Objective Evaluation of Nasal Dimensions in Children with Acoustic Rhinometry

Aims: This study was carried out to investigate the usefulness of acoustic rhinometry in the evaluation of intranasal dimensions in children. The aim was to define reference values for school children. In addition, the role of the VAS scale in the subjective evaluation of nasal obstruction in children was studied. Materials and methods: Measurements were done with Acoustic Rhinometry A1. The values of special interest were the minimal cross-sectional area (MCA) and the anterior volume of the nose (VOL). The data for reference values included 124 voluntary school children with no permanent nasal symptoms, aged between 7 and 14 years. Data were collected at baseline and after decongestion of the nose; the VAS scale was filled in before measurements. The subjects in the follow-up study (n=74, age between 1 and 12 years) were receiving intranasal spray of insulin or placebo. The nasal symptoms were recorded and acoustic rhinometry was measured at each control visit. Results: In school children, the mean total MCA was 0.752 cm2 (SD 0.165), and the mean total VOL was 4.00 cm3 (SD 0.63) at baseline. After decongestion, a significant increase in the mean TMCA and in the mean TVOL was found. A correlation was found between TMCA and age, and between TVOL and height of a child. There was no difference between boys and girls. A correlation was found between unilateral acoustic values and VAS at baseline, but not after decongestion. No difference wasfound in acoustic values or symptoms between the insulin and placebo group in the follow-up study of two years. Conclusions: Acoustic rhinometry is a suitable objective method to examine intranasal dimensions in children. It is easy to perform and well tolerated. Reference values for children between 7 and 14 years were established.Lasten nenän rakenteiden objektiivinen tutkiminen akustisella rinometrilla Tavoite: Tutkimuksen tarkoituksena oli selvittää akustisen rinometrin käyttökelpoisuutta lasten nenän rakenteiden tutkimisessa. Tavoitteena oli asettaa vertailuarvot kouluikäisille lapsille. Lisäksi tutkittiin, miten VAS-jana soveltuu lasten nenän tukkoisuuden subjektiiviseen arviointiin. Aineisto ja menetelmät: Mittaukset tehtiin Acoustic Rhinometry A1 -laitteella. Arvioinnin kohteena olivat erityisesti nenän etuosan minimipinta-ala ja tilavuus. Tutkimukseen osallistui 124 vapaaehtoista 7-14 -vuotiasta koululaista, joilla ei ollut jatkuvia nenäoireita. Mittaukset tehtiin sekä perustilanteessa että limakalvojen supistuksen jälkeen. Lapset täyttivät VAS-janan ennen jokaista mittausta. Seurantatutkimukseen osallistuneet lapset (n=74, ikä 1-12 vuotta) käyttivät nenään suihkutettavaa insuliinia tai lumelääkettä. Kontrollikäyntien yhteydessä kartoitettiin mahdollisten nenäoireiden esiintyminen ja tehtiin nenämittaus akustisella rinometrilla. Tulokset: Kouluikäisten lasten sierainten yhteenlaskettu minimipinta-ala oli 0.752 cm2 (SD 0.165) ja tilavuus 4.00 cm3 (SD 0.63). Arvot suurenivat merkitsevästi limakalvojen supistuksen jälkeen. Lasten iän ja sierainten minimipinta-alan välillä todettiin merkitsevä korrelaatio, samoin kuin lasten pituuden ja nenän tilavuuden välillä. Poikien ja tyttöjen välillä ei ollut eroa. Perustilanteessa mitatut yhden sieraimen arvot korreloivat VAS-janalla tehtyyn arvioon, mutta yhteyttä ei voitu osoittaa limakalvojen supistamisen jälkeen. Seurantatutkimuksessa ei havaittu eroa nenäoireissa tai mittaustuloksissa insuliini- ja lumelääkeryhmien välillä kahden vuoden seurannan aikana. Johtopäätökset: Akustinen rinometri sopii lasten nenän rakenteiden arviointiin. Mittaus on hyvin siedetty ja vaivaton suorittaa. Tutkimuksen perusteella voitiin asettaa 7-14 -vuotiaille lapsille käyttökelpoiset vertailuarvot.Siirretty Doriast

Patient participation in shared decision-making in palliative care - an integrative review

