The perceptions of different professionals on school absenteeism and the role of school health care : A focus group study conducted in Finland

Purpose of the study School absenteeism and school dropout jeopardize the future health and wellbeing of students. Reports on the participation of school health care in absenteeism reduction are infrequent, although physical and mental health problems are the most common causes of school absenteeism. Our aim was to explore what reasons different professionals working in schools recognize for absenteeism and which factors either promote or inhibit the inclusion of school health care in absenteeism reduction. Materials and methods Data for this qualitative study was gathered from ten focus groups conducted in two municipalities in southern Finland. The groups included (vice) principals, special education/resource/subject teachers, guidance counselors, school social workers, school psychologists, school nurses, school doctors, and social workers working in child protective services. Data analysis was predominantly inductive but the categorization of our results was based on existing literature. Results Study participants identified student-, family-, and school-related reasons for absenteeism but societal reasons went unmentioned. A number of reasons promoting the inclusion of school health care in absenteeism reduction arose, such as expertise in health-related issues and the confidentiality associated with health care. Inclusion of school health care was hindered by differences in work culture and differing perceptions regarding the aims of school health care. Conclusion Professionals working in schools were knowledgeable about the different causes of school absenteeism. Clarifying both the aims of school health care and the work culture of different professionals could facilitate the inclusion of school health care in absenteeism reduction.Peer reviewe

Oral Lesions in the Bit Area in Finnish Trotters After a Race : Lesion Evaluation, Scoring, and Occurrence

Oral lesions in the bit area are common in horses, but not comprehensively studied in harness racing horses. This study describes the type and occurrence of oral soft tissue lesions in the area affected by the bit, hereafter called the bit area, in trotters after a race. Based on our results, we suggest a system for scoring lesions according to size, type (bruise or wound), age, and depth (superficial or deep). The data was collected during a welfare program for trotters, conducted by The Finnish Trotting and Breeding Association (Suomen Hippos ry). The rostral part of the mouth of 261 horses (151 Standardbreds, 78 Finnhorses, and 32 ponies) was examined after a race in a systematic manner, using a bright light source without sedation or a mouth gag. The lip commissures (outside and inside), bars of the mandible, buccal area near the second upper premolar teeth, tongue, and hard palate were visually examined; bars of the mandible were also palpated. Points were assigned to every lesion and then added together, such that each horse got an acute lesion score. Based on the score, the horses were divided into four groups (A- D) as follows: Group A, no lesions; B, mild lesions; C, moderate lesions; D, severe lesions. Of all the horses examined, 84% (219/261) had acute lesions in the bit area. In total, 21% (55/261) had mild lesions, 43% (113/261) had moderate lesions, and 20% (51/261) had severe lesions. Visible bleeding outside the mouth was observed in 2% (6/261) of the horses. Further, 5% of the horses (13/261) had blood on the bit when it was removed from the mouth, even though no blood was visible outside the mouth. In conclusion, soft tissue lesions in the bit area were common in the Finnish trotters examined. Moreover, the absence of blood outside the mouth does not rule out serious injuries inside the mouth. The scoring system presented can be used for evaluating the severity of oral lesions in different equestrian disciplines and populations to allow for comparable data across studies.Peer reviewe

Efficacy of a novel PCR- and microarray-based method in diagnosis of a prosthetic joint infection

Peer reviewe

Molecular diagnostics for bacterial infections in bronchoalveolar lavage--a case-control, pilot study

QUESTIONS UNDER STUDY: The differentiation between infectious and noninfectious pulmonary complications is challenging. Rapid, accurate microbiological results may allow appropriate antibiotic therapy, withholding or adapting antibiotics, and thus reducing costs and risks of empirical antibiotic therapy. The objective of this proof-of-concept pilot study was to investigate the diagnostic yield of a new polymerase chain-reaction (PCR) and microarray-based rapid molecular diagnostic assay and compare the results to conventional microbiology cultures and clinical judgment. METHODS: Bronchoalveolar lavage specimens were obtained from 35 patients undergoing bronchoscopy for diagnostic reasons. Cases (n = 22) consisted of patients with suspicion of pulmonary bacterial infection. Controls (n = 13) were identified among patients undergoing bronchoscopy for indications other than suspicion of infection. RESULTS: Demographics were similar in cases and controls. The majority (73%) of patients with pulmonary infection were on empirical antibiotic therapy. Among the 22 cases, bacteria were identified by means of PCR in 77% (n = 17) as compared with 41% (n = 9) by culture (p = 0.030). In contrast, controls yielded a PCR positive result in 45% (n = 7), as compared with no positive cultures (p = 0.005). Compared with culture results, PCR had a sensitivity of 87.5% (95% confidence interval [CI] 47.4-97.9) and specificity of 28.6% (95% CI 8.6-58.1) to diagnose bacterial infection. Compared with clinical judgment, corresponding figures were 77.3% (95% CI 54.5-91.1) and 46.2% (95% CI 19.3-74.8), respectively. CONCLUSION: The PCR- and microarray-based rapid molecular diagnostic assay offers an alternative to conventional cultures for detection of potentially pathogenic bacteria in bronchoalveolar lavage of patients with pneumonia. However, the clinical relevance is unclear as it may also detect colonisers in patients without a corresponding infection