Appendiceal sonography in children: A retrospective analysis as a platform for potential implementation of diagnostic categories

- Background Sonography is an important diagnostic tool in children with suspected appendicitis. Reported accuracy and appendiceal visualisation rates vary significantly, as does the management of equivocal ultrasound findings. The aim of this study was to audit appendiceal sonography at a tertiary children's hospital, and provide baseline data for a future prospective study. - Summary of work Records of children who underwent ultrasound studies for possible appendicitis between January 2008 and December 2010 were reviewed. Variables included patient demographics, sonographic appendix characteristics, and secondary signs. Descriptive statistics and analysis using ANOVA, Mann-Whitney U test, and ROC curves were performed. Mater Human Research Ethic Committee approval was granted. - Summary of results There were 457 eligible children. Using a dichotomous diagnostic model (including equivocal results), sensitivity was 89.6%, specificity 91.6%, and diagnostic yield of 40.7%. ROC curve analysis of a 6mm diameter cut-off was 0.88 AUC (95% CI 0.80 to 0.95). - Discussion and conclusions Sonography is an accurate test for acute appendicitis in children, with a high sensitivity and negative predictive value. A diameter of 6mm as an absolute cut-off in a binary model can lead to false findings. Results were compared with available literature. Recent publications propose categorising diameter1 and integrating secondary signs2 to improve accuracy and provide more meaningful results to clinicians. This study will be a benchmark for future studies with multiple diagnostic categorisation.

Kuka kasvattaa, kuka opettaa? : Genealoginen tutkimus perheen ja koulun välisen kasvatusvastuun politiikasta

FAMILIES AND SCHOOLS AND THE POLITICS OF RESPONSIBILITIES - a genealogical study on family and school as carers and educators of the child population in modern society This study aims to uncover the politics behind such discourses in the media which have claimed the family to be totally responsible for children and which ignore the various responsibilities accorded to the state in matters concerning the child population. Using Max Weber s and Michael Mann s theorizing on the history of power relationships, feminist social history on patriarchy and Foucauldian power analytic concept of dispositif the study traces two competing child policies which have influenced the historical formation of modern generational order in Western societies. One of them is based on the interests of the hegemonic bourgeois elite and the other on the interests of the non-elite population, which were expressed during the phase of building the welfare state in Finland in the 1960 1980 s. The central strategies of the bourgeois child policy are 1) to construct the childhood years as a time for preparation and formation of the individual according to the interests of the elite, 2) to construct the family as the sole site of holistic care and responsibility of children in society, and 3) compulsory schooling of children of the non-elite population in state organized schools. To implement these strategies the elite uses strategically patriarchal cultural formations/dispositifs in modernized versions. The result has been the formation of a sexually divided and hierarchical order of care and education, where, on the one hand, there is the less important feminine care of children done by mothers at home and, on the other, the real education of the school, where children are made the object of authoritarian shaping and where the needs and the personal experiences of the child are ignored. The welfare order of care and education is based on the ethos of welfare society, where the state and the families are seen to share the responsibility for the child population. In this vein, families and schools are seen as partners who both have a caring attitude to children s welfare and learning. The study shows that discourses and terminology in the mainstream educational policy texts in Finland create a chaotic linguistic game which makes it difficult to have a rational discussion about the roles of family and school in the holistic care and education of children. This has opened the door to political discourses where familist interpretations of the question of responsibility are claimed to be based on law.

