Indicators and tools for assessing sustainability impacts of the forest bioeconomy

The sustainable use of renewable resources has become an important issue worldwide in the move towards a less fossil-fuel-intensive future. Mainstream method for fulfilling this aim is to increase the share of renewable energy and materials to substitute fossil fuels and to become fully independent from fossil fuels over the long-term. However, the environmental sustainability of this endeavor has been questioned. In addition, economic and social sustainability issues are also much debated topics in this particular context. Forest resources are often thought to contribute partially to achieving a so-called “carbon-neutral society”. In this review, we discuss sustainability issues of using forest biomass. We present several sustainability indicators for ecological, economic and social dimensions and discuss the issues in applying them in sustainability impact assessments (SIAs). We also present a number of tools and methods previously used in conducting SIAs. We approach our study from the perspective of the Finnish forestry; in addition, various aspects regarding the application of SIAs in a broader context are also presented. One of the key conclusions of the study is that although sufficient data are available to measure many indicators accurately, the impacts may be very difficult to assess (e.g. impact of greenhouse gases on biodiversity) for conducting a holistic SIA. Furthermore, some indicators, such as “biodiversity”, are difficult to quantify in the first place. Therefore, a mix of different methods, such as Multi-criteria Assessment, Life-cycle Assessment or Cost-Benefit Analysis, as well as different approaches (e.g. thresholds and strong/weak sustainability) are needed in aggregating the results of the impacts. SIAs are important in supporting and improving the acceptability of decision-making, but a certain degree of uncertainty will always have to be tolerated

Laparoscopic versus hybrid approach for treatment of incisional ventral hernia : a prospective randomised multicentre study, 1-year results

Purpose Laparoscopic incisional ventral hernia repair (LIVHR) is often followed by seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence, chronic pain and poor quality of life (QoL). We aimed to evaluate whether LIVHR combined with defect closure (hybrid) follows as a diminished seroma formation and thereby has a lower rate of hernia recurrence and chronic pain compared to standard LIVHR. Methods This study is a multicentre randomised controlled clinical trial. From November 2012 to May 2015, 193 patients undergoing LIVHR for primary incisional hernia with fascial defect size from 2 to 7 cm were recruited in 11 Finnish hospitals. Patients were randomised to either a laparoscopic (LG) or a hybrid (HG) repair group. The main outcome measure was hernia recurrence, evaluated clinically and radiologically at a 1-year follow-up visit. At the same time, chronic pain scores and QoL were also measured. Results At the 1-year-control visit, we found no difference in hernia recurrence between the study groups. Altogether, 11 recurrent hernias were found in ultrasound examination, producing a recurrence rate of 6.4%. Of these recurrences, 6 (6.7%) were in the LG group and 5 (6.1%) were in the HG group (p > 0.90). The visual analogue scores for pain were low in both groups; the mean visual analogue scale (VAS) was 1.5 in LG and 1.4 in HG (p = 0.50). QoL improved significantly comparing preoperative status to 1 year after operation in both groups since the bodily pain score increased by 7.8 points (p <0.001) and physical functioning by 4.3 points (p = 0.014). Conclusion Long-term follow-up is needed to demonstrate the potential advantage of a hybrid operation with fascial defect closure. Both techniques had low hernia recurrence rates 1 year after operation. LIVHR reduces chronic pain and physical impairment and improves QoL. Trial Registry: Clinical trial number NCT02542085.Peer reviewe

Laparoscopic versus hybrid approach for treatment of incisional ventral hernia: a prospective randomised multicentre study, 1-year results

Purpose Laparoscopic incisional ventral hernia repair (LIVHR) is often followed by seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence, chronic pain and poor quality of life (QoL). We aimed to evaluate whether LIVHR combined with defect closure (hybrid) follows as a diminished seroma formation and thereby has a lower rate of hernia recurrence and chronic pain compared to standard LIVHR.Methods This study is a multicentre randomised controlled clinical trial. From November 2012 to May 2015, 193 patients undergoing LIVHR for primary incisional hernia with fascial defect size from 2 to 7 cm were recruited in 11 Finnish hospitals. Patients were randomised to either a laparoscopic (LG) or a hybrid (HG) repair group. The main outcome measure was hernia recurrence, evaluated clinically and radiologically at a 1-year follow-up visit. At the same time, chronic pain scores and QoL were also measured.Results At the 1-year-control visit, we found no difference in hernia recurrence between the study groups. Altogether, 11 recurrent hernias were found in ultrasound examination, producing a recurrence rate of 6.4%. Of these recurrences, 6 (6.7%) were in the LG group and 5 (6.1%) were in the HG group (p > 0.90). The visual analogue scores for pain were low in both groups; the mean visual analogue scale (VAS) was 1.5 in LG and 1.4 in HG (p = 0.50). QoL improved significantly comparing preoperative status to 1 year after operation in both groups since the bodily pain score increased by 7.8 points (p Conclusion Long-term follow-up is needed to demonstrate the potential advantage of a hybrid operation with fascial defect closure. Both techniques had low hernia recurrence rates 1 year after operation. LIVHR reduces chronic pain and physical impairment and improves QoL.</p

