Koronapandemian vaikutus Rokua Geoparkin matkailuun

Tiivistelmä. Keväällä 2020 koronapandemia ja siihen liittyvät matkustusrajoitukset romahduttivat maailman matkailukysynnän ja myös Suomen pitkään kasvussa ollut matkailu pysähtyi. Koronapandemian vaikutukset Suomen matkailuun eivät kuitenkaan olleet pelkästään negatiivisia, sillä sen myötä kotimaan matkailu ja pitkään suosiossa ollut retkeily lisääntyi. Tässä tutkielmassa tarkastellaan koronapandemian vaikutuksia Rokua Geoparkin matkailuun. Tutkimuksen keskeisenä tavoitteen on selvittää, miten pandemian on vaikuttanut matkailijoiden kokonaismäärään ja millaisia muutoksia matkailijoiden käyttäytymisessä on havaittu. Lisäksi tarkastellaan, millaisia muutoksia matkailussa on tapahtunut vuosien 2020–2022 välillä ja mitkä ovat Rokua Geoparkin matkailun näkymät tulevaisuudessa. Työn teoriaosuudessa käsitellään koronapandemiaa ja sen vaikutuksia matkailuun. Lisäksi tarkastellaan resilienssin käsitettä useista eri näkökulmista. Resilienssi sopii tutkielmani aiheeseen, sillä se auttaa ymmärtämään, miten Rokua Geoparkin matkailu ja matkailuyritykset ovat selvinneet koronapandemiasta ja miten ne voivat sopeutua vastaaviin tilanteisiin tulevaisuudessakin. Teoriaosuudessa esitellään myös tutkimusalue, eli Rokua Geopark, ja sen tarjoamat matkailumahdollisuudet. Työn empiirinen osuus koostuu puolistrukturoiduista teemahaastatteluista, joihin osallistui 10 Rokua Geoparkin matkailuyritystä. Haastattelujen tarkoituksena oli selvittää, miten pandemia on vaikuttanut Rokua Geoparkin matkailuyritysten toimintaan ja saatujen tulosten perusteella arvioitiin, miten koronapandemia on vaikuttanut Rokua Geoparkin matkailuun kokonaisuudessaan. Haastattelusta saatujen tulosten perusteella Rokua geoparkin matkailun suosio lisääntyi pandemian aikana. Kotimaisia matkailijoita kävi niin paljon, että he korvasivat ulkomaalaisten kävijöiden vähenemisen. Vuonna 2022 kun koronarajoituksista luovuttiin, Rokua Geoparkin asiakasmäärä palasi ennalleen, ja ulkomaalaisten matkailijoiden määrä alkoi jälleen kasvaa. Tulosten perusteella Rokua Geoparkin matkailu selvisi kaiken kaikkiaan hyvin koronapandemiasta ja sen resilienssi osoittautui melko vahvaksi. Rokua Geopark tarjoaa paljon palveluita, joihin koronarajoitukset eivät vaikuttaneet ja Rokua Geoparkin matkailu ei ole riippuvainen kansainvälisistä matkailijoista tai matkailuyrityksistä, joihin pandemiarajoitukset vaikuttivat. Tämän perusteella Rokua Geoparkin matkailu tulee selviämään vastaavista kriiseistä hyvin myös tulevaisuudessa

Pelko julkisessa kaupunkitilassa ja uutisoinnin vaikutus siihen

Tiivistelmä. Tässä kirjallisuuskatsauksessa tarkastelen pelkoa julkisessa kaupunkitilassa ja uutisoinnin vaikutusta siihen. Erilaiset pelot ovat usein julkiseen kaupunkitilaan liitettyjä ilmiöitä. Kaupungit on rakennettu alun perin turvapaikoiksi suojaamaan ulkopuoliselta uhalta, mutta nykyään ne nähdään ennemminkin pelon paikkoina, joissa pelon kohteena ovat toiset ihmiset. Myös tilan ominaisuudet ja ympäristöstä luettavat merkit, kuten graffitit voivat aiheuttaa pelkoa. Ihmisen fyysiset ominaisuudet kuten ikä, etninen tausta ja etenkin sukupuoli vaikuttavat julkisessa tilassa koettuun pelkoon. Esimerkiksi naiset ovat tutkitusti miehiä pelokkaampia. Myös yksilön luonteella ja omilla kokemuksilla on vaikutusta koettuun pelkoon, mutta pääosin pelko on kuitenkin sosiaalisesti tuotettua. Pelko ei aina kuitenkaan ole verrannollista pelon kohteeseen. Esimerkiksi rikoksen pelko on noussut, vaikka rikollisuus todellisuudessa ei ole lisääntynyt. Uutisoinnin ajatellaan olevan keskeisessä roolissa, kun puhutaan julkiseen kaupunkitilaan liittyvistä peloista. Rikosuutisointi on lisääntynyt samanaikaisesti kasvavan rikoksen pelon kanssa, mutta niistä kumpikaan ei johdu todellisen rikollisuuden kasvusta. Usein aktiivisesti uutisia seuraavat ihmiset ovat muita pelokkaampia, mutta toisaalta muita pelokkaammat ihmiset päätyvät todennäköisemmin lukemaan rikosuutisia. Uutisointi on myös liitetty yhdeksi pelon kulttuurin syntyyn vaikuttavaksi tekijäksi, mutta toisaalta pelon kulttuurin on nähty aiheuttavan rikoksen pelon ja rikosuutisoinnin nousua. Uutisointi ja pelko ovat siis yhteydessä toisiinsa, mutta niiden välinen suhde ei ole täysin yksisuuntaista

