39 research outputs found
Employment status of young otorhinolaryngologists in Finland during a 10-year period
We determined the employment status of recently graduated otorhinolaryngologist-head and neck surgeons (ENT doctors) in Finland during the past 10 years. We also investigated the job vacancy rate of the Departments of Otorhinolaryngology-Head and Neck Surgery (Department of ORL-HNS). An electronic questionnaire was sent to all ENT doctors who had graduated during 2007-2017 and to chief physicians of all Departments of ORL-HNS. Chi-square and Fisher's test were used in the analyses. Altogether 129 ENT doctors had graduated and 125 (96.9%) responded. Thirty (24%) physicians had been employed in a position that did not correspond to their ENT doctor training. All 30 chief physicians responded and a total of 306 physicians were working at their departments (215 ENT doctors, 91 residents). However, there were only 241 available positions (197 for ENT doctors, 44 for residents). It was estimated that 65 ENT doctors would retire within 10 years. At the moment there does not seem to be a significant shortage of ENT doctors in Finland. The current national volume of resident intake in the ENT training programme is twofold in comparison with the estimated retirement rate in the public sector.Peer reviewe
Satisfaction of young ENT surgeons with their work. A Finnish national study
The objective was to investigate work satisfaction among recently graduated otorhinolaryngologist - head and neck surgeons - (ENT surgeons). An electronic questionnaire was sent to all ENT surgeons graduated in Finland during a ten-year period. Answers about work satisfaction were analyzed in detail with regards to age, gender, university of specialist training, experience, place of work and further education.Altogether 125/129 (96.9%) responded. The majority (87.8%) of the respondents enjoyed their current main occupation. The older age group (>= 40 vsPeer reviewe
Employment status of young otorhinolaryngologists in Finland during a 10-year period
We determined the employment status of recently graduated otorhinolaryngologist-head and neck surgeons (ENT doctors) in Finland during the past 10 years. We also investigated the job vacancy rate of the Departments of Otorhinolaryngology-Head and Neck Surgery (Department of ORL-HNS). An electronic questionnaire was sent to all ENT doctors who had graduated during 2007-2017 and to chief physicians of all Departments of ORL-HNS. Chi-square and Fisher's test were used in the analyses. Altogether 129 ENT doctors had graduated and 125 (96.9%) responded. Thirty (24%) physicians had been employed in a position that did not correspond to their ENT doctor training. All 30 chief physicians responded and a total of 306 physicians were working at their departments (215 ENT doctors, 91 residents). However, there were only 241 available positions (197 for ENT doctors, 44 for residents). It was estimated that 65 ENT doctors would retire within 10 years. At the moment there does not seem to be a significant shortage of ENT doctors in Finland. The current national volume of resident intake in the ENT training programme is twofold in comparison with the estimated retirement rate in the public sector
Understanding studentsâ game experiences throughout the developmental process of the Number Navigation Game
Serious games for learning have received increased attention in recent years. However, empirical studies on studentsâ gaming experiences throughout the developmental process of serious games and discussions regarding game design are missing. The aims of the present study were to analyze studentsâ gaming experiences while playing four consecutive versions of the Number Navigation Game (NNG)âa mathematical game-based learning environment focusing on flexibility and adaptivity with whole-number arithmetic; and to provide an extensive review of the NNG developmental and design process over 3 years with focus on how and why the design decisions were made, and how those choices affected studentsâ gaming experiences. The study employed a mixed-methods design of quantitative and qualitative research. The Game Experience Questionnaire about eight core game experience dimensions was answered by different groups of students at primary schools in Finland in three different experiments after students played four versions of the NNG from 2014 to 2016. Six semi structured interviews related to studentsâ game experiences, preferences and game features of the latest version of NNG were conducted. Overall, results indicate that improvement in gameâs usability and clarity in the user interface has positive impacts on studentsâ game experiences. Furthermore, there seems to be a clear advantage in having better aesthetics and value in improving extrinsic elements that could contribute to maintain playersâ enthusiasm and situational interest in serious games.</p
Tietojohtaminen
Tieto on aina ollut kaiken inhimillisen toiminnan peruste. Sen tÀrkeys yritysten ja myös julkisen sektorin organisaatioiden keskeisenÀ resurssina on kuitenkin laajasti ymmÀrretty vasta 1990-luvun lopulta alkaen. Nykyisin tiedon ja sen johtamisen tÀrkeyttÀ ei juuri tarvitse perustella. Tarvitsemme vÀlineitÀ, joiden avulla tietoa eri muodoissaan voidaan johtaa ja kehittÀÀ.
