Integration of environmental management systems into the planning phase of golf course development in Finland

This thesis investigates the integration of environmental management systems (EMS) into the planning phase of golf course development in Finland. Golf courses have the opportunity to serve as valuable green spaces and as important biodiversity habitats, but their development often creates environmental challenges related to resource consumption, chemical use and landscape alternation. Despite the growing environmental awareness in the golf industry, systematic approaches to environmental management are typically implemented during operational phases rather than being integrated from the earliest planning stages. This thesis examines current EMS implementation practices in Finnish golf development and identifies opportunities and challenges for integrating environmental management considerations during the planning phase of golf course development. To understand current practices and the opportunities and challenges of EMS implementation, data was collected through content analysis of EMS frameworks promoted in the Finnish golf industry and semi-structured interviews with five golf industry’s internal stakeholders, including golf course CEO, professional greenkeepers and course designers. Interview data was analysed thematically to identify stakeholder perspectives on EMS integration opportunities and challenges. The examined theoretical frameworks included Golf Course 2030 by the R&A and GEO Sustainable Golf Development Voluntary Sustainability Standard for Development by GEO Foundation for Sustainable Golf. The results revealed implementation gaps between theoretical EMS frameworks and practical application in golf course development. While all stakeholders demonstrated high environmental awareness, EMS knowledge remained limited to one golf-specific operational program, limiting the opportunity to explore alternative frameworks that might be more compatible. The study identified structural barriers in EMS implementation, particularly the late involvement of golf industry stakeholders in site selection decisions, which creates permanent constraints on environmental performance in the course. Additional challenges included transportation-related emissions and remote locations, limited organizational resources and cultural expectations. Stakeholders reported positive economic outcomes from existing EMS implementation, including improved financial terms and operational cost reductions. While the seasonal nature of Finnish golf was initially perceived as a constraint, stakeholders found opportunities that can support diverse land use and community access during off-season. The findings of this thesis suggest that successful EMS integration into golf course planning requires tackling structural constraints in development processes to ensure early involvement of golf industry expertise and supporting cultural shifts toward more sustainable practices

Regional variation in breast cancer survival in Finland

Background: Breast cancer is the most commonly diagnosed cancer among Finnish women and a leading cause of cancer-related death. Survival outcomes in Finland are among the highest globally, with five-year relative survival approaching 90%. Given the country’s universal healthcare system, this study aimed to describe the variation in five- and ten-year relative survival from breast cancer across the 23 welfare regions in Finland from 2000 to 2022 to identify potential regional disparities in outcomes. Materials and Methods: We performed a nationwide registry-based cohort study by using Finnish Cancer Registry (FCR) data for all female breast cancers diagnosed in 2000–2022 (100,046 patients). Five-year and ten-year survival were compared across 23 welfare regions. Relative survival ratios (RSRs) were calculated for each region (age-standardized to adjust for age differences). Results: Five-year RSR improved from 88% in 2000–2004 to 92% by 2015–2019, and ten-year RSR rose from 82% in 2000-2004 to 87% in 2010-2014. Median age at diagnosis increased over time (from around 57 years in 2000–2004 to 63 years by 2010–2014) and varied modestly between regions. The overall median age at diagnosis was 63.4 years. In each period, a few regions had slightly lower or higher survival than the national average, but differences were small (<10 percentage points). No region showed a consistent survival disadvantage over time, indicating an absence of substantial regional disparities. Conclusion: Breast cancer survival in Finland showed no major regional gaps. All regions had comparably high and improving 5- and 10-year survival, suggesting that breast cancer care is delivered equitably across the country

Huonot asiakas-työntekijäkohtaamiset sosiaali- ja terveyspalveluissa: Kuvatut loukkaukset asiakkaiden raportoimissa keskusteluissa

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Non-human stakeholders

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Academic competence and special educational needs as outcomes of early onset epilepsy: A population-based prospective follow-up study

Epilepsy in children is associated with significant academic challenges, particularly among those with early-onset seizures and comorbid intellectual disabilities (ID). This study aims to bridge gaps in existing research by examining long-term academic outcomes and special educational needs (SEN) in a cohort of children with early-onset epilepsy, including those with complicated epilepsy (CE) and major comorbidities. The study followed a population-based cohort of 64 children with epilepsy (CWE) aged 3–6 years, identified from the Pediatric Neurology Unit at Tampere University Hospital. Six years later, 43 children (67 %) participated in the follow-up. Academic competence was assessed using the Teacher Report Form (TRF), which also provided data on SEN. The findings revealed that 67 % of participants had low academic competence, with a significant proportion requiring special educational support. Children with CE had notably lower academic performance compared to those with uncomplicated epilepsy (UE). The need for SEN was higher among children with CE (81 %) than those with UE (24 %), with epilepsy type emerging as a significant predictor for SEN. Despite the small sample size and limitations in generalizability, the study underscores the pervasive impact of early-onset epilepsy on academic outcomes and highlights the necessity for ongoing educational support. Future research should focus on larger cohorts and explore the efficacy of tailored educational interventions to improve the academic performance and quality of life for CWE. Regular screening and collaboration with educators are essential to address the unique needs of these children effectively.Peer reviewe

