Perhekuntoutus puntarissa : Kelan psykiatrisen perhekuntoutuksen kehittämishankkeen arviointi

Kelan moniammatillisen perhekuntoutuksen tavoitteena oli lapsen ja nuoren toiminta- ja opiskelukyvyn parantaminen ja turvaaminen sekä yhteistyön tiivistäminen paikallisten tahojen, kuten päivähoidon, koulujen, perheneuvoloiden ja sairaanhoitopiirien, kanssa. Lapsilla ja nuorilla tuli olla lääkärin toteama psykiatrinen sairaus sekä hoitosuhde ennen kuntoutuksen aloitusta. Yhteensä 1 514 lasta ja nuorta perheineen 12:sta eri perhekuntoutushankkeesta osallistui kuntoutukseen vuosina 2005–2008. Lapset olivat hyvin heterogeeninen ryhmä iältään ja diagnooseiltaan. Lapin yliopisto ja Kuntoutussäätiö vastasivat kehittämishankkeen ulkoisesta arvioinnista. Arvioinnin tehtävänä oli kuntoutuksen kohderyhmän kuvauksen ohella tutkia, millaisia muutoksia lasten tilanteissa tapahtui kuntoutusintervention myötä. Tarkoitus oli selvittää, kokivatko lapset ja vanhemmat saaneensa tukea kuntoutuksesta. Tehtävänä oli myös selvittää, mitkä tekijät ennustivat lapsissa tapahtuneita myönteisiä muutoksia tai lasten ja vanhempien saamaa tukea sekä millaiset kuntoutuksen toimintamuodot osoittautuivat perheille hyödyllisiksi. Tiedot kerättiin kuntoutuksen alussa ja lopussa lapsille ja vanhemmille sekä perhekuntoutushankkeille suunnattujen kyselyiden avulla. Vanhempien arvioiden perusteella lasten oireet vähenivät lähes kahdella kolmesta, pysyivät ennallaan viidesosalla ja lisääntyivät vajaalla viidenneksellä. Vanhempien huoli lapsesta, perheen koherenssi ja kuntoutuksen kesto ennustivat lapsen oireilun vähenemistä. Kuntoutuksen kesto ja toimintamuoto puolestaan ennustivat vanhempien ja lasten kuntoutuksesta saamaa tukea. Lapset hyötyivät yksilö- ja perhepainotteisesta kuntoutuksesta ja vanhemmat perheterapeuttisesti ja ryhmätoimintaan painottuneesta kuntoutuksesta. Lähipiiristä saatu apu lisäsi vanhempien voimavaroja. Lasta auttoi se, että vanhemmat saivat kuntoutuksesta voimavaroja.15,00 euro

Intraspecific variability in the response of bloom-forming marine microalgae to changed climate conditions

Phytoplankton populations can display high levels of genetic diversity that, when reflected by phenotypic variability, may stabilize a species response to environmental changes. We studied the effects of increased temperature and CO2 availability as predicted consequences of global change, on 16 genetically different isolates of the diatom Skeletonema marinoi from the Adriatic Sea and the Skagerrak (North Sea), and on eight strains of the PST (paralytic shellfish toxin)-producing dinoflagellate Alexandrium ostenfeldii from the Baltic Sea. Maximum growth rates were estimated in batch cultures of acclimated isolates grown for five to 10 generations in a factorial design at 20 and 24°C, and present day and next century applied atmospheric pCO2, respectively. In both species, individual strains were affected in different ways by increased temperature and pCO2. The strongest response variability, buffering overall effects, was detected among Adriatic S. marinoi strains. Skagerrak strains showed a more uniform response, particularly to increased temperature, with an overall positive effect on growth. Increased temperature also caused a general growth stimulation in A. ostenfeldii, despite notable variability in strain-specific response patterns. Our data revealed a significant relationship between strain-specific growth rates and the impact of pCO2 on growth—slow growing cultures were generally positively affected, while fast growing cultures showed no or negative responses to increased pCO2. Toxin composition of A. ostenfeldii was consistently altered by elevated temperature and increased CO2 supply in the tested strains, resulting in overall promotion of saxitoxin production by both treatments. Our findings suggest that phenotypic variability within populations plays an important role in the adaptation of phytoplankton to changing environments, potentially attenuating short-term effects and forming the basis for selection. In particular, A. ostenfeldii blooms may expand and increase in toxicity under increased water temperature and atmospheric pCO2 conditions, with potentially severe consequences for the coastal ecosystem

EFFECT OF CARBON CONTENT ON THE PHASE TRANSFORMATION CHARACTERISTICS, MICROSTRUCTURE AND PROPERTIES OF 500 MPa GRADE MICROALLOYED STEELS WITH NONPOLYGONAL FERRITE MICROSTRUCTURES

