Luonnonsuojelun ja matkailualan suhde:esimerkkinä Japani

Tiivistelmä. Tämä tutkielma tarkastelee luonnonsuojelua ja matkailualaa, sekä niiden välistä suhdetta. Esimerkkivaltiona toimii Japani, joka on maantieteellisestä ja kulttuurisesta näkökulmasta hyvin mielenkiintoinen. Tarkoituksena on selvittää, millaisia luonnonsuojelun toimia Japanissa on, sekä myös mitä matkailualaan liittyviä käytäntöjä siellä harjoitetaan. Jotta luonnonsuojelua voidaan tarkastella perusteellisesti, on myös tiedettävä Japanin luonnon ominaisuuksista. Tutkielman tärkeimpänä tarkoituksena on selvittää, millainen luonnonsuojelun ja matkailualan suhde on, Japania esimerkkinä käyttäen. Matkailualan tiedetään vaikuttavan hyvinkin paljon ympäröivään luontoon ja myös ilmastonmuutokseen, esimerkiksi lentomatkailun myötä. Ilmastonmuutoksen, sekä myös luonnonsuojelun ollessa ajankohtaisia ilmiöitä, on tärkeää löytää ratkaisuja, jotka voivat auttaa kestävän tulevaisuuden kehittämisessä. Matkailu on nykypäivän globaalissa maailmassa yhä suositumpaa ja turismi on monessa maassa tärkein palveluala. Alan ollessa näinkin suuri, voidaan sillä olettaa olevan suuri vaikutus yhteiskuntaan ja myös ympäristöön. Japani on valtio, joka on kehittynyt nopeasti vuosikymmenten mittaan, joten sen käytäntöjä matkailun ja ympäristönsuojelun näkökulmasta on tärkeä ymmärtää. Olisiko näiden kahden alan välistä suhdetta mahdollista kehittää? Molemmat osapuolet ovat nykyajan maailmassa merkittäviä, joten molemmille aloille olisi varmasti hyödyksi kyetä harjoittamaan ja markkinoimaan kestävää elämäntapaa. Matkailualan ja luonnonsuojelun yhteistyön tärkeys korostuu tässä tutkielmassa, ja se pyrkii selvittämään näiden alojen suhteen piirteet, käyttäen Japania esimerkkinä. Keskiössä on myöskin matkailun ja luonnonsuojelun suhteen kehitys ja kuinka siitä saataisiin parempi kestävän tulevaisuuden varmistamiseksi. Molemmat matkailuala sekä luonnonsuojelu vaikuttavat nykyajan maailmassa monella tapaa paikallisten, sekä myös turistien käytöstapoihin, joten tasapainon löytäminen näiden kahden osapuolen välille on tärkeää

Kuvitteluleikin merkitys 3–6-vuotiaiden lasten toiminnanohjauksen taitojen kehityksessä

