Funktionalismin koulurakennukset uudessa käytössä:Hämeenlinnan keskuskoulun uudelleenkäyttösuunnitelma

Tiivistelmä. Diplomityöni aiheena on tutkia Hämeenlinnan keskuskoulun rakennuskokonaisuuden käyttötavan muutosta. Keskuskoulun rakennuskokonaisuus koostuu vuonna 1937 rakennetusta Keskuskoulun rakennuksesta sekä vuosina 1877–1881 rakennetusta Gaddin talosta. Rakennuskokonaisuuden koulukäyttö päättyi vuonna 2017, ja se on ollut siitä asti pääasiassa tyhjillään. Tällä hetkellä koulurakennuksen kellaria hyödyntävä kuntosalitoimija on rakennuskokonaisuuden ainoa käyttäjä. Gaddin talossa on ollut Hämeenlinnan kaupungin historiallisen museon kankaiden konservointitiloja vuoteen 2021 asti, mutta nyt konservointitoimintakin on loppunut. Diplomityöni koostuu kahdesta osasta. Ensimmäisessä osassa tutustun funktionalismin arkkitehtuuriin ja erityisesti aikakauden koulurakentamisen ominaispiireteisiin. Perehdyn vuosina 1935–1940 rakennettuihin funktionalismin koulurakennuksiin, joiden käyttötapa on jo muutettu. Perehdyn esimerkkikohteiden kautta aikakauden koulurakentamisen ominaispiirteisiin ja rakennuksiin niiden käyttötavan muutosten yhteydessä tehtyihin muutostoimiin. Pohdin, miten entisten koulurakennusten käyttötavan muutos on onnistunut vastaamaan nykypäivän käyttötarpeisiin ja säilyntämään funktionalismin piirteet sekä viittaukset rakennusten historiaan. Diplomityöni ensimmäisessä osassa tarkasteltavat kolme esimerkkikohdetta ovat: 1. Lappeenrannassa sijaitseva Armilan kansakoulu, nykyään nimeltään Armilanlinna, joka on muutettu toimitiloiksi. 2. Oulun keskuskansakoulu, joka tunnetaan myös nimellä Sammakkotalo. Rakennus toimii nykyään COR Groupin pääkonttorina. Rakennus on toiminut myös Oulun keskustan terveysasemana. 3. Oulun teknillinen oppilaitos, nykyään nimeltään Asunto Oy Oulun TEKU, joka on uuden nimensä mukaisesti muutettu asuinkohteeksi. Diplomityöni toisessa osassa syvennyn Hämeenlinnan keskuskoulun rakennuskokonaisuuden käyttötarkoituksen muutokseen. Keskuskoulun korttelissa on meneillään kaavamuutoshanke, joka sallii korttelin rakennusten käyttötavan muutoksen. Kaavamuutoksessa esitetään myös korttelin täydennysrakentamisen mahdollisuutta. Pohjustan suunnitelmaani tutkimalla Hämeenlinnan keskuskoulun koulurakennuksen ja ympäristön historiaa. Lisäksi tutustun Hämeenlinnan kaupungin strategiaan ja Keskustavisio 2035 -selvitykseen, joiden avulla pyrin määrittämään koulurakennukselle parhaiten sopivan, todellista tarvetta vastaavan, käyttötavan. Esitän keskuskoulun käyttötarkoituksen muutosta koulurakennuksesta senioritaloksi sekä senioritalon toimintoja tukeviksi palveluiksi. Lisäksi esitän Keskuskoulun kortteliin kaavaehdotuksessa esitetyn lisärakennuksen suunnitelman korttelitasolla. Sijoitan lisärakennukseen päiväkodin toimintoja. Suunnitelmassa tavoitteenani on ottaa huomioon historiallisesti ja rakennustaiteellisesti arvokkaan kohteen sekä ympäristön arvot rajoitteineen ja mahdollisuuksineen huomioiden samalla Hämeenlinnan kaupungin tulevaisuuden visiot, tavoitteet ja taloudelliset näkökulmat.School buildings of functionalism in reuse : reuse plan of Hämeenlinna Central School. Abstract. This diploma thesis researches the future possibilities of the Hämeenlinna Central School building complex. The building complex consists of the Hämeenlinna Central School, a school building built in 1937, and the Gaddi Building built between 1877–1881. The Hämeenlinna Central School has been closed since 2017 and the building complex has remained nearly empty. The only remaining tenant of the school building complex is a gym in the basement of the main building. The Gaddi Building is now empty, but previously housed the fabric preservation facilities of the Hämeenlinna City Museum. My diploma work is divided in to two sections. The first section is an exploration of functionalism in architecture, focusing primarily on school architecture. As part of this exploration, I offer a case study of three school buildings built between 1935 and 1940 which have been repurposed from their scholastic use to serve other needs of the community. These buildings offer a framework to illustrate and discuss the common features of school buildings from the era of functionalism. Through the case studies, I also investigate how changes in the use of the buildings are reflected in architectural and zoning changes. I aim to evaluate how the reuse of these example school buildings has succeeded both in meeting the demands of today and in preserving the features of functionalism and references to the history of the buildings. The example school buildings presented in the first part of my diploma thesis are: 1. Armila School in Lappeenranta, nowadays known as Armilanlinna. The building is now used as business premises. 2. Oulu Central Elementary School, now used as the headquarters of the COR Group. The building has also been used as a health station of the city of Oulu. 3. Oulu Technical School, now housing Oy Oulu’s TEKU. The building has been transformed into apartments according to its new name. In the second part of my diploma thesis, I dive into the reuse plan of Hämeenlinna Central School building complex. The Hämeenlinna Central School block is currently undergoing zoning changes that will allow multiple new purposes of use in the former school plot. The new city plan proposal concerning Hämeenlinna Central School block also presents the possibility of supplementing the block with new a building built along Lukiokatu. I lay the groundwork for my reuse plan by studying the history of Hämeenlinna Central School building complex and the history of the building site. I also explore the city’s strategy and Keskustavisio 2035 -plan to understand the needs of the city. My proposal is to change of the purpose of Hämeenlinna Central School from school building to a senior housing unit with its complementary supporting services. I will also present a new building for the block; following the guidelines of the plan proposal. I suggest this new building be a kindergarten. The aim in my proposal is to honor the values of the historical building and the site, weigh its limitations, and explore its possibilities. I also consider the city’s future visions and goals as well as financial issues in my proposal