The influence of C in the range of 0.011-0.043 wt-% on the phase transformation characteristics, mechanical properties andmicrostructure of Fe-2.0Mn-0.25Mo-0.8Ni-0.05Nb-0.03Ti steel was investigated. In the dilatometric experiments, it wasfound that a reduction in the C content increased the phase transformation temperatures, decreased the hardness andpromoted quasi-polygonal ferrite (QF) formation over granular bainitic ferrite (GBF) and bainitic ferrite (BF), but at the sametime the sensitivity of the phase transformation temperatures and hardness to cooling rates was reduced. Mechanical testingof laboratory hot rolled plates revealed that the targeted yield strength of 500 MPa was reached even in the steel withthe lowest C content (0.011wt-%). An increase in C content did not considerably increase the yield strength, although thetensile strength was more significantly increased. Impact toughness properties, in turn, were markedly deteriorated due to thisC content increment. Microstructural analysis of the hot rolled plates showed that an increase in C content decreased thefraction of QF and consequently increased the fraction of GBF and BF, as well as the size and fraction of C-enriched secondarymicroconstituents. In addition, the size of the coarsest crystallographic packets seemed to be finer in the low C steelwith QF dominated microstructure than in its higher C counterparts with higher fractions of GBF-BF, even thought theaverage crystallographic packet size was slightly finer in these higher C steels.Mechanical testing of the simulated CGHAZ’s showed that their toughness properties are not strongly dependenton C content, although there exists a general trend for toughness to slightly weaken with increasing C content. Itcould be concluded that HAZ toughness properties of these types of steels are acceptable. On the basis of dilatometricexperiments, mechanical testing and microstructural analysis it can be stated that a good combination of strength,toughness and weldability as well as microstructural stability can be reached in very low C steels with QF dominatedmicrostructures. Finally, an example of this type of microstuctural concept, which has been successfull

Crystallographic Analysis of Martensite in 0.2C-2.0Mn-1.5Si-0.6Cr Steel by EBSD

The crystallography of martensite formed in 0.2C-2.0Mn-1.5Si-0.6Cr steel was studied using the EBSDtechnique. The results showed that the observed orientation relationship was closer to the Nishiyama-Wassermann (N-W) than to the Kurdjumov-Sachs (K-S) orientation relationship (OR). The microstructure ofmartensite consisted of parallel laths forming morphological packet-like structures. Typically, there were threedifferent lath orientations in a morphological packet consisting of three specific N-W OR variants sharing thesame {111} austenite plane. A packet of martensite laths with common {111} austenite plane was termed as acrystallographic packet. Generally, the crystallographic packet size corresponded to the morphological packetsize, but occasionally the morphological packet was found to consist of two or more crystallographic packets.Therefore, the crystallographic packet size appeared to be finer than the morphological packet size. Therelative orientation between the variants in crystallographic packets was found to be near 60°/<110>. Thisappears to explain the strong peak observed near 60° in the grain boundary misorientation distribution.Martensite also contained a high fraction of boundaries with their misorientation in the range 2.5-8°.Typically these boundaries were found to be located inside the martensite laths forming lath-like sub-grains,whose long axes were parallel with the long axis of the martensite laths

Avoimen systeemin magmaattisten prosessien diagnosointi Magmakammiosimulaattorilla. Osa I: pääalkuaineet ja faasitasapainot

The Magma Chamber Simulator (MCS) is a thermodynamic tool for modeling the evolution of magmatic systems that are open with respect to assimilation of partial melts or stoped blocks, magma recharge + mixing, and fractional crystallization. MCS is available for both PC and Mac. In the MCS, the thermal, mass, and compositional evolution of a multicomponent-multiphase composite system of resident magma, wallrock, and recharge reservoirs is tracked by rigorous self-consistent thermodynamic modeling. A Recharge-Assimilation (Assimilated partial melt or Stoped blocks)-Fractional Crystallization (R(n)AS(n)FC;n(tot) The trace element and isotope MCS computational tool (MCS-Traces) is described in a separate contribution (part II).Peer reviewe

Effects of a 12-month home-based exercise program on functioning after hip fracture - Secondary analyses of an RCT