Korkean lämpötilan vaikutus hiiren poskihampaan kiilteen kehitykseen in vitro

Tutkimuksen tarkoituksena oli selvittää kuumetta vastaavan elinviljelylämpötilan vaikutusta hiiren poskihampaiden kiilteen kehittymiseen. Tutkimus tehtiin in vitro ja siinä käytettiin E18- hiiriä, joiden hampaita kasvatettiin ´kuumeessa´ (39 °C) kolmannesta kasvatuspäivästä lähtien, osaa viisi ja osaa kolme päivää. Kontrollihampaita kasvatettiin 37 °C:ssa. Hampaita kasvatettiin yhteensä 11 päivää ja lopuksi ne kuvattiin. Stereomikroskooppikuvista mitattiin kiilteen korkeus ja kruunun korkeus ja laskettiin näiden suhde. Hampaat demineralisoitiin, valettiin parafiiniin, leikattiin leikkeiksi ja värjättiin HE-värjäyksellä. Leikkeistä mitattiin kiilteen paksuus ja kiilteen ja dentiinin yhteispaksuus ja laskettiin näiden suhde. Arvoja verrattiin kasvatusryhmien kesken. Tulokset analysoitiin Mann-Whitney-testillä. Kiilteen paksuus suhteessa kiilteen ja dentiinin yhteispaksuuteen oli pienempi ´kuumehampaissa´. Viisi tai kolme päivää ´kuumeessa´kasvatettujen hampaiden välillä ei ollut juurikaan eroja. Kiilteen korkeus suhteessa kruunun korkeuteen oli pienempi ´kuumehampaissa´ kuin kontrollihampaissa. Korkea lämpötila ei muutoin näyttänyt vaikuttavan hampaiden kehitykseen. Tutkimuksen perusteella voidaan sanoa, että kasvatuslämpötilan nosto kuumeen tasolle aiheuttaa hiiren molaarihampaan kiilteen kehityksen häiriintymistä. Tulos tukee kliinisiä havaintoja, joiden mukaan korkea kuume lapsella voi aiheuttaa kiilteen kehityshäiriöitä.

Ammatillisten opettajien tieto- ja viestintätekniikan opetuskäytön intentionaalisuutta selittävät tekijät

Intention-based models have been one of the main theoretical orientations in the research on the implementation of information and communication technology (ICT). According to these models, actual behavior can be predicted from the intention towards the behavior. If the level of intention to use technology is high, the probability of actual usage of ICT increases. The purpose of this study was to find out which factors explain vocational teachers intention to use ICT in their teaching. In addition, teachers of media and information sciences and teachers of welfare and health were compared. The study also explored how regularly ICT was applied by teachers and how strong their intention to apply the technology was. This Master s thesis is a quantitative study and the data was collected using an Email survey and Eform. The instruments were based on a decomposed theory of planned behavior. The research group consisted of 22 schools of media and information sciences and 20 schools of welfare and health. The data consisted of 231 vocational teachers: 57 teachers worked with media and information sciences and 174 with welfare and health. The data was analyzed using Mann-Whitney U-test, factor analysis and regression analysis. In addition, categorized results were compared with previous study. In this study, the intention to use ICT in teaching was explained by the teachers attitudes and skills and the attitudes of their work community. However, the environment in which ICT was used, i.e., the technical environment, economical resources and time, did not explain the intention. The results did not directly support any of the intention-based models, but they could be interpreted as congruent with the technology acceptance model. The majority of the teachers used ICT at least weekly. They had a strong intention to continue to do that in the future. The study also revealed that there were more teachers who had a critical attitude towards ICT among the teachers of welfare and health. According to the results of this study, it is not possible to state that ICT would not suit any one profession because in every group with teachers with a critical attitude towards ICT there were also teachers with a positive attitude.

Electroreduction of oxygen on some novel cobalt phthalocyanine complexes

The catalytic activity of cobalt phthalocyanine monomer and some of its polymeric derivatives towards the electroreduction of molecular oxygen in salt and alkaline solutions is examined. It is found that most of these complexes exhibit a higher catalytic activity than the cobalt phthalocyanine monomer.

