Childhood community-acquired pneumonia

Background: Community-acquired pneumonia is a leading cause of morbidity and mortality in children worldwide. New, rapid methods are needed to improve the microbiologic diagnosis of pneumonia in clinical practice. The increasing incidence of parapneumonic empyema in children accentuates the importance of the identification of the causative agent and clinical predictors of empyema. Aims and methods: Two prospective studies were conducted to find feasible diagnostic methods for the detection of causative agents of pneumonia. The usefulness of pneumolysin-targeted real-time PCR in the diagnosis of pneumococcal disease was studied in children with pneumonia and empyema, and the clinical utility of induced sputum analysis in the microbiologic diagnosis of pneumonia was investigated in children with pneumonia. In addition, two retrospective clinical studies were performed to describe the frequency and clinical profile of influenza pneumonia in children and the frequency, clinical profile and clinical predictors of empyema in children. Results: Pneumolysin-PCR in pleural fluid significantly improved the microbiologic diagnosis of empyema by increasing the detection rate of pneumococcus almost tenfold to that of pleural fluid culture (75 % vs. 8 %). In whole blood samples, PCR detected pneumococcus in only one child with pneumonia and one child with pneumococcal empyema. Sputum induction provided good-quality sputum specimens with high microbiologic yield. Streptococcus pneumoniae (46 %) and rhinovirus (29 %) were the most common microbes detected. The quantification results of the paired sputum and nasopharyngeal aspirate specimens provided support that the majority of the bacteria (79 %) and viruses (55 %) found in sputum originated from the lower airways. Pneumonia was detected in 14 % of children with influenza infection. A history of prolonged duration of fever, tachypnea, and pain on abdominal palpation were found to be independently significant predictors of empyema. Conclusions: Pneumolysin-targeted real-time PCR is a useful and rapid method for the diagnosis of pneumococcal empyema in children. Induced sputum analysis with paired nasopharyngeal aspirate analysis can be of clinical value in the microbiologic diagnosis of pneumonia. Influenza pneumonia is an infrequent and generally benign disease in children with rare fatalities. Repeat chest radiograph and ultrasound imaging are recommended in children with pneumonia presenting with clinical predictors of empyema and in children with persistent fever and high CRP levels during hospitalization.Siirretty Doriast

Golfvammojen ennaltaehkäisy toiminnallisen lajinomaisen harjoittelun keinoin

Opinnäytetyön tavoitteena oli luoda golfin lajinomaisen, toiminnallisen harjoittelun harjoitepankki kuntokeskuskäyttöön golfvammojen ennaltaehkäisyn näkökulmasta. Työ lähti liikkeelle toimeksiantajan tarpeesta lisätä yhteistyötä alueen golfseuran kanssa. Fysioterapian näkökulmaa harjoitteisiin tuotiin perustelemalla harjoitteet yleisimpien golfvammojen ennaltaehkäisy mielessä pitäen. Harjoitepankki koostettiin toimeksiantajan toiveesta käyttäen kolmea eri toiminnallisen harjoittelun menetelmää; TRX® Suspension Training®, kahvakuulaharjoittelu sekä kuntosaliharjoittelu. Harjoittelumenetelmän valinnan eri asiakkaille sovittiin perustuvan opinnäytetyöhön valittuihin lajissa oleellisia ominaisuuksia mittaaviin testeihin, jotka kuntokeskusympäristössä on mahdollista toteuttaa. Käytettävien testien ja harjoitteiden valintaa opinnäytetyöhön ohjasi golfin lajianalyysi sekä siitä nousseet yleisimmät vamma-alueet ja niiden vammat, joiden vammamekanismia ja patofysiologiaa työssä selvitettiin. Yleisimpien golfvammojen vammamekanismeja ja patofysiologiaa selvittämällä saatiin selville vammojen yleisin tyyppi, rasitusvamma. Toiminnalliset harjoitteet valittiin ennaltaehkäisemään lajissa syntyviä rasitusvammoja. Harjoitteiden vaikutus opinnäytetyössä esiteltyjen vammojen ennaltaehkäisyyn olisi hyvä jatkotutkimusaihe tulevia opinnäytetöitä ajatellen.The goal of the Bachelor´s Thesis was to create an exercise catalogue of sport specific functional training for golf for the use of the fitness center from the point of view of preventing golf injuries. The point of departure in the thesis was the assignor’s need to increase cooperation with the Golf Club in the same area. A physiotherapy point of view was brought to the exercises by justifying them with the idea of preventing the most common golf injuries. The exercise catalogue was assembled based on the assignor´s wish to use three different methods of functional training; TRX® Suspension Training®, kettlebell training and gym training. The choice of the training method for different clients was agreed to be based on the tests chosen for the thesis. The tests were selected based on their suitability for measuring essential characteristics required in golf as well as because of their suitability for implementation in a fitness center environment. The selection of the tests and exercises for the thesis was guided by the sports analysis of golf and the most common injuries and sites of injuries whose injury mechanism and pathophysiology were examined in the thesis. By examining the injury mechanism and pathophysiology of the most common golf injuries it was discovered that the most common type of injury was a stress injury. Functional exercises were selected for the prevention of stress injuries that develop when playing golf. The preventive influence of the exercises on the injuries presented in the thesis would be a useful topic for a further study

