Children’s social orientations as creative processes in early childhood education and care

The purpose of this article is to study children’s social orientations as creative processes in early childhood education and care (ECEC). In this article, we focus on how children’s creative thinking abilities relate to children’s social orientations in interactive situations in ECEC. We study children’s creative thinking abilities with the Thinking Creatively in Action and Movement [TCAM] -test and children’s social orientations with the Child observation instrument of Reunamo (2007). Two hundred and eighty children in 23 ECEC institutions participated in the research. There were altogether eight randomly selected days for the observation between January and May 2015. The TCAM-test was conducted by teachers for their own group. The connections between the TCAM-test and the Child observation instrument were studied with partial correlations controlling children’s age. The results showed that children’s creative thinking abilities were associated positively with participative social orientation. An adaptive and withdrawn orientation had negative correlations with creative thinking abilities.Peer reviewe

Children’s social orientations as creative processes in early childhood education and care

The purpose of this article is to study children’s social orientations as creative processes in early childhood education and care (ECEC). In this article, we focus on how children’s creative thinking abilities relate to children’s social orientations in interactive situations in ECEC. We study children’s creative thinking abilities with the Thinking Creatively in Action and Movement [TCAM] -test and children’s social orientations with the Child observation instrument of Reunamo (2007). Two hundred and eighty children in 23 ECEC institutions participated in the research. There were altogether eight randomly selected days for the observation between January and May 2015. The TCAM-test was conducted by teachers for their own group. The connections between the TCAM-test and the Child observation instrument were studied with partial correlations controlling children’s age. The results showed that children’s creative thinking abilities were associated positively with participative social orientation. An adaptive and withdrawn orientation had negative correlations with creative thinking abilities.Peer reviewe

Buprenorphine-naloxone, buprenorphine, and methadone throughout pregnancy in maternal opioid use disorder

IntroductionCurrent WHO guidelines recommend using methadone or buprenorphine as maintenance treatments for maternal opioid use disorder. However, buprenorphine-naloxone, with a lower abuse risk than buprenorphine monotherapy or methadone, offers a potentially beneficial alternative, but scientific evidence on its effects on pregnancies, fetuses, and newborns is scarce. This paper compares the outcomes of the pregnancies, deliveries, and newborns of women on buprenorphine-naloxone, buprenorphine, or methadone maintenance treatments. According to the hypothesis, as a maintenance treatment, buprenorphine-naloxone does not have more adverse effects than buprenorphine, whereas methadone is more complicated. Material and methodsIn this population-based study, 172 pregnant women on medical-assisted treatments were followed-up at Helsinki University Women's Hospital (Finland). Women receiving the same opioid maintenance treatment from conception to delivery and their newborns were included. Consequently, 67 mother-child dyads met the final inclusion criteria. They were divided into three groups based on their opioid pharmacotherapy. The outcomes were compared among the groups and, where applicable, with the Finnish population. ResultsThe buprenorphine-naloxone and buprenorphine groups showed similar outcomes and did not significantly differ from each other in terms of maternal health during pregnancies, deliveries, or newborns. Illicit drug use during the pregnancy was common in all groups, but in the methadone group it was most common (p = 0.001). Most neonates (96%) were born full-term with good Apgar scores. They were of relatively small birth size, with those in the methadone group tending to be the smallest. Of the neonates 63% needed pharmacological treatment for neonatal opioid withdrawal syndrome. The need was lower in the buprenorphine-based groups than in the methadone group (p = 0.029). ConclusionsBuprenorphine-naloxone seems to be as safe for pharmacotherapy for maternal opioid use disorder as buprenorphine monotherapy for both mother and newborn. Hence it could be a choice for oral opioid maintenance treatment during pregnancy, but larger studies are needed before changing the official recommendations. Women on methadone treatment carry multifactorial risks and require particularly cautious follow up. Furthermore, illicit drug use is common in all treatment groups and needs to be considered for all patients with opioid use disorder.Peer reviewe

How size matters: exploring the association between quality of mental health services and catchment area size

Background: The diversity of mental health and substance abuse services (MHS) available to service users is seen as an indicator of the quality of the service system. In most countries MHS are provided by a mix of public, private and third sector providers. In Finland, officially, the municipalities are responsible for organizing the services needed, but the real extent and roles of private and third sector service providers are not known. Our previous study showed that the catchment area population size was strongly associated with diversity of mental health services. It is not known whether this was due to some types of services or some provider types being more sensitive to the size effect than others.The aim of this study was to investigate the association between area population size and diversity of mental health services, i.e. which types of services and which service providers' contributions are sensitive to population size.Methods: To map and classify services, we used the ESMS-R. The diversity of services was defined as the count of main types of care. Providers were classified as public, private or third sectors.Results: The diversity of outpatient, residential and voluntary services correlated positively with catchment area population size. The strongest positive correlation between the size of population and services available was found in third sector activities followed by public providers, but no correlation was found for diversity of private services. The third sector and public corporations each provided 44 % of the service units.Third sector providers produced all self-help services and most of the day care services. Third sector and private companies provided a significant part (59 %) of the residential care service units.Conclusions: Significant positive correlations were found between size of catchment area population and diversity of residential, outpatient and voluntary services, indicating that these services concentrate on areas with larger population bases. The third sector seems to significantly complement the public sector in providing different services. Thus the third sector be needs to be functionally integrated with other MHS services to achieve a diversified and integrated service system

