Pre-notification of arriving trauma patient at trauma centre: A retrospective analysis of the information in 700 consecutive cases

<p>Abstract</p> <p>Background</p> <p>Pre-notification of an arriving trauma patient, given by transporting emergency medical unit, is needed in terms of facilitating the admitting emergency department to get ready for the patient before the patient actually arrives. In the present study we retrospectively analyzed the pre-hospital information provided by 700 consecutive pre-notification mobile phone calls in terms to asses the response of trauma team activation regard to pre-notified information such as vital signs and level of consciousness, mechanism of injury (MOI), and estimated elapsed time (EET) from the time of pre-notification phone call to arrival.</p> <p>Results</p> <p>The median EET was 15 minutes (range 0 – 80 min, interquartile range 10 – 20 min). In 11% of the cases EET was 5 minutes or shorter. 17% of the patients were intubated and ventilated on scene at the time pre-notification phone call took place. The most commonly notified pre-hospitally diagnosed injuries were thoracic in 75 cases (11%), followed by unstable long bone (tibia, femur, humerus) fracture in 66 cases (9%), and abdominal injuries in 32 cases (5%). Trauma team was activated for 61% of 700 pre-notified patients. MOI without clinical symptoms was the reason for team activation in 75% of the cases. In 25% of the cases there were pre-hospitally observed clinical injuries or abnormalities in vital parameters.</p> <p>Conclusion</p> <p>Pre-notification phone call is of a crucial importance in organizing every day activities at a busy trauma centre, but it should not take place in too much advance. In any case, a pre-notification phone call, even on short notice, gives emergency department personnel some time to prepare for the incoming patient.</p

Koskematonta korpeako?:uusia lähtökohtia Savon myöhäisrautakautisen paikallisasutuksen tulkintaan

Tiivistelmä. Tutkielma käsittelee myöhäisrautakautista (800–1300 jaa.) asutusta, elinkeinoja ja vuorovaikutusta nykyisen Pohjois- ja Etelä-Savon (tästä eteenpäin Savo) alueella. Aikaisemmassa tutkimuksessa Savon alue on näyttäytynyt erämaana, jossa on harjoitettu eränkäyntiä kalmistollisen alueen asukkaiden toimesta. Lisäksi erämaassa on tulkittu asuneen kierteleviä lappalaisia. Aikaisempi arkeologinen tulkinta alueen myöhäisrautakautisesta asutuksesta, elinkeinoista ja vuorovaikutuksesta perustuu voimakkaasti tulkinnalle eränkäynnistä, sillä arkeologinen aineisto, etenkin metalleista valmistettu esineistö, on liitetty lähinnä muualta tulleisiin eränkävijöihin. Tämän tutkielman tarkoitus on tuoda esille Savon ”erämaassa” asuneiden paikallisten roolia arkeologisen aineiston tuottajina ja sitä kautta tuoda uusia lähtökohtia Savon alueen asutuksen tulkinnalle. Tutkimuksen pääpaino on paikallisessa asutuksessa ja toiminnassa, sillä aikaisemmassa tutkimuksessa se on jäänyt marginaaliasemaan. Paikallisväestöillä tarkoitan Savon alueella asuneita henkilöitä ja yhteisöjä, jotka eivät olleet Savon ulkopuolelta tulleita eränkävijöitä. Käytetty aineisto kattaa Savon alueen rautakautiset muinaisjäännökset ja irtolöydöt. Näitä tarkastelemalla selvitettiin alueen asutusta, elinkeinoja ja suhteita ympäröiviin alueisiin. Tarkastelin myös kriittisesti aiempaa tutkimusta ja pohdin sen vaikutusta Savon alueen rautakauden tulkintaan. Tämän perusteella Savon alueella asuneet yhteisöt olivat osana vuorovaikutusverkostoa, joka kattoi vähintäänkin ympäröivät alueet. Asutuksesta ja elinkeinoista kertovat merkit, sekä irtolöydöt, ovat todennäköisimmin peräisin näiltä paikallisilta väestöiltä, jotka elivät metsästyksellä ja kalastuksella. Kaupankäynti ja kontaktit eränkävijöihin ja muihin yhteisöihin rikastuttivat paikallisia yhteisöjä. Savon alueella liikkuminen tapahtui pääasiallisesti vesireittejä pitkin, joiden äärellä asuinpaikat ja monet irtolöydöistä sijaitsivat. Vesistöt liittyivät lisäksi kalastuksen tärkeään rooliin elannon hankinnassa, sekä kosmologioihin. Tutkimustulosten perusteella myöhäisrautakautinen Savo ei näyttäydy erämaana vaan asuttuna paikkana, jossa harjoitettiin metsästystä, kalastusta, raudanvalmistusta ja kaupankäyntiä. Uutta aineistoa on saatavilla metallinilmaisinharrastuksen suosion kasvun seurauksena, joka osaltaan luo mahdollisuuksia tutkia perifeerisinä pidettyjä alueita uusista lähtökohdista. Lisäksi erämaina pidettyjen alueiden tutkimus on tuottanut uusia tuloksia, joiden perusteella alueen asutushistoriaa on alettu tarkastella uudelleen. Jotta Savonkin asutushistorian tulkinta tarkentuu on tärkeää, että Savon rautakautista asutusta ja toimintaa tutkitaan jatkossakin

