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

Peer reviewe

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

Peer reviewe

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

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

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Self-Reported Physician Diagnosed Asthma with COPD is Associated with Higher Mortality than Self-Reported Asthma or COPD Alone – A Prospective 24-Year Study in the Population of Helsinki, Finland

Asthma and COPD are common chronic obstructive respiratory diseases. COPD is associated with increased mortality, but for asthma the results are varying. Their combination has been less investigated, and the results are contradictory. The aim of this prospective study was to observe the overall mortality in obstructive pulmonary diseases and how mortality was related to specific causes using postal questionnaire data. This study included data from 6,062 participants in the FinEsS Helsinki Study (1996) linked to mortality data during a 24-year follow-up. According to self-reported physician diagnosed asthma, COPD, or smoking status, the population was divided into five categories: combined asthma and COPD, COPD alone and asthma alone, ever-smokers without asthma or COPD and never-smokers without asthma or COPD (reference group). For the specific causes of death both the underlying and contributing causes of death were used. Participants with asthma and COPD had the highest hazard of mortality 2.4 (95% CI 1.7–3.5). Ever-smokers without asthma or COPD had a 9.5 (3.7–24.2) subhazard ratio (sHR) related to lower respiratory tract disease specific causes. For asthma, COPD and combined, the corresponding figures were 10.8 (3.4–34.1), 25.0 (8.1–77.4), and 56.1 (19.6–160), respectively. Ever-smokers without asthma or COPD sHR 1.7 (95% CI 1.3–2.5), and participants with combined asthma and COPD 3.5 (1.9–6.3) also featured mortality in association with coronary artery disease. Subjects with combined diseases had the highest hazard of overall mortality and combined diseases also showed the highest hazard of mortality associated with lower respiratory tract causes or coronary artery causes.Peer reviewe

Mortality associated with occupational exposure in Helsinki, Finland - a 24-year follow-up

Objectives: Our objective was to study mortality related to different obstructive lung diseases, occupational exposure, and their potential joint effect in a large, randomized population-based cohort. Methods: We divided the participants based on the answers to asthma and COPD diagnoses and occupational exposure and used a combined effects model and compared the results to no asthma or COPD with no occupational exposure. Results: High exposure had a hazard ratio (HR) 1.34 (1.11-1.62) and asthma and COPD coexistence 1.58 (1.10-2.27). The combined effects of intermediate exposure and coexistence had a HR 2.20 (1.18-4.09), high exposure with co-existence 1.94 (1.10-3.42) for overall mortality and sub-hazard ratio for respiratory related mortality sHR 3.21 (1.87-5.50). Conclusions: High occupational exposure increased overall, but not respiratory related mortality hazard while co-existing asthma and COPD overall and respiratory related hazard of mortalityPeer reviewe