Liikunta kuntoutuksen tukena neurologista sairautta sairastavilla : Kelan vaativaan lääkinnälliseen kuntoutukseen osallistuneiden liikuntatottumukset ja avoterapiastandardiin liittyvä liikuntakokeilu

Tausta: Väestön fyysisen aktiivisuuden ja liikunnan vähäisyys aiheuttaa haasteita suomalaiselle yhteiskunnalle. Liikkumaton elämäntapa lisää monia kansansairauksia ja kansantalouden kustannuksia ja on yhteydessä väestöryhmien välisiin terveys- ja hyvinvointieroihin. Neurologista sairautta sairastaville kuntoutujille arjen fyysinen aktiivisuus ja liikunnan harrastaminen saattaa olla ongelmallista. Kun fyysisen aktiivisuuden ja liikunnan toteuttamisen edellytykset ovat kunnossa, edistetään terveyttä ja hyvinvointia, vähennetään eriarvoisuutta sekä tuetaan ihmisten vastuuta omasta terveydentilasta ja elämäntavoista. Tutkimuksessa Liikunta kuntoutuksen tukena selvitettiin Kelan vaativan lääkinnällisen kuntoutuksen fysioterapiaa saavien kuntoutujien liikunnan harrastamista edistäviä ja rajoittavia tekijöitä sekä Kelan avoterapiastandardin sisältämää liikuntakokeilumahdollisuuden käyttöä. Menetelmät: Tutkimuksen kohderyhmänä olivat Kelan vaativan lääkinnällisen kuntoutuksen fysioterapiaa saavat neurologista sairautta sairastavat suomen- ja ruotsinkieliset kuntoutujat Varsinais-Suomen alueella (N = 564), Kelan järjestämän fysioterapian palveluntuottajat, joilla on vaikeavammaisia neurologisia kuntoutujia (Loimaa, Paimio, Turku ja Uusikaupunki) (n = 59) sekä näiden kuntien erityisliikunnasta vastaavat työntekijät (n = 4). Kuntoutujien aineisto poimittiin Kelan rekisteristä. Tutkimukseen vastasi 219 kuntoutujaa (38,8 %), 22 fysioterapeuttia (37,2 %) ja 2 kahden kunnan erityisliikunnasta vastaavaa työntekijää. Tutkimus toteutettiin kyselynä kuntoutujille sekä puhelinhaastatteluna ja sähköpostikyselynä fysioterapeuteille ja kunnan liikuntatoimen työntekijöille. Tulokset: Kyselyyn vastanneet kuntoutujat harrastivat eniten kävelyä tai juoksua, uintia tai vesijuoksua, luonnossa liikkumista ja kuntosaliharjoittelua. Luonnossa liikkumista, uintia tai vesijuoksua, kuntosaliharjoittelua ja tanssia sekä keilailua ja ratsastusta halusivat harrastaa myös ne kuntoutujat, jotka eivät aikaisemmin olleet harrastaneet näitä lajeja. Avoterapiastandardiin kuuluvaa liikuntakokeilumahdollisuutta oli hyödynnetty 58 vastaajan (26,7 %) fysioterapiassa. Nykyistä liikunnan harrastamista kohtalaisesti edistivät vastaajan tietämys liikunnan ja terveyden välisistä yhteyksistä sekä perheenjäsenten asenteet ja rajoitti merkittävästi neurologinen oire. Liikunnan harrastamista lievästi edistävät oma motivaatio liikkua ja oma asenne, avustaja, asiantuntijoiden ohjaus, kuljetusjärjestelyt ja liikuntakaveri. Lievästi nykyistä liikunnan harrastamista rajoittivat vastaajan liikunnalliset taidot sekä taloudellinen tilanne. Fysioterapeutit ja liikuntatoimi halusivat kehittää neurologista sairautta sairastavien kuntoutujien liikuntamahdollisuuksia ja toivoivat lisää tiedottamista kunnan liikuntapalveluista ja Kelan avoterapiastandardin käytöstä. Johtopäätökset: Neurologista sairautta sairastavat kuntoutujat, fysioterapeutit ja kunnan erityisliikunnan työntekijät kannattivat avoterapiastandardin liikuntakokeilumahdollisuuden käyttöä, mikäli liikuntatoiminnan edellytykset ovat kunnossa. Hyvin toteutettuna liikunta tukee kuntoutumista

