The movement of food between Britain and The EU and how Brexit has affected it

This research aims to evaluate the effects of Brexit on food logistics between the EU and Britain. The research has been conducted as a media analysis. The research includes a hypothesis of Brexit's effects based on different models. It is followed by a media analysis of the actual effects of Brexit on food logistics. Media analysis was conducted based on The Guardian, Financial Times, and BBC

Luku- ja kirjoitustaitokampanjoihin sisältyvistä yhteiskunnallisista merkityksistä

Based on the documentary material dealing with literacy campaigns, the article examines the types of meanings inherent when defining illiteracy as a social problem. ln doing so, the author questions the overall ideology proposed in the material studied. ln addition, he deals with the possible emancipatory role of literacy in the conditions prevailing in developing countries.Artikkelissa tarkastellaan luku- ja kirjoitustaitokampanjoita käsittelevän kansainvälisen dokumenttiaineiston perusteella sitä, millaisia merkityksiä sisältyy lukuja kirjoitustaidottomuuden määrittelyyn yhteiskunnalliseksi ongelmaksi, ja asetetaan kyseenalaiseksi tässä aineistossa ilmenevä yleismaailmallinen ideologia. Lisäksi pohditaan luku- ja kirjoitustaidon mahdollisista emansipatorista merkitystä kehitysmaiden oloissa

Association of Sequential Organ Failure Assessment (SOFA) components with mortality

Background Sequential Organ Failure Assessment (SOFA) is a practical method to describe and quantify the presence and severity of organ system dysfunctions and failures. Some proposals suggest that SOFA could be employed as an endpoint in trials. To justify this, all SOFA component scores should reflect organ dysfunctions of comparable severity. We aimed to investigate whether the associations of different SOFA components with in-hospital mortality are comparable. Methods We performed a study based on nationwide register data on adult patients admitted to 26 Finnish intensive care units (ICUs) during 2012-2015. We determined the SOFA score as the maximum score in the first 24 hours after ICU admission. We defined organ failure (OF) as an organ-specific SOFA score of three or higher. We evaluated the association of different SOFA component scores with mortality. Results Our study population comprised 63,756 ICU patients. Overall hospital mortality was 10.7%. In-hospital mortality was 22.5% for patients with respiratory failure, 34.8% for those with coagulation failure, 40.1% for those with hepatic failure, 14.9% for those with cardiovascular failure, 26.9% for those with neurologic failure and 34.6% for the patients with renal failure. Among patients with comparable total SOFA scores, the risk of death was lower in patients with cardiovascular OF compared with patients with other OFs. Conclusions All SOFA components are associated with mortality, but their weights are not comparable. High scores of other organ systems mean a higher risk of death than high cardiovascular scores. The scoring of cardiovascular dysfunction needs to be updated.Peer reviewe

Mortality prediction in intensive care units including premorbid functional status improved performance and internal validity

Objective: Prognostic models are key for benchmarking intensive care units (ICUs). They require up-to-date predictors and should report transportability properties for reliable predictions. We developed and validated an in-hospital mortality risk prediction model to facilitate benchmarking, quality assurance, and health economics evaluation. Study Design and Setting: We retrieved data from the database of an international (Finland, Estonia, Switzerland) multicenter ICU cohort study from 2015 to 2017. We used a hierarchical logistic regression model that included age, a modified Simplified Acute Physiology Score-II, admission type, premorbid functional status, and diagnosis as grouping variable. We used pooled and meta-analytic cross-validation approaches to assess temporal and geographical transportability. Results: We included 61,224 patients treated in the ICU (hospital mortality 10.6%). The developed prediction model had an area under the receiver operating characteristic curve 0.886, 95% confidence interval (CI) 0.882-0.890; a calibration slope 1.01, 95% CI (0.99-1.03); a mean calibration -0.004, 95% CI (-0.035 to 0.027). Although the model showed very good internal validity and geographic discrimination transportability, we found substantial heterogeneity of performance measures between ICUs (I-squared: 53.4-84.7%). Conclusion: A novel framework evaluating the performance of our prediction model provided key information to judge the validity of our model and its adaptation for future use. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license ( http:// creativecommons.org/ licenses/ by/ 4.0/ )Peer reviewe

Variation in severity-adjusted resource use and outcome in intensive care units

Purpose Intensive care patients have increased risk of death and their care is expensive. We investigated whether risk-adjusted mortality and resources used to achieve survivors change over time and if their variation is associated with variables related to intensive care unit (ICU) organization and structure. Methods Data of 207,131 patients treated in 2008-2017 in 21 ICUs in Finland, Estonia and Switzerland were extracted from a benchmarking database. Resource use was measured using ICU length of stay, daily Therapeutic Intervention Scoring System Scores (TISS) and purchasing power parity-adjusted direct costs (2015-2017; 17 ICUs). The ratio of observed to severity-adjusted expected resource use (standardized resource use ratio; SRUR) was calculated. The number of expected survivors and the ratio of observed to expected mortality (standardized mortality ratio; SMR) was based on a mortality prediction model covering 2015-2017. Fourteen a priori variables reflecting structure and organization were used as explanatory variables for SRURs in multivariable models. Results SMR decreased over time, whereas SRUR remained unchanged, except for decreased TISS-based SRUR. Direct costs of one ICU day, TISS score and ICU admission varied between ICUs 2.5-5-fold. Differences between individual ICUs in both SRUR and SMR were up to > 3-fold, and their evolution was highly variable, without clear association between SRUR and SMR. High patient turnover was consistently associated with low SRUR but not with SMR. Conclusion The wide and independent variation in both SMR and SRUR suggests that they should be used together to compare the performance of different ICUs or an individual ICU over time.Peer reviewe

Early snowmelt significantly enhances boreal springtime carbon uptake

We determine the annual timing of spring recovery from space-borne microwave radiometer observations across northern hemisphere boreal evergreen forests for 1979-2014. We find a trend of advanced spring recovery of carbon uptake for this period, with a total average shift of 8.1 d (2.3 d/decade). We use this trend to estimate the corresponding changes in gross primary production (GPP) by applying in situ carbon flux observations. Micrometeoro-logical CO2 measurements at four sites in northern Europe and North America indicate that such an advance in spring recovery would have increased the January-June GPP sum by 29 g.C.m(-2) [8.4 g.C.m(-2) (3.7%)/decade]. We find this sensitivity of the measured springtime GPP to the spring recovery to be in accordance with the corresponding sensitivity derived from simulations with a land ecosystem model coupled to a global circulation model. The model-predicted increase in springtime cumulative GPP was 0.035 Pg/decade [15.5 g.C.m(-2) (6.8%)/decade] for Eurasian forests and 0.017 Pg/decade for forests in North America [9.8 g.C.m(-2) (4.4%)/decade]. This change in the springtime sum of GPP related to the timing of spring snowmelt is quantified here for boreal evergreen forests.Peer reviewe

Preface to the special issue on Monitoring and Modelling of Carbon-Balance-, Water- and Snow-Related Phenomena at Northern Latitudes

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