The educational paradigm shift-a phenomenographic study of medical teachers' experiences of practices

BackgroundThis paper proposes a novel approach to the development of competence-oriented higher education, a national transformation aimed at harmonising and digitising undergraduate medical and dental education in Finland.MethodsWe apply phenomenography as a viable qualitative method for medical education research. To better understand medical teachers' expectations towards the change in the educational paradigm, we need to study teachers' experiences of the current practices in undergraduate medical and dental education. The phenomenographic approach facilitates solid links between research, educational development, and change.ResultsThe phenomenographic study maps the qualitatively different ways in which medical teachers experience undergraduate medical and dental education practices. The answers reflect the changing educational paradigm in medical schools, suggesting practical implications for further development of medical and dental education and training. Core content analysis is preferred instructional scaffold for both teachers and students to prioritise the extensive medical education objectives. The change towards competence-based orientation is in progress and national co-operation accelerates its impact.ConclusionThere is an obvious need to enrich the content of the current curriculum with national guidelines that aim for congruence in assessment and objectives. Our results suggest an assessment application for the theoretical concepts presented and promote the competence orientation of education throughout the curricula of medical and dental undergraduate education. Moreover, our results contribute to current European discourses on competence-based approaches in higher education. Up-to-date pedagogical faculty development programmes are a key prerequisite for teacher empowerment and future orientation in teaching and learning for healthcare professions.Peer reviewe

Ammatillisten opettajien "Oppiminen Online" - Osaamisperusteisen lähestymisen visualisointi osaamismerkein ohjautuvassa oppimisessa

Vocational education in Finland is based on competence-based qualification requirements. Meanwhile, digital open badges promote competence-based assessment and shared expertise in digital environments. The educational setting supports gamified learning solutions and enhances student motivation. The current study aims to examine how learners experience the competence-based approach in the badge-driven learning process of professional development. The theoretical framework focuses on the concept of instructional badging in the competence-based approach. Coordinated by the country’s northernmost school of profesional teacher education, “Learning Online” is a national professional development program (PDP) of digital pedagogical competences for vocational teachers in Finland. The data were collected in 2017 from in-service trained professional teachers and pre-service students (n=329) of vocational teacher education who had earned digital open badges in a Learning Online PDP. A questionnaire was used to collect both quantitative and qualitative data. The study provides an example of using two different methods to build knowledge describing participants’ experiences. The study employed constrained correspondence analysis and phenomenography to analyse participants’ different experiences. Both used methods highlight the badge learners’ experiences and offer to deepen the existing knowledge of digital open badge-driven learning complementing one other by explaining different aspects of the phenomenon. The results describe the impact of the competence-based approach on teachers’ professional development in digital open badge-driven learning. Ammatillinen koulutus perustuu Suomessa osaamisperusteisiin ammattitaitovaatimuksiin. Digitaaliset avoimet osaamismerkit mahdollistavat osaamisperusteisen arvioinnin ja asiantuntijuuden jakamisen digitaalisissa ympäristöissä. Osaamismerkein ohjautuva oppiminen tukee pelillistettyjä oppimisratkaisuja ja edistää opiskelijan motivaatiota. Tämän tutkimuksen tavoitteena on tarkastella, miten ammatilliset opettajat kokevat osaamisperusteisen osaamismerkein ohjautuvan oppimisen ammatillisessa osaamisen kehittämisessä. Teoreettinen viitekehys keskittyy oppimista ohjaavien osaamismerkkien myöntämiseen erityisesti osaamisperusteisen oppimisen kontekstissa. “Oppiminen Online” on ammatillisille opettajille suunnattu kansallinen digipedagogisen osaamisen kehittämisohjelma, jota koordinoi maan pohjoisin opettajakorkeakoulu. Tutkimusaineisto kerättiin syksyllä 2017 ohjelmassa digitaalisia osaamismerkkejä suorittaneilta ammatillisilta opettajilta ja ammatillisen opettajankoulutuksen opiskelijoilta (n=329). Kyselylomakkeella koottiin sekä määrällistä että laadullista aineistoa, tavoitteena kuvata erilaisilla tutkimusmenetelmillä osallistujien kokemuksia. Määrällinen analyysi tehtiin rajoitettuna korrespondessianalyysina, jonka lisäksi osallistujien erilaisia kokemuksia tarkasteltiin fenomenografisen tutkimusotteen avulla. Molemmat käytetyt menetelmät nostavat esiin ammatillisten opettajien erilaiset kokemukset osaamismerkein ohjautuvasta oppimisesta, ja syventävät täten olemassa olevaa käsitystä selittämällä ilmiön eri osa-alueita. Tulokset kuvaavat osaamisperusteisuuden ilmenemistä osaamismerkein ohjautuvassa ammatillisten opettajien osaamisen kehittämisessä