Long-Term Outcome and Treatment in Persistent and Transient Congenital Hyperinsulinism : A Finnish Population-Based Study

Context: The management of congenital hyperinsulinism (CHI) has improved. Objective: To examine the treatment and long-term outcome of Finnish patients with persistent and transient CHI (P-CHI and T-CHI). Design: A population-based retrospective study of CHI patients treated from 1972 to 2015. Patients: 106 patients with P-CHI and 132 patients with T-CHI (in total, 42 diagnosed before and 196 after year 2000) with median follow-up durations of 12.5 and 6.2 years, respectively. Main outcome measures: Recovery, diabetes, pancreatic exocrine dysfunction, neurodevelopment. Results: The overall incidence of CHI (n = 238) was 1:11 300 live births (1972-2015). From 2000 to 2015, the incidence of P-CHI (n = 69) was 1:13 500 and of T-CHI (n = 127) 1:7400 live births. In the 21st century P-CHI group, hyperinsulinemic medication was initiated and normoglycemia achieved faster relative to earlier. Of the 74 medically treated P-CHI patients, 68% had discontinued medication. Thirteen (12%) P-CHI patients had partial pancreatic resection and 19 (18%) underwent near-total pancreatectomy. Of these, 0% and 84% developed diabetes and 23% and 58% had clinical pancreatic exocrine dysfunction, respectively. Mild neurological difficulties (21% vs 16%, respectively) and intellectual disability (9% vs 5%, respectively) were as common in the P-CHI and T-CHI groups. However, the 21st century P-CHI patients had significantly more frequent normal neurodevelopment and significantly more infrequent diabetes and pancreatic exocrine dysfunction compared with those diagnosed earlier. Conclusions: Our results demonstrated improved treatment and long-term outcome in the 21st century P-CHI patients relative to earlier.Peer reviewe

Laboratory-based surveillance of COVID-19 in the Greater Helsinki area, Finland, February-June 2020