Comparative analysis of the antiglioblastoma activity of adenosine A_2A receptor and CK1δ blockers

Glioblastoma multiforme (GBM), a multifactorial deadliest cancer with constrained clinical efficacy due to heterogeneity, drug resistance, side effects of the chemotherapeutic drug, necessitating the development of novel cancer therapeutics. The adenosine A2A receptor targeted binding of antagonist leads to regulation of downstream effectors, mediating the phosphorylation of Casein kinase 1δ kinase domain (CK1δ) in cancers. Here, we performed a comparative investigation of Food and Drug Administration (FDA) approved drugs, istradefylline and riluzole inhibiting adenosine A2A receptor and CK1δ isoform in GBM cell growth. Molecular interaction of riluzole with CK1δ isoform and istradefylline with adenosine A2A receptor was identified through molecular docking and dynamic simulations. The potential of these two FDA approved drugs in inhibiting GBM cell growth was investigated through various in-vitro analysis including dose-dependent dynamic assay, cell cycle assay, apoptosis assay by flow cytometry. Further the effect of these drugs on spheroid cell growth and cell size was measured. In silico analyses demonstrated that riluzole binds strongly to CK1δ isoform with a binding energy of −9.02 kcal/mol, whereas istradefylline binds to adenosine A2A receptor with −9.88 kcal/mol. In vitro evaluation revealed that riluzole increased cell growth inhibition by 24 % in LN229 cells and 36 % in SNB19 cells than istradefylline. Riluzole arrested the cell cycle at S phase in both cell lines, whereas istradefylline arrest was cell line specific. Three-dimensional (3D) spheroid model of 1321N1 GBM cells further demonstrated that riluzole inhibits ∼50 % higher cell growth inhibition than istradefylline with effective reduction in spheroid volume and size. Overall, our analysis revealed that blocking of adenosine A2A receptor downstream signaling pathway protein CK1δ with its inhibitor, riluzole, showed higher anti-GBM effect than its upstream signaling blocker, istradefylline. Thus, blocking adenosine A2A receptor downstream effector signaling protein through its antagonist and blocking its effector protein CK1δ could provide an opportunity to develop targeted therapy for GBM.Peer reviewe

Resilience testing in action: piloting the health system resilience testing tool with a pandemic scenario in Finland

Background: System-wide approaches to measure, prepare for and manage the next acute shock are needed. We document the application of the health system resilience testing tool to a hypothetical pandemic scenario in Finland. Methods: The resilience testing tool promoted pre-crisis identification of resilience gaps and was built on the Health Systems Performance Assessment Framework and the Shock Cycle Framework. It included guidance on building a shock scenario, conducting a semi-structured resilience testing dialogue with health system stakeholders, and evaluating resilience. A hypothetical scenario of a pandemic affecting predominantly children was addressed in a semi-structured, mixed-methods resilience test in Finland. The resilience test brought together national experts and other stakeholders to identify the health system weaknesses exposed by the scenario. Results: The resilience testing tool enabled the preparation for the high-level dialogue that identified actionable systemic weaknesses that undermine resilience. The identified weaknesses in the Finnish health system included: a lack of clarity of the process and value-basis of decision-making; sustaining trust towards and between authorities; multi-sectoral collaboration; safeguarding the health workforce; and developing a comprehensive knowledge base. Conclusions: The main benefit of the resilience testing methodology is the ability to bring key actors together to exchange different perspectives on how a health system functions during a crisis. The discussions at the high-level dialogue revealed the need for a mechanism, such as a resilience testing tool, to elucidate the range of practical challenges and how to potentially address them. The discussions also captured themes that are not routinely identified in existing performance assessment mechanisms, such as ethical considerations, values, and political determinants of the health system response. The Finnish pilot study was used to update the structure and facilitation of the resilience testing tool. Further suggested improvements for resilience testing include greater clarification for participants on the scenario, an increased emphasis on recovery and learning, and a greater representation of stakeholders from the community.Peer reviewe

Strength model for softened heat-affected zone of S700 butt-welded connections

The growing use of high strength steel in construction necessitates updates to the weld design rules, particularly for the heat-affected zone (HAZ), where welding induces softening and potential strength reduction. This study examines gas metal arc-welded joints of S700 high-strength low-alloy steel, focusing on the softened HAZ. Tensile tests show that small-scale specimens have ∼5 % lower strength than standard-sized counterparts, emphasizing the impact of specimen size on strength assessment. The thermally simulated wide HAZ soft zone has ∼10 % lower strength compared to the welded specimens with narrower soft zone, indicating the magnitude of the constraint effect. The lowest strength of the simulated HAZ was reached with ∼18 s t8/5-time and peak temperature of 912C°, leading to ∼17 % decrease in strength compared to the base material. The welds with a long (∼18 s) t8/5-time have approximately 8 % lower strength than the welds with a short (∼6 s) t8/5-time. Based on the experiments, the study introduces a novel semi-empirical equation with two damage parameters to predict the softened HAZ tensile strength. The effect of a triaxial stress state on the tensile strength was considered indirectly, by considering the relative width of the soft zone and the relative hardness values of the soft zone and the stronger adjacent zones, including weld metal. Using the developed equation, the relative width 0.52 of the soft zone provides the same strength as the base material.Peer reviewe