442 research outputs found
Composition of weed flora in spring cereals in Finland
vokKirjasto Aj-kKevätviljapeltojen rikkakasvit ja niiden runsau
Fysioterapeuttinen hoito TMD-potilaalla:tapaussarja
Tiivistelmä. Purentaelimistön toimintahäiriöt (TMD) on väestössä yleisenä esiintyvä vaiva, jonka oirekirjo on laaja ja hoidontarve vaihteleva. Oireina ilmenee useimmin leukanivelten, puremalihasten sekä kasvojen alueen kiputiloja, päänsärkyä, alaleuan liikehäiriöitä sekä heijastekipuja pään ja kaulan alueella. TMD-oireiden vaikutukset toimintakykyyn ovat osalla potilasryhmästä merkittäviä. Hoidontarvetta TMD:n vuoksi ilmenee noin 7–9% :lla väestöstä.
Käsitys niskan ja kaulan alueen biomekaanisten tekijöiden yhteydestä TMD-oireiluun on lisääntynyt viimeaikaisten tutkimusten myötä, mikä on ohjannut ajattelemaan myös TMD-potilaan hoitoa laaja-alaisemmin, myös varsinaisen purentaelimistön ulkopuolelle. Fysioterapia hoitomuotona ja erityisesti fyysisen harjoittelun menetelmät keskittyvät toiminnallisuuteen ja sen kautta oireiden lievittymiseen TMD:n hoidossa. Näyttö fysioterapian eri menetelmien tuloksellisuudesta TMD:n hoitomuotoina on kuitenkin vielä melko vähäistä ja sitä kaivataan lisää.
Tämä tapaussarja koostuu kolmelle koehenkilölle toteutetusta yksilöllisestä fysioterapiahoitojaksosta. Koehenkilöiksi valikoitiin henkilöt, joilla oli diagnosoituna lihasperäinen TMD, ja oirekuvaan oli liittynyt niskakipua. Henkilöt täyttivät ennen tutkimusta purentaelimistön toimintahäiriöiden diagnosoimiseen laaditun Diagnostic Criteria for Temporomandibular disorders (DC/TMD) -oirekyselyn, ja heille tehtiin kliininen tutkimus DC/TMD-protokollan mukaisesti. Koehenkilöt osallistuivat fysioterapeutin toteuttamaan fysioterapiahoitoon, joka sisälsi kolme tai neljä terapiakäyntiä. Lisäksi tutkimukseen sisältyi fysioterapeutin ja hammaslääkärin toteuttamat alkututkimukset sekä hoitokokeilun päätteeksi loppumittaukset. Kipuja ja muita oireita sekä niiden vaikutuksia toimintakykyyn kartoitettiin sekä tutkimusjakson alussa että lopussa DC/TMD (Axis I ja Axis II), Neck Disability Index (NDI) ja Örebron (lyhyt versio) -kyselyillä. Lisäksi koehenkilöt piirsivät kipukuviin kipuoireidensa lokalisaatiot alkututkimusten yhteydessä (Liitteet 1–3). DC/TMD -kysymyspatteristosta käytössä oli TMD oirekysely (DC/TMD-FIN) sekä Kivun haitta-aste (GCPS 2.0_FIN), josta laskettiin kasvokivun intensiteettiä kuvaava Characteristic Pain Intencity (CPI) sekä haitta-astetta kuvaava GCPS-indeksi (I-IV, matala intensiteetti — korkea intensiteetti — kohtalaisesti rajoittava — vaikeasti rajoittava). Koehenkilöiden kokemuksia fysioterapeuttisesta hoidosta kartoitettiin Palaute fysioterapeuttisesta hoidosta -kyselylomakkeella hoitojakson lopuksi. Fysioterapiamenetelmänä käytettiin yksilöllisesti suunniteltua harjoitusohjelmaa tähdäten sen säännölliseen toteuttamiseen omatoimiharjoitteluna, sekä lisäksi fysioterapeutin toteuttamia manuaalisia käsittelyitä vastaanottokäynneillä. Tutkimuksen tavoitteena oli arvioida fysioterapeuttisen hoidon vaikutuksia oireisiin, kuten kipuun ja päänsärkyyn, lihasperäisen TMD:n tapauksissa.
