A quasi-experimental study of a basics of evidence-based practice educational intervention for health and social care professionals

Education is one of the central interventions to promote evidence-based practice (EBP) in service organizations. An educational intervention to promote EBP among health and social care professionals was implemented in a Finnish hospital. The aim of this study was to explore the outcomes of an educational intervention, focusing on the basics of EBP for health and social care professionals, using a quasi-experimental study design. The data were collected with a questionnaire before, immediately after, and 6 months after the education (n = 48). The data were analyzed with descriptive statistics and nonparametric tests. Immediately after the education, an increase was found in the EBP knowledge of participants, in participants’ confidence in their own ability to conduct database searches and read scientific articles, and in the number of participants using databases at work. Six months after the education, improvements were still found between the first and the third measurement in the participants’ knowledge and confidence in their own ability to conduct database searches and read scientific articles. The number of those who had made an initiative about a research topic regarding the development of their own work had increased from the first to the third measurement. The educational intervention produced a statistically significant improvement on most of the areas evaluated. Significant improvements were often found even 6 months after the education was finished. However, the low completion rate and a quasi-experimental before and after design limit the conclusions that can be derived from this study.©2020 the Authors. Creative Commons Non-Commercial (CC BY-NC). This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).fi=vertaisarvioitu|en=peerReviewed

Nachfrage und Angebot zur Benutzungsbetreuung von Software im universitären Lehrbetrieb

Im vorliegenden Aufsatz gehen wir der rekursiven Figur nach, dass die Nutzung einer Softwareunterstützung für Lernprozesse selbst erlernt werden muss. Gerade Lehrende sind in einer Doppelrolle: Sie müssen – häufig gleichzeitig – lernen, wie sie eine Lernsoftware selbst benutzen bzw. wie sie sie didaktisch in ihre Lehrveranstaltung einbinden und wie sie Studierende in die Nutzung einführen. Nicht zuletzt aufgrund dieser Doppelrolle ist der für die Nutzung notwendige Lernprozess einer gewissen Dynamik unterworfen

Effects of single family room architecture on parent-infant closeness and family centered care in neonatal environments : a single-center pre-post study

OBJECTIVE: The aim of this study was to evaluate the effects of a single family room architecture in a neonatal intensive care unit (SFR-NICU) on parents’ presence, parent–infant skin-to-skin contact (SSC) and the quality of family centered care. STUDY DESIGN: Two cohorts of parents of preterm infants were compared: those in the unit before and after the move to SFR-NICU. The parents used daily diaries to report their presence and SSC, and they responded to daily text message questions about the quality of family centered care. RESULTS: Parents spent more time in the SFR-NICU, but no significant change was found in SSC. Parents rated the quality of family centered care highly in both unit architectures, without a change in rating after the move. CONCLUSION: The SFR-NICU increased parents’ presence but not SSC. The change in architecture did not affect parents’ evaluations of the quality of family centered care, which was already highly rated before the move.©The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visithttp://creativecommons.org/licenses/by/4.0/.Open access funding provided by University of Turku (UTU) including Turku University Central Hospital.fi=vertaisarvioitu|en=peerReviewed

Diagnostic accuracy of contrast-enhanced CT for neck abscesses : A systematic review and meta-analysis of positive predictive value

Objectives To review the diagnostic accuracy of contrast-enhanced computed tomography (CT) in differentiating abscesses from cellulitis in patients with neck infections, using surgical findings as the reference standard. Materials and methods Previous studies in the last 32 years were searched from PubMed and Embase. Because of partial verification bias (only positive abscess findings are usually verified surgically), sensitivity and specificity estimates are unreliable, and we focused on positive predictive value (PPV). For all studies, PPV was calculated as the proportion of true positives out of all positives on imaging. To estimate pooled PPV, we used both the median with an interquartile range and a model-based estimate. For narrative purposes, we reviewed the utility of common morphological CT criteria for abscesses, such as central hypodensity, the size of the collection, bulging, rim enhancement, and presence of air, as well as sensitivity and specificity values reported by the original reports. Results 23 studies were found reporting 1453 patients, 14 studies in children (771 patients), two in adults (137 patients), and seven including all ages (545 patients). PPV ranged from 0.67 to 0.97 in individual studies, had a median of 0.84 (0.79–0.87), and a model-based pooled estimate of 0.83 (95% confidence interval 0.80–0.85). Most morphological CT criteria had considerable overlap between abscesses and cellulitis. Conclusions The pooled estimate of PPV is 0.83 for diagnosing neck abscesses with CT. False positives may be due to limited soft tissue contrast resolution. Overall, none of the morphological criteria seem to be highly accurate for differentiation between abscess and cellulitis.© 2022 Hagelberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.fi=vertaisarvioitu|en=peerReviewed

