Antidiabeetilise ravi valik ja ravikombinatsioonid. Kuidas on muutunud meie arusaamine diabeedi ravist?

Eesti Arst 2016; 95(10):673–68

Political neutrality or editorial slant? Comparing coverage and content of Estonia’s largest nationwide daily newspapers

This thesis studied whether there exists a form of media bias in the two of the largest news outlets Postimees and Eesti Päevaleht in Estonia. The study coded a combination of 258 editorials that were taken from the timeframe between 26th of October of 2020 to 26th of April of 2021. The found data was used to compare the outlets differences in issue bias and framing bias. Issue bias consists of the coverage of policy issues, policy actors, and an ideological leniency. Framing bias consists of an outlet providing either positive or negative opinions and statements on political actors that would show either preferences towards political actors or a strong deviation from media neutrality. The analyses showed differences in policy issue coverage but not in political actor coverage. Furthermore, an ideological leniency was not detected for either outlet. Both outlets showed a deviation from media neutrality with average negative scores towards both political actors and respective coalitions in the timeframe. Moreover, Eesti Päevaleht was found to be much more negative and likely to criticise political actors whilst the attitudes of Postimees were comparatively less often and milder.https://www.ester.ee/record=b5508348*es

Reieluu proksimaalse osa murru diagnoosiga patsientide taastusravi Eestis aastatel 2009–2017

Väitekirja elektrooniline versioon ei sisalda publikatsiooneReieluu puusaliigese piirkonna murd on üks kõige sagedasemaid ja raskemaid traumasid eakatel. Sellise murruga haigete prognoos on tõsine – murrust taastumine võib võtta üle aasta. Suurel osal haigetest ei taastu varasem kehaline võimekus, mistõttu väheneb või kaob nende iseseisvus igapäevatoimetustega hakkamasaamisel. Eelnevast tulenevalt on sellise murruga haigete ravi üks alussammastest järjepidev, koordineeritud taastusravi. Eestis saab iga päev keskmiselt 3–4 inimest sellise murru diagnoosi. Varasemalt on leitud, et siinsete haigete ravitulemused on võrdlemisi kasinad, mis võivad olla tingitud puudulikust ravikäsitlusest. See-eest on ravikäsitlus, seal hulgas taastusravi, Eestis põhjalikult uurimata. Käesoleva doktoritöö eesmärk oli hinnata esmase reieluu puusaliigese piirkonna murru diagnoosiga haigete taastusravi Eestis aastatel 2009–2017 ja selle vastavust rahvusvaheliste ravijuhiste soovitustele. Täpsemalt keskenduti osutatud füsioteraapia mahu uurimisele. Lisaks hinnati antud diagnoosiga haigete elulemust. Uuringusse kaasati 11 491 haiget, kelle taastusravi oli vastuolus mitmes rahvusvahelises ravijuhises toodud soovitustega. Aktiiv- ja järelravis nägi füsioteraapia pakkumine välja järgmine: 8-päevane aktiivravi oli võrdlemisi lühike, jättes enamiku taastumisest järelravi kanda. Aktiivravi ajal ei saanud 24% haigetest füsioteraapiat. Aktiivravi järel ei saanud 60% haigetest füsioteraapiat ning ülejäänud said seda võrdlemisi väikeses koguses (mediaan 6 tundi). Lisaks esines mitmekordne maakondade vaheline ja sisene ebavõrdsus peale aktiivravi kasutatud füsioteraapia mahus. Ajaliste suundumuste analüüs näitas probleemide püsimist või süvenemist üheksa-aastasel perioodil: 2017. aastal ei saanud pooled haigetest endiselt aktiivravi järel füsioteraapiat; füsioteraapiatundide jagumise ebaühtlustumist haigete vahel; maakondade vaheline ja sisene ebavõrdsus säilis või hoopiski suurenes. Puudulik taastusravi võib selgitada vaadeldud diagnoosiga haigete võrdlemisi kõrget suremust alates kolmandast kuust pärast murdu. Kokkuvõttes esinesid Eestis olulised puudujäägid reieluu puusaliigese piirkonna murru ravi ühes alussambas, taastusravis. Doktoritöö tulemused näitavad vajadust praeguse süsteemi ulatuslikuks korrastamiseks.Hip fracture is one of the most common and serious injuries in the elderly. It can lead to severe consequences, and its recovery may take over a year. These patients often do not recover in full, meaning that some of them lose their independent living. Therefore, ongoing, coordinated rehabilitation is one of the fundamental care pillars of hip fracture management. Each day, 3-4 people sustain a hip fracture in Estonia, and these patients’ relatively poor outcomes have been reported. The poor outcomes may due to insufficient case management; however, their care, especially rehabilitation, is not examined in detail. The study aimed to evaluate index hip fracture management during 2009-2017 in Estonia, focusing in particular on rehabilitation and its compliance with the international guidelines. The study focused on these patients’ physical therapy use and mortality. The study included 11,491 patients, and their rehabilitation conflicted with the recommendations of multiple international guidelines. An eight-day-long acute care was relatively short, leaving most of the recovery for the post-acute phase. Nonetheless, a quarter of the patients received no physical therapy during acute care. Most of the patients, 60%, received no physical therapy during post-acute care, and the remainder received a relatively small amount, a median of 6 hours. Patients’ post-acute rehabilitation was limited due to the wide use of suboptimal hospital care. Moreover, the analyses revealed multi-fold inter- and intra-regional disparities in post-acute physical therapy use. Intra-regional disparities show the unequal allocation of rehabilitation resources within the counties of Estonia. The aforementioned issues persisted the whole nine-year-spanning study period: only half of index hip fracture patients received post-acute rehabilitation in the final year of the study; the inequality in the division of physical therapy resources increased among its receivers, and large inter-regional and intra-regional disparities remained persistent or even increased. Consequently, hip fracture management is lacking one of its fundamental care pillars – ongoing, coordinated post-acute care that prevents these patients from availing essential rehabilitation. To improve the situation, there is a need for system-wide improvements.https://www.ester.ee/record=b545988

