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71.
72.
A sample of 194 examinees (117 women and 77 men), representative of the population, with a history of low back pain, were examined clinically and radiographed. The angles between vertebrae at the levels of L4-L5 and L5-S1 were measured from the lateral lumbar erect, maximal flexion, and maximal extension views. Average mobility at L4-L5 was 14.5 degrees in women and 13.4 in men, and at L5-S1 11.5 degrees in women and 12.1 in men. Mobility became more restricted with increasing age both in women and men; especially at L4-L5. In women decreased radiographic mobility at L4-L5 was significantly (p = 0.002) correlated with restricted side-bending and rotation found at the physical examination. These correlations were clearly less significant among men. At L5-S1, restricted extension in women but restricted flexion and Schober's test in men were significantly correlated with decreased radiographic mobility. 相似文献
73.
Kristina Mikkonen Monika Koskinen Camilla Koskinen Meeri Koivula Minna Koskimki Marja‐Leena Lhteenmki Hanne Mki‐Hakola Outi Wallin Tuulikki Sjgren Leena Salminen Marjorita Sormunen Terhi Saaranen Heli‐Maria Kuivila Maria Kriinen 《Health & social care in the community》2019,27(6):1555-1563
Competent educators are needed to ensure that social and healthcare professionals are effective and highly competent. However, there is too little evidence‐based knowledge of current and required enhancements of educators' competences in this field. The aim of this study was to describe social and healthcare educators’ perceptions of their competence in education. The study had a qualitative design, based on interviews with educators and rooted in critical realism. Forty‐eight participants were recruited from seven universities of applied sciences and two vocational colleges in Finland, with the assistance of contact persons nominated by the institutions. The inclusion criterion for participation was employment by an educational institution as a part‐time or full‐time, social and/or healthcare educator. Data were collected in the period February–April 2018. The participants were interviewed in 16 focus groups with two to five participants per group. The acquired data were subjected to inductive content analysis, which yielded 506 open codes, 48 sub‐categories, nine categories and one main category. The educators’ competence was defined as a multidimensional construct, including categories of educators’ competences in practicing as an educator, subject, ethics, pedagogy, management and organisation, innovation and development, collaboration, handling cultural and linguistic diversity, and continuous professional development. Educators recognised the need for developing competence in innovation to meet rapid changes in a competitive and increasingly global sociopolitical environment. Enhancement of adaptability to rapid changes was recognised as a necessity. The findings have social value in identifying requirements to improve social and healthcare educators' competence by helping educational leadership to improve educational standards, construct a continuous education framework and create national and/or international curricula for teacher education degree programs to enhance the quality of education. We also suggest that educational leadership needs to establish, maintain and strengthen collaborative strategies to provide effective, adaptable support systems, involving educators and students, in their working practices. 相似文献
74.
75.
Nonna Heiskanen Heli Saarelainen Henna Kärkkäinen Pirjo Valtonen Tiina Lyyra-Laitinen Tomi Laitinen Esko Vanninen Seppo Heinonen 《Journal of diabetes and its complications》2010,24(4):234-241
ObjectiveThe aim of the present study was to evaluate the influence of gestational diabetes mellitus (GDM) on hemodynamics and cardiovascular autonomic regulation at rest and their responses to head-up tilt (HUT).Research Design and MethodsWe prospectively studied 79 pregnant women (51 with GDM, 28 without GDM) during the third trimester of pregnancy and after parturition. The maternal electrocardiogram and arterial blood pressure were noninvasively measured. Heart rate and blood pressure were measured in the supine position and in the upright position. Stroke volume was assessed from noninvasive blood pressure signals, heart rate variability (HRV) was analyzed in frequency domain, and baroreflex sensitivity by the cross-spectral and sequence methods.ResultsBetween the GDM group and control pregnant women there were no significant differences in hemodynamics and cardiovascular autonomic regulation throughout the protocol. Increased normalized low-frequency component and low-frequency to high-frequency ratio suggested a change in sympathovagal balance towards sympathetic predominance during pregnancy in both groups. The response to head-up tilt (HUT) was similar in both GDM and control pregnant women. The pregnancy modulated the response to HUT in systolic and diastolic blood pressure, stroke volume, cardiac index, peripheral resistance, total power of HRV, and its low- and high-frequency components.ConclusionsOur results suggest that pregnancy modulates cardiovascular autonomic regulation and hemodynamics equally in subjects with GDM and without GDM, suggesting that metabolic disorder during pregnancy does not result in cardiovascular dysfunction when GDM is in good balance. 相似文献
76.