Background Shared decision-making is a process where the decisions regarding patients' care are done in collaboration with the patient, the patient's family and a healthcare professional or an interdisciplinary team. Shared decision-making is considered to be a part of patient centred care, and it enables patient autonomy which is a cornerstone of palliative care. In the past, research on the experiences of palliative care patients' participation in shared decision-making involving a nurse has been limited as the focus has mainly been on specific medical interventions, rather than holistic palliative care. Objectives To synthesise research findings on patient participation in shared decision-making in palliative care. Research design An integrative literature review. Methods The literature search was conducted by searching computerised databases (CINAHL, PubMed, PsychINFO and COCHRANE). The search resulted in 12 articles. The quality of the included articles was evaluated with JBI checklist, and the data analysis was done using inductive content analysis. Reporting was done according to a PRISMA checklist. Findings Patients do participate in shared decision-making and desire to participate in everyday nursing care decisions, treatment-related medical decisions and end-of-life decisions. The prerequisites for patient participation in shared decision-making are interdisciplinary teamwork, open communication, good patient-healthcare professional relationship, a favourable environment and mutual information. Conclusion Palliative care patients do participate and desire to participate in decisions that cover a much broader range of topics than just medical interventions and this should be addressed in future research and in practise. The main responsibility for successful patient participation in shared decision-making lies with the healthcare professionals and the organisations providing palliative care. There is a need to conduct more research from the patient's perspective and explore the meaning of participating in shared decision-making from the patient's point of view.Peer reviewe

Balloon Dilation of the Eustachian Tube in Chronic Eustachian Tube Dysfunction: A Retrospective Study of 107 Patients

BACKGROUNDEustachian tube dysfunction affects from 1% to 5% of adults. This study evaluates the effectiveness of balloon dilation of eustachian tube for treating nonselected patients with eustachian tube dysfunction in a long term.METHODSWe evaluated all balloon dilation of eustachian tube operations at Turku University Hospital from 2013 to 2016. The data from 107 patients and 167 ears were collected retrospectively and a questionnaire was sent to these patients regarding their symptoms.RESULTSAn evident reduction of the symptoms was noticed. Aural fullness, otalgia, recurrent acute otitis media, or otitis media with effusion as well as symptoms from changes to ambient pressure and the ability to do the Valsalva maneuver were significantly improved. The mean followup time with the questionnaire was 33 months. Of patients, 80% (36/45) reported long-term reduction of symptoms.CONCLUSIONSIn our study, balloon dilation of eustachian tube seems to have reduced symptoms of eustachian tube dysfunction and the results appear to be long lasting.</p

Patient participation in shared decision-making in palliative care - an integrative review

Background Shared decision-making is a process where the decisions regarding patients' care are done in collaboration with the patient, the patient's family and a healthcare professional or an interdisciplinary team. Shared decision-making is considered to be a part of patient centred care, and it enables patient autonomy which is a cornerstone of palliative care. In the past, research on the experiences of palliative care patients' participation in shared decision-making involving a nurse has been limited as the focus has mainly been on specific medical interventions, rather than holistic palliative care.Objectives To synthesise research findings on patient participation in shared decision-making in palliative care.Research design An integrative literature review.Methods The literature search was conducted by searching computerised databases (CINAHL, PubMed, PsychINFO and COCHRANE). The search resulted in 12 articles. The quality of the included articles was evaluated with JBI checklist, and the data analysis was done using inductive content analysis. Reporting was done according to a PRISMA checklist.Findings Patients do participate in shared decision-making and desire to participate in everyday nursing care decisions, treatment-related medical decisions and end-of-life decisions. The prerequisites for patient participation in shared decision-making are interdisciplinary teamwork, open communication, good patient-healthcare professional relationship, a favourable environment and mutual information.Conclusion Palliative care patients do participate and desire to participate in decisions that cover a much broader range of topics than just medical interventions and this should be addressed in future research and in practise. The main responsibility for successful patient participation in shared decision-making lies with the healthcare professionals and the organisations providing palliative care. There is a need to conduct more research from the patient's perspective and explore the meaning of participating in shared decision-making from the patient's point of view

Contents, Methods, and Outcomes of Adolescent Sexual Health Promotion in School Environments : A Scoping Review

ABSTRACT BACKGROUND Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. METHODS Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. RESULTS After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. CONCLUSIONS The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.Peer reviewe

Development of otology specific outcome measure : Ear Outcome Survey-16 (EOS-16)

Purpose: An important outcome measure of patient care is the impact on the patient's health-related quality of life (HRQoL). Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms, hearing problems, psychosocial impact, and the need for care. The optimal length of the recall period has not been studied. For these reasons, a new survey is needed that would cover most chronic ear diseases. Methods: A preliminary 24-item survey (EOS-24) was created. Untreated adult patients (included n = 186) with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL instrument. The recruiting otologists evaluated the severity of the disease and the disability caused by it. A control group was recruited. Based on the patients' responses in different diagnosis groups, the items were reduced according to pre-defined criteria. The resulting survey was validated using a thorough statistical analysis. Results: The relevance and necessity of the original 24 items were thoroughly investigated, leading to the exclusion of 8 items and the modification of 1. The remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups, thus constituting the final instrument, EOS-16. The most suitable recall period was three months. Conclusions: EOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient population. The survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument. (C) 2021 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd.Peer reviewe

Development of otology specific outcome measure: Ear Outcome Survey-16 (EOS-16)