Burden of mental, behavioral, and neurodevelopmental disorders in the Finnish most preterm children : a national register study

Etiologies and the whole picture in childhood mental, behavioral, and neurodevelopmental disorders related to gestational age are unclear. This study included all Finnish children (N = 341,632) born between January 1, 2001, and December 31, 2006, whose data including their mothers (N = 241,284) were collected from national registers. Children with unclear gestational age (GA) (N = 1245), severe congenital malformations (N = 11,746), and moderate/severe/undefined cognitive impairment (N = 1140), and those who died during the perinatal period (N = 599) were excluded. The main outcome was the prevalence of mental and behavioral disorders (International Classification of Disorders) at 0 − 12 years of age in association with GA, adjusted for gender and prenatal variables. Out of all included (N = 326,902) children 16.6% (N = 54,270) were diagnosed to have any mental health disorder at 0 − 12 years. Adjusted Odd Ratio (OR) were for any disorder in preterm (< 37 weeks) 1.37 [1.28 − 1.46] and 4.03 [3.08 − 5.26] in extreme preterm (≤ 28 weeks) versus term born children, p < 0.05. The lower the GA at birth, the higher the risk for multiple disorders and earlier onset of disorder, p < 0.05. Adjusted ORs were for male/female 1.94 [1.90 − 1.99], maternal mental health disorder (yes/not) 1.99 [1.92 − 2.07], and smoking during pregnancy (yes/not) 1.58 [1.54 − 1.62], and these risks were more common in preterm versus term born children (p < 0.05). Extreme early birth was a strong risk factor per se for any or multiple and early shown mental health disorders. Other risk factors for mental health accumulated to preterm children.© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.fi=vertaisarvioitu|en=peerReviewed

Functionality Investigations of Dry-Lubricated Molybdenum Trioxide Cylindrical Roller Thrust Bearings

In addition to using conventional lubricants, such as oil and grease, rolling bearings can also be used with a dry lubricant. For example, the use of dry lubricant systems is necessary when the application of oils or greases is not possible (e.g., at high temperatures or in aerospace applications). The requirements of a solid lubricant are to reduce friction and wear of mechanical contact partners. In this work, a molybdenum-based coating system was applied by means of physical vapor deposition (PVD). The coating system consists of a molybdenum (Mo) reservoir with molybdenum trioxide (MoO3) as the top layer. The MoO3, which is particularly important for the run-in and the lubricating effect, is intended to continuously regenerate from the reservoir via tribo-oxidation. To determine the friction and wear behavior, cylindrical roller thrust bearings were used. Experiments demonstrated that the lubrication system is effective and that the frictional behavior has been improved. On the one hand, the frictional torque of the rolling bearings has been considerably reduced and, on the other, significantly extended operating times have been determined compared to unlubricated reference experiments. Simultaneously, material analyses have been carried out by means of scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). The investigations showed that the MoO3 was transferred to uncoated bearing components. This improved the tribological behavior and reduced abrasive and adhesive wear

Production-related surface and subsurface properties and fatigue life of hybrid roller bearing components

By combining different materials, for example, high-strength steel and unalloyed structural steel, hybrid components with specifically adapted properties to a certain application can be realized. The mechanical processing, required for production, influences the subsurface properties, which have a deep impact on the lifespan of solid components. However, the influence of machining-induced subsurface properties on the operating behavior of hybrid components with a material transition in axial direction has not been investigated. Therefore, friction-welded hybrid shafts were machined with different process parameters for hard-turning and subsequent deep rolling. After machining, subsurface properties such as residual stresses, microstructures, and hardness of the machined components were analyzed. Significant influencing parameters on surface and subsurface properties identified in analogy experiments are the cutting-edge microgeometry, S, and the feed, f, during turning. The deep-rolling overlap, u, hardly changes the residual stress depth profile, but it influences the surface roughness strongly. Experimental tests to determine fatigue life under combined rolling and rotating bending stress were carried out. Residual stresses of up to −1000 MPa, at a depth of 200 µm, increased the durability regarding rolling-contact fatigue by 22%, compared to the hard-turned samples. The material transition was not critical for failure. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Investigation of the Hardness Development of Molybdenum Coatings under Thermal and Tribological Loading

