Finnish Version of the Eating Assessment Tool (F-EAT-10) : A Valid and Reliable Patient-reported Outcome Measure for Dysphagia Evaluation

Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) referred to fiberoptic endoscopic evaluation of swallowing (FEES) completed F-EAT-10 before the examination and after 2 weeks. Patients underwent the 100-ml water swallow test (WST) and FEES was evaluated using the following three scales: the Yale Pharyngeal Residue Severity Rating Scale, Penetration-Aspiration Scale, and the Dysphagia Outcome Severity Scale. An operative cohort of 19 patients (median age 75.8 years, 57.9% female) underwent an endoscopic operation on Zenker's diverticulum, tight cricopharyngeal muscle diagnosed in videofluorography, or both. Patients completed the F-EAT-10 preoperatively and 3 months postoperatively. The cut-off score for controls was = 3 is abnormal. Re-questionnaires for test-retest reliability analysis were available from 92 FEES patients and 123 controls. The intraclass correlation coefficient was excellent for the total F-EAT-10 score (0.93, 95% confidence interval 0.91-0.95). Pearson correlation coefficients were strong (p < 0.001) for each of the questions and the total score. Internal consistency as assessed by Cronbach's alpha was excellent (0.95). Some correlations between findings in FEES and 100-ml WST with F-EAT-10 were observed. The change in subjective symptoms of operative patients paralleled the change in F-EAT-10. F-EAT-10 is a reliable, valid, and symptom-specific patient-reported outcome measure for assessing dysphagia among Finnish speakers.Peer reviewe

Finnish Version of the Eating Assessment Tool (F-EAT-10): A Valid and Reliable Patient-reported Outcome Measure for Dysphagia Evaluation

Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) referred to fiberoptic endoscopic evaluation of swallowing (FEES) completed F-EAT-10 before the examination and after 2 weeks. Patients underwent the 100-ml water swallow test (WST) and FEES was evaluated using the following three scales: the Yale Pharyngeal Residue Severity Rating Scale, Penetration-Aspiration Scale, and the Dysphagia Outcome Severity Scale. An operative cohort of 19 patients (median age 75.8 years, 57.9% female) underwent an endoscopic operation on Zenker's diverticulum, tight cricopharyngeal muscle diagnosed in videofluorography, or both. Patients completed the F-EAT-10 preoperatively and 3 months postoperatively. The cut-off score for controls was = 3 is abnormal. Re-questionnaires for test-retest reliability analysis were available from 92 FEES patients and 123 controls. The intraclass correlation coefficient was excellent for the total F-EAT-10 score (0.93, 95% confidence interval 0.91-0.95). Pearson correlation coefficients were strong (p < 0.001) for each of the questions and the total score. Internal consistency as assessed by Cronbach's alpha was excellent (0.95). Some correlations between findings in FEES and 100-ml WST with F-EAT-10 were observed. The change in subjective symptoms of operative patients paralleled the change in F-EAT-10. F-EAT-10 is a reliable, valid, and symptom-specific patient-reported outcome measure for assessing dysphagia among Finnish speakers

"Tuossahan olen minä... Vai olenko?" Lapsen itsetunnon havainnointi kuvallisten menetelmien avulla

Tässä opinnäytetyössä arvioidaan varhaiskasvatusikäisten lasten itsetuntoa ja minäkuvaa käyttämällä kuvallista ilmaisua havainnoinnin välineenä. Opinnäytetyömme tarkoituksena oli myös tarjota keinoja havainnoinnin toteuttamiseksi päivittäisessä arjessa varhaiskasvatusympäristössä. Opinnäytetyö toteutettiin Keravalaisessa varhaiskasvatusyksikössä. Kohderyhmänä toimi 3-6-vuotiaat alueellisen pienryhmän lapset. Ryhmän kuudestatoista lapsesta yhdeksän sai vanhemmilta kirjallisen suostumuksen osallistua opinnäytetyön toteuttamiseen. Toteutustapana käytettiin luovaa kuvallista ilmaisua toiminnallisena menetelmänä sekä prosessin kirjallista havainnointia. Teoreettisena viitekehyksenä toimivat minäkuva, itsetunnon osa-alueet, viestintä ja kuvallinen ilmaisu luovana toimintona sekä toiminnan suunnittelussa että toteutuksessa. Toiminnallisissa osuuksissa havainnoimme lapsen sanallista (ja sanatonta) viestintää sekä tarkkailemalla että esittämällä toiminnan päätteeksi kysymyksiä jokaisen henkilökohtaiseen prosessiin liittyen. Opinnäytetyömme tuloksena havaitsimme, että kuvallisten menetelmiä käyttämällä voidaan saada tietoa siitä, millaisena lapsi näkee itsensä. Kuvalliset menetelmät auttavat lapsia verbalisoimaan ja konkretisoimaan tunteita, joita muuten voisi olla vaikeaa sanoa ääneen. Lisäksi havainnot vahvistivat lähipiirin, kasvatuksen ja ympäristön merkitystä itsetunnon kehittymiselle. Toisaalta tulkitsemalla sanallista ja sanatonta viestintää voidaan lasten käytöksestä saada hyvinkin monipuolisia signaaleja."That is me... Or is it?" Observing children's self esteem by using graphical methods This thesis project evaluates the self-esteem and self-image of pre-adolescent children in the early phase of education by interpreting images and paintings that they create. The purpose of this thesis was also to provide methods with which the observation could be carried out in daily basis in the early childhood education unit. The thesis was carried out in an early childhood education unit in Kerava. Target group was a regional in-group in which the children are 3-6-year-olds. Nine out of sixteen got a written permission from their parents to participate in this thesis project. Executive methods were practical creative methods in the area of graphical expression and written observation during the process. Theoretical context was self-image, areas of self-esteem, communication and graphical expression as a creative method in both planning and fulfilling the activity. During the functional parts we observed the verbal (and non-verbal) communication of the children by both overseeing and asking questions about their personal experiences during the process. As a result of our thesis we perceived that by using graphical methods it is possible to receive information about how a child sees him- or herself. Graphical methods help children to verbalize and concrete feelings which otherwise would be hard to say out loud. In addition the perceptions strengthened the meaning of vicinity, rearing and environment according to the development of self-esteem. On the other hand by interpreting verbal and non-verbal communication it is possible to receive quite many-sided signals from children’s behavior