Spatial scale matters for predicting plant invasions along roads

Biological invasions threaten global biodiversity and can have severe economic and social impacts. The complexity of this problem challenges effective management of invasive alien species as the contribution of many factors involved in the invasion processes across different spatial scales is not well understood.Here, we identify the most important determinants associated with the occurrence of two invasive alien plants, the North American goldenrods (Solidago canadensis and S. gigantea), commonly found in agricultural landscapes of Europe. We used Google Street View images to perform a remote, large-scale inventory of goldenrods along 1347 roadside transects across Poland. Using open access geospatial data and machine learning techniques, we investigated the relative role of nearly 50 variables potentially affecting the distribution of studied species at five spatial scales (from within 0.25 to 5 km of the studied locations).We found that the occurrence of goldenrods along roadsides was simultaneously associated with multiple drivers among which those related to human impacts, climate, soil properties and landscape structure were the most important, while local characteristics, such as road parameters or the presence of other alien plants were less influential. However, the relative contribution of different variables in predicting goldenrod distribution changed across spatial scales.Synthesis: Mechanisms underlying plant invasions are highly complex and a number of factors can jointly influence the outcomes of this process. However, since different invasion drivers operate at different spatial scales, some important associations may be overlooked when focusing on a single spatial context. Although associations were consistent in direction (positive or negative) across scales, their relative influence on goldenrod occurrence often changed. Socio-economic factors were largely important at local scales, while the effect of landscape factors broadly increased with increasing spatial scale. We highlight that using multi-scale approaches involving a wide range of variables may enable setting priorities for the management of invasive alien plants.Mechanisms underlying plant invasions are highly complex and a number of factors can jointly influence the outcomes of this process. However, since different invasion drivers operate at different spatial scales, some important associations may be overlooked when focusing on a single spatial context. Although associations were consistent in direction (positive or negative) across scales, their relative influence on goldenrod occurrence often changed. Socio-economic factors were largely important at local scales, while the effect of landscape factors broadly increased with increasing spatial scale. We highlight that using multi-scale approaches involving a wide range of variables may enable setting priorities for the management of invasive alien plants.imag

Seasonal patterns of habitat use of resident birds in Białowieża Forest and its links to post-disturbance management