HLA-C antibodies in women with recurrent miscarriage suggests that antibody mediated rejection is one of the mechanisms leading to recurrent miscarriage

AbstractHLA-C is the only polymorphic classical HLA I antigen expressed on trophoblast cells. It is known that higher incidence of C4d deposition on trophoblast cells is present in women with recurrent miscarriage. C4d is a footprint of antibody-mediated classical complement activation. Therefore, this study hypothesize that antibodies against HLA-C may play a role in the occurrence of unexplained consecutive recurrent miscarriage.Present case control study compared the incidence of HLA-C specific antibodies in 95 women with at least three consecutive miscarriages and 105 women with uneventful pregnancy. In the first trimester of the next pregnancy, presence and specificity of HLA antibodies were determined and their complement fixing ability. The incidence of HLA antibodies was compared with uni- and multivariate logistic regression models adjusting for possible confounders.Although in general a higher incidence of HLA antibodies was found in women with recurrent miscarriage 31.6% vs. in control subjects 9.5% (adjusted OR 4.3, 95% CI 2.0–9.5), the contribution of antibodies against HLA-C was significantly higher in women with recurrent miscarriage (9.5%) compared to women with uneventful pregnancy (1%) (adjusted OR 11.0, 95% CI 1.3–89.0). In contrast to the control group, HLA-C antibodies in the recurrent miscarriage group were more often able to bind complement.The higher incidence of antibodies specific for HLA-C in women with recurrent miscarriage suggests that HLA-C antibodies may be involved in the aetiology of unexplained consecutive recurrent miscarriage

Normal Gestational Weight Gain Protects From Large-for-Gestational-Age Birth Among Women With Obesity and Gestational Diabetes

Background: Pre-pregnancy obesity, excess gestational weight gain (GWG), and gestational diabetes (GDM) increase fetal growth. Our aim was to assess whether normal GWG is associated with lower risk for a large-for-gestational-age (LGA; over the 90th percentile of birth weight for sex and gestational age) infant and lower birth weight standard deviation (SD) score in the presence of GDM and maternal obesity. Methods: This multicenter case-control study is part of the Finnish Gestational Diabetes (FinnGeDi) Study and includes singleton pregnancies of 1,055 women with GDM and 1,032 non-diabetic controls. Women were divided into 12 subgroups according to their GDM status, pre-pregnancy body mass index (BMI; kg/m(2)), and GWG. Non-diabetic women with normal BMI and normal GWG (according to Institute of Medicine recommendations) served as a reference group. Results: The prevalence of LGA birth was 12.2% among women with GDM and 6.2% among non-diabetic women (p < 0.001). Among all women, normal GWG was associated with lower odds of LGA [odds ratio (OR) 0.57, 95% CI: 0.41-0.78]. Among women with both obesity and GDM, the odds for giving birth to a LGA infant was 2.25-fold (95% CI: 1.04-4.85) among those with normal GWG and 7.63-fold (95% CI: 4.25-13.7) among those with excess GWG compared with the reference group. Compared with excess GWG, normal GWG was associated with 0.71 SD (95% CI: 0.47-0.97) lower birth weight SD score among women with GDM and obesity. Newborns of normal weight women with GDM and normal GWG had 0.28 SD (95% CI: 0.05-0.51) lower birth weight SD scores compared with their counterparts with excess GWG. In addition, in the group of normal weight non-diabetic women, normal GWG was associated with 0.46 SD (95% CI: 0.30-0.61) lower birth weight SD scores compared with excess GWG. Conclusion: GDM, obesity, and excess GWG are associated with higher risk for LGA infants. Interventions aiming at normal GWG have the potential to lower LGA rate and birth weight SD scores even when GDM and obesity are present.Peer reviewe