Port connectivity indices:an application to European RoRo shipping

In recent years, there has been significant interest in the development of connectivity indicators for ports. For short sea shipping, especially in Europe, Roll-on Roll-off (RoRo) shipping is almost equally important as container shipping. In contrast with container shipping, RoRo shipments are primarily direct, thus the measurement of its connectivity requires a different methodology. In this paper, we present a methodology for measuring the RoRo connectivity of ports and illustrate its use through an application to European RoRo shipping. We apply the methodology on data collected from 23 different RoRo shipping service providers concerning 620 unique routes connecting 148 ports. We characterize the connectivity of the ports in our sample and analyze the results. We show that in terms of RoRo connectivity, neither the number of links nor the link quality (frequency, number of competing providers, minimum number of indirect stops) strictly dominate the results of our proposed indicator. The highest ranking ports combine link quality and number. Finally, we highlight promising areas for future research based on the insights obtained

Adverse childhood experiences exacerbate the association between day-to-day discrimination and mental health symptomatology in undergraduate students

Background: Background: Background: Adverse childhood experiences (ACEs) and day-to-day discrimination (hereafter, “discrimination”) both contribute to mental health symptomatology in young adulthood, but how these constructs interact and whether they are associated with mental health remains unclear. This study evaluated whether the relation between discrimination in young adulthood and mental health symptomatology varied as a function of ACEs exposure. Methods: Undergraduates (n = 251) completed self-report measures related to ACEs, discrimination, and mental health symptomatology (i.e., depression, anxiety, somatization, and psychological distress). Linear and logistic regression models were implemented to test for potential exacerbation effects of ACEs on the relation between discrimination and mental health symptomatology. Results: Participants with greater discrimination exposure and ACEs reported significantly more depression, anxiety, and somatic symptoms, along with more psychological distress, relative to those with less discrimination exposure and few or no ACEs. Limitations: Data were cross-sectional, thus, causality cannot be inferred. ACEs and discrimination measures examined ACE counts and general discrimination, respectively, which did not allow for examination of possible differences across specific ACEs (e.g., childhood sexual abuse vs. neglect) or specific types of discrimination (e.g., sexual-orientation-based discrimination vs. race-based discrimination). Conclusions: Conclusions: These results are among the first to inform the conceptualization of ACEs and discrimination in etiological models of young adults’ mental health. Both ACEs and discrimination, rather than exposure to only one of these stressors, may be synergistically associated with young adults’ mental health symptomatology. Clinicians could address stress-sensitive mental health issues by assessing for both ACEs and discrimination exposure

Outcome after Hybrid Outflow Interventions for Chronic Limb-threatening Ischemia

Background and Aims: Because chronic limb-threatening ischemia (CLTI) is often associated with multilevel arterial disease, it usually requires revascularization at different sites of the limb vasculature. We aim to assess the outcome of the hybrid interventions including open surgical revascularization together with outflow segment percutaneous transluminal angioplasty (PTA) in patients with chronic limb-threatening ischemia. Material and Methods: This study included all hybrid outflow-PTA interventions (n = 80) on patients suffering from CLTI performed in Helsinki University Hospital between 2003 and 2015. Follow-up ended on 31 December 2019. Patient data were prospectively collected into our vascular registry and scrutinized retrospectively. Thirty-one patients (39%) suffered from rest pain (Rutherford category IV) and 49 patients (61%) had ischemic ulcers (Rutherford category V-VI). The most common open surgical procedure was femoral endarterectomy (n = 63, 79%) and the most common endovascular procedure was superficial femoral artery percutaneous transluminal angioplasty (n = 65, 81%). Mean follow-up time was 56 months (range: 4 days-183 months). Results: Limb salvage was at 30 days-92%, at 1 year-91%, and at 5 and 10 years-86%. Survival and amputation-free survival were at 30 days-93% and 86%, at 1 year-80% and 76%, at 5 years-51% and 48%, and at 10 years-21% and 21%. Wound healing at 3, 6, and 12 months was 48%, 71%, and 87%. Freedom from target lesion revascularization was at 30 days-97%, at 1 year-88%, at 5 years-72%, and at 10 years-66%. Conclusion: Hybrid outflow revascularization is an important tool in the vascular surgeon's armamentarium for treatment of patients with multilevel arterial disease causing chronic limb-threatening ischemia.Peer reviewe

Spectroscopy of pentaquark states

We construct a complete classification of pentaquark states in terms of the spin-flavour SU(6) representations. We find that only some definite SU(3) representations are allowed, singlets, octets, decuplets, anti-decuplets, 27-plets and 35-plets. The latter three contain exotic states, which cannot be constructed from three quarks only. This complete classification scheme is general and model independent and is useful both for model builders and experimentalists. The mass spectrum is obtained from a Gursey-Radicati type mass formula, whose coefficients have been determined previously by a study of qqq baryons. The ground state pentaquark which is identified with the recently observed Theta(1540) state, is predicted to be an isosinglet anti-decuplet state. Its parity depends on the interplay between the spin-flavour and orbital contributions to the mass operator.Comment: 26 pages, 4 figures, 11 tables, revised version with 2 extra tables, an updated list of references and expanded discussion of the results. Accepted for publication in Eur. Phys. J.