Resident bird species staying in the same area year-round may face very different habitat conditions between seasons in temperate forests. This may cause resident forest birds to use different habitats during winter and spring. Furthermore, habitat use and their seasonal shifts could be additionally affected by large scale forest disturbances (e.g. outbreaks of bark beetles) and post-disturbance management, as they likely affect the availability of crucial resources for reproduction and survival. We investigated the impact of the European spruce bark beetle (Ips typographus) outbreak and post-outbreak management on winter and spring habitat use of 18 resident bird species in Bialowieza Forest, Eastern Poland. We showed differences in habitat use of resident birds in winter and spring, at the level of species, community and three foraging guilds (i.e. invertivore bark foragers, invertivore arboreal gleaners and omnivores). First, bird species richness and bird abundance recorded at 111 sites in winter were not related or even showed a negative relationship with richness and abundance in spring, indicating that winter and spring bird diversity hotspots did not spatially overlap. Second, the wintering community as a whole, and the invertivore arboreal gleaners in specific, shifted their density towards more coniferous sites and increased their density at moderately salvage-logged sites, while decreasing their density at strongly salvagelogged sites. The wintering invertivore bark foragers shifted towards more outbreak sites (i.e. both salvagelogged and natural regeneration) and distributed more evenly along the natural regeneration - salvage-logged gradient. The distributions of habitat use were species-specific and there was no single habitat or level of disturbance preferred or avoided by all species or groups in spring or winter. This study highlights the importance of considering habitat use outside of the breeding season, when assessing habitat requirements of resident forest bird communities to evaluate the impact of post-disturbance management. In addition, it shows the significance of maintaining the heterogeneity of forest habitats to the wintering resident bird community, especially when deciding on post-disturbance management actions

Establishment and long-term maintenance of primary intestinal epithelial cells cultured from the rainbow trout,Oncorhynchus mykiss.

A novel method for the establishment and long-term maintenance ofex vivocultures from intestinal regions of the rainbow trout,Oncorhynchus mykiss(Walbaum), is reported. Adherence of cells was observed within hours, epithelial island formation recorded at 48 h and rapid proliferation with confluence achieved between 9-14 days. In addition to metabolic characterisation, basic morphology of growing cells was characterised using histology, immunofluorescence, transmission electron microscopy (TEM) and transepithelial electrical resistance (TEER). Regional differences in intestinal ethoxyresorufin-O-deethylase (EROD) and 7-ethoxycoumarin-O-deethylation (ECOD) activities in these primary grown enterocytes were compared following exposure to model inducers [i.e.α-NF,β-NF, B(a)P] which demonstrated significant differences. Regional differences in dietary uptake and metabolism of contaminants can therefore be studied in thisin vitrosystem to increase our understanding of fundamental processes, while concurrently providing a means to reduce the number of fish required for biological studies in line with the principles of the 3Rs (Reduce, Refine and Replace).This article has an associated First Person interview with the first author of the paper

Evaluating Google Street View for tracking invasive alien plants along roads

Invasive alien plants are considered a major driver of global biodiversity loss. Therefore, there is a huge demand of spatial and temporal data on their distribution for investigating possible drivers of species invasions and for predictions of future distributions. We use Google Street View imagery (GSV) as a new source of spatial and temporal data. GSV provides millions of panoramic views along road networks worldwide allowing for the identification of many plant species, including invasive ones. Thus, GSV has a great potential to support ecological research in documenting species distribution, but reliable validation of its precision and accuracy is lacking. Here, we describe and evaluate an approach using GSV to visually track the spread of invasive alien plants, the North American goldenrods (Solidago canadensis and S. gigantea) occurring abundantly along road network in Poland (Central Europe). We determined presence/absence of the species along 160 randomly selected transects of a length of 500 m by visual inspection of GSV images and compared it with field surveys at the same transects. We show that the occurrence of goldenrods in GSV is a reliable predictor of their occurrence in the wild. Sampling parameters, like road width, season when GSV pictures were taken and number of months elapsed since taking the GSV pictures, did not change the correlation between outputs of the two methods (GSV and field sampling). Furthermore, both the occurrence of goldenrods observed in the field and their occurrence in GSV have similar relations to habitat characteristics investigated (the same direction of relationship and similar effect size). We suggest Google Street View images may be an additional tool to be used in the detection and tracking of the spread of invasive alien plants along roadsides. The approach may be useful in assessing temporal changes in roadside vegetation and managing problematic plant species across large spatial scales and may contribute to the further development of more efficient sampling methods in ecological studies

Komplekssete interrogatiiv-relatiivadverbide kasutusdünaamika 16.–20. sajandi eesti kirjakeele korpuste põhjal

http://www.ester.ee/record=b5145361*es