PurposeAn important outcome measure of patient care is the impact on the patient’s health-related quality of life (HRQoL). Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms, hearing problems, psychosocial impact, and the need for care. The optimal length of the recall period has not been studied. For these reasons, a new survey is needed that would cover most chronic ear diseases.MethodsA preliminary 24-item survey (EOS-24) was created. Untreated adult patients (included n = 186) with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL instrument. The recruiting otologists evaluated the severity of the disease and the disability caused by it. A control group was recruited. Based on the patients’ responses in different diagnosis groups, the items were reduced according to pre-defined criteria. The resulting survey was validated using a thorough statistical analysis.ResultsThe relevance and necessity of the original 24 items were thoroughly investigated, leading to the exclusion of 8 items and the modification of 1. The remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups, thus constituting the final instrument, EOS-16. The most suitable recall period was three months.ConclusionsEOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient population. The survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.</p

Local treatment of a pleural mesothelioma tumor with ONCOS-102 induces a systemic antitumor CD8(+) T-cell response, prominent infiltration of CD8(+) lymphocytes and Th1 type polarization

Peer reviewe

Phase I study with ONCOS-102 for the treatment of solid tumors - an evaluation of clinical response and exploratory analyses of immune markers

Peer reviewe

Musiikkiharrastus, hyvinvointi ja soittamisen ilo! : Ideoita viulunsoitonopetukseen

Viulu on yksi haastavimmista ja suosituimmista instrumenteista klassisessa musiikissa. Viulunsoitto vaatii ahkeraa ja kurinalaista harjoittelua. Opinnäytetyön tavoitteena oli löytää vinkkejä positiivisen oppimiskokemuksen ja motivaation kehittymiselle soitonopetuksessa. Työssä tutustuttiin viulunsoiton pedagogiikkaan ja opetustapoihin, jotka tukevat positiivista oppimiskokemusta ja sisäisen motivaation syntymistä. Lisäksi pohdittiin mitä voisi olla taitava opettajuus. Opinnäytetyössä tutkittiin musiikin terapeuttisia vaikutuksia ja niiden yhteyksiä ihmisen hyvinvointiin. Tavoitteena oli selvittää voisiko musiikkiterapian menetelmiä hyödyntää soitonopetuksessa enemmän. Opinnäytetyö toteutettiin laadullisena tutkimuksena. Tiedonhankinnassa tutustuttiin opinnäytetyöhön liittyvään kirjallisuuteen. Kirjallisuuteen tutustumisen lisäksi menetelmätapoja olivat haastattelututkimus sekä kirjoittajan omat kokemukset soittajana ja opettajana. Haastattelu toteutettiin teemahaastatteluna kahdelle viulunsoitonopettajalle, pianonsoitonopettajalle ja säveltäjälle. Opinnäytetyössä pyrittiin vertailemaan kirjoittajan omia kokemuksia, haastattelututkimuksen tuloksia sekä lähdeaineiston tietoa toisiinsa. Haastattelututkimuksen ja lähdeaineistojen perusteella voidaan todeta, että musiikkiterapian menetelmiä kuten improvisointi, säveltäminen, tarinasäveltäminen, musiikin kuuntelu ja laulaminen voitaisiin hyödyntää enemmän soitonopetuksessa. Opinnäytetyössä selvisi, että soitonopetuksessa opettajalla on suuri merkitys positiivisen oppimiskokemuksen ja motivaation ylläpitämisessä. Opettajan työ voi olla haastavaa, mutta hyvin antoisaa. Musiikkiharrastuksella ja musiikilla itsessään on monia hyvinvointiin vaikuttavia tekijöitä. Musiikin terapeuttisia vaikutuksia hyödynnetään paljon musiikkiterapiassa, mutta jo pelkkä musiikkiharrastus voi toimia terapeuttisena, ja parantaa ihmisen hyvinvointia.The violin is one of the most difficult and popular instruments in classical music. Playing the violin demands hard and disciplined practicing. The aim of this work was to find ideas for enhancing positive learning experiences and motivation in instrument teaching. The thesis examined violin pedagogy and such teaching methods that support positive learning experiences and inner motivation. Additionally, the focus was on what constitutes proficient teaching. The therapeutic effects of music and its connection to well-being were examined as well, and the goal of the thesis was to determine if the methods of music therapy could be utilized in teaching. The thesis was implemented as qualitative research. The theoretical background consisted of literature related to the thesis. In addition to reviewing literature, the methods included interviews and the author`s own playing and teaching experiences. The interviews were implemented as theme interviews with two violin teachers, a piano teacher and a composer. The aim was to compare the author`s own experiences, the results of the interviews and literature to each other. Based on the interviews and literature, music therapy methods, such as improvising, composing, story composing, listening to music and singing could be utilized more in teaching. It was discovered that the teacher has a great importance in maintaining positive learning experiences and motivation. Being a teacher can be very challenging, but on the other hand, it can also be very rewarding. Music as a hobby and music itself has many connections to well-being. The therapeutic effect of music has been widely used in music therapy, but even music as a hobby could be sufficiently therapeutic and improve people’s well-being