HMSN POLYNEUROPATIA. SAIRASTUMISEN KRIISI JA SELVIYTYMINEN

TIIVISTELMÄ Tiina Harjunpää, Miguel Pelegrin-Jokinen ja Annika Ruuskanen. HMSN polyneuropatia : sairastumisen kriisi ja selviytyminen. Helsinki, kevät 2012, 66 s. Diakonia-ammattikorkeakoulu, Diak Etelä, Helsinki. Hoitotyön koulutusohjelma, sairaanhoitaja (AMK). Tässä opinnäytetyössä tutkimustehtävänä on selvittää, minkälaisia psyykkisiä vaikutuksia ja selviämiskeinoja pitkäaikaissairauteen sairastuneilla henkilöillä on. Samalla kartoitetaan, minkälaista tukea he kokevat tarvitsevansa. Toiseksi halutaan selvittää pitkäaikaissairauteen sairastuneiden kriisikokemusta. Teoreettisena taustana kriisikokemusten analysoinnissa käytetään Johan Cullbergin kriisiteoriaa. Tässä työssä on kvalitatiivinen lähestymistapa. Tutkimusaineisto hankittiin kyselylomakkeella. Teknisesti kysely toteutettiin webropol-alustalla. Kyselyllä kartoitimme diagnoosin saamisen jälkeistä kriisikokemusta ja psyykkistä sopeutumista elämään sairauden kanssa sekä sairastuneen voimavaroja, sosiaalista selviytymistä ja niiden taustalla olevia tekijöitä. Lihastautiliitto julkaisi jäsenistölleen kutsun osallistua tutkimukseen jäsen- ja tiedotusjulkaisussaan, Porras-lehdessä 3/2011 sekä Facebook sivustolla. Kyselyyn ilmoittautui 26 henkilöä, joista 20 vastasi kyselyyn. Lomakkeessa oli 13 kysymystä, joihin ihmiset saivat vastata vapaamuotoisesti. Tällä tavoin saimme selville vastaajien kokemuksia sairastumisesta ja siihen liittyvistä tuntemuksista. Sairastuminen ja sairausdiagnoosin varmistuminen on kriisi: vastaajat kuvasivat kokemustaan hämmennyksestä, pelosta, ahdistuksesta ja epätoivosta. Tilanteesta syntyneet tunteet kuuluvat osana kriisin reaktiovaiheeseen. Uudelleenorientaation vaiheessa vastaajat turvautuivat vertaistukeen ja verkostoihinsa oppien ja opetellen sopeutumaan sairauden kanssa elämiseen. Hyvällä hoitotyöllä ja hoitohenkilöstön tietämyksellä HMSN -sairaudesta on myös tärkeä merkitys selviytymiselle pitkäaikaissairauden kanssa. Asiasanat: peroneaalinen lihasatrofia, hermoston taudit, krooniset taudit, sairastuminen, selviytyminen, henkinen hyvinvointi, hoitotyö, tukimuodot, sosiaalinen tuk

Simkania negevensis infection among Brazilian children hospitalized with community-acquired pneumonia