Tutkimuksen tuloksista havaittiin niskakivun vähentyneen kaikilla koehenkilöillä hoitojakson aikana niskakivun vaikutuksia päivittäisiin toimintoihin kuvaavalla Neck Disability Index (NDI) mitattuna. Kasvokivun elämänlaadullisen haitta-asteen arvioi terapiajakson aikana vähentyneen yksi koehenkilöistä, kun sen arvioimiseen käytettiin Graded Chronic Pain Scale, (GCPS)-indeksiä. Örebron työkyvyttömyyden riskiä arvioivan kyselyn perusteella havaittiin kahden koehenkilön osalta työkyvyttömyysriskin pienenemää terapiajakson aikana, kun taas yhden henkilön osalta työkyvyttömyysriskin kanssa korreloivat pisteet nousivat terapiajakson alku- ja loppumittausten välillä.
Tutkimuksen tulokset fysioterapian vaikutuksista TMD-potilaiden kokemiin oireisiin sekä niiden haittavaikutuksiin tukevat osaltaan aiempaa näkemystä fysioterapian mahdollisuuksista osana TMD-potilaan kokonaishoitoa. Tutkimus luo hyvän pohjan jatkotutkimusasetelman muodostamiselle aiheesta ja fysioterapiamenetelmien tuloksellisuuden tarkemmalle arvioinnille.Physiotherapeutic treatment on a TMD-patient : a case series. Abstract. Temporomandibular disorder (TMD) is a common condition in a population with wide of symptoms and with varying need for a treatment. Typical symptoms include pain in the temporomandibular joints, masseter muscles and facial area, headache, mandibular dysfunction and reflective pain both in head and neck region. TMD symptoms have significant effects on a performance in some patients. 7–9% of population require a treatment for TMD.
Recent studies have increased the understanding of the association of head and neck biomechanical factors for TMD symptoms. This has led thinking the treatment of TMD patient more broadly, also outside the actual occlusal system. Physiotherapy and physical training focus on enhancing functionality and thereby alleviation of symptoms in the TMD treatment. However, evidence for the effectiveness of different physiotherapy methods as a treatment for TMD is still rather limited and a further research is required on this topic.
This case series consisted of an individual physiotherapy treatment session for three patients. Control subjects were diagnosed with a muscular TMD and they all suffered from a symptomatic neck pain. Subjects filled the Diagnostic Criteria for Temporomandibular Disorder (DC/TMD) symptoms query prior to the study, and they underwent a clinical study according to the DC/TMS protocol. Subjects participated in a physiotherapy treatment, including three to four therapy visits, that were performed by a physiotherapist, as well as final measurements at the end of the treatment trial. Pain and other symptoms and their effects on performance were investigated both at the beginning and at the end of the study using DC/TMD (Axis I and Axis II), Neck Disability Index (NDI) and Örebro (a short version) surveys. In addition, subjects marked the localizations of their pain symptoms on pain images as a part of their initial studies (Appandices 1–3). Subjects’ experience of physiotherapeutic treatment were mapped using the ‘Feedback of Physiotherapeutic Treatment’ questionnaire at the end of the treatment period. The utilized physiotherapy method in this study was an individually designed exercise program which aimed at its regular implementation as a self-practise. It also included manual treatments performed by a physiotherapist during the reception visits. The aim of this study was to evaluate the effects of physiotherapeutic treatment on symptoms such as pain and headache in a muscular based TMD.