Objectives: The aim was to characterise age-and sex-specific severe acute respiratory syndrome coronavirus disease-2 (SARS-CoV-2) RT-PCR sampling frequency and positivity rate in Greater Helsinki area in Finland during February & ndash;June 2020. We also describe the laboratory capacity building for these diagnostics. Methods: Laboratory registry data for altogether 80,791 specimens from 70,517 individuals was analysed. The data included the date of sampling, sex, age and the SARS-CoV-2 RT-PCR test result on specimens collected between 1 February and 15 June 2020. Results: Altogether, 4057/80,791 (5.0%) of the specimens were positive and 3915/70,517 (5.6%) of the individuals were found positive. In all, 37% of specimens were from male and 67% from female subjects. While the number of positive cases was similar in male and female subjects, the positivity rate was significantly higher in male subjects: 7.5% of male and 4.4% of female subjects tested positive. The highest incidence/100,000 was observed in those aged >80 years. The proportion of young adults in positive cases increased in late May 2020. Large dips in testing frequency were observed during every weekend and also during public holidays. Conclusions: Our data suggest that men pursue SARS-CoV-2 testing less frequently than women. Consequently, a subset of coronavirus disease-2019 infections in men may have gone undetected. People sought testing less frequently on weekends and public holidays, and this may also lead to missing of positive cases. The proportion of young adults in positive cases increased towards the end of the study period, which may suggest their returning back to social behaviour with an increased risk of infection. (c) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).Peer reviewe

Siberian Subtype Tickborne Encephalitis Virus, Finland

We isolated 11 Siberian subtype tickborne encephalitis virus (TBEV) strains from Ixodes persulcatus ticks from a TBEV-endemic focus in the Kokkola Archipelago, western Finland. Thus I. persulcatus and the Siberian TBEV are reported in a focus considerably northwest of their previously known range in eastern Europe and Siberia

Four decades of global surface albedo estimates in the third edition of the CM SAF cLoud, Albedo and surface Radiation (CLARA) climate data record

We present the surface albedo data in the third edition of the CM SAF cLoud, Albedo and surface Radiation (CLARA) data record family. The temporal coverage of this edition is extended from 1979 until the near-present day. The core algorithms and data format remain unchanged from previous editions, but now white- and blue-sky albedo estimates are also available for the first time in CLARA data. We present an overview of the retrieval, followed by an assessment of the accuracy and stability of the data record, based on collocated comparisons with reference surface albedo measurements and intercomparisons with preceding satellite-based albedo data records. Specific attention is paid to addressing the spatial representativeness problem inherent in the “point-to-pixel” validation of satellite-based coarse surface albedo estimates against in situ measurements. We find the CLARA-A3 albedo data to match or improve upon the accuracy and robustness of the predecessor record (CLARA-A2), with good agreement found when compared to in situ measurements. In cases of a large bias, the spatial representativeness of the measurement site typically explains most of the increase. We conclude with a summarizing discussion on the observed strengths and weaknesses of the new data record, including guidance for potential users. The data are available at https://doi.org/10.5676/EUM_SAF_CM/CLARA_AVHRR/V003 (Karlsson et al., 2023b).</p

Music Students’ Experienced Workload, Livelihoods and Stress in Higher Education in Finland and the United Kingdom

Neoliberal education policies—viewing students’ life as human capital, economic investment for the labour market and consumer power—may increase students’ workload in higher education. In this mixed methods study, we examined music students’ experiences of workload in Finland and the United Kingdom in connection with stress and livelihoods. We used Bayesian mixed effects ordinal probit regression modeling to estimate effects of countries and livelihoods as predictors for music students’ experienced workload in relation to their main subject of study (or principal study) and stress. We analysed music students’ lived experiences of workload to find further predictors for the developmental work in universities and educational policies. Results indicate that where neoliberal university culture impacts on music students’ livelihoods alongside their studies, this is likely to increase stress but not necessarily impact on the workload associated with their main subject of study. However, stress has a notable effect on students’ experiences of workload. In order to support music students’ learning, well-being and future careers, we suggest paying attention to certain aspects in universities in relation to workload, such as the gap between well-off students compared to low-income students who need to work as well as studying, and stress, particularly with female and non-binary gender students. Furthermore, we propose alternative ways to navigate neoliberal university culture. Keywords: higher education; livelihoods; music student; stress; student experience; student workloa

Interaction between parental psychosis and early motor development and the risk of schizophrenia in a general population birth cohort.

