Vihreän kasvun Häme : Hämeen elinkeino-, liikenne- ja ympäristökeskuksen alueellinen maaseutusuunnitelma 2014–2020

Hämeen ELY-keskuksen alueellisessa maaseutusuunnitelmassa luodaan pohja Manner-Suomen maaseudun kehittämisohjelman 2014–2020 toteutukselle alueella. Laajapohjaisen osallistavan strategiatyön kautta ohjelmassa nousi esille neljä painopistealuetta ja kaksi läpikäyvää teemaa: 1. Ruokaketju 2. Metsä- ja puutuoteala, metsästä saatava energia ja muu metsään liittyvä yritystoiminta 3. Matkailu ja siihen liittyvä palveluliiketoiminta 4. Asuminen 5. Biotalous – läpikäyvä teema 6. Yrittäjyys – läpikäyvä teema. Suunnitelman visio on, että Hämeen maaseutu on vuonna 2020 elinvoimainen, vihreän kasvun ja hyvinvoinnin edelläkävijä. Maaseutua kehitetään monimuotoisena, houkuttelevana asuinmaaseutuna, joka tarjoaa toimeentulon lisäksi riittävät palvelut ja muut viihtyisän ja hyvinvoivan pysyvän ja vapaa-ajanasumisen edellytykset. Hämeestä kehitetään vihreän talouden edelläkävijä. Hämeen erinomainen saavutettavuus ja pääkaupungin läheisyys hyödynnetään. Hämeen kilpailukykyä parannetaan osaamispääomaa hyödyntämällä ja innovaatioympäristöjä kehittämällä. Suunnitelmassa tuodaan kultakin painopistealueelta esille nykytila ja mahdollisuudet sekä tavoitteet ja esimerkkejä toimenpiteistä

Ventilation/Perfusion SPECT Imaging-Diagnosing Other Cardiopulmonary Diseases Beyond Pulmonary Embolism

Ventilation/perfusion single-photon emission computed tomography (V/P SPECT) is the scintigraphic technique recommended primarily for the diagnosis of acute pulmonary embolism (PE) and is golden standard for the diagnosis of chronic PE. Furthermore, interpreting ventilation and corresponding perfusion images enables pattern recognition of many other cardiopulmonary disorders that affect lung function and also allows quantification of their extent. Using Technegas for the ventilation imaging, grading of small airway disease in COPD is possible and the method is recommended for PE diagnosis in patients with severe COPD that is not possible with radiolabelled liquid aerosols. An optimal combination of nuclide activities, acquisition times for ventilation and perfusion, collimators, and imaging matrix yields an adequate V/P SPECT study in approximately 20 minutes of imaging time. The holistic interpretation strategy of V/P SPECT uses all relevant information about the patient and ventilation/ perfusion patterns. PE is diagnosed when there is more than one subsegment showing a V/P mismatch representing an anatomic lung unit. Apart from PE, other pathologies should be identified and reported, such as obstructive lung disease, heart failure, and pneumonia according to the European Association of Nuclear Medicine guidelines. Semin Nucl Med 49:4-10 (C) 2018 Published by Elsevier Inc.Peer reviewe

GOLD criteria overestimate airflow limitation in one-third of cases in the general Finnish population

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Prevalence of abnormal findings when adopting new national and international Global Lung Function Initiative reference values for spirometry in the Finnish general population

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Responses of FEV6, FVC, and FET to inhaled bronchodilator in the adult general population

<p>Abstract</p> <p>Background</p> <p>The assessment of bronchodilator-induced change in forced vital capacity (FVC) is dependent on forced expiratory time (FET) in subjects with airflow limitation. Limited information is available on the concurrent responses of FVC, forced expiratory volume in six seconds (FEV₆), and FET in the bronchodilation test among patients with obstructive airways disease or in the general population. The aim of this study was to assess the changes in FEV₆, FVC, and FET, and their relationships in a standardized bronchodilation test in the general population.</p> <p>Methods</p> <p>We studied bronchodilation response in a general adult population sample of 628 individuals (260 men, 368 women) with flow-volume spirometry. The largest FVC, the corresponding FET and the largest FEV₆both at the baseline and after 0.4 mg of inhaled salbutamol were selected for analysis.</p> <p>Results</p> <p>After administration of salbutamol FEV₆decreased on average -13.4 (95% CI -22.3 to -4.5) ml or -0.2% (-0.4% to 0.0%) from the baseline. The 95^thpercentile of change in FEV₆was 169.1 ml and 5.0%. FVC decreased on average -42.8 (-52.4 to -33.3) ml or -1.0% (-1.2% to -0.7%). Concurrently FET changed on average -0.2 (-0.4 to 0.0) seconds or 0.4% (-1.4% to 2.3%). There were four subjects with an increase of FVC over 12% and only one of these was associated with prolonged FET after salbutamol. Changes in FEV₆and FVC were more frequently positive in subjects with reduced FEV₁/FVC in baseline spirometry.</p> <p>Conclusion</p> <p>In general adult population, both FEV₆and FVC tended to decrease, but FET remained almost unchanged, in the bronchodilation test. However, those subjects with signs of airflow limitation at the baseline showed frequently some increase of FEV₆and FVC in the bronchodilation test without change in FET. We suggest that FEV₆could be used in assessment of bronchodilation response in lieu of FVC removing the need for regulation of FET during bronchodilation testing.</p

COPD in Helsinki, Finland: socioeconomic status based on occupation has an important impact on prevalence

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The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland

Background: Mortality and hospitalization due to asthma have decreased in many European countries, but asthma symptoms still cause a lot of morbidity and costs. Objectives: We evaluated prevalence trends of asthma, asthma symptoms and allergic rhinoconjunctivitis in adults aged 20-69 years during a 20-year period from 1996 to 2016 in the city of Helsinki, the capital of Finland. Methods: Three cross-sectional postal surveys were conducted in random population samples 10 years apart. In 1996, 2006 and 2016, a total of 6062 (response rate 75.9%), 2449 (61.9%) and 4026 subjects (50.3%) took part, respectively. Results: In all responders, the prevalence of physician-diagnosed asthma was 6.6% in 1996, 10% in 2006 and 10.9% in 2016. The prevalence increased from 1996 to 2006, but stabilized from 2006 to 2016, both in men and women and in smokers and non-smokers. The prevalence of current asthma (8.5% in 2006 and 8.8% in 2016) and of asthma with rhinoconjunctivitis (7.6% in 2006 and 7.5% in 2016) remained also at the same level. Allergic rhinoconjunctivitis decreased significantly from 2006 (42.7%) to 2016 (39.0%, p=0.004). Those with physician diagnosed asthma reported significantly less symptoms in 2016 compared to 2006 and 1996, although there was no change in smoking habits or medication use. Young asthmatics (20-29 years) without rhinoconjunctivitis reported least symptoms. Conclusion: Previously observed increase of physician-diagnosed asthma prevalence in adults seems to be levelling off in Helsinki, and patients have fewer symptoms than 20 years ago. In addition, allergic rhinoconjunctivitis is less frequent than 10 years earlier. (247 words).Peer reviewe

Long-term smoking increases the need for acute care among asthma patients : a case control study

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