Evaluation of asthma risk index application in treating early childhood asthma

Abstract Finnish current care guidelines recommend that the treatment of asthma in young children should be based on the number of wheezing episodes and on the assessment of asthma risk profile consisting of two major and three minor criteria, constructed on the basis of the international asthma predictive index. The aim of the present study was to assess whether the current guidelines and risk profile determination are applied in the treatment of asthma in children aged less than three years. In all, 179 children aged 1-35 months were admitted for wheezing during four winter-months from 1 st Nov, 2006 to 28 th Feb. 2007. The data on treatment decisions, and major and minor asthma risk factors were retrospectively collected from patient records. Recorded data sufficient for the retrospective determination of the asthma risk profile were found for 112/179(63 %) children. Data on minor criteria were missing in almost all cases. Most of the children with data not available were first-time wheezers. Twenty-one children (19%) were on maintenance medication at admission. The decision whether or not to start maintenance medication was in line with the current care guidelines in 76/91(84 %) children. In conclusion, the treatment of asthma in young children mostly took place according to the national current care guidelines, though the application of the asthma risk profile was insufficient. The minor criteria of the asthma risk profile are not sufficiently sensible for clinical practice, and therefore need to be up-to-dated

Intermediate ions as a strong indicator of new particle formation bursts in a boreal forest

Secondary aerosol formation from gas-phase precursors is a frequent phenomenon occurring in a boreal environment. Traditionally, this process is identified visually from observational data on total and ion number size distributions. Here, we introduce a new, objective classification method for the new particle formation events based on measured intermediate-ion concentrations. The intermediate-ion concentration is a suitable indicator of new particle formation, because it is linked to the atmospheric new particle formation. The concentration of intermediate ions is typically very low (below 5 cm(-3)) when there is no new particle formation or precipitation events occurring. In this study, we analysed concentrations of negative intermediate ions at the Station for Measuring Ecosystem Atmosphere Relations (SMEAR II) in Hyytiala, Finland, during the years 2003-2013. We found that the half-hour median concentration of negative intermediate ions in sizes 2-4 nm was > 20 cm(-3) during 77.5% of event days classified by traditional method. The corresponding value was 92.3% in the case of 2-7 nm negative ions. In addition, the intermediate-ion concentration varied seasonally in a similar manner as the number of event days, peaking in the spring. A typical diurnal variation of the intermediate-ion concentration resembled that of the particle concentration during the event days. We developed here a new method for classifying new particle formation events based on intermediate-ion concentrations. The new method is complementary to the traditional event analysis and it can also be used as an automatic way of determining new particle formation events from large data sets.Peer reviewe

Toimintamalli vanhuksen toimintakyvyn arviointiin sairaalassa

Sairaalahoitoon joutuneen vanhuksen toimintakykyyn kannattaa panostaa välittömästi. TOIMIA-asiantuntijaverkoston uusi suositus ohjaa toimintakyvyn arviointiin sairaalassa, kotiutumisen suunnitteluun ja kuntoutuksen jatkuvuuteen

A long-term comparison of nighttime cluster events and daytime ion formation in a boreal forest

New particle formation (NPF) events are typically observed during daytime when photochemical oxidation takes place. However, nighttime nucleation mode particles have been observed across various locations only sporadically. We present 11 years (2003-2013) of air ion number size distribution data from the SMEAR II station in Hyytiala, Finland, where during a third of the nights a sub-3 nm negative (n = 1324 days) and positive (n = 1174 days) ion events took place. To investigate nocturnal clustering at sizes above the constant small ion pool, we defined cluster events (CE) as a nocturnal event with 2-3 nm ion concentrations reaching 70 cm-3 between 18:00 and 24:00 local time. CE (n = 221 days) were characterized by a rapid, 10-fold increase in the median 2-3 nm ion concentration from the start (similar to 10 cm(-3)) to the event peak (similar to 100 cm(-3)). Furthermore, small and intermediate ions during the CE, NPF events and nonevents were compared: while concentrations of 1.5-2 nm ions were the highest during CE (median 235 cm(-3)), as compared with the NPF events (96 cm(-3)) or the daytime and nighttime nonevents (similar to 20 cm(-3)), 3-7 nm ion concentrations increased notably only during NPF events (median 52 cm(-3)). Specifically, ion concentrations during CE decreased for sizes above-2.4 nm ( 3 nm in diameter in nighttime Hyytiald.Peer reviewe

The legacy of Finnish-Estonian air ion and aerosol workshops

Atmospheric air ions, clusters and aerosol particles participate in a variety of atmospheric processes and considerably affect e.g. global climate and human health. When measured, air ions as well as atmospheric clusters and particles have been observed to be present practically always and everywhere. In this overview, we present a brief summary of the main achievements and legacy of the series of workshops organized mainly by the University of Helsinki and the University of Tartu. The legacy covers the development and standardization of new instruments, such as ion spectrometers, mass spectrometers and aerosol particle counters, as well as work toward theoretical understanding of new-particle formation and evolution of atmospheric clusters. One important legacy is the establishment of the SMEAR-Estonia station at Jarvselja.Peer reviewe

Iäkkäiden henkilöiden lyhytaikaiseen sairaalahoitoon liittyvä toimintakyvyn arviointi kuntoutumisen käynnistäjänä

TOIMIA-suositu

Measuring atmospheric ion bursts and their dynamics using mass spectrometry

Atmospheric ions are produced after a cascade of reactions starting from initial ionization by high energetic radiation. Such ionization bursts generate ions that rapidly react and generate a suite of ion products. Primary ions are in the atmosphere originate from radioactive decay, gamma radiation from the soil or cosmic ray events. In this work, we modified an existing instrumentation and developed a novel setup for detecting ion bursts. The setup consists of a continuous flow ionization chamber coupled to Atmospheric Pressure interface Time-Of-Flight (APi-TOF) mass spectrometer. The APi-TOF sampling rate was set to 100 Hz in order to detect individual ion bursts from ionization events. Besides counting the individual ionization events, the developed setup is able to follow the rapidly changing chemical composition of ions during ion burst cascade. The setup can give us insights into the primary ionization mechanisms and their importance in atmospheric ion and aerosol dynamics.Peer reviewe