11 research outputs found

    One Screening Magnetic Resonance Imaging Sequence in Evaluation of Chondral and Meniscal Lesions of the Knee − A Pilot Study

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    This prospective study aimed to evaluate if chondral and meniscal lesions in symptomatic knees of osteoarthritis patients can be reliably identified using only one sagittal dual-echo MRI (Magnetic Resonance Imaging) sequence. MRI was performed on 13 patients after knee arthroscopy due to knee pain and clinically suspected osteoarthritis using a 1.5-Tesla scanner with knee coil and a sagittal dual-echo turbo spin-echo PD (Proton Density)- and T2-weighted sequence. The MRI and arthroscopic findings were then compared. Of 65 articular surfaces, 47 were damaged. For articular cartilage lesions, the overall sensitivity of MRI was 46.8%, specificity 72.2%, and diagnostic accuracy 53.9%, and for meniscal ruptures 81.2%, 66.7%, and 73.1%, respectively. The present study showed that the reliability of screening MRI of knees using only one sagittal dual-echo sequence does not suffice for diagnosis of chondral or meniscal lesions, and should therefore not replace routine knee MRI or diagnostic arthroscopy

    Effects of risk-based multifactorial fall prevention on health-related quality of life among the community-dwelling aged: a randomized controlled trial

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    BACKGROUND: This study aimed to assess the effects of a risk-based, multifactorial fall prevention programme on health-related quality of life among the community-dwelling aged who had fallen at least once during the previous 12 months. METHODS: The study is a part of a single-centre, risk-based, multifactorial randomised controlled trial. The intervention lasted for 12 months and consisted of a geriatric assessment, guidance and treatment, individual instruction in fall prevention, group exercise, lectures on themes related to falling, psychosocial group activities and home exercise. Of the total study population (n = 591, 97% of eligible subjects), 513(251 in the intervention group and 262 in the control group) participated in this study. The effect of the intervention on quality of life was measured using the 15D health-related quality of life instrument consisting of 15 dimensions. The data were analysed using the chi-square test or Fisher's exact test, the Mann-Whitney U-test and logistic regression. RESULTS: In men, the results showed significant differences in the changes between the intervention and control groups in depression (p = 0.017) and distress (p = 0.029) and marginally significant differences in usual activities (p = 0.058) and sexual activity (p = 0.051). In women, significant differences in the changes between the groups were found in usual activities (p = 0.005) and discomfort/symptoms (p = 0.047). For the subjects aged 65 to 74 years, significant differences in the changes between the groups were seen in distress (p = 0.037) among men and in usual activities (p = 0.011) among women. All improvements were in favour of the intervention group. CONCLUSION: Fall prevention produced positive effects on some dimensions of health-related quality of life in the community-dwelling aged. Men benefited more than women

    How is the New Public Management applied in the occupational health care system? - decision-makers' and OH personnel's views in Finland

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    <p>Abstract</p> <p>Background</p> <p>In many countries occupational health care system is in change. Occupational health studies are mainly focused on occupational health substance and content. This study offers new perspectives on municipal OHS and its operations from management perspective.</p> <p>Aim</p> <p>The aim of this study is to analyse how New Public Management (NPM) doctrines are applied in the Finnish occupational health care system (OHS). The main focus is to describe and compare the views of decision-makers' and OH workers within the framework of NPM.</p> <p>Methods</p> <p>The data were collected by semi-structured interviews from 17 municipal decision-makers' and 26 municipal OH workers. Data was analyzed by examining coded data in a theory-driven way according to Hood's doctrine of NPM.</p> <p>Results</p> <p>The doctrines were not as compatible with the OH personnel view as with the decision-makers' view. Decision-makers and OH personnel highlighted the strict criteria required for operation evaluation. Moreover, decision-makers strongly accentuated professional management in the public sector and the reorganization of public sector units. These were not equally relevant in OH personnel views. In OH personnel views, other doctrines (more attention to performance and accomplishments, emphasizing and augmentation of the competition and better control of public expense and means test) were not similarly in evidence, only weak evidence was observed when their importance viewed as medium by decision-makers. Neither of the respondents group kept the doctrine of management models of the private sector relevant.</p> <p>Conclusions</p> <p>The NPM and Hoods doctrine fitted well with OH research. The doctrine brought out view differences and similarities between decision-makers and OH personnel. For example, policymakers highlighted more strongly the structural change by emphasizing professional management compared to OH personnel. The need for reorganization of municipal OH, regardless of different operational preconditions, was obvious for both decision-makers and OH personnel. The adaptation of more clarify management to a municipal context is not trouble-free. The municipality systemic structure, complex operational environment, and reconciliation of political and officer authority set challenges to management of municipalities.</p

    Exercise and diabetes: relevance and causes for response variability

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    How to improve the outcome of the animal protection inspections on Finnish fur farms?

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    Willow bark proanthocyanidins with potential for water treatment:chemical characterization and zinc/bisphenol A removal

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    Abstract This study investigates the chemical structure of proanthocyanidin-rich crude extracts from willow bark and these materials were tested initially as adsorbents for artificial (waste)water treatment. The crude extracts were obtained through mild water extraction and the colorant fractions were further chromatographically fractionated to understand the chemical structure of the willow bark proanthocyanidins. The chemistry of crude extracts and purified fractions were investigated using nuclear magnetic resonance (NMR) and ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Both NMR (liquid and solid-state) and UPLC-MS/MS suggest that the crude extracts constitute of interflavan linked flavan-3-ols, i.e. proanthocyanidins with both procyanidin (PC)-type and prodelphinidin (PD)-type subunits, with the PC/PD ratio of approximately 2.3–2.5. PD-type proanthocyanidins were detected from the purified colorant fractions only with UPLC-MS/MS. Both the UPLC-MS/MS and size exclusion chromatography suggest that the crude extracts have an average oligomerization degree of roughly 5–6 flavan-3-ol units. Adsorption experiments showed that the activated foams made of crude extracts were effective in removing both zinc and Bisphenol A (BPA) with removal efficiencies of roughly 80–90% and thus these willow bark-derived proanthocyanidins are promising in water treatment. The significance of this study suggests the upgrading use of crude extracts for water treatment could significantly improve the value of willow bark
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