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Search: WFRF:(Rintala A)

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  • Veer, IM, et al. (author)
  • Psycho-social factors associated with mental resilience in the Corona lockdown
  • 2021
  • In: Translational psychiatry. - : Springer Science and Business Media LLC. - 2158-3188. ; 11:1, s. 67-
  • Journal article (peer-reviewed)abstract
    • The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.
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  • Bass, Gary Alan, 1979-, et al. (author)
  • Techniques for mesoappendix transection and appendix resection: insights from the ESTES SnapAppy study
  • 2023
  • In: European Journal of Trauma and Emergency Surgery. - : Springer Science and Business Media LLC. - 1863-9933 .- 1615-3146 .- 1863-9941. ; 49, s. 17-32
  • Journal article (peer-reviewed)abstract
    • Introduction: Surgically managed appendicitis exhibits great heterogeneity in techniques for mesoappendix transection and appendix amputation from its base. It is unclear whether a particular surgical technique provides outcome benefit or reduces complications. Material and methods: We undertook a pre-specified subgroup analysis of all patients who underwent laparoscopic appendectomy at index admission during SnapAppy (ClinicalTrials.gov Registration: NCT04365491). We collected routine, anonymized observational data regarding surgical technique, patient demographics and indices of disease severity, without change to clinical care pathway or usual surgeon preference. Outcome measures of interest were the incidence of complications, unplanned reoperation, readmission, admission to the ICU, death, hospital length of stay, and procedure duration. We used Poisson regression models with robust standard errors to calculate incident rate ratios (IRRs) and 95% confidence intervals (CIs). Results: Three-thousand seven hundred sixty-eight consecutive adult patients, included from 71 centers in 14 countries, were followed up from date of admission for 90days. The mesoappendix was divided hemostatically using electrocautery in 1564(69.4%) and an energy device in 688(30.5%). The appendix was amputated by division of its base between looped ligatures in 1379(37.0%), with a stapler in 1421(38.1%) and between clips in 929(24.9%). The technique for securely dividing the appendix at its base in acutely inflamed (AAST Grade 1) appendicitis was equally divided between division between looped ligatures, clips and stapled transection. However, the technique used differed in complicated appendicitis (AAST Grade 2 +) compared with uncomplicated (Grade 1), with a shift toward transection of the appendix base by stapler (58% vs. 38%; p < 0.001). While no statistical difference in outcomes could be detected between different techniques for division of appendix base, decreased risk of any [adjusted IRR (95% CI): 0.58 (0.41–0.82), p = 0.002] and severe [adjusted IRR (95% CI): 0.33 (0.11–0.96), p = 0.045] complications could be detected when using energy devices. Conclusions: Safe mesoappendix transection and appendix resection are accomplished using heterogeneous techniques. Technique selection for both mesoappendix transection and appendix resection correlates with AAST grade. Higher grade led to more ultrasonic tissue transection and stapled appendix resection. Higher AAST appendicitis grade also correlated with infection-related complication occurrence. Despite the overall well-tolerated heterogeneity of approaches to acute appendicitis, increasing disease acuity or complexity appears to encourage homogeneity of intraoperative surgical technique toward advanced adjuncts.
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  • Forssten, Maximilian Peter, 1996-, et al. (author)
  • Surgical management of acute appendicitis during the European COVID-19 second wave: safe and effective
  • 2023
  • In: European Journal of Trauma and Emergency Surgery. - : Springer Science and Business Media LLC. - 1863-9933 .- 1615-3146 .- 1863-9941. ; 49, s. 57-67
  • Journal article (peer-reviewed)abstract
    • Introduction: The COVID-19 (SARS-CoV-2) pandemic drove acute care surgeons to pivot from long established practice patterns. Early safety concerns regarding increased postoperative complication risk in those with active COVID infection promoted antibiotic-driven non-operative therapy for select conditions ahead of an evidence-base. Our study assesses whether active or recent SARS-CoV-2 positivity increases hospital length of stay (LOS) or postoperative complications following appendectomy. Methods: Data were derived from the prospective multi-institutional observational SnapAppy cohort study. This preplanned data analysis assessed consecutive patients aged ≥ 15years who underwent appendectomy for appendicitis (November 2020–May 2021). Patients were categorized based on SARS-CoV-2 seropositivity: no infection, active infection, and prior infection. Appendectomy method, LOS, and complications were abstracted. The association between SARS-CoV-2 seropositivity and complications was determined using Poisson regression, while the association with LOS was calculated using a quantile regression model. Results: Appendectomy for acute appendicitis was performed in 4047 patients during the second and third European COVID waves. The majority were SARS-CoV-2 uninfected (3861, 95.4%), while 70 (1.7%) were acutely SARS-CoV-2 positive, and 116 (2.8%) reported prior SARS-CoV-2 infection. After confounder adjustment, there was no statistically significant association between SARS-CoV-2 seropositivity and LOS, any complication, or severe complications. Conclusion: During sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management.