The increasing global demand for innovative and environmentally friendly lubricants can be met through the use of solid lubricants. By switching from conventional lubricants such as various oils or grease to solid lubricants, new scopes of application can also be opened up. The main requirements for solid lubricants are a reduction in the coefficient of friction (CoF) and an increase in wear resistance. Due to the favourable material properties, molybdenum (Mo) coatings fulfil the tribological requirements and are therefore promising solid lubricants which can be applied via physical vapour deposition (PVD). In this work, the impact of substrate temperature on the hot hardness of deposited Mo coatings was determined. The specimen with the highest hot hardness was then tribologically examined both at the micro and nano level. Through an analysis of the wear tracks by means of nanoindentation and scanning electron microscopy (SEM), it was possible to detect the influence of the tribological load separately from that of the thermal loads. The results showed that the tribological load influenced the Mo coating by significantly increasing its hardness. This was achieved due to the work hardening of the Mo layer leading to an increase in the wear resistance of the coating

Fewer maternal depression symptoms after the Close Collaboration with Parents intervention : Two-year follow-up

Aim To test whether the implementation of the Close Collaboration with Parents intervention at a neonatal intensive care unit (NICU) decreases depression symptoms of mothers up to two years after the delivery of preterm infants. Methods We used a non-equivalent two-group design, comparing mothers of very low birthweight infants in the same NICU before (2001–2006) and after (2011–215) the intervention. The unit carried out the educational intervention (2009–2012) that was targeted at its healthcare team and aimed to improve their skills to collaborate with parents. Maternal depression symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) six months and two years after the expected birth date of the infant. Results We found a median difference of 2.56 (95% CI from 1.64 to 3.48) in EPDS at the two-year follow-up between the pre-intervention and post-intervention groups, p < 0.001. Furthermore, we found no interaction between measurement time-points and group, implying that the intervention effect on maternal depression symptoms was similar at the six-month and two-year time-points. Conclusion The intervention seems to have long-term preventive effects on maternal depressive symptoms. This effect is of clinical significance as prolonged maternal depression associates with adverse child outcomes.© 2022 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.fi=vertaisarvioitu|en=peerReviewed

Single Center Experience with a 4-Week 177Lu-PSMA-617 Treatment Interval in Patients with Metastatic Castration-Resistant Prostate Cancer

Background: 177Lu-PSMA-617 is a promising theragnostic treatment for metastatic castration-resistant prostate cancer (mCRPC). However, both the optimal treatment dose and interval in mCRPC and the rate of identification of responders from non-responders among possible treatment candidates are unknown. Methods: 62 men with mCRPC who were treated with 177Lu-PSMA-617 during 1/2017–2/2019 were included in the study. Treatment responses, overall survival (OS) and progression free survival (PFS) were determined. The median follow-up time was 1.4 years (IQR 0.5–2.2). Tumor volume of metastases (MTV), SUVmax and tumor lesion activity (TLA) were quantitated from pre-treatment PSMA PET/CT images together with pre-treatment PSA. Results: An average of three treatment cycles (2–5) were given within a four-week interval. PFS was 4.9 months (2.4–9.6) and OS was 17.2 months (6–26.4). There were no major adverse events reported. A significant PSA response of >50% was found in 58.7% of patients, which was significantly associated with longer OS, p < 0.004. PSA response was not associated with staging PSMA-derived parameters. Conclusions: 177Lu-PSMA-617 treatment in four-week intervals was safe and effective. Almost 60% of patients had a significant PSA response, which was associated with better OS. Pre-treatment PSA kinetics or staging PSMA PET/CT-derived parameters were not helpful in identifying treatment responders from non-responders; better biomarkers are needed to aid in patient selection.© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).fi=vertaisarvioitu|en=peerReviewed