Secure coding intention via protection motivation theory based survey

Abstract. According to studies, programming skills are obtained by a large number of persons but most of them lack the ability to produce secure software. This statement reflects the essence of this thesis and provides a direction to problem solving. The focus of this study is a research into the possibility of using a questionnaire prepared with the use of a protection motivation theory (PMT) to provide a indication of intention for software developers towards secure programming techniques. This study answers the following research question: Can secure programming intention be aroused with a PMT questionnaire? The questionnaire consists of three categories: background-, awareness-/knowledge- and PMT questions. Background questions are used to identify the focus group. Awareness and knowledge questions are used to provide secure coding information which is reflected by cognitive thinking via PMT questions. The questionnaire was built as web survey and distributed via professional social network. The questionnaire uses focused subject group working in micro and small enterprises (<50 employees). The study results are analysed against PMT components to validate focus group selection as a correct choice. Survey findings analysed in qualitative manner (partly in quantitative), indicates that majority of subjects created intention towards studying or using secure coding techniques. The focus group PMT analysis results shows that in each PMT section, at least over half indicated positive response into it. These results will provide a deeper research direction for how to promote secure coding

LAPAROSCOPIC VERSUS OPEN SURGERY FOR ACUTE ADHESIVE SMALL-BOWEL OBSTRUCTION : A PROPENSITY SCORE-MATCHED ANALYSIS

Background and Aims: The laparoscopic approach has been increasingly used to treat adhesive small-bowel obstruction. The aim of this study was to compare the outcomes of a laparoscopic versus an open approach for adhesive small-bowel obstruction. Material and Methods: Data were retrospectively collected on patients who had surgery for adhesive small-bowel obstruction at a single academic center between January 2010 and December 2012. Patients with a contraindication for the laparoscopic approach were excluded. A propensity score was used to match patients in the laparoscopic and open surgery groups based on their preoperative parameters. Results: A total of 25 patients underwent laparoscopic adhesiolysis and 67 patients open adhesiolysis. The open adhesiolysis group had more suspected bowel strangulations and more previous abdominal surgeries than the laparoscopic adhesiolysis group. Severe complication rate (Clavien-Dindo 3 or higher) was 0% in the laparoscopic adhesiolysis group versus 14% in the open adhesiolysis group (p = 0.052). Twenty-five propensity score-matched patients from the open adhesiolysis group were similar to laparoscopic adhesiolysis group patients with regard to their preoperative parameters. Length of hospital stay was shorter in the laparoscopic adhesiolysis group compared to the propensity score-matched open adhesiolysis group (6.0 vs 10.0 days, p = 0.037), but no differences were found in severe complications between the laparoscopic adhesiolysis and propensity score-matched open adhesiolysis groups (0% vs 4%, p = 0.31). Conclusion: Patients selected to be operated by the open approach had higher preoperative morbidity than the ones selected for the laparoscopic approach. After matching for this disparity, the laparoscopic approach was associated with a shorter length of hospital stay without differences in complications. The laparoscopic approach may be a preferable approach in selected patients.Peer reviewe

Parents and Pediatric Weight Management Attrition: Experiences and Recommendations

Background: One of the most frequently cited challenges faced by pediatric weight management programs/clinics is attrition, with many studies reporting rates greater than 50%. Few studies have evaluated parental perspectives on recommendations for weight-management treatment enhancement. The aim of this study was to elicit perspectives on areas for improvement, discussions with staff about discontinuation, and potentially modifiable aspects of attrition from parents who prematurely discontinued stage 3 pediatric weight management treatment. Methods: This study was performed as a semistructured interview as part of a telephone survey assessing reasons for attrition. Results: Interviews were performed with 147 parents of children who attended programs/clinics at 13 children's hospitals participating in the National Association of Children's Hospitals and Related Institutions (now Children's Hospital Association) FOCUS on a Fitter Future II collaborative. The majority of parents (65%) denied talking to staff about their decisions to stop coming. When describing what could have been done to retain families, parents most frequently discussed changing logistics (e.g., hours and locations). Parents described changes in logistics and components (i.e., nutrition education, exercise, and behavior education/support) when asked what would work best for their family for pediatric weight management. Conclusions: Parental responses appeared to express frustration about flexibility with appointment times and treatment locations. The most frequently desired components were those traditionally offered by stage 3 pediatric weight management programs/clinics, and this may suggest a need for treatment delivery of these components to be more individualized. Additional discussion with families about their desire to discontinue treatment may provide a timely opportunity to address this need.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140333/1/chi.2013.0069.pd

