Polven artroplastiapotilas 2012-2013 : poikkileikkaus leikkausjonon potilaista

Tausta ja aineisto: Tutkimuksessa selvitettiin polven tekonivelleikkaukseen jonottavien potilaiden oireita, toimintakykyä ja elämänlaatua kolmella kyselylomakkeella. Tutkimusaineiston muodosti 250 tekonivelleikkausjonossa olevaa Tekonivelsairaala Coxan potilasta. Kaikki vastasivat OKS-lomakkeeseen. Lisäksi puolelle potilaista (125) lähetettiin KOOS-lomake ja toiselle puolelle RAND 36-lomakke. Menetelmät: Tutkimuksessa käytetyt lomakkeet olivat Oxford Knee Score (OKS), Knee injury and Osteoarthritis Outcome Score (KOOS) ja RAND 36-Item Health Survey-kysely (RAND 36). Populaation tuloksia tarkasteltiin kokonaisuutena, sukupuolen mukaan ja jaettuna kolmeen ikäryhmään: alle 66-vuotiaat, 66-75-vuotiaat ja yli 76-vuotiaat. Tulokset: Tutkimuksen tulosten mukaan preoperatiivisesti potilaiden subjektiivinen toimintakyky ja koettu elämänlaatu on lähes kaikissa tapauksissa heikko ja oireet vaikeat. Miesten pisteiden mediaani oli 40 % parempi kuin naisilla RAND 36-tutkimuksen fyysistä toimintakykyä mittaavassa osiossa. RAND 36-lomakkeen fyysisen toimintakyvyn osiossa vanhimman ikäryhmän mediaani oli 33 % heikompi verraten nuorempiin (p=0,014). Psyykkistä hyvinvointia kuvaavassa osiossa nuorimman ryhmän mediaani oli kaksinkertainen vanhempiin ryhmiin verrattuna. p=0,016). KOOS-kyselyn päivittäisiä toimia kuvaavassa osiossa nuorin ikäryhmä sai 15,50 % paremmat pisteet kuin keskimmäinen ikäryhmä ja 19,94 % paremmat kuin vanhin ryhmä (p=0,031). RAND 36- ja KOOS-lomakkeissa molemmissa nähdään selkeä alenema kautta linjan verrattuna viitearvoihin. Yhteenveto: Tutkimuksen aineiston demografiset tiedot vastasivat hyvin kansallista rekisteriaineistoa. Puuttuvia tietoja oli lomakkeissa vähän ja näiden vaikutukset analyysiin jäivät pieniksi. Miesten ja naisten väliset erot tuloksissa olivat vähäiset. Vanhemmat ikäryhmät saivat nuorempia huonompia pisteitä useassa osa-alueanalyysissä. Kuitenkaan ikä ei suoraan korreloinut huonompiin pisteisiin, eli tutkittavien toimintakyky, elämänlaatu ja oiretilanne on heterogeeninen kaikissa ikäluokissa. Tämän opinnäytteen alkuperäisyys on tarkastettu Turnitin OriginalityCheck-ohjelmalla Tampereen Yliopiston laatujärjestelmän mukaisesti

Asuinkerrostalo Energiayhteisönä

Aurinkosähköjärjestelmät ovat kasvattaneet kuluttajien keskuudessa suosiota viimevuosien aikana. Ne eivät kuitenkaan ole olleet yhteneväisesti asuinkerrostalojen käytettävissä pientaloihin verrattuna. Uuden lainsäädännön mahdollistamat energiayhteisöt tuovat asuinkerrostaloille mahdollisuuden toimia aurinkoenergian pientuottajana ja käyttää itsetuotettua sähköenergiaa yhteneväisesti niin taloyhtiön kuin asukkaidenkin sähköntarpeisiin. Tässä työssä tutkitaan energiayhteisön perustamisen kannattavuutta kolmen pääkaupunkiseudulla sijaitsevan esimerkkikiinteistön kulutuksen kautta. Työn aluksi esitellään energiayhteisöjen toimintaperiaatteita ja määritellään asuinkerrostalolle sopivat energiayhteisöjen tyypit. Tämän jälkeen käydään läpi aurinkosähköjärjestelmän mitoitukseen liittyviä tekijöitä ja niiden kannattavuuden mittareita. Työn pääpaino on laskentaosuudessa, jossa ensin esitellään tarkasteltavat esimerkkikohteet, aurinkosähköjärjestelmän mitoituksen menetelmät ja energiayhteisöjen kannattavuuden mittarit. Aurinkovoiman tuotanto-odotuksia työssä arvioitiin Fingridin koko maan aurinkovoiman tuotantoa skaalaamalla. Näiden työkalujen avulla arvioidaan useamman erityyppisen energiayhteisön kannattavuutta asuinkerrostalossa. Työn tulokset osoittavat, että takaisinmaksuajalla mitattuna asuinkerrostaloon energiayhteisön perustaminen on kannattavaa tarkastelluissa kohteissa. Etenkin havaitaan, että tehohinnoitelluissa siirtotuotteissa on kannattavaa kasvattaa mitoitettavaa aurinkoenergiajärjestelmää, kun tehomaksu perustuu päiväajan sähkönkulutukseen. Suurella järjestelmällä tehomaksun suuruutta voidaan pudottaa merkittävästi myös syys- ja kevätaikaan, jolloin järjestelmän kannattavuus paranee