Tiivistelmä. Alle kouluikäisten lasten toiminnanohjauksen taitojen kehitykseen ja tukemisen merkitykseen on alettu viime vuosina kiinnittää yhä enemmän huomiota niin kansainvälisessä kuin kotimaisessa tutkimuksessa. Varhaislapsuuden on osoitettu olevan merkittävä ajanjakso toiminnanohjauksen perustan luomiselle. Lähes 90 vuotta sitten venäläinen kehityspsykologi Lev Vygotsky esitti innovatiivisen teorian, jonka mukaan kuvitteluleikki, joka on 3–6-vuotiaiden lasten johtavaa toimintaa, olisi erityisen merkityksellinen konteksti lasten oman toiminnan säätelyn kehittymiselle. Vahvasta teoreettisesta pohjasta huolimatta kuvitteluleikin merkitystä lasten toiminnanohjauksen taitojen kehityksessä on tutkittu suhteellisen vähän. Tämän kandidaatintutkielman tavoitteena on aiemman tutkimuskirjallisuuden perusteella selvittää, miten toiminnanohjauksen taidot kehittyvät ennen kouluikää ja millainen merkitys kuvitteluleikillä on näiden taitojen kehityksessä kolmen ja kuuden ikävuoden välillä. Tutkielman teoreettisena viitekehyksenä on Vygotskyn kulttuurihistoriallinen kehityksen ja oppimisen teoria, josta käsin kuvitteluleikkiä ja toiminnanohjausta tarkastellaan. Tutkielma on toteutettu integroivana kirjallisuuskatsauksena ja sen aineisto koostuu pääosin kansainvälisistä vertaisarvioiduista tutkimuksista. Tutkielman tulokset osoittavat toiminnanohjauksen kehityksen olevan yksilöllinen ja dynaaminen prosessi, jossa ympäristön tuella on keskeinen merkitys. Ennen kouluikää kehittyvät erityisen nopeasti toiminnanohjauksen ydintoiminnot — inhibitiokyky, työmuisti ja kognitiivinen joustavuus — jotka luovat perustan arjen monimutkaiselle toiminnanohjaukselle. Tutkielman tulosten mukaan kuvitteluleikki voi toimia hedelmällisenä kontekstina sekä toiminnanohjauksen taitojen harjoittelulle, että vahvistamiselle. Kuvitteluleikki voi muodostaa lähikehityksen vyöhykkeen, jolloin lapsen on leikkitilanteessa mahdollista ohjata omaa toimintaansa taitavammin kuin leikin ulkopuolella. Lasten säännöllinen, omaehtoinen kuvitteluleikki, luontainen taipumus mielikuvitukselliseen ajatteluun ja toimintaan, sekä intensiiviset kuvitteluleikkiin yhdistetyt interventiot voivat toimia myös kehityksen lähteenä, toiminnanohjauksen taitoja leikin ulkopuolelle kehittäen

Sex differences in faecal occult blood test screening for colorectal cancer

Background: This analysis of patients in a randomized population-based health services study was done to determine the effects of faecal occult blood test (FOBT) screening of colorectal cancer (CRC) in outcomes beyond mortality, and to obtain explanations for potential sex differences in screening effectiveness. Methods: In the Finnish FOBT screening programme (2004-2011), people aged 60-69 years were randomized into the screening and control arms. Differences in incidence, symptoms, tumour location, TNM categories, non-vital outcomes and survival in the screening and control arms were analysed. Results: From 321 311 individuals randomized, 743 patients with screening-detected tumours and 617 control patients with CRC were analysed. CRC was less common in women than in men (0.34 versus 0.50 per cent; risk ratio (RR) 0.82, 95 per cent c.i. 0.74 to 0.91) and women were less often asymptomatic (16.7 versus 22.0 per cent; RR 0.76, 0.61 to 0.93). Women more often had right-sided tumours (32.0 versus 21.3 per cent; RR 1.51, 1.26 to 1.80). Among men with left-sided tumours, those in the screening arm had lower N (RR 1.23, 1.02 to 1.48) and M (RR 1.57, 1.14 to 2.17) categories, as well as a higher overall survival rate than those in the control arm. Furthermore among men with left-sided tumours, non-radical resections (26.2 versus 15.7 per cent; RR 1.67, 1.22 to 2.30) and postoperative chemotherapy sessions (61.6 versus 48.2 per cent; RR 1.28, 1.10 to 1.48) were more frequent in the control arm. Similar benefits of screening were not detected in men with right-sided tumours or in women. Conclusion: Biennial FOBT screening seems to be effective in terms of improving several different outcomes in men, but not in women. Differences in incidence, symptoms and tumour location may explain the differences in screening efficacy between sexes.Peer reviewe

Differences in textural properties of cooked caponized and broiler chicken breast meat