Background Long-term functional limitations are common after hip fractures. Exercise may alleviate these negative consequences but there is no consensus on an optimal training program. The objective was to study the effects of a 12-month home-based supervised, progressive exercise program on functioning, physical performance, and physical activity. Methods Secondary analysis of a randomized controlled trial targeting patients with surgical repair of a hip fracture, aged >= 60 years, Mini-Mental State Examination (MMSE) score of >= 12. The participants were randomized into Exercise (n = 61) or Usual care (n = 60). Assessments at baseline, 3, 6, and 12 months included Lawton's Instrumental Activities of Daily Living (IADL), Short Physical Performance Battery (SPPB), handgrip strength, and self-reported frequency of sessions of leisure-time physical activity. Analyzed using mixed-effects models. Results Participants' (n = 121) mean age was 81 years (SD 7), and 75% were women. The mean IADL score at baseline was 17.1 (SD 4.5) in the exercise group, and 17.4 (5.1) in the usual care group. The mean SPPB scores were 3.9 (1.6) and 4.2 (1.8), and handgrip strength was 17.7 (8.9) kg and 20.8 (8.0) kg, respectively. The age- and sex-adjusted mean changes in IADL over 12 months were 3.7 (95% CI 2.8-4.7) in the exercise and 2.0 (1.0-3.0) in the usual care group (between-group difference, p = 0.016); changes in SPPB 4.3 (3.6-4.9) and 2.1 (1.5-2.7) (p < 0.001); and changes in handgrip strength 1.2 kg (0.3-2.0) and 1.0 kg (-1.9 to -0.2) (p < 0.001), respectively. We found no between-group differences in changes in the frequency of leisure-time activity sessions. Conclusion A 12-month home-based supervised, progressive exercise program improved functioning and physical performance more than usual care among patients with hip fractures. However, the training did not increase leisure-time physical activity.Peer reviewe

Chloroquine and Its Derivatives Exacerbate B19V-Associated Anemia by Promoting Viral Replication

Human parvovirus B19 (B19V) is typically associated with a childhood febrile illness known as erythema infectiosum. The infection usually resolves without consequence in healthy individuals. However, in patients with immunologic and/or hematologic disorders, B19V can cause a significant pathology. The virus infects and kills red cell precursors but anemia rarely supervenes unless there is pre-existing anemia such as in children living in malaria-endemic regions. The link between B19V infection and severe anemia has, however, only been confirmed in certain malaria-endemic countries in parallel with chloroquine (CQ) usage. This raises the possibility that CQ may increase the risk of severe anemia by promoting B19V infection. To test this hypothesis, we examined the direct effect of CQ and other commonly used antimalarial drugs on B19V infection in cultured cell lines. Additionally, we examined the correlation between B19V infection, hemoglobin levels and use of CQ in children from Papua New Guinea hospitalized with severe anemia. The results suggest strongly that CQ and its derivatives aggravate B19V-associated anemia by promoting B19V replication. Hence, careful consideration should be given in choosing the drug partnering artemisinin compounds in combination antimalarial therapy in order to minimize contribution of B19V to severe anemia

On Imprimitive Representations of Finite Reductive Groups in Non-defining Characteristic

In this paper, we begin with the classification of Harish-Chandra imprimitive representations in non-defining characteristic. We recall the connection of this problem to certain generalizations of Iwahori-Hecke algebras and show that Harish-Chandra induction is compatible with the Morita equivalence by Bonnaf\'{e} and Rouquier, thus reducing the classification problem to quasi-isolated blocks. Afterwards, we consider imprimitivity of unipotent representations of certain classical groups. In the case of general linear and unitary groups, our reduction methods then lead to results for arbitrary Lusztig series

Future HAB science: Directions and challenges in a changing climate

There is increasing concern that accelerating environmental change attributed to human-induced warming of the planet may substantially alter the patterns, distribution and intensity of Harmful Algal Blooms (HABs). Changes in temperature, ocean acidification, precipitation, nutrient stress or availability, and the physical structure of the water column all influence the productivity, composition, and global range of phytoplankton assemblages, but large uncertainty remains about how integration of these climate drivers might shape future HABs. Presented here are the collective deliberations from a symposium on HABs and climate change where the research challenges to understanding potential linkages between HABs and climate were considered, along with new research directions to better define these linkages. In addition to the likely effects of physical (temperature, salinity, stratification, light, changing storm intensity), chemical (nutrients, ocean acidification), and biological (grazer) drivers on microalgae (senso lato), symposium participants explored more broadly the subjects of cyanobacterial HABs, benthic HABs, HAB effects on fisheries, HAB modelling challenges, and the contributions that molecular approaches can bring to HAB studies. There was consensus that alongside traditional research, HAB scientists must set new courses of research and practices to deliver the conceptual and quantitative advances required to forecast future HAB trends. These different practices encompass laboratory and field studies, long-term observational programs, retrospectives, as well as the study of socioeconomic drivers and linkages with aquaculture and fisheries. In anticipation of growing HAB problems, research on potential mitigation strategies should be a priority. It is recommended that a substantial portion of HAB research among laboratories be directed collectively at a small sub-set of HAB species and questions in order to fast-track advances in our understanding. Climate-driven changes in coastal oceanographic and ecological systems are becoming substantial, in some cases exacerbated by localized human activities. That, combined with the slow pace of decreasing global carbon emissions, signals the urgency for HAB scientists to accelerate efforts across disciplines to provide society with the necessary insights regarding future HAB trends