Bioavailability, Antipsoriatic Efficacy and Tolerability of a New Light Cream with Mometasone Furoate 0.1%

Mometasone furoate, a potent glucocorticoid (class III) with a favorable benefit/risk ratio, has emerged as a standard medication for the treatment of inflammatory skin disorders. The purpose of the investigation presented here was to determine the noninferiority of a topical mometasone formulation, a light cream (O/W 60/40 emulsion) with mometasone furoate 0.1% (water content of 33%) versus marketed comparators. Using the vasoconstrictor assay, a strong blanching effect of the new cream (called Mometasone cream) comparable to that of a mometasone comparator, a fatty cream with mometasone furoate 0.1%, could be demonstrated. Thus, the topical bioavailability of the active ingredient mometasone furoate (0.1%) was regarded to be similar for Mometasone cream and the mometasone comparator. Using the psoriasis plaque test, a strong antipsoriatic effect comparable to that of the mometasone comparator was found for Mometasone cream after 12 days of occlusive treatment. A nearly identical reduction in the mean infiltrate thickness and similar mean AUC values were noted with both formulations confirmed by clinical assessment data. The noninferiority of Mometasone cream to its active comparator with re-spect to the AUC of change to baseline in infiltrate thickness was demonstrated. Both medications were well tolerated. Overall, Mometasone cream and the mometasone comparator showed similar efficacy and tolerability. Mometasone cream, in addition to its high potency and good tolerability, provides the properties of a light cream, which might make this new medication particularly suitable for application on acutely inflamed and sensitive skin. Copyright (C) 2012 S. Karger AG, Base

Gastrointestinal manifestations after Roux-en-Y gastric bypass surgery in individuals with and without type 2 diabetes

Background: Roux-en-Y gastric bypass (RYGB) surgery is an effective treatment for obesity, which improves cardiovascular health and reduces the risk of premature mortality. However, some reports have suggested that RYGB may predispose patients to adverse health outcomes, such as inflammatory bowel disease (IBD) and colorectal cancer. Objectives: The present prospective study aimed to evaluate the impact of RYGB surgery on cardiovascular risk factors and gastrointestinal inflammation in individuals with and without type 2 diabetes (T2D). Setting: University hospital setting in Finland. Methods: Blood and fecal samples were collected at baseline and 6 months after surgery from 30 individuals, of which 16 had T2D and 14 were nondiabetics. There were also single study visits for 6 healthy reference patients. Changes in cardiovascular risk factors, serum cholesterol, and triglycerides were investigated before and after surgery. Fecal samples were analyzed for calprotectin, anti-Saccharomyces cerevisiae immunoglobulin A antibodies (ASCA), active lipopolysaccharide (LPS) concentration, short-chain fatty acids (SCFAs), intestinal alkaline phosphatase activity, and methylglyoxal-hydro-imidazolone (MG-H1) protein adducts formation. Results: After RYGB, weight decreased on average 221.6% (-27.2 +/- 7.8 kg), excess weight loss averaged 51%, and there were improvements in cardiovascular risk factors. Fecal calprotectin levels (P < .001), active LPS concentration (P < .002), ASCA (P < .02), and MG-H1 (P < .02) values increased significantly, whereas fecal SCFAs, especially acetate (P < .002) and butyrate (P < .03) levels, were significantly lowered. Conclusion: The intestinal homeostasis is altered after RYGB, with several fecal markers suggesting increased inflammation; however, clinical significance of the detected changes is currently uncertain. As chronic inflammation may predispose patients to adverse health effects, our findings may have relevance for the suggested association between RYGB and increased risks of incident IBD and colorectal cancer. (C) 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.Peer reviewe

Total fecal IgA levels increase and natural IgM antibodies decrease after gastric bypass surgery