Is there diquark clustering in the nucleon?

It is shown that the instanton-induced interaction in qq pairs, iterated in t-channel, leads to a meson-exchange interactions between quarks. In this way one can achieve a simultaneous understanding of low-lying mesons, baryons and the nuclear force. The discussion is general and does not necessarily rely on the instanton-induced interaction. Any nonperturbative gluonic interaction between quarks, which is a source of the dynamical chiral symmetry breaking and explains the $\pi$ - $\rho$ mass splitting, will imply an effective meson exchange picture in baryons. Due to the (anti)screening there is a big difference between the initial 't Hooft interaction and the effective meson-exchange interaction. It is demonstrated that the effective meson-exchange interaction, adjusted to the baryon spectrum, does not bind the scalar diquark and does not induce any significant quark-diquark clustering in the nucleon because of the nontrivial role played by the Pauli principle.Comment: Final version to appear in Phys. Rev. D; typos have been corrected; some formulae have been written in a more detailed form; some references have been update

Meson exchange and nucleon polarizabilities in the quark model

Modifications to the nucleon electric polarizability induced by pion and sigma exchange in the q-q potentials are studied by means of sum rule techniques within a non-relativistic quark model. Contributions from meson exchange interactions are found to be small and in general reduce the quark core polarizability for a number of hybrid and one-boson-exchange q-q models. These results can be explained by the constraints that the baryonic spectrum impose on the short range behavior of the mesonic interactions.Comment: 11 pages, 1 figure added, expanded discussio

Sustainability of cellulose dissolution and regeneration in 1,5-diazabicyclo[4.3.0]non-5-enium acetate : a batch simulation of the IONCELL-F process

The recyclability of 1,5-diazabicyclo[4.3.0] non-5-enium acetate ([DBNH][OAc]), as a direct dissolution solvent for cellulose, was evaluated during laboratory scale recycling trials. The main objective was to simulate the conditions of a spinning bath from a Lyocell-type air-gap spinning process, called the IONCELL-F process. The saline solution was then concentrated, recycled and reused as many times as possible before cellulose dissolution was no longer possible. The chemical compositions of the ionic liquid and pulp were recorded throughout the experiments. The results of the experiments showed that [DBNH][OAc] can be recycled from aqueous media with an average recovery rate of 95.6 wt% using basic laboratory equipment, without any further process intensification or optimisation. The recycling of the ionic liquid did not change the chemical composition or degree of polymerisation of the recovered pulp but the colour of the regenerated pulps gradually darkened as the recycling times increased. The ionic liquid was found to hydrolyse 6.0-13.6 mol% per cycle, under these conditions. The build-up of the hydrolysis product, 3-( aminopropyl)-2-pyrrolidonium acetate, killed the dissolution feature at between 30.6-45.6 wt% hydrolysis product. The enzymatic digestibility of the regenerated pulp samples was studied with both a monocomponent endoglucanase and a cellulase mixture. The amount of residual [DBNH][OAc] in the regenerated pulps was determined, by both NMR and capillary electrophoresis. Although hydrolysis of the ionic liquid occurs, this study clearly shows potential for industrial application, with appropriate process equipment and recycling conditions.Peer reviewe

The π−\pi-Gluon Exchange Interaction Between Constituent Quarks

The interaction mediated by irreducible pion and gluon exchange between constituent quarks is calculated and shown to have a strong tensor component, which tends to cancel the pion exchange tensor interaction between quarks. Its spin-spin component is somewhat weaker than the pion exchange spin-spin interaction, while its central and spin-orbit components are small in comparison to the corresponding single gluon exchange interactions. The combination of the $\pi-$gluon exchange interaction with the single pion exchange interaction and a weak gluon exchange interaction between constituent quarks has the qualitative features required for understanding the hyperfine splittings of the spectra of the nucleon and the $\Delta$ resonances.Comment: LaTeX, 17 pages, 5 Postscript figure

Magnetic moments of antidecuplet pentaquarks

We analyze the magnetic moment of the exotic pentaquarks of the flavor antidecuplet in the constituent quark model for the case in which the ground state is in an orbital L(p)=0(+) or a L(p)=1(-) state. We derive sum rules for the magnetic moments. The magnetic moment of the Theta(1540) is found to be 0.38, 0.09 and 1.05 mu_N for J(p)=1/2(-), 1/2(+) and 3/2(+), respectively, which is compared with the results obtained in other approaches.Comment: 15 pages, 1 figure, 3 tables. Revised version, extended introduction and discussion, accepted for publication in Physics Letters