Obliteration of radical cavities with autogenous cortical bone; long-term results

<p>Abstract</p> <p>Background</p> <p>To evaluate the long-term surgical outcome(s) in patients who have undergone canal-wall-down operation with mastoid and epitympanic obliteration using autologous cortical bone chips, bone pate and meatally-based musculoperiosteal flap technique.</p> <p>Method</p> <p>Retrospective evaluation of seventy patients operated during 1986–1991 due to a cholesteatoma. An otomicroscopy was performed to evaluate the postoperative outer ear canal configuration with a modified Likert scale (1 – 4). The outer ear canal physical volume was assessed by tympanometry. The hearing outcome and a patient-filled questionnaire were also analyzed.</p> <p>Results</p> <p>The posterior wall results were 1.8 (± 0.9 SD) and the attic region 1.8 (± 0.9 SD) (ns., p > 0.05). These values show either no cavity formation or minor formation of a cavity, with a good functional result. The mean volume of the operated ear canal was 1.7 (± 0.5 SD) ml. The volume of the contralateral ear canal was 1.2 (± 0.3 SD) ml (*** p < 0.0001). A comparison of the current mean ABG to the preoperative mean ABG and to the ABG at one-year postoperatively, 5-years postoperatively or 10-years postoperatively showed no statistical significance (p > 0.05).</p> <p>Conclusion</p> <p>ABG does not significantly change in the long-term. The configuration of the cavity tends to change, however, the obliteration material is stable in the long-term and clinically significant cavitation rarely occurs.</p

Low prevalence of zoonotic multidrug-resistant bacteria in veterinarians in a country with prudent use of antimicrobials in animals

The occurrence of multidrug-resistant zoonotic bacteria in animals has been increasing worldwide. Working in close contact with livestock increases the risk of carriage of these bacteria. We investigated the occurrence of extended-spectrum beta-lactamase (ESBL) and plasmidic AmpC beta-lactamase producing Enterobacteriaceae (ESBL/pAmpC-PE) and livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) in Finnish veterinarians (n = 320). In addition to microbiological samples, background information was collected. Bacterial whole genome sequencing was performed to deduce sequence types (STs), spa types and resistance genes of the isolates. In total, 3.0% (9/297) of the veterinarians carried ESBL producing Escherichia coli, with one ESBL producing E. coli isolate producing also AmpC. Seven different STs, sequences of several different plasmid groups as well as several different bla(ESBL/pAmpC )genes existed in different combinations. No carbapenemase or colistin resistance genes were detected. MRSA was detected in 0.3% (1/320) of the samples. The strain belonged to LA-MRSA clonal complex (CC) 398 (ST398, spa type 011, lacking Panton-Valentine leukocidin genes). In conclusion, this study shows low carriage of multidrug-resistant zoonotic bacteria in Finnish veterinarians. However, finding LA-MRSA for the first time in a sample from a veterinarian in a country with prudent use of animal antimicrobials and regarding the recent rise of LA-MRSA on Finnish pig farms, a strong recommendation to protect people working in close contact with animals carrying LA-MRSA CC398 is given. Further studies are needed to explain why the prevalence of LA-MRSA in veterinarians is lower in Finland than in other European countries.Peer reviewe

The irrelevance of stated plans in predicting farm successions in Finland

This study estimates the value of farmers stated succession plans in predicting revealed succession decisions. The stated succession plan exists when a farmer answers in a survey questionnaire that the farm is going to be transferred to a new entrant within a five year period. The succession is revealed when the farm is transferred to a successor. The stated and revealed behaviour is estimated as a recursive Binomial-Probit- Model, which accounts for censoring of the decision variables and controls for a potential correlation between the estimating equations. The results suggest that the succession plans, as stated by elderly farmers in the questionnaires, do not provide information that is significant and valuable in predicting the true, revealed successions, once certain farm and farmer characteristics are controlled for.;Suomalaisen maatalouden rakenne on muuttunut nopeastiviimeisen vuosikymmenen aikana maatilojen määrä on vähentynyt ja keskikoko kasvanut. Samaan aikaan tehtyjen sukupolvenvaihdosten määrä on vähentynyt. Maatalouden rakennekehityksen ennustamiseksi viljelijöiltä onkin viime aikoina alettu toistuvasti kysellä heidän sukupolvenvaihdossuunnitelmiaan. Aikaisempien tutkimusten perusteella viljelijöiden sukupolvenvaihdossuunnitelmat muuttuvat kuitenkin ajan myötä. Tässä tutkimuksessa verrataan viljelijöiden sukupolvenvaihdosaikomuksia koskevia kyselyvastauksia ja toteutunutta kehitystä toisiinsa. Tavoitteena on selvittää, voidaanko viljelijäkyselyjen perusteella ylipäätään tuottaa tilastoista ja viljelijöiden ikäjakaumista saatavan tiedon lisäksi sellaista tietoa, joka auttaisi ennustamaan sukupolvenvaihdosten määrää ja maatalouden rakennekehityksen nopeutta yhä tarkemmin. Tutkimusaineistona käytettiin kirjanpitotila-aineistoa vuosilta 19962001 sekä näille tiloille vuosina 19961997 tehtyä kyselyä. Kyselyssä selvitettiin, aiottiinko tilalla tehdä sukupolvenvaihdos seuraavan viiden vuoden aikana. Tarkastelussa oli mukana 97 tilaa, jotka vastasivat kyselyyn 19961997 ja jotka olivat mukana kirjanpitotila- aineistossa vuoteen 2001 asti. Tarkastelu perustui rekursiiviseen probit-analyysiin. Tulosten perusteella viljelijäkyselyjen vastausten perusteella ei voida ennustaa toteutuneita sukupolvenvaihdoksia. Yhtenä syynä tähän on, että sukupolvenvaihdossuunnitelmat muuttuvat ajan myötä. Lisäksi viljelijäkyselyt on yleensä suunnattu ikääntyville viljelijöille eikä niissä oteta huomioon mahdollisen jatkajan odotuksia tai mielipiteitä

Timing and type of exit from farming: farmers' early retirement programmes in Finland

We analyse farmers' choice between three discrete occupational options: (1) exit and close down the farming operation; (2) exit and transfer the farm to a new entrant; (3) continue farming and retain the option to exit later. The optimisation problem is formulated as a recursive optimal stopping problem. The unknown parameters are first estimated by a switching-type multivariate probit model and then by the simulated maximum likelihood (SML) method, controlling for serial correlation of the errors. The results suggest that the timing and type of farmer exit decisions respond elastically to the economic environment, and to farmer and farm characteristics

Farmer's exit decisions and early retirement programs in Finland

This paper estimates farmer decisions between three discrete occupational choices: exit and close down the farming operation (1), exit and transfer the farm to a new entrant (2), or continue farming and retain the option to exit later on (3). The farmer optimisation problem is formulated as a recursive optimal stopping problem. The unknown parameters are first estimated by a switching-type, reduced form Probit models and, then by the Simulated maximum likelihood (SML) method, controlling for serial correlation in the errors. Serial correlation in the errors is controlled for by the Geweke-Hajivassiliou-Keane (GHK) simulation technique. The results suggest that the timing and the type of farmer exit decisions respond elastically to farmer characteristics, farm characteristics, and economic environment. Early retirement programs and the level of farmer retirement benefits are predicted to play a key role in steering structural development and enhancing family farms in the Nordic agricultural sectors