The reduction of a neck pain was seen in all three subjects during the treatment period was measured by the NDI. Moreover, the disability degree caused by the fascial pain was decreased in one subject during the treatment period as estimated by the GCPS-index. Based on the Örebro Disability Risk Questionnaire, a decrease in disability risk was observed in two subjects during the treatment period, while for one subject, scores correlating with a disability risk were increased between baseline and final measurements.
The results are in line with prior studies, suggesting that physiotherapeutic treatment may be beneficial as part of the overall treatment of a TMD patient. This study creates a good basis for the formation of a set of further research on this topic, and for a more accurate evaluation of the effectiveness of physiotherapy methods
Global warming will affect the maximum potential abundance of boreal plant species
Forecasting the impact of future global warming on biodiversity requires understanding how temperature limits the distribution of species. Here we rely on Liebig's Law of Minimum to estimate the effect of temperature on the maximum potential abundance that a species can attain at a certain location. We develop 95%‐quantile regressions to model the influence of effective temperature sum on the maximum potential abundance of 25 common understory plant species of Finland, along 868 nationwide plots sampled in 1985. Fifteen of these species showed a significant response to temperature sum that was consistent in temperature‐only models and in all‐predictors models, which also included cumulative precipitation, soil texture, soil fertility, tree species and stand maturity as predictors. For species with significant and consistent responses to temperature, we forecasted potential shifts in abundance for the period 2041–2070 under the IPCC A1B emission scenario using temperature‐only models. We predict major potential changes in abundance and average northward distribution shifts of 6–8 km yr−1. Our results emphasize inter‐specific differences in the impact of global warming on the understory layer of boreal forests. Species in all functional groups from dwarf shrubs, herbs and grasses to bryophytes and lichens showed significant responses to temperature, while temperature did not limit the abundance of 10 species. We discuss the interest of modelling the ‘maximum potential abundance’ to deal with the uncertainty in the predictions of realized abundances associated to the effect of environmental factors not accounted for and to dispersal limitations of species, among others. We believe this concept has a promising and unexplored potential to forecast the impact of specific drivers of global change under future scenarios.202
Oraalinen antikoagulaatiohoito sydänsairauksissa
Sydänpotilailla antikoagulaatiolääkityksen tärkeimmät käyttöaiheet ovat eteisvärinä, mekaaninen tekoläppä ja vaikea hiippaläpän ahtauma. Muissa sydänsairauksissa antikoagulaatiohoitoa ei yleensä käytetä, ellei liitännäissairaus edellytä sitä. Vakaassa sepelvaltimotaudissa riittää yleensä suora antikoagulantti tai varfariini yksinään. Asetyylisalisyylihapon tai ADP-reseptorin salpaajan samanaikainen käyttö lisää vuotovaaraa. Tavanomaisissa sydäntoimenpiteissä hoitoa ei yleensä tauoteta.Peer reviewe
The role of surfactants in Köhler theory reconsidered
International audienceAtmospheric aerosol particles typically consist of inorganic salts and organic material. The inorganic compounds as well as their hygroscopic properties are well defined, but the effect of organic compounds on cloud droplet activation is still poorly characterized. The focus of the present study is the organic compounds that are surface active i.e. tend to concentrate on droplet surface and decrease the surface tension. Gibbsian surface thermodynamics was used to find out how partitioning between droplet surface and the bulk of the droplet affects the surface tension and the surfactant bulk concentration in droplets large enough to act as cloud condensation nuclei. Sodium dodecyl sulfate (SDS) was used together with sodium chloride to investigate the effect of surfactant partitioning on the Raoult effect (solute effect). While accounting for the surface to bulk partitioning is known to lead to lowered bulk surfactant concentration and thereby to increased surface tension compared to a case in which the partitioning is neglected, the present results show that the partitioning also alters the Raoult effect, and that the change is large enough to further increase the critical supersaturation and hence decrease cloud droplet activation. The fraction of surfactant partitioned to droplet surface increases with decreasing droplet size, which suggests that surfactants might enhance the activation of larger particles relatively more thus leading to less dense clouds. Cis-pinonic acid-ammonium sulfate aqueous solutions were studied in order to study the partitioning with compounds found in the atmosphere and to find out the combined effects of dissolution and partitioning behavior. The results show that the partitioning consideration presented in this paper alters the shape of the Köhler curve when compared to calculations in which the partitioning is neglected either completely or in the Raoult effect. In addition, critical supersaturation was measured for SDS particles with dry radii of 25-60nm using a static parallel plate Cloud Condensation Nucleus Counter. The experimentally determined critical supersaturations agree very well with theoretical calculations taking the surface to bulk partitioning fully into account and are much higher than those calculated neglecting the partitioning
2-Iodo-imidazolium receptor binds oxoanions via charge-assisted halogen bonding.