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T16:48:53Z No. of bitstreams: 1 Nascimento-Carvalho C M Simkania negevensis....pdf: 173851 bytes, checksum: 1a4914fb77ceb9788402bb332485bc45 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T16:49:04Z (GMT) No. of bitstreams: 1 Nascimento-Carvalho C M Simkania negevensis....pdf: 173851 bytes, checksum: 1a4914fb77ceb9788402bb332485bc45 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T17:03:09Z (GMT) No. of bitstreams: 1 Nascimento-Carvalho C M Simkania negevensis....pdf: 173851 bytes, checksum: 1a4914fb77ceb9788402bb332485bc45 (MD5)Made available in DSpace on 2014-12-22T17:03:09Z (GMT). No. of bitstreams: 1 Nascimento-Carvalho C M Simkania negevensis....pdf: 173851 bytes, checksum: 1a4914fb77ceb9788402bb332485bc45 (MD5) Previous issue date: 2009Universidade Federal da Bahia. Escola de Medicina. Departamento de Pediatria. Salvador, BA, Brasil.São Paulo University. Faculty of Public Health. Department of Epidemiology. São Paulo, SP, Brasil.National Public Health Institute. Oulu, Finland.Universidade Federal da Bahia. Escola de Medicina. Departamento de Patologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.Universidade Federal da Bahia. Escola de Medicina. Departamento de Diagnóstico de Imagem. Salvador, BA, Brasil.National Public Health Institute. Oulu, Finland.University of Turku. Department of Virology. Turku, Finland.National Public Health Institute. Oulu, Finland.University of Turku. Department of Pediatrics. Turku, Finland

Procalcitonin is useful in identifying bacteraemia among children with pneumonia

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T18:30:27Z No. of bitstreams: 1 Nascimento-Carvalho CM Procalcitonin is useful....pdf: 120414 bytes, checksum: 5a88036f201a432801728f2e814e780d (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T18:30:37Z (GMT) No. of bitstreams: 1 Nascimento-Carvalho CM Procalcitonin is useful....pdf: 120414 bytes, checksum: 5a88036f201a432801728f2e814e780d (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2014-12-22T18:47:43Z (GMT) No. of bitstreams: 1 Nascimento-Carvalho CM Procalcitonin is useful....pdf: 120414 bytes, checksum: 5a88036f201a432801728f2e814e780d (MD5)Made available in DSpace on 2014-12-22T18:47:43Z (GMT). No. of bitstreams: 1 Nascimento-Carvalho CM Procalcitonin is useful....pdf: 120414 bytes, checksum: 5a88036f201a432801728f2e814e780d (MD5) Previous issue date: 2010Universidade Federal da Bahia. Escola de Medicina Veterinária. Departamento de Pediatria. Salvador, BA, BrasilSão Paulo University. Faculty of Public Health. Epidemiology Department. São Paulo, SP, BrasilUniversidade Federal da Bahia. Escola de Medicina. Departamento de Diagnóstico de Patologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Escola de Medicina Veterinária. Departamento de Diagnóstico de Imagem. Salvador, BA, BrasilParis Descartes University. St Vincent-Cochin Hospital. Paris, FranceNational Institute for Health and Welfare. Oulu, FinlandNational Institute for Health and Welfare. Oulu, FinlandUniversity of Turku. Virology. Turku, FinlandParis Descartes University. St Vincent-Cochin Hospital. Paris, FranceNational Institute for Health and Welfare. Oulu, FinlandUniversity of Turku. Paediatrics Department. Turku, FinlandParis Descartes University. St Vincent-Cochin Hospital. Paris, FranceEmpirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN- α ) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infi ltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN- α were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN- α (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56 – 7.56), non-bacteraemic typical bacterial (1.47; 0.24 – 4.07), atypical bacterial (0.18; 0.06 – 1.03) and only viral (0.65; 0.11 – 2.22) subgroups was signifi cant ( p 0.02). PCT was 2 ng/ml in 52 (33%) cases. The presence of IFN- α was associated with PCT 2 ng/ml (90% vs. 64%, p 0.02). The negative predictive value (95% confi dence interval) of PCT 2 ng/ml was 95% (89 – 100%), 89% (78 – 100%), 93% (85 – 100%) for differentiation of bacteraemic from viral, atypical bacterial and nonbacteraemic typical bacterial infection, respectively, and 58% (49 – 68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN- α was uncommonly detected

Respiratory viral infections among children with community-acquired pneumonia and pleural effusion