Diagnosis, natural course and treatment outcomes of groove pancreatitis

Background: Groove pancreatitis (GP) is a rare form of chronic pancreatitis with limited data on its diagnostics and treatment outcomes. The aim of this study was to assess its diagnostics, natural course, and treatment options. Methods: The study is a retrospective population-based study from Southern Finland, including all patients with suspected GP between January 2005 and December 2015. Two certified gastrointestinal radiologists re-reviewed the imaging studies. The radiological re-review, clinical judgment, and final histopathology confirmed the GP diagnoses. Results: Out of 67 patients with possible GP, 39 patients were considered to have high radiological certainty of GP. Out of these 39, five patients had cancer instead. Thirty-three patients with confirmed GP formed the final study cohort. Patients with GP were mostly middle-aged (median 55 years) men. All had at least moderate alcohol consumption. No intervention was needed in 14 patients. In five-year follow-up all conservatively treated patients became asymptomatic, while 10 out of 16 patients undergoing at least one intervention were asymptomatic at five years. Conclusion: The radiological diagnosis of GP is difficult, and a low threshold for cancer suspicion should be kept. Symptoms of GP decrease with time and suggest conservative treatment as the first-line option.Peer reviewe

Self-reported reasons for on-duty sleepiness among commercial airline pilots

Experimental and epidemiological research has shown that human sleepiness is determined especially by the circadian and homeostatic processes. The present field study examined which work-related factors airline pilots perceive as causing on-duty sleepiness during short-haul and long-haul flights. In addition, the association between the perceived reasons for sleepiness and actual sleepiness levels was examined, as well as the association between reporting inadequate sleep causing sleepiness and actual sleep-wake history. The study sample consisted of 29 long-haul (LH) pilots, 28 short-haul (SH) pilots, and 29 mixed fleet pilots (flying both SH and LH flights), each of whom participated in a 2-month field measurement period, yielding a total of 765 SH and 494 LH flight duty periods (FDPs) for analyses (FDP, a period between the start of a duty and the end of the last flight of that duty). The self-reports of sleepiness inducers were collected at the end of each FDP by an electronic select menu. On-duty sleepiness was rated at each flight phase by the Karolinska Sleepiness Scale (KSS). The sleep-wake data was collected by a diary and actigraph. The results showed that "FDP timing" and "inadequate sleep" were the most frequently reported reasons for on-duty sleepiness out of the seven options provided, regardless of FDP type (SH, LH). Reporting these reasons significantly increased the odds of increased on-duty sleepiness (KSS >= 7), except for reporting "inadequate sleep" during LH FDPs. Reporting "inadequate sleep" was also associated with increased odds of a reduced sleep-wake ratio (total sleep time/amount of wakefulnessPeer reviewe