This study was aimed at evaluating textural properties of cooked chicken breast meats obtained from 3 production systems (conventional raising, feed modification, and caponization) and determining the relationship between instrumental parameters and sensory attributes associated with the texture of capon meat. Texture of cooked breast meats was determined using 3 instrumental methods: Warner-Bratzler Shear (WBS), texture profile analysis (TPA), and uniaxial compression (UC), and sensory analysis by trained panelists. The results indicated that cooked caponized meat showed the lowest values of WBS force, shear energy, hardness, Young's modulus of UC, and the 2 sensory attributes (firmness and number of chews) (P < 0.05). In contrast, springiness and juiciness were the highest in the caponized meat (P < 0.05), suggesting that capon meat was more tender and juicier than the others. Feed-modified chicken samples showed intermediate textural characteristics between the samples of capon and conventionally raised broiler. Pearson's correlation revealed that WBS force, shear energy, Young's modulus of UC, gumminess, and springiness were strongly correlated with 3 sensory attributes (firmness, number of chews, and juiciness). Partial least squares regression (PLSR) demonstrated that 72% of all sensory attributes for the first 2 PLSR components were explained by 36% of the instrumental parameters and the production systems. Loading and score plot illustrated that conventional raising contributed to a high degree of firmness and number of chews, and positively correlated with shear energy, WBS force, gumminess, hardness, and Young's modulus. Contrarily, caponization was negatively correlated with those sensory attributes. The univariate analysis indicated that firmness and number of chews were positively correlated with all instrumental parameters, except springiness. Juiciness was positively correlated with springiness but negatively correlated with the others. The study suggested that the cooked meat of capons could be differentiated from those of broilers raised conventionally and with feed-modified diets based on textural properties. Based on the optimized simulating equation, texture of caponized breast could be explained by WBS force, shear energy, Young's modulus, and gumminess

Dispensary level pilot implementation of rapid diagnostic tests: an evaluation of RDT acceptance and usage by providers and patients – Tanzania, 2005

BACKGROUND\ud \ud Malaria rapid diagnostic tests (RDTs) may assist in diagnosis, improve prescribing practices and reduce potential drug resistance development. Without understanding operational issues or acceptance and usage by providers and patients, the costs of these tests may not be justified.\ud \ud OBJECTIVES\ud \ud To evaluate the impact of RDTs on prescribing behaviours, assess prescribers' and patients' perceptions, and identify operational issues during implementation.\ud \ud METHODS\ud \ud Baseline data were collected at six Tanzanian public dispensaries. RDTs were implemented for eight weeks and data collected on frequency of RDT use, results, malaria diagnoses and the prescription of antimalarials. Patients referred for RDTs completed a standardised exit interview. Qualitative methods assessed attitudes toward and satisfaction with RDTs, perceptions about the test and operational issues related to implementation.\ud \ud RESULTS\ud \ud Of 595 patients at baseline, 200 (33%) were diagnosed clinically with malaria but had a negative RDT. Among the 2519 RDTs performed during implementation, 289 (11.5%) had a negative result and antimalarials prescribed. The proportion of "over-prescriptions" at baseline was 54.8% (198/365). At weeks four and eight this decreased to 16.1% (27/168) and 16.4% (42/256) respectively.A total of 355 patient or parent/caregiver and 21 prescriber individual interviews and 12 focus group discussions (FGDs) were conducted. Patients, caregivers and providers trusted RDT results, agreed that use of RDTs was feasible at dispensary level, and perceived that RDTs improved clinical diagnosis. Negative concerns included community suspicion and fear that RDTs were HIV tests, the need for additional supervision in interpreting the results, and increased work loads without added compensation.\ud \ud CONCLUSION\ud \ud Overprescriptions decreased over the study period. There was a high degree of patient/caregiver and provider acceptance of and satisfaction with RDTs. Implementation should include community education, sufficient levels of training and supervision and consideration of the need for additional staff

Treatment challenges in and outside a specialist network setting: Pancreatic neuroendocrine tumours

Pancreatic Neuroendocrine Neoplasms comprise a group of rare tumours with special biology, an often indolent behaviour and particular diagnostic and therapeutic requirements. The specialized biochemical tests and radiological investigations, the complexity of surgical options and the variety of medical treatments that require individual tailoring, mandate a multidisciplinary approach that can be optimally achieved through an organized network. The present study describes currents concepts in the management of these tumours as well as an insight into the challenges of delivering the pathway in and outside a Network