Tietojohtaminen on nuori tieteenala, ja sen kÀsitteet ovat vielÀ vakiintumattomia. Tieto ja siihen liittyvÀt ilmiöt ovat monimutkaisia ja abstrakteja. Jotta nÀitÀ asioita voidaan kehittÀÀ, tarvitaan tÀsmÀllisiÀ kÀsitteitÀ, joilla asioista voi puhua ja kirjoittaa. On myös tÀrkeÀÀ, ettÀ tietojohtamisen parissa työskentelevÀt henkilöt hallitsevat tietyt peruskÀsitteet. Yksi ja ehkÀ keskeisin tÀmÀn kirjan tavoite onkin luoda ymmÀrrystÀ tietojohtamiseen liittyvistÀ kÀsitteistÀ ja siitÀ, miten ne liittyvÀt toisiinsa.
Kirja on tarkoitettu tietojohtamisen opintoja yliopistossa tai ammattikorkeakoulussa aloitteleville henkilöille perusoppikirjaksi, sekÀ myös asiantuntijoille ja johtajille, jotka soveltavat tietojohtamista kÀytÀnnössÀ. SekÀ tieto ettÀ johtaminen ovat isoja sanoja, kuten myös niiden yhdistelmÀ tietojohtaminen. NÀin ollen tietojohtamista ei tule mÀÀritellÀ liian kapeasti. TÀssÀ hengessÀ on kirjoitettu myös tÀmÀ kirja.
Tietojohtamisen koulutusohjelma perustettiin Tampereen teknilliseen yliopistoon 1999. Reilun kymmenen vuoden aikana yliopistossa on julkaistu alalta kymmeniÀ vÀitöskirjoja, satoja muita opinnÀytteitÀ, tieteellisiÀ artikkeleja ja myös lukuisia aiheeseen liittyviÀ kirjoja ja tutkimusraportteja. KÀsillÀ oleva kirja on kuitenkin ensimmÀinen alan suomenkielinen perusteos. Sen kirjoittamiseen on osallistunut lukuisa joukko tietojohtamisen opettajia ja tutkijoita. Se on vuoropuhelun tulos ja lyhyt johdanto tietojohtamisen maailmaan, jota kohtaan se toivottavasti herÀttÀÀ lukijansa uteliaisuuden
Somatic mTOR mutation in clonally expanded T lymphocytes associated with chronic graft versus host disease
Graft versus host disease (GvHD) is the main complication of allogeneic hematopoietic stem cell transplantation (HSCT). Here we report studies of a patient with chronic GvHD (cGvHD) carrying persistent CD4(+) T cell clonal expansion harboring somatic mTOR, NFKB2, and TLR2 mutations. In the screening cohort (n=134), we detect the mTOR P2229R kinase domain mutation in two additional cGvHD patients, but not in healthy or HSCT patients without cGvHD. Functional analyses of the mTOR mutation indicate a gain-of-function alteration and activation of both mTORC1 and mTORC2 signaling pathways, leading to increased cell proliferation and decreased apoptosis. Single-cell RNA sequencing and real-time impedance measurements support increased cytotoxicity of mutated CD4(+) T cells. High throughput drug-sensitivity testing suggests that mutations induce resistance to mTOR inhibitors, but increase sensitivity for HSP90 inhibitors. Our findings imply that somatic mutations may contribute to aberrant T cell proliferations and persistent immune activation in cGvHD, thereby paving the way for targeted therapies. Chronic graft versus host disease (cGvHD) is a major cause of morbidity and mortality in allogeneic bone marrow transplantation. Here the authors identify a recurrent activating mTOR mutation in expanded donor T-cell clones of 3 cGvHD patients, which suggests somatic mutations may contribute to GvHD pathogenesis and opens avenues to targeted therapies.Peer reviewe
Somatic mTOR mutation in clonally expanded T lymphocytes associated with chronic graft versus host disease
Graft versus host disease (GvHD) is the main complication of allogeneic hematopoietic stem cell transplantation (HSCT). Here we report studies of a patient with chronic GvHD (cGvHD) carrying persistent CD4+ T cell clonal expansion harboring somatic mTOR, NFKB2, and TLR2 mutations. In the screening cohort (nâ=â134), we detect the mTOR P2229R kinase domain mutation in two additional cGvHD patients, but not in healthy or HSCT patients without cGvHD. Functional analyses of the mTOR mutation indicate a gain-of-function alteration and activation of both mTORC1 and mTORC2 signaling pathways, leading to increased cell proliferation and decreased apoptosis. Single-cell RNA sequencing and real-time impedance measurements support increased cytotoxicity of mutated CD4+ T cells. High throughput drug-sensitivity testing suggests that mutations induce resistance to mTOR inhibitors, but increase sensitivity for HSP90 inhibitors. Our findings imply that somatic mutations may contribute to aberrant T cell proliferations and persistent immune activation in cGvHD, thereby paving the way for targeted therapies.</p