Metabolic syndrome is not associated with erectile dysfunction in apparently healthy men

Aims: To investigate whether metabolic syndrome (MetS) is associated with erectile dysfunction (ED) among apparently healthy men when depressive symptoms and serum testosterone levels are taken into account.Methods: A study population of 549 men at risk for cardiovascular disease or type 2 diabetes was drawn from the participants of a population survey, the Harmonica Project. MetS was diagnosed with the United States National Cholesterol Education Program Third Adult Treatment Panel (ATPIII) 2005 definition, the International Diabetes Federation (IDF) 2005 definition and the Harmonization 2009 definition. ED was evaluated by the International Index of Erectile Function (IIEF-5) questionnaire. Depressive symptoms were assessed with Beck's Depression Inventory (BDI).Results: Of the 549 men (mean age 58.4 +/- 6.7 years), 56.5 % reported ED. The prevalence of MetS was 48.6%, 35.5%, and 50.6% according to the IDF, the ATPIII, and the Harmonization criteria, respectively. We found no difference in the prevalence of ED between men with or without MetS. In a multivariate analysis, age, presence of depressive symptoms and lower education were significant predictors of ED.Conclusions: The prevalence of ED is quite high even in apparently healthy men. Depressive symptoms are a critical component to consider in men suffering from ED. </div

Low-molecular-weight heparin for prevention of placenta-mediated pregnancy complications: protocol for a systematic review and individual patient data meta-analysis (AFFIRM)

BACKGROUND: Placenta-mediated pregnancy complications include pre-eclampsia, late pregnancy loss, placental abruption, and the small-for-gestational age newborn. They are leading causes of maternal, fetal, and neonatal morbidity and mortality in developed nations. Women who have experienced these complications are at an elevated risk of recurrence in subsequent pregnancies. However, despite decades of research no effective strategies to prevent recurrence have been identified, until recently. We completed a pooled summary-based meta-analysis that strongly suggests that low-molecular-weight heparin reduces the risk of recurrent placenta-mediated complications. The proposed individual patient data meta-analysis builds on this successful collaboration. The project is called AFFIRM, An individual patient data meta-analysis oF low-molecular-weight heparin For prevention of placenta-medIated pRegnancy coMplications. &nbsp; METHODS/DESIGN: We conducted a systematic review to identify randomized controlled trials with a low-molecular-weight heparin intervention for the prevention of recurrent placenta-mediated pregnancy complications. Investigators and statisticians representing eight trials met to discuss the outcomes and analysis plan for an individual patient data meta-analysis. An additional trial has since been added for a total of nine eligible trials. The primary analyses from the original trials will be replicated for quality assurance prior to recoding the data from each trial and combining it into a common dataset for analysis. Using the anonymized combined data we will conduct logistic regression and subgroup analyses aimed at identifying which women with previous pregnancy complications benefit most from treatment with low-molecular-weight heparin during pregnancy. &nbsp; DISCUSSION: The goal of the proposed individual patient data meta-analysis is a thorough estimation of treatment effects in patients with prior individual placenta-mediated pregnancy complications and exploration of which complications are specifically prevented by low-molecular-weight heparin. &nbsp; SYSTEMATIC REVIEW REGISTRATION: PROSPERO (International Prospective Registry of Systematic Reviews) 23 December 2013, CRD42013006249.</div

Hypoglycemia in Type 1 Diabetic Pregnancy: Role of preconception insulin aspart treatment in a randomized study