Perceived Well-being Effects During the Implementation of a Self-tracking Technology

In recent years, both individuals and the healthcare sector have become more interested to measure and improve health and well-being by using different self-tracking technologies. However, the number of studies concerning the experiences that people have with these technologies is still rather limited. This study investigates the expectations and perceived short-term effects of using self-tracking technologies on users’ well-being. The focus is on the first weeks of usage i.e., the implementation phase. The study is qualitative in nature and based on thematic analysis of ten semi-structured interviews. The results reveal that the perceived well-being effects of using a self-tracking technology are relatively minor during the implementation phase and in line with the expectations. The increase in well-being is expected to occur in a longer time scale. Perceived psychological well-being is found to be affected the most during the implementation phase. The results also reveal interesting findings regarding the use of self-tracking technologies. The results are discussed and several important implications are drawn

CRITICAL EXPERIENCES DURING THE IMPLEMENTATION OF A SELF-TRACKING TECHNOLOGY

Emerging technologies have brought several new ways to track, measure and evaluate own activity. Well-being, nutrition, physical training, mood, and sleep are a few of the various measures that can be self-tracked by different technological solutions. At the same time, people are becoming more interested in themselves and their own well-being, and constant tracking of own activities is getting more and more popular both on individual level as well as in general healthcare. This study examines critical experiences that occur during the implementation phase of the innovation-decision process and their influence to adopting or rejecting a self-tracking technology. The study is qualitative in nature and empirically based on thematic analysis of ten semi-structured interviews used together with the critical incident technique. The theoretical basis of the study comes from two well-established technology acceptance models: unified theory of acceptance and use of technology 2 (UTAUT2) and innovation-decision process. The results reveal the experiences and factors that are important for users in terms of deciding whether to adopt or reject a self-tracking technology during the initial phase of implementation. The results are also reflected to UTAUT2 and the innovation-decision process

Camera-Based Meal Type and Weight Estimation in Self-Service Lunch Line Restaurants

Individuals, restaurant owners and health organizations are all interested in accurate information about food intake, but collecting the information in sufficiently automated way remains a practical challenge. In controlled environments, such as lunch line restaurants, the food intake can be estimated by measuring the portions upon purchase and separately monitoring the food waste, but even this requires often complicated setups such as repeated weighing of the plate after every meal component. In this work we explore the feasibility of using a combination of ceiling-mounted cameras and computer vision for estimating both the types and weights of individual food items the customers are taking in a lunch line restaurant. We describe the imaging system and weighing- based sensing for obtaining ground truth training data, and develop and evaluate deep learning models for the computer vision tasks. We demonstrate high accuracy especially in meal type identification and hence validate the feasibility of the approach. We release the annotated dataset for further development of improved methods.Peer reviewe

Connectivity to computers and the Internet among patients with schizophrenia spectrum disorders : a cross-sectional study

Purpose: Information and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs). Patients and methods: A cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients' medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics. Results: In total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and > 30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45-65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (P <0.001), and younger people and those with higher education were associated with more active use. Conclusion: Patients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.Peer reviewe

Connectivity to computers and the Internet among patients with schizophrenia spectrum disorders: a cross-sectional study