Coupled ocean-atmosphere inter-decadal modes in the tropics

Homogencous upper air data for 50 years (1949-1998) from the National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis project, sea surface temperatures and sea level pressure are used to bring out the three dimensional structure of two dominant decadal/multi-decadal variations in the tropics. The global three dimensional modes represent generalized forms of inter-decadal modes studied earlier only with surface data. In the vertical, both modes show approximate first baroclinic structures over the tropics. The Walker circulation associated with the multidecadal mode has a wavenumber two structure in the zonal direction. It is shown that the magnitude of major ascending and descending motions associated with the multi-decadal Hadley and Walker circulations, are comparable to those associated with the dominant inter-annual mode. Implications of these large scale global circulations associated with the low frequency oscillations in modulating regional climate on a inter-annual time scale are discussed.

Jos olisin viisas niin siivoisin : Lasten luovat prosessit päiväkodissa

It has been found usually to talk in the early childhood education in connection with the creativity about arts and skills and about play. In this treatise, the creativity is approached besides play but also from the point of view of the creativity of the everyday. The starting point for the study is the view according to which the creativity is complex interaction between a creative person and an environment. The theoretical body of the study is the Componential theory of creativity of Amabile (1996). The process which is open and product which is new and suitable or acceptable were defined creative. In the opinion of many researchers, the creativity is a phenomenon that has determined in a certain time and place so the creativity is examined from the point of view of the social constructionism. As creative processes in the day nursery it has been defined pretend play, child´s involvement and children´s agentive perception which is based on the Children´s agentive perception theory of Reunamo (2007). The purpose of the study is to clarify how the child's personal factors and the social environment affect the creative processes of children in the day nursery. This Master's thesis is based on the Children' s agentive perception uncovered study led by Jyrki Reunamo (2010) which was carried out in the spring of 2010 in Keski-Uusimaa and in Hämeenlinna and Taiwan. From the study, a name has also been used "on the sources of Orientation", a research project and development project. The study includes the children's evaluation sector, the observation sector, the children's interview sector and the evaluation sector of the pedagogic environment. 891 Children 1-7 year-old by age participated in the study. All the sectors which belong to the study of Reunamo were utilized in this treatise and the Finnish day nurseries or preschool groups which had participated in the study were marked off as the target group. The main component analysis, sum variables, the correlation coefficients, Mann-Whitney s U-test and Kruskall-Wallas test were used for the statistical examination of the quantitative material. In this treatise it was noticed, both the personal properties of the child and a social environment, that they affected all the examined creative processes which also had a significant connection with each other statistically. The definition of creativity was filled best by the participative answers. However, the number of the participative answers was only 8% in the questions concerning adults. That raised the question whether an attempt should be made to have effect so that the children's better participation also in the interaction with the adults would be possible in the educational culture of the day nursery. In the further study, the conscious building of the social environment which supports the creativity from a social constructionism point of view could indeed be an interesting task. The treatise is suitable for an examination of the interaction between the child's person and a social environment especially from the point of view of the creativity.

The Effect of Food-Related Lifestyle on the Choices of Consumers of Five Food Products

