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Background: Health sciences education prepares students for social‐ and healthcare by developing evidence‐based nursing, leadership and working life skills, including collaboration. Due to the changes caused by the global pandemic, health sciences education has shifted more to online and hybrid contexts, which can challenge students' competence development. Students' competence development and interaction in collaborative hybrid learning is a little researched area. Objectives: To observe and evaluate health sciences students' competence development in a collaborative hybrid learning context. Methods: This quasi‐experimental mixed‐method study was implemented by providing educational intervention. First‐year Bachelor's degree health sciences students (n = 18) of a Finnish university completed an educational intervention with synchronous online and face‐to‐face learning. Students' collaborative hybrid learning and interaction were video observed, while self‐evaluation of competence development was made with a questionnaire. Results: In the collaborative interactions, the students showed analytical thinking, problem‐ solving and communication and technology skills. Extensive knowledge of health sciences and ethics skills was not strongly visible in interaction. The students effectively used collaborative work time to perform tasks. Cognitive interaction (monitoring and evaluating learning) was observed in 85% and socio‐emotional interaction (expressions of emotions and motivation) in 53% of the data. Related to the students' learning results, the students' ability to communicate and interact with culturally different people improved after the educational intervention. Conclusion: Collaborative learning methods in hybrid learning can create opportunities for students to construct their competence in interaction. Attention should be paid to different areas of competence and the role of socio‐emotional interaction. Lay Description: What is already known about this topic: Health sciences education prepares students for social and healthcare by developing working life skills, including collaboration.Hybrid learning brings benefits but challenges the equity of students with different attention modes.Collaborative learning is widely used but has not been studied much in hybrid context.Students' competence development and interaction in collaborative hybrid learning is a little researched area. What this paper adds: The purpose was to observe and evaluate health sciences students' competence development in a collaborative hybrid learning context.Hybrid collaborative interaction encourages students to construct knowledge in health sciences.The students utilised the collaborative time appropriately.Socioemotional interactions were very visible in collaborative learning. Implications for practice: This study helps educational organisations to design hybrid model education.The design requires pedagogical and technical competence and should include collaborative methods.Attention should be paid to different areas of competence in collaborative learning.The role of socio‐emotional interaction needs more focus in hybrid learning. [ABSTRACT FROM AUTHOR]

Objective:Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months.Methods:Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire.Results:The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children.Conclusion:Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement. [ABSTRACT FROM AUTHOR]

As pregnancy may trigger overweight in women, new means for its prevention are being sought. The aim here was to investigate the effect of individual dietary counselling during and after pregnancy on post‐partum weight and waist circumference up to 4 years post‐partum. A cohort of women (n = 256) were randomized to receive repeated individual dietary counselling by a nutritionist during and after pregnancy, or as controls not receiving dietary counselling, from the first trimester of pregnancy until 6 months after delivery. Counselling aimed to bring dietary intake into line with recommendations, with particular focus on the increase in the intake of unsaturated fatty acids instead of saturated. Pre‐pregnancy weight was taken from welfare clinic records. Weight and waist circumference were measured at 4 years after delivery. The proportion of overweight women increased from 26% prior to pregnancy to 30% at 4 years after delivery among women receiving dietary counselling, as against considerably more, from 32% to 57%, among controls. The prevalence of central adiposity was 31% in women receiving dietary counselling, 64% in controls. Likewise, both the risk of overweight (odds ratio: 0.23, 0.08–0.63, P = 0.005) and central adiposity (odds ratio: 0.18, 0.06–0.52, P = 0.002) were lower in women receiving dietary counselling compared with controls. Repeated dietary counselling initiated in early pregnancy can be beneficial in long‐term weight control after delivery. [ABSTRACT FROM AUTHOR]

Background: Tramadol is widely used for acute, chronic, and neuropathic pain. Its primary active metabolite is O-desmethyltramadol (M1), which is mainly accountable for the μ-opioid receptor-related analgesic effect. Tramadol is metabolized to M1 mainly by cytochrome P450 (CYP)2D6 enzyme and to other metabolites by CYP3A4 and CYP2B6. We investigated the possible interaction of tramadol with the antifungal agents terbinafine (CYP2D6 inhibitor) and itraconazole (CYP3A4 inhibitor). Methods: We used a randomized placebo-controlled crossover study design with 12 healthy subjects, of which 8 were extensive and 4 were ultrarapid CYP2D6 metabolizers. On the pretreatment day 4 with terbinafine (250 mg once daily), itraconazole (200 mg once daily) or placebo, subjects were given tramadol 50 mg orally. Plasma concentrations of tramadol and M1 were determined over 48 h and some pharmacodynamic effects over 12 h. Pharmacokinetic variables were calculated using standard non-compartmental methods. Results: Terbinafine increased the area under plasma concentration-time curve (AUC) of tramadol by 115 % and decreased the AUC of M1 by 64 % ( P < 0.001). Terbinafine increased the peak concentration ( C) of tramadol by 53 % ( P < 0.001) and decreased the C of M1 by 79 % ( P < 0.001). After terbinafine pretreatment the elimination half-life of tramadol and M1 were increased by 48 and 50 %, respectively ( P < 0.001). Terbinafine reduced subjective drug effect of tramadol ( P < 0.001). Itraconazole had minor effects on tramadol pharmacokinetics. Conclusions: Terbinafine may reduce the opioid effect of tramadol and increase the risk of its monoaminergic adverse effects. Itraconazole has no meaningful interaction with tramadol in subjects who have functional CYP2D6 enzyme. [ABSTRACT FROM AUTHOR]

Background Patient preference for the choice of treatment modality for prostate cancer has increasingly gained attention. Objective To assess the impact of client-oriented decision on long-term mortality, disease progression and biochemical failure compared with standard treatment protocol ( TP). Methods With data from a Finnish multicentre, randomized controlled trial with two arms [104 in the enhanced patient participation ( EPP) arm and 106 in the TP arm], disease-specific and disease-free survival, biochemical failure with elevated prostate-specific antigen ( PSA) level and disease progression were compared between the two arms using Wilcoxon test and also Cox proportional hazards regression model. Results Patients in the EPP arm had a higher risk of death by 37% [ HR, 1.37 (0.87-2.17)] compared with those in the TP arm. Patients in the EPP arm were at increased risk of having biochemical failure by 14% [ HR, 1.14 (0.72-1.79)] and for having disease progression by 2% [ HR, 1.02 (0.61-1.70)] compared with those in the TP arm. All the differences were non-significant. Conclusions Patients actively involved in the choice of treatment had higher risk of prostate cancer death but only slightly increased risk of biochemical failure and clinical disease progression. These findings would provide a good reference when patient autonomy for the choice of treatment modality is addressed. [ABSTRACT FROM AUTHOR]