Finland’s forests 2018

Luken kirjat, raportit, oppaat ja esitteet201

Language motivation in a reconfigured Europe: access, identity, autonomy

In this paper, I propose that we need to develop an appropriate set of conceptual tools for examining motivational issues pertaining to linguistic diversity, mobility and social integration in a rapidly changing and expanding Europe. I begin by drawing on research that has begun to reframe the concept of integrative motivation in the context of theories of self and identity. Expanding the notion of identity, I discuss the contribution of the Council of Europe's European Language Portfolio in promoting a view of motivation as the development of a plurilingual European identity and the enabling of access and mobility across a multilingual Europe. Next, I critically examine the assumption that the individual pursuit of a plurilingual identity is unproblematic, by highlighting the social context in which motivation and identity are constructed and embedded. To illuminate the role of this social context, I explore three inter-related theoretical frameworks: poststructuralist perspectives on language motivation as 'investment'; sociocultural theory; and theories of autonomy in language education. I conclude with the key message that, as with autonomy, language motivation today has an inescapably political dimension of which we need to take greater account in our research and pedagogical practice

Driving pressure during general anesthesia for open abdominal surgery (DESIGNATION) : study protocol of a randomized clinical trial

Background Intraoperative driving pressure (Delta P) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (V-T) is kept constant, Delta P may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. Delta P may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery. Methods The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged >= 18 years and with a body mass index <= 40 kg/m(2), scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) ("individualized high PEEP") or one in which PEEP of 5 cm H2O without RM is used ("low PEEP"). In the "individualized high PEEP" group, PEEP is set at the level at which Delta P is lowest. In both groups of the trial, V-T is kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events. Discussion DESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery

Comparison of integrative nature conservation in forest policy in Europe: a qualitative pilot study of institutional determinants

In this pilot study, we examine the relationship between the organisation of property rights and the economic importance of forestry on the one hand and the degree to which integrative nature conservation is formally implemented in forest policy on the other hand. Further, we are interested in whether political institutions moderate this relationship. We first offer a conceptualization of integrative nature conservation in forests and how to measure its implementation in law, ordinances and private agreements for a sample of European national and sub-national jurisdictions (Austria, Croatia, Finland, France, the Netherlands, Switzerland, Flanders, Baden-Württemberg and Piedmont). We subsequently try to assess the implementation of these rules and to relate them both to the structural characteristics of forestry and to an appraisal of pluralism in forest policy. Our qualitative analysis reveals that among the jurisdictions with a more centralized and corporatist forest policy, integrative nature conservation in forests tend to be less formally implemented the more corporatism dominates decision-making. It also confirms the expectation that among the more consensual jurisdictions with a strong forestry sector, rules tend to be less formally implemented. Further, the suspicion prevails that in the latter case, such rules are either complemented with exceptions for private forests or higher compensation. A more in-depth comparative examination is needed to further corroborate these findings

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research