Obesity is associated with low-grade inflammation and increased systemic oxidative stress. Roux-en-Y gastric bypass (RYGB) surgery is known to ameliorate the obesity-induced metabolic dysfunctions. We aimed to study the levels of natural antibodies in feces, before and 6 months after RYGB surgery in obese individuals with and without type 2 diabetes (T2D). Sixteen individuals with T2D and 14 non-diabetic (ND) individuals were operated. Total IgA, IgG and IgM antibody levels and specific antibodies to oxidized low-density lipoprotein (oxLDL), malondialdehyde-acetaldehyde adducts (MAA adducts), Porphyromonas gingivalis gingipain A hemagglutinin domain (Rgp44) and phosphocholine (PCho) were measured using chemiluminescence immunoassay. Total fecal IgA was elevated, while total IgM and IgG were not affected by the surgery. Fecal natural IgM specific to oxLDL decreased significantly in both T2D and ND individuals, while fecal IgM to Rgp44 and PCho decreased significantly in T2D individuals. A decrease in IgG to MAA-LDL, Rgp44 and PCho was detected. RYGB surgery increases the levels of total fecal IgA and decreases fecal natural IgG and IgM antibodies specific to oxLDL. Natural antibodies and IgA are important in maintaining the normal gut homeostasis and first-line defense against microbes, and their production is markedly altered with RYGB surgery.Peer reviewe

Matrix-metalloproteinase-2,-8 and-9 in serum and skin blister fluid in patients with severe sepsis

Peer reviewe

Study on the clinical application of pulsed DC magnetic technology for tracking of intraoperative head motion during frameless stereotaxy

BACKGROUND: Tracking of post-registration head motion is one of the major problems in frameless stereotaxy. Various attempts in detecting and compensating for this phenomenon rely on a fixed reference device rigidly attached to the patient's head. However, most of such reference tools are either based on an invasive fixation technique or have physical limitations which allow mobility of the head only in a restricted range of motion after completion of the registration procedure. METHODS: A new sensor-based reference tool, the so-called Dynamic Reference Frame (DRF) which is designed to allow an unrestricted, 360° range of motion for the intraoperative use in pulsed DC magnetic navigation was tested in 40 patients. Different methods of non-invasive attachment dependent on the clinical need and type of procedure, as well as the resulting accuracies in the clinical application have been analyzed. RESULTS: Apart from conventional, completely rigid immobilization of the head (type A), four additional modes of head fixation and attachment of the DRF were distinguished on clinical grounds: type B1 = pin fixation plus oral DRF attachment; type B2 = pin fixation plus retroauricular DRF attachment; type C1 = free head positioning with oral DRF; and type C2 = free head positioning with retroauricular DRF. Mean fiducial registration errors (FRE) were as follows: type A interventions = 1.51 mm, B1 = 1.56 mm, B2 = 1.54 mm, C1 = 1.73 mm, and C2 = 1.75 mm. The mean position errors determined at the end of the intervention as a measure of application accuracy were: 1.45 mm in type A interventions, 1.26 mm in type B1, 1.44 mm in type B2, 1.86 mm in type C1, and 1.68 mm in type C2. CONCLUSION: Rigid head immobilization guarantees most reliable accuracy in various types of frameless stereotaxy. The use of an additional DRF, however, increases the application scope of frameless stereotaxy to include e.g. procedures in which rigid pin fixation of the cranium is not required or desired. Thus, continuous tracking of head motion allows highly flexible variation of the surgical strategy including intraoperative repositioning of the patient without impairment of navigational accuracy as it ensures automatic correction of spatial distortion. With a dental cast for oral attachment and the alternative option of non-invasive retroauricular attachment, flexibility in the clinical use of the DRF is ensured

Long-Term Survival After Transhiatal Versus Transthoracic Esophagectomy: A Population-Based Nationwide Study in Finland

Background No population-based studies comparing long-term survival after transhiatal esophagectomy (THE) and transthoracic esophagectomy (TTE) exist. This study aimed to compare the 5-year survival of esophageal cancer patients undergoing THE or TTE in a population-based nationwide setting. Methods This study included all curatively intended THE and TTE for esophageal cancer in Finland during 1987-2016, with follow-up evaluation until 31 December 2019. Cox proportional hazard models provided hazard ratios (HRs) with 95% confidence intervals (CIs) of 5-year and 90-day mortality. The results were adjusted for age, sex, year of operation, comorbidities, histology, neoadjuvant treatment, and pathologic stage. Results A total of 1338 patients underwent THE (n = 323) or TTE (n = 1015). The observed 5-year survival rate was 39.3% after THE and 45.0% after TTE (p = 0.072). In adjusted model 1, THE was not associated with greater 5-year mortality (HR 0.99; 95% CI 0.82-1.20) than TTE. In adjusted model 2, including T stage instead of pathologic stage, the 5-year mortality hazard rates after THE (HR 0.87, 95% CI 0.72-1.05) and TTE were comparable. The 90-day mortality rate for THE was higher than for TTE (adjusted HR 0.72; 95% CI 0.45-1.14). In subgroup analyses, no differences between THE and TTE were observed in Siewert II gastroesophageal junction cancers, esophageal cancers, or pN0 tumors, nor in the comparison of THE and TTE with two-field lymphadenectomy. The sensitivity analysis, including patients with missing patient records, who underwent surgery during 1996-2016 mirrored the main analysis. Conclusions This Finnish population-based nationwide study suggests no difference in 5-year or 90-day mortality after THE and TTE for esophageal cancer.</p