Diseño de un programa de fiscalización para reducir la evasión en los profesionales de la salud afectos a rentas de cuarta categoría, distrito de Chiclayo 2014

Como sabemos el estado peruano obtiene ingresos para ejercer su soberanía a través de la recaudación de impuestos principalmente. Es labor de SUNAT vigilar por el correcto cumplimiento de esta obligación y de concientizar a la población de lo mismo. Al respecto se cuenta con estadísticos que avalan la existencia de contribuyentes que evaden impuestos, siendo esto una problemática que debilita la recaudación y atenta con el bienestar de todos. Para ello, se detectó la oportunidad de diseñar un programa de fiscalización para reducir la evasión de impuestos, siendo esto aplicable en los profesionales de la salud, pues son un segmento del cual se espera mejorar su contribución mensual. Los objetivos planteados fueron determinar el incremento patrimonial no justificado, realizar el cruce de información con otras entidades públicas y privadas, implantar acciones de fiscalización en donde intervengan empresas, instituciones y personas a fin de detectar ingresos no declarados. Adicionalmente se propondrá celebrar convenios con lugares estratégicos a fin de mantener a la población informada. La investigación fue descriptivo – analítico, teniendo como instrumentos la observación y encuesta. Como resultados trascendió la falta de información de estas personas, quienes manifestaron desconocer la obligación de llevado de libros o la obligación de emitir recibo de honorarios por todos los ingresos percibidos, entre otros. Finalmente se detectó que existe una real y urgente necesidad de implementar un programa de fiscalización en los profesionales de salud afectos a renta de cuarta categoría, esto influiría positivamente en cifras incrementando el ingreso por recaudación de impuestos

Biodegradable nanomats produced by electrospinning : expanding multifunctionality and potential for tissue engineering

With increasing interest in nanotechnology, development of nanofibers (n-fibers) by using the technique of electrospinning is gaining new momentum. Among important potential applications of n-fiber-based structures, scaffolds for tissue-engineering represent an advancing front. Nanoscaffolds (n-scaffolds) are closer to natural extracellular matrix (ECM) and its nanoscale fibrous structure. Although the technique of electrospinning is relatively old, various improvements have been made in the last decades to explore the spinning of submicron fibers from biodegradable polymers and to develop also multifunctional drug-releasing and bioactive scaffolds. Various factors can affect the properties of resulting nanostructures that can be classified into three main categories, namely: (1) Substrate related, (2) Apparatus related, and (3) Environment related factors. Developed n-scaffolds were tested for their cytocompatibility using different cell models and were seeded with cells for to develop tissue engineering constructs. Most importantly, studies have looked at the potential of using n-scaffolds for the development of blood vessels. There is a large area ahead for further applications and development of the field. For instance, multifunctional scaffolds that can be used as controlled delivery system do have a potential and have yet to be investigated for engineering of various tissues. So far, in vivo data on n-scaffolds are scarce, but in future reports are expected to emerge. With the convergence of the fields of nanotechnology, drug release and tissue engineering, new solutions could be found for the current limitations of tissue engineering scaffolds, which may enhance their functionality upon in vivo implantation. In this paper electrospinning process, factors affecting it, used polymers, developed n-scaffolds and their characterization are reviewed with focus on application in tissue engineering

The CEDAR Project

The LHC project at CERN requires both the handling of a huge amount of engineering information and the control of the coherence of this information as the design work evolves on the machine and the experiments. A commercial Engineering Data Management System, (EDMS), is being implemented to manage data for the design, construction, installation and maintenance of both the accelerator and the experiments. This CERN-wide project is called CEDAR The World Wide Web is used to make the information accessible at CERN and in the external collaborating laboratories around the world. In this paper we describe the objectives of the CEDAR project, the different subprojects in the machine and the experiments as well as the first results of the implementation work

Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration

The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings

Identifying Local and Centralized Mental Health ServicesThe Development of a New Categorizing Variable

The challenges of mental health and substance abuse services (MHS) require shifting of the balance of resources from institutional care to community care. In order to track progress, an instrument that can describe these attributes of MHS is needed. We created a coding variable in the European Service Mapping Schedule-Revised (ESMS-R) mapping tool using a modified Delphi panel that classified MHS into centralized, local services with gatekeeping and local services without gatekeeping. For feasibility and validity, we tested the variable on a dataset comprising MHS in Southern Finland, covering a population of 2.3 million people. There were differences in the characteristics of services between our study regions. In our data, 41% were classified as centralized, 37% as local without gatekeeping and 22% as local services with gatekeeping. The proportion of resources allocated to local services varied from 20% to 43%. Reclassifying ESMS-R is an easy way to compare the important local vs. centralized balance of MHS systems globally, where such data exists. Further international studies comparing systems and validating this approach are needed

Regional Correlates of Psychiatric Inpatient Treatment

Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components