BACKGROUND: Delayed motor development in infancy and family history of psychosis are both associated with increased risk of schizophrenia, but their interaction is largely unstudied. AIM: To investigate the association of the age of achieving motor milestones and parental psychosis and their interaction in respect to risk of schizophrenia. METHODS: We used data from the general population-based prospective Northern Finland Birth Cohort 1966 (n=10,283). Developmental information of the cohort members was gathered during regular visits to Finnish child welfare clinics. Several registers were used to determine the diagnosis of schizophrenia among the cohort members and psychosis among the parents. Altogether 152 (1.5%) individuals had schizophrenia by the age of 46 years, with 23 (15.1%) of them having a parent with psychosis. Cox regression analysis was used in analyses. RESULTS: Parental psychosis was associated (P<0.05) with later achievement of holding the head up, grabbing an object, and walking without support. In the parental psychosis group, the risk for schizophrenia was increased if holding the head up (hazard ratio [HR]: 2.46; degrees of freedom [df]=1; 95% confidence interval [95% CI]: 1.07-5.66) and touching the thumb with the index finger (HR: 1.84; df=1; 95% CI: 1.11-3.06) was later. In the group without parental psychosis, a delay in the following milestones increased the risk of schizophrenia: standing without support and walking without support. Parental psychosis had an interaction with delayed touching thumb with index finger (HR: 1.87; df=1; 95% CI: 1.08-3.25) when risk of schizophrenia was investigated. CONCLUSIONS: Parental psychosis was associated with achieving motor milestones later in infancy, particularly the milestones that appear early in a child's life. Parental psychosis and touching the thumb with the index finger had a significant interaction on risk of schizophrenia. Genetic risk for psychosis may interact with delayed development to raise future risk of schizophrenia, or delayed development may be a marker of other risk processes that interact with genetic liability to cause later schizophrenia.This study was supported by grants from the Brain and Behavior Research Foundation, Northern Finland Health Care Support Foundation, Sigrid Jusélius Foundation, and the Signe and Ane Gyllenberg Foundation, Finland. NFBC 1966 received financial support from the Academy of Finland (104781, 120315, 129269, 1114194, 24300796, 268336, 278286), Center of Excellence in Complex Disease Genetics and SALVE, Oulu University Hospital, Oulu, Finland, Biocenter of Oulu, Finland, University of Oulu, Finland (75617, 24002054, 2400692), Ministry of Social Affairs and Health (50459, 50691, 50842, 2749, 2465), NHLBI grant 5R01HL087679-02 through the STAMPEED program (1RL1MH083268-01), NIH/NIMH (5R01MH63706:02), ENGAGE project and grant agreement HEALTH-F4-2007-(201413), EU FP7 EurHEALTHAgeing (277849), EU FP7 EurHealth Epi-Migrant (279143), European Regional Development Fund 537/2010 (24300936) and the Medical Research Council, UK (G0500539, G0600705, G1002319, PrevMetSyn/SALVE).This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.eurpsy.2015.04.00

A HPMT based set-up to characterize scintillating crystals

We have developed a fully automatic measurement set-up, capable of measuring light yields arising from scintillating crystals in a linear range of about four orders of magnitude. The photodetector is a Hybrid Photomultiplier Tube especially developed to optimize linear range and photon detection. Crystal and photodetector are temperature controlled by a closed water circuit, as this is essential when measuring low light yield scintillating crystals with a marked temperature dependence of their light yield. Gamma sources can be placed either on top or on the side of the crystal. In this latter case, the source can be automatically moved by a computer-controlled step motor to provide a uniformity profile of the light yield along the crystal. Tagged and not-tagged operation modes are possible. The whole set-up is computer-controlled in an effort to provide fast and reliable measurements, to characterize many crystals per day. This is important for the quality control of the Lead Tungstate crystals that will be applied in the electromagnetic calorimeter of the CMS-detector at the LHC at CERN