A detailed (1)H-NMR study of the anion binding properties of the 2-iodo-imidazolium receptor 1 in DMSO allows to fully attribute the observed affinities to strong charge-assisted C-IX(-) halogen bonding (XB). Stronger binding was observed for oxoanions over halides. Phosphate, in particular, binds to 1 with an association constant of ca. 10(3) M(-1), which is particularly high for a single X-bond. A remarkably short C-IO(-) contact is observed in the structure of the salt 1·H(2)PO(4)(-)
The quality of warfarin therapy and CHA(2)DS(2)-VASc score associate with the incidence of myocardial infarction and cardiovascular outcome in patients with atrial fibrillation : data from the nationwide FinWAF Registry
Aims The impact of the quality of warfarin therapy on cardiovascular outcomes excluding stroke is largely unknown. The aims of this study were to evaluate the association between the warfarin control and the incidence and outcome of myocardial infarction (MI) and to validate the predictive value of the CHA2DS2-VASc score for MI in atrial fibrillation (AF) patients taking warfarin. Methods and results The nationwide FinWAF Registry consists of 54 568 AF patients (mean age 73.31 +/- 10.7 years, 52% men) taking warfarin. The quality of warfarin therapy was assessed continuously by calculating the time in therapeutic range within a 60-day window using the Rosendaal method (TTR60). Adjusted Cox proportional hazards models were prepared for the incidence of MI and cardiovascular mortality in six different TTR60 categories. During the 3.2 +/- 1.6 years of follow-up, the annual incidence of MI (95% confidence interval) was 3.3% (3.0-3.5%), 2.9% (2.6-3.3%), 2.4% (2.1-2.7%), 1.9% (1.7-2.2%), 1.7% (1.5-2.0%), and 1.2% (1.1-1.3%) among patients with TTR60 80%, respectively. Well-managed warfarin therapy (TTR60 >80%) was associated also with a lower cardiovascular mortality, whereas a high CHA(2)DS(2)-VASc score correlated with poor outcome. Conclusion Cardiovascular outcome was superior among AF patients with good warfarin control and in those with a low CHA(2)DS(2)-VASc score. The inverse association between the TTR60 and incidence of MI and cardiovascular mortality indicate that in AF patients the quality of warfarin therapy is critical not only for prevention of stroke but also with regard to cardiovascular outcome.Peer reviewe
Theories of Reference: What Was the Question?
The new theory of reference has won popularity. However, a number of noted philosophers have also attempted to reply to the critical arguments of Kripke and others, and aimed to vindicate the description theory of reference. Such responses are often based on ingenious novel kinds of descriptions, such as rigidified descriptions, causal descriptions, and metalinguistic descriptions. This prolonged debate raises the doubt whether different parties really have any shared understanding of what the central question of the philosophical theory of reference is: what is the main question to which descriptivism and the causal-historical theory have presented competing answers. One aim of the paper is to clarify this issue. The most influential objections to the new theory of reference are critically reviewed. Special attention is also paid to certain important later advances in the new theory of reference, due to Devitt and others
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