The purpose of this study was to find out whether food-related lifestyle guides and explains product evaluations, specifically, consumer perceptions and choice evaluations of five different food product categories: lettuce, mincemeat, savoury sauce, goat cheese, and pudding. The opinions of consumers who shop in neighbourhood stores were considered most valuable. This study applies means-end chain (MEC) theory, according to which products are seen as means by which consumers attain meaningful goals. The food-related lifestyle (FRL) instrument was created to study lifestyles that reflect these goals. Further, this research has adopted the view that the FRL functions as a script which guides consumer behaviour. Two research methods were used in this study. The first was the laddering interview, the primary aim of which was to gather information for formulating the questionnaire of the main study. The survey consisted of two separate questionnaires. The first was the FRL questionnaire modified for this study. The aim of the other questionnaire was to determine the choice criteria for buying five different categories of food products. Before these analyses could be made, several data modifications were made following MEC analysis procedures. Beside forming FRL dimensions by counting sum-scores from the FRL statements, factor analysis was run in order to elicit latent factors underlying the dimensions. The lifestyle factors found were adventurous, conscientious, enthusiastic, snacking, moderate, and uninvolved lifestyles. The association analyses were done separately for each choice of product as well as for each attribute-consequence linkage with a non-parametric Mann-Whitney U test. The testing variables were FRL dimensions and the FRL lifestyle factors. In addition, the relation between the attribute-consequence linkages and the demographic variables were analysed. Results from this study showed that the choice of product is sequential, so that consumers first categorize products into groups based on specific criteria like health or convenience. It was attested that the food-related lifestyles function as a script in food choice and that the FRL instrument can be used to predict consumer buying behaviour. Certain lifestyles were associated with the choice of each product category. The actual product choice within a product category then appeared to be a different matter. In addition, this study proposes a modification to the FRL instrument. The positive towards advertising FRL dimension was modified to examine many kinds of information search including the internet, TV, magazines, and other people. This new dimension, which was designated as being open to additional information, proved to be very robust and reliable in finding differences in consumer choice behaviour. Active additional information search was linked to adventurous and snacking food-related lifestyles. The results of this study support the previous knowledge that consumers expect to get many benefits simultaneously when they buy food products. This study brought detailed information about the benefits sought, the combination of benefits differing between products and between respondents. Household economy, pleasure and quality were emphasized with the choice of lettuce. Quality was the most significant benefit in choosing mincemeat, but health related benefits were often evaluated as well. The dominant benefits linked to savoury sauce were household economic benefits, expected pleasurable experiences, and a lift in self-respect. The choice of goat cheese appeared not to be an economic decision, self-respect, pleasure, and quality being included in the choice criteria. In choosing pudding, the respondents considered the well-being of family members, and indulged their family members or themselves.

Heraproteiinivalmisteen vaikutus laihdutukseen ja laihdutustuloksen pysyvyyteen ylipainoisilla aikuisilla