6G White Paper on Machine Learning in Wireless Communication Networks

The focus of this white paper is on machine learning (ML) in wireless communications. 6G wireless communication networks will be the backbone of the digital transformation of societies by providing ubiquitous, reliable, and near-instant wireless connectivity for humans and machines. Recent advances in ML research has led enable a wide range of novel technologies such as self-driving vehicles and voice assistants. Such innovation is possible as a result of the availability of advanced ML models, large datasets, and high computational power. On the other hand, the ever-increasing demand for connectivity will require a lot of innovation in 6G wireless networks, and ML tools will play a major role in solving problems in the wireless domain. In this paper, we provide an overview of the vision of how ML will impact the wireless communication systems. We first give an overview of the ML methods that have the highest potential to be used in wireless networks. Then, we discuss the problems that can be solved by using ML in various layers of the network such as the physical layer, medium access layer, and application layer. Zero-touch optimization of wireless networks using ML is another interesting aspect that is discussed in this paper. Finally, at the end of each section, important research questions that the section aims to answer are presented

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Erilainen oppija näytöissä Ammattiopisto Lappiassa

Kehittämishankkeemme tehtiin Ammattiopisto Lappian erilaisten oppijoiden ohjauskäytäntöjen ja tuen tarpeen selvittämiseksi näyttöjen yhteydessä. Kehittämishankeen tarkoituksena oli selventää Ammattiopisto Lappian erityisopetuksen nykyistä toimintamallia. Työ tehtiin palvelemaan kaikkia Ammattiopisto Lappian aloja. Kehittämishanke sisältää esimerkkinäytöt sähkö-, catering-, ja hiusalaoilta. Näytöissä pääpaino on erilaisten oppijoiden tuen tarpeen ja ohjauksen näkökulmissa. Työn alkupuolella keskityttiin Ammattiopisto Lappian erityistä tukea tarvitsevien opiskelijoiden määrään ja niihin syihin, jotka aiheuttavat lisätuen tarpeen. Lisäksi alkupuolella työtä kuvattiin erityisopetuksen nykyinen toimintaohje. Työ sisältää HOJKS- prosessimallin ja uudistetun HOJKS-lomakkeen (liite 1.). Erityisopetuksen toteutus ja seuranta sekä kehitysnäkymät käsiteltiin työn keskivaiheilla. Työn loppuosassa on alakohtaista pohdintaa erilaisten oppijoiden huomioimisesta näytöissä ja niihin liittyvää materiaalia löytyy liitteistä. Työmme tuloksena saimme havaita, että oppilaitoksessamme erityisopetuksen käytännöt olivat hyvinkin erilaisia. Erityisesti näytöissä erilaisten oppijoiden huomioiminen vaihteli huomattavasti. Huomionarvoista oli se, että lähes kaikilla aloilla erilaiset oppijat oli jotenkin huomioitu ja heille oli olemassa tukitoimia. Kaikille aloille yhteistä oli se, että ammattiosaamisen näytöissä edetään opetussuunnitelman perusteiden mukaisesti ja lähtökohtana ovat kansalliset näyttöaineistot. Näyttötehtävien suunnittelussa, opettajalla tulisi olla tarpeeksi resurssia näytön valmisteluun ja tukea tarvitsevien opiskelijoiden tukemiseen ja ohjaukseen näyttöjä varten. Toivottavasti tämä kehittämishanke palvelee koko Ammattiopiston henkilökuntaa näyttöjen suunnittelussa ja toteutuksessa, huomioiden erilaiset oppijat ja heidän tuen ja ohjauksen tarve erityisesti näytöissä. Erityisopetuksen toimintamallin selkeytyminen ja edelleen kehittyminen auttaa kaikkia Ammattiopisto Lappian osapuolia, jotka ovat jollain tavalla tekemisissä erityisopetuksen kanssa.We carried out our development project in order to look at the different kinds of learners’ tutoring practices and need for special support in connection to demonstrations at the Lappia Vocational College. The objective of the development project was to clarify the current operational model of the Lappia Vocational College special teaching. The work was done to benefit all the fields at the Lappia Vocational College. The development project includes demonstration examples in the fields of electrical engineering, catering, and hairdressing. The main emphasis in the demonstrations lies in the points of views of different learners’ need for support and tutoring. In the initial part of the work we concentrated on the number of the Lappia Vocational College students in need of special teaching and the reasons for that need. Additionally, the current special teaching instructions were described in the early part of the work. The work includes the HOJKS process model and the renewed HOJKS form (Appendix 1). The realisation and evaluation of the special teaching and the development vistas were looked into in the middle part of the work. The final parts of the work contain field-specific contemplations on how to pay attention to different kinds of learners in the demonstrations, and material related to them can be found in the appendices. As a result of our work we came to the conclusion that the practices of special teaching at out College varied greatly. Especially as regards the demonstrations, paying attention to different kinds of learners varied considerably. It was found significant that attention had been paid to different kinds of learners in almost all the fields and they had been provided support. Common to all the fields was that demonstrations of vocational skills proceed in accordance to the basics of the curriculum and the points of departure are the national demonstration materials. In the planning of demonstration tasks the teacher should be provided with enough resources to prepare the demonstration and enough means to support and tutor the students who need support for their demonstrations. Hopefully this development project will serve the entire staff of the Vocational College in terms of planning and realising the demonstrations with attention to different kinds of learners and their needs for support and guidance particularly in terms of the demonstrations. Making the special teaching operational model clearer and developing it further will help all the parties at the Lappia Vocational College somehow involved with the special teaching