFP and SF was determined by gas chromatography with flame ionization and mass spectrometric detection. Results: Arthropathies resulted in a significant reduction in the SF proportions of n-6 polyunsaturated FA (PUFA), more pronouncedly in OA than in RA. OA was also characterized with reduced percentages of 22:6n-3 and lower product/precursor ratios of n-3 PUFA. The proportions of total monounsaturated FA increased in both RA and OA SF. Regarding IFP, RA patients had lower proportions of 20:4n-6, total n-6 PUFA, and 22:6n-3, as well as lower product/precursor ratios of n-3 PUFA compared to OA patients. The average chain length of SF FA decreased in both diagnoses and the double bond index in OA. Conclusions: The observed complex alterations in the FA signatures could have both contributed to but also limited the inflammatory processes and cartilage destruction in the RA and OA knees.Peer reviewe

Feasibility of written instructions in airway management training of laryngeal tube

Peer reviewe

Synovial Fluid Fatty Acid Profiles Are Differently Altered by Inflammatory Joint Pathologies in the Shoulder and Knee Joints

Simple Summary Anomalies of fatty acid metabolism characterize osteoarthritis and rheumatoid arthritis in the knee joint. No previous study has investigated the synovial fluid fatty acid manifestations in these aging-related inflammatory diseases in the shoulder. The present experiment compared the fatty acid alterations between the shoulder and knee joints in trauma controls and in patients with end-stage osteoarthritis or end-stage rheumatoid arthritis. The fatty acid signatures in the synovial fluid of trauma controls were mostly uniform in both anatomical locations. Shoulders with rheumatoid arthritis were characterized by elevated percentages of arachidonic acid and docosahexaenoic acid and with reduced proportions of oleic acid. The fatty acid profiles of knees with osteoarthritis or rheumatoid arthritis were relatively uniform and displayed lower proportions of linoleic acid, docosahexaenoic acid and total n-6 polyunsaturated fatty acids. The results indicate location- and disease-dependent differences in the synovial fluid fatty acid composition. These alterations may affect joint lubrication, synovial inflammation and pannus formation as well as cartilage and bone degradation and contribute to the pathogeneses of inflammatory joint diseases. Anomalies of fatty acid (FA) metabolism characterize osteoarthritis (OA) and rheumatoid arthritis (RA) in the knee joint. No previous study has investigated the synovial fluid (SF) FA manifestations in these aging-related inflammatory diseases in the shoulder. The present experiment compared the FA alterations between the shoulder and knee joints in patients with end-stage OA or end-stage RA. SF samples were collected during glenohumeral or knee joint surgery from trauma controls and from OA and RA patients (n = 42). The FA composition of SF total lipids was analyzed by gas chromatography with flame ionization and mass spectrometric detection and compared across cohorts. The FA signatures of trauma controls were mostly uniform in both anatomical locations. RA shoulders were characterized by elevated percentages of 20:4n-6 and 22:6n-3 and with reduced proportions of 18:1n-9. The FA profiles of OA and RA knees were relatively uniform and displayed lower proportions of 18:2n-6, 22:6n-3 and total n-6 polyunsaturated FAs (PUFAs). The results indicate location- and disease-dependent differences in the SF FA composition. These alterations in FA profiles and their potential implications for the production of PUFA-derived lipid mediators may affect joint lubrication, synovial inflammation and pannus formation as well as cartilage and bone degradation and contribute to the pathogeneses of inflammatory joint diseases.Peer reviewe

Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review

Higher education for health care professionals faces numerous challenges. It is important to develop and apply methods supporting education, especially the practical skills. This scoping review aimed to explore the activities and learning outcomes of digital technology in practical skills teaching and learning in higher education for the social and health professions. Scoping review recommendations and the PRISMA-ScR checklist were applied. Randomized controlled trials published between 2016 and 2021 involving students in higher education who were taking courses in the social sciences and health care and reported interventions with digital technology activities and practices in practical teaching and learning were included. The CINAHL Plus, PubMed, Scopus, ERIC, and Sociological Abstracts/Social Services Abstracts databases were searched. Teaching methods were blended, e-learning or other online-based, and digital simulation-based activities. Teaching and learning environments, methods, resources, and activity characteristics varied, making a summary difficult. Interventions were developed in a face-to-face format prior to digitalization. The outcomes were measured at the knowledge level, not at the performance level. One-third of the studies showed a significant improvement in practical skills in the intervention group in comparison to the control conditions. The use of digital technology in the learning and teaching process have potential to develop of students' skills, knowledge, motivation, and attitudes. The pedagogy of technology use is decisive. The development of new digital methods for teaching and learning practical skills requires the engagement of students and teachers, in addition the researchers.publishersversionPeer reviewe

Finnish schoolchildren’s perceived health-related quality of life deteriorates remarkably with age

Glavna tema ovog završnog rada su razvojne mogućnosti osiguranja imovine konkretno strojeva od loma na tržištu Republike Hrvatske, koje uvelike ovise o gospodarskoj situaciji u zemlji, a također i okruženja u kojem se nalazi. Opasnosti od požara, poplava, uništenja stroja, ozljede na radu su svakodnevne, a čovjek je svjestan situacije tek kad se dogodi. Ljudi bi trebali shvatiti da osiguranje nije trošak nego investicija koja im u bližoj ili daljoj budućnosti može spriječiti značajan financijski trošak, zbog iznenadno nastale štete. Strojevi u bilo kojoj grani industrije su veoma skupi i iziskuju veliki financijski kapital bilo za pojedinca ili tvrku i njihovim oštećenjem nastaju velike štete. Ako nisu osigurani, prilikom oštećenja nastaju veliki problemi. Naročito u proizvodnom pogonu, npr. tiskarski strojevi vrlo su skupi i složeni, pa se kod nekih šteta treba direktno uništeni dio nabavljati ili reparirati u tvornici, koja može biti i izvan Europe. Također kod visokosofisticirane opreme, pored troškova popravka, cijene rada, cijene utrošenog materijala, pojavljuju se dodatni troškovi različitih stručnjaka i specijalista, kao i troškovi zračnog prijevoza, prekovremenog rada, što u konačnici rezultira vrlo visokim iznosom koji treba nadoknaditi. Ali to i jest smisao osiguranja, rizik od nastale štete prebaciti na osiguravajuće društvo. Znači, osiguranje ne predstavlja samo sigurnost u suvremenim uvjetima, već i neke druge važne faktore, kao što su stabilnost financijskog sustava, razvoj gospodarstva zemlje, mogućnost investiranja kapitala i sl