Psyykenlääkkeet ja sydän

Vertaisarvioitu. English summaryMonet masennus- ja psykoosilääkkeet pidentävät QT-aikaa ja voivat siten altistaa käyttäjänsä äkkikuolemalle. Näiden lääkkeiden aloitus edellyttää riskinarviointia ja jatkuva käyttö muun muassa EKG-seurantaa. Varsinkin klotsapiini voi aiheuttaa kardiomyopatian tai ennen sitä myokardiitin, jonka ilmetessä lääkitys kannattaa keskeyttää. Monet psykoosilääkkeet huonontavat kardiologista riskiprofiilia, sillä ne lisäävät painoa ja muuttavat glukoosi- ja lipidiaineenvaihduntaa. Psyykenlääkehoitoja aloitettaessa kannattaa tehdä kardiovaskulaarinen riskinarvio, ja heti, kun potilaan psyykkinen tila sen sallii, puuttua erityisesti tupakointiin ja painon lisääntymiseen elintapainterventiolla tai jopa lääkitystä muuttamalla. Psyykenlääkkeiden sekä sydän- ja verisuonitautilääkkeiden välillä esiintyy merkittäviä yhteisvaikutuksia. Eräät masennuslääkkeet voivat aiheuttaa vuotokomplikaatioita tukosta estävien lääkkeiden ja antikoagulanttien kanssa. Yhteisvaikutusriski on erityisen suuri monilääkityillä vanhuksilla.Peer reviewe

Kuntien tilintarkastuksen laatu ja toimivuus : Nykytila ja kehittämistarpeet

Tutkimushankkeen tavoitteena oli selvittää, miten hyvin kuntien ja kuntayhtymien tilintarkastus täyttää sille laissa asetetut tavoitteet hallinnon ja talouden laillisuuden varmentajana. Tutkimusraportissa esitetään useita toimenpide-ehdotuksia ja lainsäädännön kehittämisehdotuksia. Kunnallisen tilintarkastuspalvelun tilaajat ovat asiakkaan roolissa saamaansa palveluun valtaosin tyytyväisiä. Kuntien ja kuntayhtymien hankintaosaamisessa esiintyy kuitenkin puutteita. Lisäksi kunnallisen tilintarkastuksen laadussa on PRH:n toimeksiantokohtaisissa laaduntarkastuksissa havaittu suhteellisen runsaasti puutteita. Tilintarkastusmarkkinoilla kuntatilintarkastusta tarjoavien yhteisöjen supistuminen on myös huolestuttavaa. Yksi ongelma kilpailutuksessa on tarjouspyyntöjen valintakriteeristön hintapainotus ja tarkastuspäivien lukumäärän kiinnittäminen etukäteen. Tilintarkastuksen kilpailutus näyttää johtaneen alhaisiin tarkastushintoihin ja siihen liittyen sellaiseen tarkastuspäivien määrään, joka on riski julkishallinnon hyvän tilintarkastustavan toteutumiselle. Em. ongelmiin liittyy kyselyissä ja haastatteluissa ilmi tullut toive julkishallinnon hyvän tilintarkastustavan nykyistä selkeämmästä määrittelystä. Toiveita esitettiin myös tilintarkastusvalvonnalle vuorovaikutuksen ja kehittävän otteen lisäämisestä.Tämä julkaisu on toteutettu osana valtioneuvoston selvitys- ja tutkimussuunnitelman toimeenpanoa. (tietokayttoon.fi) Julkaisun sisällöstä vastaavat tiedon tuottajat, eikä tekstisisältö välttämättä edusta valtioneuvoston näkemystä