Kohti yhteisiä tavoitteita : GAS-koulutuksen arviointihankkeen loppuraportti

Goal Attaiment Scaling eli GAS on tavoiteasetannan menetelmä, jonka avulla pyritään ottamaan asiakkaan arki kuntoutuksen lähtökohdaksi. GAS-koulutusta avokuntoutuksen ammattihenkilöille on toteutettu 15 ammattikorkeakoulussa eri puolilla Suomea vuodesta 2011 alkaen. Tämän arviointitutkimuksen tarkoituksena oli selvittää, miten koulutuksen suorittaneet ammattilaiset käyttävät GAS-menetelmää ja minkälaisena he kokevat sen käytettävyyden ja hyödynnettävyyden. Lisäksi haluttiin kartoittaa sekä koulutuksiin osallistuneiden että kouluttajien näkemyksiä GAS-menetelmästä ja -koulutuksesta ja sen kehittämistarpeista. Tutkimuksen aineisto koottiin GAS-koulutukseen osallistuneille kuntoutusammattilaisille kohdennetulla sähköisellä kyselyllä ja GAS-kouluttajien haastatteluilla. Kyselyn vastaajista (n = 178) suurin osa ilmoitti kuntoutujien osallistuvan tavoitteiden asettamiseen ja yli puolet vastaajista koki menetelmän parantaneen kuntoutujien kuntoutusmotivaatiota. Yhteistyö hoitovastuutahon kanssa GAStavoitteiden suunnittelussa ja asettamisessa on vastausten perusteella melko vähäistä. Vajaa puolet vastaajista arvioi GAS-menetelmän käyttöönoton lisänneen tai syventäneen moniammatillista yhteistyötä. Tarkasteltaessa GAS-menetelmän hallintaa havaittiin, että koulutukseen osallistuneilla näyttäisi olevan vaikeuksia lähtö- ja tavoitetason määrittelyssä, indikaattorien sanallistamisessa sekä T-scoren ymmärtämisessä. Noin kaksi kolmasosaa vastaajista arvioi GAS-koulutuksen vastanneen odotuksia, mutta kaiken kaikkiaan koulutustyytyväisyyden suhteen ammattikorkeakoulukohtaiset erot olivat suuria tilastollisesti merkitsevällä tasolla. Avoimissa vastauksissa teemoiksi nousivat moniammatillisuus ja ammattikohtaisuus koulutuksen toteutuksessa, kuntoutujiin liittyvät haasteet sekä kouluttajien GAS-osaaminen. Kouluttajien haastatteluissa esille nousivat koulutukseen osallistuneiden vastustavat ennakkoasenteet, moniammatillisen työskentelyn puute arjessa, totutuista rooleista poisoppiminen, vaikeus asettaa arkielämälähtöisiä ja tarkoituksenmukaisia tavoitteita sekä se, että kuntoutukselta puuttuu usein kokonaistavoite. Kouluttajat olivat syventäneet ja laajentaneet koulutussisältöjä ja muokanneet välitehtäviä kukin omalla tavallaan ja omien ryhmiensä tarpeista lähtien, joten GAS-koulutuksen yhdenmukaisuudesta ei voitane puhua. Raportin yhteenvetona kuvataan hyvän GAS-koulutuskäytännön elementit

Outcomes of High-Frequency Gastric Electric Stimulation for the Treatment of Severe, Medically Refractory Gastroparesis in Finland

Background and Aims: Severe, medically uncontrollable gastroparesis is a rare entity, which can be treated using a high-frequency gastric electric stimulator implanted surgically. Previous follow-ups have proven positive outcomes with gastric electric stimulator in patients with gastroparesis. The aim of this study was to evaluate the efficacy and safety of gastric electric stimulator in patients, in whom gastroparesis could not be controlled by conservative means in our country. Materials and Methods: This is a retrospective multi-center cohort comprising all patients who had been implanted gastric electric stimulator for severe, medically refractory gastroparesis during 2007-2015 in Finland. Results: Fourteen patients underwent implantation of gastric electrical stimulator without any postoperative complications. Laparoscopic approach was used in 13 patients (93%). Prior implantation, all patients needed frequent hospitalization for parenteral feeding, 13 had severe nausea, 11 had severe vomiting, 10 had notable weight loss, and 6 had frequent abdominal pain. After operation, none of the patients required parenteral feeding, 11 patients (79%) gained median of 5.1 kg in weight (P <0.01), and symptoms were relieved markedly in 8 and partially in 3 patients (79%). Of partial responders, two continued to experience occasional vomiting and one mild nausea. Five patients needed medication for gastroparesis after the operation. One patient did not get any relief of symptoms, but gained 6 kg in weight. No major late complications occurred. Conclusion: Gastric electrical stimulator seems to improve the nutritional status and give clear relief of the symptoms of severe, medically uncontrollable gastroparesis. Given the low number of operations, gastric electrical stimulator seems to be underused in Finland.Peer reviewe

Failure to rescue after reoperation for major complications of elective and emergency colorectal surgery : A population-based multicenter cohort study