Treatment challenges in and outside a network setting: Head and neck cancers

Head and neck cancer (HNC) is a rare disease that can affect different sites and is characterized by variable incidence and 5-year survival rates across Europe. Multiple factors need to be considered when choosing the most appropriate treatment for HNC patients, such as age, comorbidities, social issues, and especially whether to prefer surgery or radiation-based protocols. Given the complexity of this scenario, the creation of a highly specialized multidisciplinary team is recommended to guarantee the best oncological outcome and prevent or adequately treat any adverse effect. Data from literature suggest that the multidisciplinary team-based approach is beneficial for HNC patients and lead to improved survival rates. This result is likely due to improved diagnostic and staging accuracy, a more efficacious therapeutic approach and enhanced communication across disciplines. Despite the benefit of MTD, it must be noted that this approach requires considerable time, effort and financial resources and is usually more frequent in highly organized and high-volume centers. Literature data on clinical research suggest that patients treated in high-accrual centers report better treatment outcomes compared to patients treated in low-volume centers, where a lower radiotherapy-compliance and worst overall survival have been reported. There is general agreement that treatment of rare cancers such as HNC should be concentrated in high volume, specialized and multidisciplinary centers. In order to achieve this goal, the creation of international collaboration network is fundamental. The European Reference Networks for example aim to create an international virtual advisory board, whose objectives are the exchange of expertise, training, clinical collaboration and the reduction of disparities and enhancement of rationalize migration across Europe. The purpose of our work is to review all aspects and challenges in and outside this network setting planned for the management of HNC patients

Testicular germ-cell tumours and penile squamous cell carcinoma: Appropriate management makes the difference

Germ-cell tumours (GCT) of the testis and penile squamous cell carcinoma (PeSCC) are a rare and a very rare uro-genital cancers, respectively. Both tumours are well defined entities in terms of management, where specific recommendations - in the form of continuously up-to-dated guide lines-are provided. Impact of these tumour is relevant. Testicular GCT affects young, healthy men at the beginning of their adult life. PeSCC affects older men, but a proportion of these patients are young and the personal consequences of the disease may be devastating. Deviation from recommended management may be a reason of a significant prognostic worsening, as proper treatment favourably impacts on these tumours, dramatically on GCT and significantly on PeSCC. RARECAREnet data may permit to analyse how survivals may vary according to geographical areas, histology and age, leading to assume that non-homogeneous health-care resources may impact the cure and definitive outcomes. In support of this hypothesis, some epidemiologic datasets and clinical findings would indicate that survival may improve when appropriate treatments are delivered, linked to a different accessibility to the best health institutions, as a consequence of geographical, cultural and economic barriers. Finally, strong clues based on epidemiological and clinical data support the hypothesis that treatment delivered at reference centres or under the aegis of a qualified multi-institutional network is associated with a better prognosis of patients with these malignancies. The ERN EURACAN represents the best current European effort to answer this clinical need

Utilizing image texture to detect land-cover change in Mediterranean coastal wetlands

Land-use/cover change dynamics were investigated in a Mediterranean coastal wetland. Change Vector Analysis (CVA) without and with image texture derived from the co-occurrence matrix and variogram were evaluated for detecting land-use/cover change. Three Landsat Thematic Mapper (TM) scenes recorded on July 1985, 1993 and 2005 were used, minimizing change detection error caused by seasonal differences. Images were geometrically, atmospherically and radiometrically corrected. CVA without and with texture measures were implemented and assessed using reference images generated by object-based supervised classification. These outputs were used for cross-classification to determine the ‘from–to’ change used to compare between techniques. The Landsat TM image bands together with the variogram yielded the most accurate change detection results, with Kappa statistics of 0.7619 and 0.7637 for the 1985–1993 and 1993–2005 image pairs, respectively