Johdanto: Lihavuus on maailmalaajuisesti merkittävä kansanterveydellinen ja –taloudellinen ongelma. Lihavuuden ehkäisemiseksi ja epidemian leviämisen hillitsemiseksi on tärkeää tuntea lihavuuteen vaikuttavat tekijät. Yksittäisistä ruoka-aineista maidon käytön on havaittu monissa epidemiologisissa ja kokeellisissa tutkimuksissa olevan yhteydessä alhaisempaan painoon, ehkäisevän lihomista ja edistävän laihtumista. Maidon sisältämistä yhdisteistä kalsiumin vaikutuksia on tutkittu eniten. Myös heraproteiinin on esitetty olevan yksi mahdollinen painoon vaikuttava komponentti, ja näyttöä tästä on saatu eläinkokeista. Tavoitteet: Tutkimuksessa tavoitteena oli selvittää, vaikuttaako päivittäin nautittu heraproteiinia sisältävä välipalajuoma laihtumiseen tai saavutetun laihdutustuloksen pysyvyyteen ylipainoisilla aikuisilla. Aineisto ja menetelmät: Tutkimus toteutettiin osana Valio Oy:n OMPPU2-tutkimusta, joka oli satunnaistettu, lumekontrolloitu ja kaksoissokkoutettu kahden rinnakkaisen ryhmän tutkimus. Tutkimus alkoi rekrytoinneilla alkuvuodesta 2010, joissa tutkimukseen valittiin 105 ylipainoista (BMI 27–35), tervettä, 20–50-vuotiasta naista ja miestä. Tutkimushenkilöt satunnaistettiin tutkimus- ja verrokkiryhmiin, ja molemmat ryhmät nauttivat tutkimusvalmisteensa päivittäin hedelmätäysmehuun sekoitettuna (tutkimusryhmä heraproteiinijauheen ja verrokkiryhmä maltodekstriinijauheen). Tutkimus koostui kahdesta jaksosta: viiden kuukauden laihdutusjaksosta ja tätä seuranneesta kolmen kuukauden painonhallintajaksosta. Tutkimuskäynneillä tutkimuksen alussa, laihdutusjakson lopussa ja painonhallintajakson lopussa mitattiin tutkimushenkilöiden paino ja vyötärönympärys sekä määritettiin kehonkoostumus bioimpedanssilaitteella. Tutkimushenkilöiden ruoankäyttö ja ravinnonsaanti laskettiin samoissa aikapisteissä kerättyjen kolmen päivän ruokapäiväkirjojen perusteella. Tutkimushenkilöitä, joilla tutkimusvalmisteen käyttö oli alle 50 %, ei otettu huomioon tilastoanalyyseissä. Tilastollinen analyysi tehtiin käyttäen kahden riippumattoman otoksen t-testiä ja kaksisuuntaista parittaista t-testiä normaalijakautuneilla muuttujilla, ja Mann-Whitneyn U-testiä ja Wilcoxonin ttestiä ei-normaalijakautuneilla muuttujilla. Tutkimusvalmisteen ja painonmuutosten välinen korrelaatio laskettiin käyttäen Pearsonin korrelaatiokertoimia. Tulokset on ilmaistu keskiarvoina (keskihajonta). Tulokset: Molemmat ryhmät laihtuivat laihdutusjakson aikana. Heraproteiiniryhmässä painonpudotus oli 2,4 (3,8) kg (p=0,002) ja verrokkiryhmässä 3,4 (4,1) kg (p<0,001). Ryhmien välinen ero ei ollut merkitsevä. Rasvamassa väheni verrokkiryhmässä 2,4 (3,8) kg (p<0,001), mikä oli viiteellisesti enemmän (p=0,054) kuin heraproteiiniryhmässä 1,1 (3,1) kg (p=0,129). Rasvaprosentti ja viskeraalirasvan määrä pienenivät verrokkiryhmässä heraproteiiniryhmää enemmän (p<0,025). Vyötärönympärys pieneni heraproteiiniryhmässä 1,9 (3,0) cm (p=0,001) ja verrokkiryhmässä 3,8 (3,8) cm (p<0,001) ryhmien välisen eron ollessa merkitsevä (p=0,017). Maltodekstriinin käyttö korreloi käänteisesti painonmuutosten kanssa laihdutusjaksolla (r=-0,389, p=0,013). Painonhallintajaksolla painossa ei tapahtunut merkitseviä muutoksia kummassakaan ryhmässä. Heraproteiinin käytön ja painonmuutosten välisestä negatiivisesta korrelaatiosta oli viitteitä tällä jaksolla (r=-0,344, p=0,063). Kun tarkasteltiin koko tutkimuksen aikana tapahtuneita muutoksia (laihdutusjakson alusta painonhallintajakson loppuun), ei ryhmien välillä ollut merkitseviä eroja painon tai kehonkoostumuksen muutoksissa. Energiansaanti väheni molemmissa ryhmissä merkitsevästi laihdutusjakson aikana (p<0,01), mutta muutos ei eronnut ryhmien välillä. Ravintoaineista rasvan saanti väheni (p<0,001) ja C-vitamiinin saanti lisääntyi (p<0,001) molemmissa ryhmissä laihdutusjaksolla. Alkoholin saanti väheni verrokkiryhmässä (p=0,017). Proteiinin saanti lisääntyi heraproteiiniryhmässä merkitsevästi enemmän kuin verrokkiryhmässä (p=0,002). Painonhallintajaksolla energiansaanti ei muuttunut kummassakaan ryhmässä laihdutusjakson loppuun verrattuna. Fyysisessä aktiivisuudessa tutkimuksen aikana ei ollut eroa ryhmien välillä. Johtopäätökset: Heraproteiinin ei havaittu tehostavan laihdutusta maltodekstriiniin verrattuna tässä tutkimuksessa. Sen sijaan maltodekstriiniä nauttineessa ryhmässä rasvaprosentti ja erityisesti vatsan alueen rasva pienenivät heraproteiiniryhmää enemmän laihdutusjaksolla. Tulos oli lähes täysin vastakkainen tutkimushypoteesin kanssa, eikä vaikuttaisi selittyvän eroilla energiansaannissa tai fyysisessä aktiivisuudessa. Tämä tutkimus ei siis tue olettamusta, että heraproteiini osana laihdutusruokavaliota auttaisi laihdutuksessa. Painonhallintajaksolla heraproteiinin ja painonmuutosten välinen lähes merkitsevä käänteinen korrelaatio saattaa viitata heraproteiinin merkitykseen painonhallinnassa. Vapaasti elävien ihmisten kohdalla sekoittavia tekijöitä on kuitenkin vaikea vakioida, mikä vaikeuttaa johtopäätösten tekemistä.