Publisher Copyright: © 2022 The Author(s)Background: As complications inevitably occur, minimizing the failure-to-rescue rate is of paramount interest. Most of the failure-to-rescue research in colorectal surgery has previously focused on elective surgery and anastomotic dehiscence. The aim of this study was to characterize and compare the major postoperative complications demanding reoperation after elective versus emergency colorectal surgery, and to the identify risk factors for failure-to-rescue. Methods: In this population-based retrospective multicenter cohort study, adult patients undergoing a reoperation for colorectal surgery complication between 2006 and 2017 in 10 hospitals were included. The data were manually extracted. Failure-to-rescue was defined as 90-day mortality after the reoperation. Results: In total, 14,290 patients underwent index colorectal resection, of which 862 patients (5.8%) underwent emergency reoperation within 30 days (438 [4.3%] after elective, 424 [10.4%] after emergency index operation, P 3× compared with elective surgery. The 4 most common complication types constitute three-fourths of the complications, providing a target for quality improvement.Peer reviewe

INtravenous Contrast computed tomography versus native computed tomography in patients with acute Abdomen and impaired Renal functiOn (INCARO) : a multicentre, open-label, randomised controlled trial - study protocol

Introduction CT is the primary imaging option for acute abdominal pain in adults. Intravenous (IV) contrast media use improves CT quality but may cause post-contrast acute kidney injury (PC-AKI). Retrospective studies show no association between reduced baseline renal function and IV contrast CT, but, to our knowledge, no data from randomised controlled trials exist. Methods and analysis The INCARO (INtravenous Contrast computed tomography versus native computed tomography in patients with acute Abdomen and impaired Renal functiOn) trial is a multicentre, open-label, parallel group, superiority, individually randomised controlled trial comparing IV contrast-enhanced CT to native CT in patients requiring emergency abdominal or body CT with impaired renal function defined as an estimated glomerular filtration rate (eGFR) of 15 to 45 mL/min/1.73 m(2). The primary outcome is a composite of all-cause mortality or renal replacement therapy (RRT) within 90 days from CT. Secondary outcomes are AKI measured by KDIGO (The Kidney Disease: Improving Global Outcomes) criteria within 72 hours from CT, organ dysfunction defined by mSOFA (modified Sequential Organ Failure Assessment) criteria after 48 hours from CT, alive and hospital-free days within 90 days after CT, and time from imaging to definitive treatment. All-cause mortality, need for RRT and renal transplant in long-term follow-up are also measured. The calculated sample size is 994 patients. Patient recruitment is estimated to take 3 years. Ethics and dissemination The Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.Peer reviewe

Meta-analysis of antibiotics versus appendicectomy for non-perforated acute appendicitis

Background: For more than a century, appendicectomy has been the treatment of choice for appendicitis. Recent trials have challenged this view. This study assessed the benefits and harms of antibiotic therapy compared with appendicectomy in patients with non-perforated appendicitis. Methods: A comprehensive search was conducted for randomized trials comparing antibiotic therapy with appendicectomy in patients with non-perforated appendicitis. Key outcomes were analysed using random-effects meta-analysis, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Five studies including 1116 patients reported major complications in 25 (4.9 per cent) of 510 patients in the antibiotic and 41 (8.4 per cent) of 489 in the appendicectomy group: risk difference -2.6 (95 per cent c.i. -6.3 to 1.1) per cent (low-quality evidence). Minor complications occurred in 11 (2.2 per cent) of 510 and 61 (12.5 per cent) of 489 patients respectively: risk difference -7.2 (-18.1 to 3.8) per cent (very low-quality evidence). Of 550 patients in the antibiotic group, 47 underwent appendicectomy within 1 month: pooled estimate 8.2 (95 per cent c.i. 5.2 to 11.8) per cent (high-quality evidence). Within 1 year, appendicitis recurred in 114 of 510 patients in the antibiotic group: pooled estimate 22.6 (15.6 to 30.4) per cent (high-quality evidence). For every 100 patients with non-perforated appendicitis, initial antibiotic therapy compared with prompt appendicectomy may result in 92 fewer patients receiving surgery within the first month, and 23 more experiencing recurrent appendicitis within the first year. Conclusion: The choice of medical versus surgical management in patients with clearly uncomplicated appendicitis is value-and preference-dependent, suggesting a change in practice towards shared decision-making is necessary.Peer reviewe