Barral, Aldina Maria Prado “Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento”.Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-31T12:18:17Z No. of bitstreams: 1 Barral A Respiratory viral infections... (1).pdf: 117646 bytes, checksum: cbaf68977d2c646d56d5b7d83c51bb62 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-31T12:43:01Z (GMT) No. of bitstreams: 1 Barral A Respiratory viral infections... (1).pdf: 117646 bytes, checksum: cbaf68977d2c646d56d5b7d83c51bb62 (MD5)Made available in DSpace on 2017-08-31T12:43:01Z (GMT). No. of bitstreams: 1 Barral A Respiratory viral infections... (1).pdf: 117646 bytes, checksum: cbaf68977d2c646d56d5b7d83c51bb62 (MD5) Previous issue date: 2013Fundação de Amparo à Pesquisa no Estado da Bahia (FAPESB), Salvador, Brazil, the Paediatric Research Foundation, the Helsinki University Central Hospital Research and Development Fund, the Academy of Finland (project 1122539). ),Federal University of Bahia. School of Medicine. Paediatrics Department. Salvador, BA, BrasilFederal University of Bahia. Professor Hosannah de Oliveira Paediatric Centre. Salvador, BA, BrasilSão Paulo University. Faculty of Public Health. Epidemiology Department. São Paulo, SP, BrasilFederal University of Bahia. School of Medicine. Image Diagnosis Department. Salvador, BA, BrasilFederal University of Bahia. School of Medicine. Pathology Department. Salvador, BA, BrazilNational Institute for Health and Welfare. Bacterial Laboratory. OuluNational Institute for Health and Welfare. Bacterial Laboratory. Oulu / Oulu University Hospital. Clinical Microbiology Laboratory. OuluNational Institute for Health and Welfare. Bacterial Laboratory. OuluUniversity Central Hospital. Virology Laboratory. Laboratory Division. Helsinki, HelsinkiUniversity of Helsinki. Haartman Institute. Helsinki, HelsinkiUniversity of Turku. Virology Department. Turku, FinlandUniversity of Turku. Paediatrics Department. Turku, FinlandPleural effusion (PE), a complication of community-acquired pneumonia (CAP), is usually attributed to a bacterial infection. Nonetheless, viral infections have not been investigated routinely. We searched for bacterial and viral infections among 277 children hospitalized with CAP. Among these children 206 (74%) had radiographic confirmation, of whom 25 (12%) had PE. The aetiology was established in 18 (72%) PE cases: bacterial (n = 5; 28%), viral (n = 9; 50%), and viral-bacterial (n = 4; 22%) infections were found. Infection by rhinovirus (n = 3), enterovirus, Streptococcus pneumoniae (n = 2 each), Haemophilus influenzae, Moraxella catarrhalis, Mycoplasma pneumoniae, influenza A virus, and respiratory syncytial virus (RSV) (n = 1 each) were detected as probable sole infections. Parainfluenza virus 1/3 + influenza A virus and RSV + influenza A virus (n = 1 each) were identified as mixed viral-viral infections. Probable viral non-bacterial infection was identified in a third of the cases with CAP and PE. It is advisable to investigate viral as well as bacterial infections among children with CAP and PE

Human bocavirus and acute wheezing in children

BACKGROUND: Human bocavirus is a newly discovered parvovirus. It has been detected primarily in children with acute lower respiratory tract infection, but its occurrence, clinical profile, and role as a causative agent of respiratory tract disease are not clear. METHODS: We investigated the presence of human bocavirus by quantitative polymerase chain reaction of nasopharyngeal aspirate specimens and selected serum samples obtained from 259 children (median age, 1.6 years) who had been hospitalized for acute expiratory wheezing. The samples were analyzed for 16 respiratory viruses by polymerase chain reaction, virus culture, antigen detection, and serological assays. RESULTS: At least 1 potential etiologic agent was detected in 95% of children, and >1 agent was detected in 34% of children. Human bocavirus was detected in 49 children (19%). A large proportion of the cases were mixed infections with other viruses, but human bocavirus was the only virus detected in 12 children (5%). High viral loads of human bocavirus were noted mainly in the absence of other viral agents, suggesting a causative role for acute wheezing. In addition, infections that had uncertain clinical relevance and low viral loads were prevalent. Human bocavirus DNA was frequently detected in serum specimens obtained from patients with acute wheezing, suggesting systemic infection. CONCLUSIONS: Human bocavirus is prevalent among children with acute wheezing and can cause systemic infection. Results suggest a model for bocavirus infection in which high viral loads are potentially associated with respiratory symptoms and low viral loads indicate asymptomatic shedding. Therefore, quantitative polymerase chain reaction analysis may be important for additional studies of human bocavirus

The role of respiratory viral infections among children hospitalized for community-acquired pneumonia in a developing country

We report an investigation for 16 bacteria and viruses among 184 children hospitalized with pneumonia in Salvador, Brazil. Etiology was established in 144 (78%) cases. Viral, bacterial, and mixed infections were found in 110 (60%), 77 (42%), and 52 (28%) patients, respectively. Rhinovirus (21%) and Streptococcus pneumoniae (21%) were the most common pathogens. Our results demonstrate the importance of viral and pneumococcal infections among those patients.Fundacao de Amparo a Pesquisa no Estado da Bahia (FAPESB), Salvador, BrazilPediatric Research Foundation, Helsinki, Finlan