Occupational Noise, Smoking, and a High Body Mass Index are Risk Factors for Age-related Hearing Impairment and Moderate Alcohol Consumption is Protective: A European Population-based Multicenter Study
A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pure-tone average [PTA]) were collected and the participants filled out a questionnaire on environmental risk factors and medical history. People with a history of disease that could affect hearing were excluded. PTAs were adjusted for age and sex and tested for association with exposure to risk factors. Noise exposure was associated with a significant loss of hearing at high sound frequencies (>1 kHz). Smoking significantly increased high-frequency hearing loss, and the effect was dose-dependent. The effect of smoking remained significant when accounting for cardiovascular disease events. Taller people had better hearing on average with a more pronounced effect at low sound frequencies (<2 kHz). A high body mass index (BMI) correlated with hearing loss across the frequency range tested. Moderate alcohol consumption was inversely correlated with hearing loss. Significant associations were found in the high as well as in the low frequencies. The results suggest that a healthy lifestyle can protect against age-related hearing impairment
Hearing among older adultsâan epidemiological study
Abstract
Age-related hearing impairment is the most common type of hearing impairment among adults. Adult-onset hearing impairment is one of the leading causes of disease burden worldwide and it is associated with social isolation and depression. As the proportion of older people is increasing in Western countries, the socioeconomic importance of adult hearing impairment will increase notably.
The aim of the present contribution was to study the epidemiological aspects of hearing and related factors among older adults. The prevalence of hearing impairment, defined either by audiometry or by a self-report, and the differences between these two were analyzed. Tinnitus and hyperacusis were also studied. Furthermore, the prevalence of ear diseases, otological risk factors, and noise exposure and their association with hearing thresholds were analyzed. In addition, audiogram configurations and certain subject-related factors and their relation to hearing were assessed.
The subjects were randomly sampled from the population register and they responded to an extensive questionnaire. Otological status was examined and pure tone audiometry was conducted. Data on 850 subjects aged 54â66 years were analyzed.
Hearing impairment was found to be a highly common condition with a prevalence of 26.7% when defined by better ear and 42.2% when defined by worse ear. Men had worse hearing than women. High-frequency sloping audiogram configurations were common. Self-reported hearing difficulty and measured hearing impairment seem to be associated at high frequencies. At least one ear disease or otological risk factor for hearing impairment was found among 18.4% of the subjects and noise exposure among 46%, more often by men. Interestingly, noise exposure did not seem to associate with hearing levels among subjects screened for ear disease or otological risk factors.
The results of the present study suggest that hearing impairment is a highly common condition among older adults and this should be taken into account when future hearing healthcare is planned. Furthermore, it seems that most of the subjects reporting hearing difficulty had no measured hearing impairment according to the criteria applied for eligibility for hearing aid fitting in Finland. Based on the results of the present study, the criteria for hearing impairment entitling persons for hearing aid fitting should be reconsidered.TiivistelmÀ
IkÀkuulo on yleisin aikuisten kuulovian aiheuttaja, ja aikuisiÀn kuulovika on merkittÀvÀ terveydellinen haittatekijÀ. Kehittyneiden maiden ikÀjakauman painottuessa vanhempiin ikÀluokkiin aikuisten kuulovioista tulee merkittÀvÀ sosioekonominen rasite yhteiskunnille.
Tutkimuksen tavoitteena oli selvittÀÀ aikuisten kuulovikojen epidemiologiaa ja kuulovikoihin liittyviÀ tekijöitÀ. Myös kuulovian vallitsevuus mÀÀriteltynÀ kuulokÀyrÀn tai tutkittavan oman ilmoituksen perusteella selvitettiin. Samoin tutkittiin muita kuulemiseen liittyviÀ ongelmia, kuten tinnitusta ja ÀÀniyliherkkyyttÀ. Edelleen arvioitiin erilaisten kuuloon vaikuttavien tekijöiden, kuten korvasairauksien, muiden kuulovian riskitekijöiden ja melulle altistumisen, vallitsevuutta vÀestössÀ sekÀ niiden assosiaatiota kuulemiseen. NÀiden lisÀksi tutkittiin kuulokÀyrien muotoja ja niiden yhteyttÀ tutkittavan ilmoittamaan kuulo-ongelmaan.
Tutkittavat valittiin satunnaisesti vĂ€estörekisteristĂ€. He tĂ€yttivĂ€t laajan kyselylomakkeen, heidĂ€n korvansa tutkittiin lÀÀkĂ€rin vastaanotolla ja lisĂ€ksi heille tehtiin kuulotutkimukset. Tutkimukseen osallistui 850 55â66-vuotiasta henkilöÀ.
Tutkimus osoitti, ettĂ€ kuulovika on tĂ€ssĂ€ ikĂ€ryhmĂ€ssĂ€ hyvin yleinen löydös ja miehillĂ€ yleisempi kuin naisilla. Tutkittavan ilmoittama kuulovika ennusti mitattujen kuulokynnysten heikkenemistĂ€ korkeilla taajuuksilla (4â8 kHz). Samoin korkeille taajuuksille laskeva kuulokĂ€yrĂ€n muoto oli yleisin. Erilaisia kuulovian riskitekijöitĂ€ raportoi 18.4 % tutkittavista. TĂ€mĂ€n lisĂ€ksi 46 % kertoi merkittĂ€vĂ€stĂ€ altistumisesta melulle, miehet naisia useammin. YllĂ€ttĂ€en melualtistumisella ei nĂ€yttĂ€nyt olevan yhteyttĂ€ kuulokynnyksiin siinĂ€ ryhmĂ€ssĂ€ tutkittavia, joilla ei ollut korvaperĂ€isiĂ€ riskitekijöitĂ€ kuulovialle.
Tutkimustulokset osoittavat, ettÀ kuulovika on hyvin yleinen löydös tÀmÀn ikÀisillÀ aikuisilla. Vanhenevat ikÀluokat ovat merkittÀvÀ haaste kuulonhuollolle, ja tÀmÀ olisi otettava huomioon pÀÀtettÀessÀ kuulonhuollon rahoituksesta. Useat niistÀ aikuisista, jotka kokivat kuulo-ongelmia, eivÀt kuulokÀyrÀlöydöksensÀ mukaan tÀyttÀneet Suomessa kÀytössÀ olevia kriteereitÀ kuulokojesovitukselle. TÀmÀn tutkimuksen perusteella nÀyttÀÀkin siltÀ, ettÀ kuntoutustarvetta arvioitaessa kuulovian kriteereitÀ tulisi kansallisesti tarkistaa ottamalla huomioon myös huonomman korvan kuulokynnykset sekÀ kuulon alenema korkeilla taajuuksilla