PurposeInformation and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs).Patients and methodsA cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients’ medical records and a self-reported, structured questionnaire. Data analysis included descriptive statistics.ResultsIn total, 297 patients were included in this study (response rate =96%). More than half of them (n=156; 55%) had a computer and less than half of them (n=127; 44%) had the Internet at home. Of those who generally had access to computers and the Internet, more than one-fourth (n=85; 29%) used computers daily, and >30% (n=96; 33%) never accessed the Internet. In total, approximately one-fourth of them (n=134; 25%) learned to use computers, and less than one-third of them (n=143; 31%) were known to use the Internet by themselves. Older people (aged 45–65 years) and those with less years of education (primary school) tended not to use the computers and the Internet at all (PConclusionPatients had quite good access to use computers and the Internet, and they mainly used the Internet to seek information. Social, occupational, and psychological functioning (which were evaluated with Global Assessment of Functioning) were not associated with access to and frequency of computer and the Internet use. The results support the use of computers and the Internet as part of clinical work in mental health care.</p

Internal interface diversification as a security measure in sensor networks

More actuator and sensor devices are connected to the Internet of Things (IoT) every day, and the network keeps growing, while software security of the devices is often incomplete. Sensor networks and the IoT in general currently cover a large number of devices with an identical internal interface structure. By diversifying the internal interfaces, the interfaces on each node of the network are made unique, and it is possible to break the software monoculture of easily exploitable identical systems. This paper proposes internal interface diversification as a security measure for sensor networks. We conduct a study on diversifiable internal interfaces in 20 IoT operating systems. We also present two proof-of-concept implementations and perform experiments to gauge the feasibility in the IoT environment. Internal interface diversification has practical limitations, and not all IoT operating systems have that many diversifiable interfaces. However, because of low resource requirements, compatibility with other security measures and wide applicability to several interfaces, we believe internal interface diversification is a promising and effective approach for securing nodes in sensor networks.</p

Epidemiological and treatment-related factors contribute to improved outcome of oropharyngeal squamous cell carcinoma in Finland

Background: Treatment for oropharyngeal squamous cell carcinoma (OPSCC) has changed, as the proportion of human papilloma virus (HPV)-related disease has increased. We evaluated nationwide information on its management and outcome during the treatment paradigm change period.Methods: We included all patients diagnosed and treated for OPSCC at the five Finnish university hospitals from 2000 to 2009. Patient records and pathology registries provided the clinicopathological data. p16 staining was performed on primary tumor samples of patients who had received treatment with curative intent.Results: A total of 674 patients were diagnosed and treated for OPSCC and the incidence increased along the study period. Of the evaluable tumors 58.5% were p16-positive and the number of p16-positive tumors increased along the years. The treatment was given with curative intent for 600 patients and it was completed in 564. Of them, 47.9% underwent primary surgery and 52.1% received definitive oncological treatment. Also, the treatment protocol changed towards a more oncological approach. Among patients treated with curative intent the five-year overall, disease-specific and disease-free survival rates were 60.1, 71.5 and 57.0%. In multivariate analysis, p16-positivity seemed to relate to reduced disease mortality in lateral and anterior-wall disease. Depending on primary tumor localization, also sex, classes T3-4, presence of regional metastasis and radiotherapy modality had an association with disease mortality.Conclusion: The incidence of p16-positive OPSCC and delivery of definitive oncological treatment increased in Finland during the study period. An improved survival outcome compared with the previous nationwide investigation was observed in this subset of patients.Peer reviewe

Biallelic loss-of-function P4HTM gene variants cause hypotonia, hypoventilation, intellectual disability, dysautonomia, epilepsy, and eye abnormalities (HIDEA syndrome)

Purpose: A new syndrome with hypotonia, intellectual disability, and eye abnormalities (HIDEA) was previously described in a large consanguineous family. Linkage analysis identified the recessive disease locus, and genome sequencing yielded three candidate genes with potentially pathogenic biallelic variants: transketolase (TKT), transmembrane prolyl 4-hydroxylase (P4HTM), and ubiquitin specific peptidase 4 (USP4). However, the causative gene remained elusive. Methods: International collaboration and exome sequencing were used to identify new patients with HIDEA and biallelic, potentially pathogenic, P4HTM variants. Segregation analysis was performed using Sanger sequencing. P4H-TM wild-type and variant constructs without the transmembrane region were overexpressed in insect cells and analyzed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and western blot. Results: Five different homozygous or compound heterozygous pathogenic P4HTM gene variants were identified in six new and six previously published patients presenting with HIDEA. Hypoventilation, obstructive and central sleep apnea, and dysautonomia were identified as novel features associated with the phenotype. Characterization of three of the P4H-TM variants demonstrated yielding insoluble protein products and, thus, loss-of-function. Conclusions: Biallelic loss-of-function P4HTM variants were shown to cause HIDEA syndrome. Our findings enable diagnosis of the condition, and highlight the importance of assessing the need for noninvasive ventilatory support in patients.Peer reviewe