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  • Oppewal, A, et al. (author)
  • Correlates of Sedentary Behaviour in Adults with Intellectual Disabilities-A Systematic Review
  • 2018
  • In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 15:10
  • Journal article (peer-reviewed)abstract
    • Individuals with intellectual disabilities (ID) are at high risk for high levels of sedentary behaviour. To inform the development of programmes to reduce sedentary behaviour, insight into the correlates is needed. Therefore, the aim of this study is to review the evidence on correlates of sedentary behaviour in adults with ID. We performed a systematic literature search in Ovid Medline, Ovid Embase, Web of Science and Google Scholar up to 19 January 2018, resulting in nine included studies that were published from 2011 to 2018. Correlates were categorized according to the ecological model. Studies predominantly focused on individual level correlates. Of those correlates studied in more than one study, having epilepsy was associated with less sedentary behaviour and inconsistent results were found for sex, genetic syndromes, weight status, physical health, mobility, level of ID, and mental health. Of the few interpersonal and environmental factors studied, only living arrangements were studied in more than one study, with inconsistent results. To date, we have limited and inconclusive evidence about correlates of sedentary behaviour in adults with ID. Only when future studies unravel correlates and determinants, across all domains of the ecological model, will the potential opportunities to improve health by reducing sedentary behaviour come within reach.
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  • Saccardi, R, et al. (author)
  • Benchmarking of survival outcomes following Haematopoietic Stem Cell Transplantation (HSCT): an update of the ongoing project of the European Society for Blood and Marrow Transplantation (EBMT) and Joint Accreditation Committee of ISCT and EBMT (JACIE)
  • 2023
  • In: Bone marrow transplantation. - : Springer Science and Business Media LLC. - 1476-5365 .- 0268-3369. ; 58:6, s. 659-666
  • Journal article (peer-reviewed)abstract
    • From 2016 EBMT and JACIE developed an international risk-adapted benchmarking program of haematopoietic stem cell transplant (HSCT) outcome to provide individual EBMT Centers with a means of quality-assuring the HSCT process and meeting FACT-JACIE accreditation requirements relating to 1-year survival outcomes. Informed by previous experience from Europe, North America and Australasia, the Clinical Outcomes Group (COG) established criteria for patient and Center selection, and a set of key clinical variables within a dedicated statistical model adapted to the capabilities of the EBMT Registry. The first phase of the project was launched in 2019 to test the acceptability of the benchmarking model through assessment of Centers’ performance for 1-year data completeness and survival outcomes of autologous and allogeneic HSCT covering 2013–2016. A second phase was delivered in July 2021 covering 2015–2019 and including survival outcomes. Reports of individual Center performance were shared directly with local principal investigators and their responses were assimilated. The experience thus far has supported the feasibility, acceptability and reliability of the system as well as identifying its limitations. We provide a summary of experience and learning so far in this ‘work in progress’, as well as highlighting future challenges of delivering a modern, robust, data-complete, risk-adapted benchmarking program across new EBMT Registry systems.
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  • Bonnechere, B, et al. (author)
  • Mobile health solutions: An opportunity for rehabilitation in low- and middle income countries?
  • 2023
  • In: Frontiers in public health. - : Frontiers Media SA. - 2296-2565. ; 10, s. 1072322-
  • Journal article (peer-reviewed)abstract
    • Mobile health (mHealth) development has advanced rapidly, indicating promise as an effective patient intervention. mHealth has many potential benefits that could help the treatment of patients, and the development of rehabilitation in low- and middle-income countries (LMICs). mHealth is a low-cost option that does not need rapid access to healthcare clinics or employees. It increases the feasibility and rationality of clinical treatment expectations in comparison to the conventional clinical model of management by promoting patient adherence to the treatment plan. mHealth can also serve as a basis for formulating treatment plans and partially compensate for the shortcomings of the traditional model. In addition, mHealth can help achieve universal rehabilitation service coverage by overcoming geographical barriers, thereby increasing the number of ways patients can benefit from the rehabilitation service, and by providing rehabilitation to individuals in remote areas and communities with insufficient healthcare services. However, despite these positive potential aspects, there is currently only a very limited number of studies performed in LMICs using mHealth. In this study, we first reviewed the current evidence supporting the use of mHealth in rehabilitation to identify the countries where studies have been carried out. Then, we identify the current limitations of the implementation of such mHealth solutions and propose a 10-point action plan, focusing on the macro (e.g., policymakers), meso (e.g., technology and healthcare institutions), and micro (e.g., patients and relatives) levels to ease the use, validation, and implementation in LMICs and thus participate in the development and recognition of public health and rehabilitation in these countries.