The visible and the tangible : on the questions of materiality in the study of medieval images and objects

Non peer reviewe

Met expectations and the well-being of ethnic remigrants: A longitudinal study

Peer reviewe

Argumentointia monenlaisissa konteksteissa

Kirja-arvostelu: Arvosteltu teos: Cornelia Ilie & Giuliana Garzone (toim.): Argumentation across communities of practice. Multi-disciplinary perspectives. Argumentation in Context 10. Amsterdam: John Benjamins Publishing Company 2017. 345 s. isbn 978-90-272-1127_9.Non peer reviewe

Correction to: A comparative study of parental knowledge and adaptation of immigrant youth

An amendment to this paper has been published and can be accessed via the original article

Correction to: A comparative study of parental knowledge and adaptation of immigrant youth

An amendment to this paper has been published and can be accessed via the original article

Type 2 diabetes and cognitive performance in middle age : a cross-sectional study

Introduction: Type 2 diabetes has been associated with cognitive decrements already in middle-age. However, the sample sizes of the studies have been small and the neuropsychological tests used have been heterogeneous. In addition, only a few studies have matched the groups in terms of age, education and gender. In this cross-sectional matched pairs study, we investigated the cognitive performance of Finnish middle-aged type 2 diabetes patients compared to healthy individuals. Method: A neuropsychological test battery consisting of 16 tests and 21 outcome measures was applied to 28 patients and 28 age-, education- and gender-matched healthy individuals. Various exclusion criteria were applied to minimize the risk of cognitive dysfunction due to factors other than diabetes. Results: We did not find between-group differences in any of the neuropsychological tests measuring attention, concept formation and reasoning, construction and motor performance, executive functions, memory, processing speed or working memory. In addition, there were no group differences in the frequency or severity of subjective cognitive symptoms, or in anxiety, depression, burnout, fatigue or alcohol use disorder symptoms. The effect sizes in this study were mostly negligible or small, with the mean effect size being −0.12. Conclusions: In a carefully matched sample of middle-aged type 2 diabetes patients and healthy individuals, we found no significant effects and no meaningful evidence of cognitive differences between the groups.Peer reviewe

Associations of changes in diet and leisure-time physical activity with employer's direct cost of short-term sickness absence

Several unhealthy lifestyles are associated with increased sickness absence (SA). This study examined the associations of changes in diet and leisure-time physical activity (LTPA) with employer’s direct cost of subsequent short-term (<10 working days) SA. The survey data from phases 1 (2000−2002) and 2 (2007) of the Helsinki Health Study (HHS), a longitudinal cohort study of initially 40−60-year-old employees of the City of Helsinki, Finland, were linked with SA register data. Final data consisted of 4157 employees. Dietary habits were inquired with a short food frequency questionnaire. Consumption of fruits (F) and vegetables (V) was used to indicate healthiness of diet. LTPA was measured with a series of questions on the intensity and the amount of LTPA. Data on short-term SA and salaries (2008−2012) were received from the employers’ registers. A two-part model was used to analyse the associations. Those who improved their F&V consumption from non-daily to daily and persevered physically active got 620 € (95% CI −1194, −47) lower cost than those remaining non-daily F&V consumers and physically inactive. When examining LTPA only, those who persevered physically active or improved from moderately active to active got 19% less cost for the employer than those remaining inactive. Dietary changes were not independently associated with the cost. Improving employees’ diet and LTPA may reduce employer’s direct cost of SA. Although the associations of diet with SA cost were not statistically significant, improvements in diet may contribute to the beneficial associations of LTPA and employer’s cost of SA.Several unhealthy lifestyles are associated with increased sickness absence (SA). This study examined the associations of changes in diet and leisure-time physical activity (LTPA) with employer’s direct cost of subsequent short-term (<10 working days) SA. The survey data from phases 1 (2000−2002) and 2 (2007) of the Helsinki Health Study (HHS), a longitudinal cohort study of initially 40−60-year-old employees of the City of Helsinki, Finland, were linked with SA register data. Final data consisted of 4157 employees. Dietary habits were inquired with a short food frequency questionnaire. Consumption of fruits (F) and vegetables (V) was used to indicate healthiness of diet. LTPA was measured with a series of questions on the intensity and the amount of LTPA. Data on short-term SA and salaries (2008−2012) were received from the employers’ registers. A two-part model was used to analyse the associations. Those who improved their F&V consumption from non-daily to daily and persevered physically active got 620 € (95% CI −1194, −47) lower cost than those remaining non-daily F&V consumers and physically inactive. When examining LTPA only, those who persevered physically active or improved from moderately active to active got 19% less cost for the employer than those remaining inactive. Dietary changes were not independently associated with the cost. Improving employees’ diet and LTPA may reduce employer’s direct cost of SA. Although the associations of diet with SA cost were not statistically significant, improvements in diet may contribute to the beneficial associations of LTPA and employer’s cost of SA.Peer reviewe

Lääkehoitoa toteutetaan monessa eri toimintaympäristössä

Teema : riskilääkkeet – onko niitä