Monopoles, Dirac operator, and index theory for fuzzy SU(3) / (U(1) x U(1))

The intersection of the ten-dimensional fuzzy conifold Y-F(10) with S-F(5) x S-F(5) is the compact eight-dimensional fuzzy space X-F(8). We show that X-F(8) is (the analogue of) a principal U(1) x U(1) bundle over fuzzy SU(3) / U(1) x U(1)) ( M-F(6)). We construct M-F(6) using the Gell-Mann matrices by adapting Schwinger's construction. The space M-F(6) is of relevance in higher dimensional quantum Hall effect and matrix models of D-branes. Further we show that the sections of the monopole bundle can be expressed in the basis of SU(3) eigenvectors. We construct the Dirac operator on M-F(6) from the Ginsparg-Wilson algebra on this space. Finally, we show that the index of the Dirac operator correctly reproduces the known results in the continuum.

An estimate of the number of tropical tree species

The high species richness of tropical forests has long been recognized, yet there remains substantial uncertainty regarding the actual number of tropical tree species. Using a pantropical tree inventory database from closed canopy forests, consisting of 657,630 trees belonging to 11,371 species, we use a fitted value of Fisher's alpha and an approximate pantropical stem total to estimate the minimum number of tropical forest tree species to fall between similar to 40,000 and similar to 53,000, i.e., at the high end of previous estimates. Contrary to common assumption, the Indo-Pacific region was found to be as species-rich as the Neotropics, with both regions having a minimum of similar to 19,000-25,000 tree species. Continental Africa is relatively depauperate with a minimum of similar to 4,500-6,000 tree species. Very few species are shared among the African, American, and the Indo-Pacific regions. We provide a methodological framework for estimating species richness in trees that may help refine species richness estimates of tree-dependent taxa.

Tuning the metal-insulator transition in NdNiO3 heterostructures via Fermi surface instability and spin fluctuations

We employed in situ pulsed laser deposition (PLD) and angle-resolved photoemission spectroscopy (ARPES) to investigate the mechanism of the metal-insulator transition (MIT) in NdNiO3 (NNO) thin films, grown on NdGaO3(110) and LaAlO3(100) substrates. In the metallic phase, we observe three-dimensional hole and electron Fermi surface (FS) pockets formed from strongly renormalized bands with well-defined quasiparticles. Upon cooling across the MIT in NNO/NGO sample, the quasiparticles lose coherence via a spectral weight transfer from near the Fermi level to localized states forming at higher binding energies. In the case of NNO/LAO, the bands are apparently shifted upward with an additional holelike pocket forming at the corner of the Brillouin zone. We find that the renormalization effects are strongly anisotropic and are stronger in NNO/NGO than NNO/LAO. Our study reveals that substrate-induced strain tunes the crystal field splitting, which changes the FS properties, nesting conditions, and spin-fluctuation strength, and thereby controls the MIT via the formation of an electronic order parameter with QAF similar to (1/4,1/4,1/4 +/- delta).