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  • Hotakainen, K, et al. (author)
  • Differential expression of trypsinogen and tumor-associated trypsin inhibitor (TATI) in bladder cancer
  • 2006
  • In: International Journal of Oncology. - 1019-6439. ; 28:1, s. 95-101
  • Journal article (peer-reviewed)abstract
    • Tumor-associated trypsin inhibitor (TATI) is a marker of mucinous ovarian carcinoma, but it is also widely expressed in other malignant tumors and normal human tissues. Elevated serum concentrations of TATI are of prognostic value in ovarian, kidney, and bladder cancer. Tumor-associated trypsin is co-expressed with TATI in many malignancies and is thought to be involved in tumor invasion. TATI mRNA has been shown to be overexpressed in bladder cancer. We therefore studied whether trypsinogen expression also can be detected in bladder cancer and how this and TATI expression are associated with the clinicopathological characteristics of the tumors. We used RT-PCR, in situ hybridization and immunohistochemistry to detect trypsinogen-and TATI mRNA and protein in tissue samples from 28 bladder cancer patients and ten benign urothelia. TATI expression was detected in all benign tissues and non-invasive tumors. However, the expression was lower in the muscle-invasive tumors (pT2; n=5), whereas trypsinogen expression was seen in all but one non-invasive tumor. We conclude that trypsinogen is expressed in both malignant and benign bladder epithelium, whereas TATI expression decreases with increasing stage and grade of the tumor. This may suggest that a balanced expression of TATI and trypsinogen is required in normal tissue and that this balance is disrupted during tumor progression.
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  • Marklund, Björn, et al. (author)
  • Retention Footprint : Visualising and monitoring student retention in study programmes across Europe
  • 2012
  • In: Proceedings of the 40th SEFI Annual Conference 2012 - Engineering Education 2020. - : European Society for Engineering Education (SEFI). - 9782873520052
  • Conference paper (peer-reviewed)abstract
    • Most of the universities across Europe have their own way of measuring and monitoring student progression, retention, attrition, drop out, etc. The way of holding statistics and calculating indicators differs as well as the demands of different stakeholders within the universities and society. ATTRACT (Enhance the Attractiveness of Studies in Science and Technology) is a European Commission supported project aiming to increase knowledge and inform practice about student recruitment and retention in engineering and technology education. Within this project partners agreed to test and evaluate a method of visualising and monitoring student retention in a so-called footprint in selected fields of programmes. The tool was originally developed in the Swedish project "Ung Ingenjör" http://www.kth.se/unging The test had three sub aims: 1. The overall level was to test if the visualising method can be used to compare/benchmark engineering education in Europe concerning retention. 2. The next level was to test and evaluate how the method can be used in assessing engineering education. 3. The final level aimed to test if the method can be used to compare different student groups concerning study background coupled to retention. The footprint itself can only be an indicator as such and the reasons behind study progress, drop out, low graduation rate etc. can only be found through further quantitative and qualitative analysis and discussions. The results from this exercise show the complexity of finding reasons and proper actions. The results also show that the way of monitoring facts and figures in a visual presentation trigs the viewer to dig deeper and do further analysis.
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  • Pelkonen, Markku, et al. (author)
  • Biological nitrogen removal from landfill leachate : A pilot-scale study
  • 1999
  • In: Waste Management & Research. - : Wiley. - 0734-242X .- 1096-3669 .- 1399-3070. ; 17:6, s. 493-497
  • Journal article (peer-reviewed)abstract
    • A pilot-scale two-stage process including an anaerobic pretreatment (up-flow anaerobic sludge blanket, UASB) unit and a pre-denitrification activated sludge process was studied for treating leachates from a municipal landfill (waste aged 4 to 5 years, area 2.5 ha) and from a windrow composting area (1 ha). A single-stage pilot process was used for nitrification studies. The leachate characteristics were as follows: COD 740 to 2400 mg l-1 (chemical oxygen demand), BOD7 (biochemical oxygen demand) approximately 1000 mg l-1, N(tot) 40 to 120 mg l-1 and the temperature was between 2 and 21°C. The results show that 45 to 50 COD removal could be achieved in the UASB reactor even at temperatures below 10°C. The activated sludge process was operated with a 1.1 to 2.2 d hydraulic retention time and at between 8 and 21°C. The removal efficiencies were 80 to 90 for COD, over 98 for BOD7, over 90 for NH4-N and over 70 for N(tot). The dependence of denitrification efficiency on leachate biodegradable COD fraction and COD to N ratio was evaluated. Overall treatment efficiencies were good and applicable for design purposes. The total costs were estimated for a full scale pre-denitrification process at FIM 10 to 20 m-3 and FIM 50 to 90 (kg N removed)-1 (3.5 to 7 DM m-3 and 17 to 30 DM [kg N removed]-1) for a landfill representing circumstances in Southern Finland with an annual average flow of 50 m3 d-1.
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