Comparisons and Recommendations

For the last decade a major trend within tax administrations has been to shift from a roughly one size fits all approach—where close to all taxpayers experience a deterrence approach—to a more responsive and collaborative approach as in co-operative compliance programmes. Such programmes build on the idea that the participating corporations disclose relevant information including their tax risks and are transparent to the tax administrations and in return will tax administrations provide real-time predictability and clarity concerning taxation issues of relevance for the corporation. In brief, co-operative compliance builds on the slogan: “…certainty in exchange for transparency” (OECD 2016, 7). Co-operative compliance has increasingly become a core concern and way of organizing the relation between tax authorities and large corporate tax payers when it comes to securing tax compliance. This working paper is the result of research by Work Package 6 in EU’s Horizon 2020 funded programme FairTax that has been running for the four-year period 2015-2019. Our research in Work Package 6 addresses how proactive engagements with large corporate taxpayers have affected regulation of tax collection and administrative processes, changed relationships between stakeholders and tax administrations, and influenced tax compliance in the Nordic countries. The aim of this working paper is to provide a comparison of the experiences in four of the Nordic countries: Denmark, Finland, Norway and Sweden and to propose recommendations. The Nordic countries are considered similar and so were the co-operative compliance programmes that were implemented in each country, yet the outcomes were very different. We thus dealt with various case characteristics (Flyvbjerg 2006) where the outcomes hinged on a complexity of elements. We argue that the Swedish case is an extreme case due to its turbulent life and concomitantly with only a handful of participants that have very little activity. The Norwegian case, in contrast, is an example of a maximum variation case because of the much longer history of collaborative relationships and the outcome of the work with tax risk. The combination of a collaborative way of working and systematic risk management and monitoring may either reflect a most likely scenario of future tax administration—or perhaps the least likely. Lastly, we argue that the Danish and Finnish cases represent paradigmatic cases because both of these align largely with the standards set by the OECD and because they therefore present more ordinary or regular ways of working with co-operative compliance. Analyzing a wide variety of case characteristics means that our findings can be of general interest, beyond the Nordic countries

Targeted Query Expansions as a Method for Searching Mixed Quality Digitized Cultural Heritage Documents

Digitization of cultural heritage is a huge ongoing effort in many countries. In digitized historical documents, words may occur in different surface forms due to three types of variation - morphological variation, historical variation, and errors in optical character recognition (OCR). Because individual documents may differ significantly from each other regarding the level of such variations, digitized collections may contain documents of mixed quality. Such different types of documents may require different types of retrieval methods. We suggest using targeted query expansions (QE) to access documents in mixed-quality text collections. In QE the user-given search term is replaced by a set of expansion keys (search words); in targeted QE the selection of expansion terms is based on the type of surface level variation occurring in the particular text searched. We illustrate our approach in a highly inflectional compounding language, Finnish while the variation occur across all natural languages. We report a minimal-scale experiment based on the QE method and discuss the need to support targeted QEs in the search interface.ye

Metabonomic, transcriptomic, and genomic variation of a population cohort

Peer reviewe

Loss-of-function mutation in IKZF2 leads to immunodeficiency with dysregulated germinal center reactions and reduction of MAIT cells

Peer reviewe

Loss-of-function mutation in IKZF2 leads to immunodeficiency with dysregulated germinal center reactions and reduction of MAIT cells

Peer reviewe

Genetic Determinants of Circulating Glycine Levels and Risk of Coronary Artery Disease

Background-Recent studies have revealed sexually dimorphic associations between the carbamoyl-phosphate synthase 1 locus, intermediates of the metabolic pathway leading from choline to urea, and risk of coronary artery disease (CAD) in women. Based on evidence from the literature, the atheroprotective association with carbamoyl-phosphate synthase 1 could be mediated by the strong genetic effect of this locus on increased circulating glycine levels. Methods and Results-We sought to identify additional genetic determinants of circulating glycine levels by carrying out a metaanalysis of genome-wide association study data in up to 30 118 subjects of European ancestry. Mendelian randomization and other analytical approaches were used to determine whether glycine-associated variants were associated with CAD and traditional risk factors. Twelve loci were significantly associated with circulating glycine levels, 7 of which were not previously known to be involved in glycine metabolism (ACADM, PHGDH, COX1 8-ADAMTS3, PSPH, TRIB 1 , PTPRD, and ABO). Glycine-raising alleles at several loci individually exhibited directionally consistent associations with decreased risk of CAD. However, these effects could not be attributed directly to glycine because of associations with other CAD-related traits. By comparison, genetic models that only included the 2 variants directly involved in glycine degradation and for which there were no other pleiotropic associations were not associated with risk of CAD or blood pressure, lipid levels, and obesity-related traits. Conclusions-These results provide additional insight into the genetic architecture of glycine metabolism, but do not yield conclusive evidence for a causal relationship between circulating levels of this amino acid and risk of CAD in humans.Peer reviewe