Objective: A recent randomized trial compared prandial insulin aspart (IAsp) with human insulin in type 1 diabetic pregnancy. The aim of this exploratory analysis was to investigate the incidence of severe hypoglycemia during pregnancy and compare women enrolled preconception with women enrolled during early pregnancy. Research design and methods: IAsp administered immediately before each meal was compared with human insulin administered 30 min before each meal in 99 subjects (44 to IAsp and 55 to human insulin) randomly assigned preconception and in 223 subjects (113 for IAsp and 110 for human insulin) randomly assigned in early pregnancy (<10 weeks). NPH insulin was the basal insulin. Severe hypoglycemia (requiring third-party assistance) was recorded prospectively preconception (where possible), during pregnancy, and postpartum. Relative risk (RR) of severe hypoglycemia was evaluated with a gamma frailty model. Results: Of the patients, 23% experienced severe hypoglycemia during pregnancy with the peak incidence in early pregnancy. In the first half of pregnancy, the RR of severe hypoglycemia in women randomly assigned in early pregnancy/preconception was 1.70 (95% CI 0.91–3.18, P = 0.097); the RR in the second half of pregnancy was 1.35 (0.38–4.77, P = 0.640). In women randomly assigned preconception, severe hypoglycemia rates occurring before and during the first and second halves of pregnancy and postpartum for IAsp versus human insulin were 0.9 versus 2.4, 0.9 versus 2.4, 0.3 versus 1.2, and 0.2 versus 2.2 episodes per patient per year, respectively (NS). Conclusions: These data suggest that initiation of insulin analog treatment preconception rather than during early pregnancy may result in a lower risk of severe hypoglycemia in women with type 1 diabetes

Delivery of a Small for Gestational Age Infant and Greater Maternal Risk of Ischemic Heart Disease

Background: Delivery of a small for gestational age (SGA) infant has been associated with increased maternal risk of ischemic heart disease (IHD). It is uncertain whether giving birth to SGA infant is a specific determinant of later IHD, independent of other risk factors, or a marker of general poor health. The purpose of this study was to investigate the association between delivery of a SGA infant and maternal risk for IHD in relation to traditional IHD risk factors. Methods and Findings: Risk of maternal IHD was evaluated in a population based cross-sectional study of 6,608 women with a prior live term birth who participated in the National Health and Nutrition Examination Survey (1999–2006), a probability sample of the U.S. population. Sequence of events was determined from age at last live birth and at diagnosis of IHD. Delivery of a SGA infant is strongly associated with greater maternal risk for IHD (age adjusted OR; 95 % CI: 1.8; 1.2, 2.9; p = 0.012). The association was independent of the family history of IHD, stroke, hypertension and diabetes (family historyadjusted OR; 95 % CI: 1.9; 1.2, 3.0; p = 0.011) as well as other risk factors for IHD (risk factor-adjusted OR; 95 % CI: 1.7; 1.1, 2.7; p = 0.025). Delivery of a SGA infant was associated with earlier onset of IHD and preceded it by a median of 30 (interquartile range: 20, 36) years. Conclusions: Giving birth to a SGA infant is strongly and independently associated with IHD and a potential risk factor that precedes IHD by decades. A pregnancy that produces a SGA infant may induce long-term cardiovascular changes tha

Phenotypic and genotypic differences between Indian and Scandinavian women with gestational diabetes mellitus

Objective Gestational diabetes mellitus (GDM) is a transient form of diabetes characterized by impaired insulin secretion and action during pregnancy. Population-based differences in prevalence exist which could be explained by phenotypic and genetic differences. The aim of this study was to examine these differences in pregnant women from Punjab, India and Scandinavia. Methods Eighty-five GDM/T2D loci in European and/or Indian populations from previous studies were assessed for association with GDM based on Swedish GDM criteria in 4018 Punjabi Indian and 507 Swedish pregnant women. Selected loci were replicated in Scandinavian cohorts, Radiel (N = 398, Finnish) and STORK/STORK-G (N = 780, Norwegian). Results Punjabi Indian women had higher GDM prevalence, lower insulin secretion and better insulin sensitivity than Swedish women. There were significant frequency differences of GDM/T2D risk alleles between both populations. rs7178572 at HMG20A, previously associated with GDM in South Indian and European women, was replicated in North Indian women. The T2D risk SNP rs11605924 in the CRY2 gene was associated with increased GDM risk in Scandinavian but decreased GDM risk in Punjabi Indian women. No other overlap was seen between GDM loci in both populations. Conclusions Gestational diabetes mellitus is more common in Indian than Swedish women, which partially can be attributed to differences in insulin secretion and action. There was marked heterogeneity in the GDM phenotypes between the populations which could only partially be explained by genetic differences.Peer reviewe

To which countries do European psychiatric trainees want to move to and why?

publisher: Elsevier articletitle: To which countries do European psychiatric trainees want to move to and why? journaltitle: European Psychiatry articlelink: http://dx.doi.org/10.1016/j.eurpsy.2017.06.010 content_type: article copyright: © 2017 Elsevier Masson SAS. All rights reserved.publisher: Elsevier articletitle: To which countries do European psychiatric trainees want to move to and why? journaltitle: European Psychiatry articlelink: http://dx.doi.org/10.1016/j.eurpsy.2017.06.010 content_type: article copyright: © 2017 Elsevier Masson SAS. All rights reserved.BACKGROUND: There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country. METHODS: Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration. RESULTS: A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have 'ever' considered to move to a different country in their future, 53.5% were considering it 'now', at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (2500€) incomes, personal reasons were paramount (44.5%). CONCLUSIONS: A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities