Amount of external CME in groups of specialties: a nation-wide survey among Finnish doctors

<p>Abstract</p> <p>Background</p> <p>Continuing medical education (CME) is an integral part of continuing professional development and a prerequisite for good quality in health care. We aimed to describe and analyse the number of days spent in formal CME outside the workplace by specialty among Finnish doctors of working age.</p> <p>Findings</p> <p>The number of days in formal CME outside the workplace in 2005 reported by specialists was obtained from an annual postal survey, conducted by the Finnish Medical Association in March 2006, of all working-age doctors. Those who had attained their specialist degree before 2005 were included in the study. The 49 specialties were re-categorised into 15 groups. The mean reported number of days and 95% confidence intervals were calculated. Differences were analysed by Poisson regression adjusted for relevant covariates.</p> <p>The response rate to the question about CME was 70.2% (7,374) among specialists. The median age (interquartile range) of the respondents was 49 years (from 44 to 55 years), and 51.7% (3,810) were female. The mean reported number of days in CME was 8.8 (95% CI 8.7-9.0). Neurologists and surgery specialists participated in CME the most frequently (10.3 and 10.4 days) and ophthalmologists the least (7.6 days). In comparison with anaesthesiology and intensive care specialists, most specialists reported having significantly more formal CME, and no group reported having less.</p> <p>Conclusions</p> <p>Significant variation was observed, and we therefore suggest studies seeking to account for this variation.</p> <p>The results have originally been published in Finnish in the Finnish Medical Journal.</p

Evaluating housing quality, health and safety using an Internet-based data collection and response system: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Typically housing and health surveys are not integrated together and therefore are not representative of population health or national housing stocks. In addition, the existing channels for distributing information about housing and health issues to the general public are limited. The aim of this study was to develop a data collection and response system that would allow us to assess the Finnish housing stock from the points of view of quality, health and safety, and also to provide a tool to distribute information about important housing health and safety issues.</p> <p>Methods</p> <p>The data collection and response system was tested with a sample of 3000 adults (one per household), who were randomly selected from the Finnish Population Register Centre. Spatial information about the exact location of the residences (i.e. coordinates) was included in the database inquiry. People could participate either by completing and returning a paper questionnaire or by completing the same questionnaire via the Internet. The respondents did not receive any compensation for their time in completing the questionnaire.</p> <p>Results</p> <p>This article describes the data collection and response system and presents the main results of the population-based testing of the system. A total of 1312 people (response rate 44%) answered the questionnaire, though only 80 answered via the Internet. A third of the respondents had indicated they wanted feedback. Albeit a majority (>90%) of the respondents reported being satisfied or quite satisfied with their residence, there were a number of prevalent housing issues identified that can be related to health and safety.</p> <p>Conclusions</p> <p>The collected database can be used to evaluate the quality of the housing stock in terms of occupant health and safety, and to model its association with occupant health and well-being. However, it must be noted that all the health outcomes gathered in this study are self-reported. A follow-up study is needed to evaluate whether the occupants acted on the feedback they received. Relying solely on an Internet-based questionnaire for collecting data would not appear to provide an adequate response rate for random population-based surveys at this point in time.</p

Bright ultrashort echo time SWIFT MRI signal at the osteochondral junction is not located in the calcified cartilage

In this study, we aimed to precisely localize the hyperintense signal that is generated at the osteochondral junction when using ultrashort echo time magnetic resonance imaging (MRI) and to investigate the osteochondral junction using sweep imaging with Fourier transformation (SWIFT) MRI. Furthermore, we seek to evaluate what compositional properties of the osteochondral junction are the sources of this signal. In the study, we obtained eight samples from a tibial plateau dissected from a 68-year-old male donor, and one additional osteochondral sample of bovine origin. The samples were imaged using high-resolution ultrashort echo time SWIFT MRI and microcomputed tomography (μCT) scans. Localization of the bright signal in the osteochondral junction was performed using coregistered data sets. Potential sources of the signal feature were examined by imaging the bovine specimen with variable receiver bandwidths and by performing variable flip angle T1 relaxation time mapping. The results of the study showed that the hyperintense signal was found to be located entirely in the deep noncalcified articular cartilage. The intensity of this signal at the interface varied between the specimens. Further tests with bovine specimens indicated that the imaging bandwidth and T1 relaxation affect the properties of the signal. Based on the present results, the calcified cartilage has low signal intensity even in SWIFT imaging. Concomitantly, it appears that the bright signal seen in ultrashort echo time imaging resides within the noncalcified cartilage. Furthermore, the most likely sources of this signal are the rapid T1 relaxation of the deep cartilage and the susceptibility-induced effects arising from the calcified tissues

Peripheral blood monocytes show increased osteoclast differentiation potential compared to bone marrow monocytes

Abstract Bone marrow (BM) and peripheral blood (PB) derived mononuclear cells are precursors of in vitro osteoclast differentiation. However, few studies have compared the phenotypic and functional properties of osteoclasts generated from these sources and the effects of different growth factors on osteoclastogenesis. Both cell types differentiated into functional osteoclasts, but culturing the cells with or without transforming growth factor beta (TGF-β) and dexamethasone revealed differences in their osteoclastogenic capacity. When receptor activator for nuclear factor κB ligand (RANKL) and macrophage colony-stimulating factor (M-CSF) were used for differentiation, we did not observe differences in bone resorption activity or expression of osteoclastogenic genes calcitonin receptor (CR) and nuclear factor of activated T-cells (NFATc1) between the osteoclasts formed from the two sources. Addition of TGF-β and dexamethasone led to higher number of nuclei in multinuclear cells and increased expression of tartrate resistant acid phosphatase (TRACP) 5a and 5b, CR and NFATc1 in PB- derived osteoclasts depicting the higher osteoclastogenic potential and responsiveness to TGF-β and dexamethasone in PB monocytes. These results conclude that the choice of the osteoclast precursor source as well as the choice of osteoclastogenic growth factors are essential matters in determining the phenotypic characteristics of heterogeneous osteoclast populations

In Vivo contrast-enhanced cone beam CT provides quantitative information on articular cartilage and subchondral bone

In post-traumatic osteoarthritis, both articular cartilage and subchondral bone undergo characteristic pathological changes. This study investigates potential of delayed cone beam computed tomography arthrography (dCBCTa) to simultaneously detect variations in cartilage and subchondral bone. The knees of patients (n\ua0=\ua017) with suspected joint injuries were imaged using a clinical CBCT scanner at 5 and 45\ua0min after the intra-articular injection of anionic contrast agent (Hexabrix™) with hydroxyapatite phantoms around the knee. Normalized attenuation (i.e., contrast agent partition, an indicator of tissue composition) in cartilage, bone mineral density (BMD) in subchondral bone plate (SBP), subchondral bone and trabecular bone, and thicknesses of SBP and cartilage were determined. Lesions of cartilage were scored using International Cartilage Repair Society (ICRS) grading. Normalized attenuation in the delayed image (t\ua0=\ua045\ua0min) increased along the increase of ICRS grade (p\ua0=\ua00.046). Moreover, BMD was significantly higher in SBPs under damaged cartilage (ICRS\ua0=\ua01–2 or ICRS\ua0≥\ua03; p\ua0=\ua00.047\ua0and p\ua0=\ua00.038, respectively) than in SBP under non-injured tissue (ICRS\ua0=\ua00). For the first time, dCBCTa enabled the detection of articular cartilage injuries and subchondral bone alterations simultaneously in vivo. Significant relations between ICRS grading and both cartilage and bone parameters suggest that dCBCTa has potential for quantitative imaging of the knee joint