Helka Sahi Heli Kukko Tom Böhling Erkki Tukiainen Harri Sihto Heikki Joensuu Virve Koljonen 《European journal of plastic surgery》2010,33(6):349-353
Merkel cell carcinoma (MCC) is a rare neuroendocrine carcinoma typically affecting the elderly. Only 5% to 10% of the patients
are younger than 50 years at the time of the diagnosis. The purpose of this study was to compare the tumour and disease characteristics
between exceptionally young and the typical elderly MCC population. Further, quantitative polymerase chain reaction analysis
was used to study for Merkel cell polyomavirus (MCPyV) in their primary MCC tumours. Patients diagnosed with MCC in Finland
from 1979 to 2004 were identified from the files of the Finnish Cancer Registry. Presence of MCPyV DNA in tumour samples was
investigated using quantitative polymerase chain reaction. Six of 181 MCC patients were ≤50 years, with male-to-female ratio
of 1:1. An altered immune condition state was observed in five patients. The Kaplan–Meier analysis showed a trend towards
worse MCC-specific survival both in 5- and 10-year surveillance for younger patients. Five primary tumour tissue samples,
available for analysis, contained MCPyV DNA. Our data shows that MCC, ≤50 years of age, is rarer then previously estimated.
Moreover, our data showed marked differences both in patient demographics and in primary tumour characteristics as compared
to surveys including older MCC patients. Course of disease seemed to be worse in the exceptionally young patients. All MCC
primary tumours in this study contained MCPyV DNA. 相似文献
77.
78.
Heliövaara-Peippo S Oksjoki R Halmesmäki K Kaaja R Teperi J Grenman S Kivelä A Surcel HM Tomas E Tuppurainen M Hurskainen R Paavonen J 《Maturitas》2011,69(4):354-358
Objective
To compare, whether women with menorrhagia, treated with either hysterectomy or LNG-IUS, differ in their cardiovascular risk profile during 10-year follow-up.Study design
A total of 236 women were randomized to treatment by hysterectomy (n = 117) or LNG-IUS (n = 119). Their cardiovascular risk factors were analyzed at baseline, at 5 years, and at 10 years. As 55 originally randomized to the LNG-IUS group had hysterectomy during the follow-up, all analyzes were performed by actual treatment modality.Main outcome measures
Waist circumference, body-mass index (BMI), blood pressure, and the levels of blood lipids, serum high-sensitivity CRP (hsCRP) and tumor necrosis factor alpha (TNF-α) were measured, and the use of medication for hypertension, diabetes, hypercholesterolemia, and ischemic heart disease was analyzed.Results
After 5 years, an increase in the use of diabetes medication during the follow-up was only detected in the hysterectomy group (from 1.7% to 6.7%, P = 0.008 vs from 5.1% to 8.4%, P = 0.08), as well as they had significantly higher serum levels of TNF-α (108.59 pg/ml vs 49.02 pg/ml, P = 0.001) and hsCRP (1.55 μg/ml vs 0.78 μg/ml, P = 0.038) at 5- and 10-years. There was no difference between the groups in the use of cardiovascular medication, neither was there difference in blood pressure, waist circumference, BMI, or concentrations of blood lipids.Conclusions
Hysterectomy seems to be associated with increased levels of serum inflammatory markers and increased diabetes medication, which in turn, may predispose individual to future cardiovascular events. 相似文献79.
80.
Andriy Ivannikov Igor Kalyakin Jarmo Hmlinen Paavo H.T. Leppnen Tapani Ristaniemi Heikki Lyytinen Tommi Krkkinen 《Journal of neuroscience methods》2009,180(2):340-351
In this paper, a new method intended for ERP denoising in multichannel EEG data is discussed. The denoising is done by separating ERP/noise subspaces in multidimensional EEG data by a linear transformation and the following dimension reduction by ignoring noise components during inverse transformation. The separation matrix is found based on the assumption that ERP sources are deterministic for all repetitions of the same type of stimulus within the experiment, while the other noise sources do not obey the determinancy property. A detailed derivation of the technique is given together with the analysis of the results of its application to a real high-density EEG data set. The interpretation of the results and the performance of the proposed method under conditions, when the basic assumptions are violated – e.g. the problem is underdetermined – are also discussed.Moreover, we study how the factors of the number of channels and trials used by the method influence the effectiveness of ERP/noise subspaces separation. In addition, we explore also the impact of different data resampling strategies on the performance of the considered algorithm. The results can help in determining the optimal parameters of the equipment/methods used to elicit and reliably estimate ERPs. 相似文献