Puusta valmistettujen tuotteiden hiilivaraston muutoksen laskenta kasvihuonekaasuinventaariossa : Menetelmäkehitys Suomen kasvihuonekaasuinventaarioon

Tämän tutkimuksen päätavoite oli kehittää puutuotelaskentamenetelmä, jolla voidaan tuottaa estimaatit Suomen kasvihuonekaasujen inventaarioraportointiin. Laskentamenetelmän oli perustuttava ilmastosopimuksen ja Kioton pöytäkirjan osapuolikokousten päätöksiin. Tässä tutkimuksessa puutuotteilla tarkoitetaan puusta valmistettuja puolivalmisteita, joita ovat sahatavara, puulevyt, paperi ja kartonki sekä muut puolivalmisteet, kuten hirret ja puhelinpylväät. Kioton pöytäkirjan laskennassa puutuotteiden alkuperän selvittäminen oli yksi tärkeimmistä tavoitteista. Alkuperällä tarkoitetaan tässä tapauksessa sitä, onko puutuotteisiin käytetty puu peräisin Kioton pöytäkirjan aktiviteeteistä (metsänhoito, metsitys, metsänhävitys) vai näiden kolmen luokan ulkopuolisilta alueilta. Tavoitteena oli arvioida hakkuupoistumat näissä luokissa vuodesta 1990 alkaen. Tutkimuksessa tuotettiin erilaisilla laskentavaihtoehdoilla aikasarjat ilmastosopimuksen ja Kioton pöytäkirjan mukaisiin laskentoihin käyttäen tuotantoon perustuvaa laskentaa, jossa huomioidaan kotimaassa tuotetut ja vientiin menneet puutuotteet, jotka on valmistettu kotimaisesta puusta. Laskennan luotettavuutta saatiin parannettua kokoamalla vuosia 1900–1960 koskeva kansallinen aineisto sekä selvittämällä suomalaisille puutuotteille soveltuvat kansalliset hiilenmuuntokertoimet. Sahatavara, puulevyt ja puumassat (paperin ja kartongin hiilitaseiden arvioimiseksi) jaettiin laskennassa mielekkäisiin alaryhmiin, jotta puutuotteiden hiilitaseista saataisiin luotettavammat tulokset. Laskennassa käytettiin kullekin alaryhmälle sopivia hiilenmuuntokertoimia, ja kullekin puutuoteryhmälle omia kotimaisuusasteitaan. Tutkimuksen tulokset antavat tietoa siitä, kuinka puutuotteet on tarkoituksenmukaisinta laskea Suomen kasvihuonekaasuinventaariossa ottaen huomioon ilmastosopimuksen päätösten ja IPCC:n raportointiohjeiden asettamat vaatimukset.201

A new method for estimating carbon dioxide emissions from drained peatland forest soils for the greenhouse gas inventory of Finland

Reporting the greenhouse gas (GHG) emissions from the LULUCF sector in the GHG inventory requires sound methods for estimating both the inputs and outputs of carbon (C) in managed ecosystems. Soil CO2 balance of forests consists of the CO2 released from decomposing soil organic matter (SOM) and the C entering the soil through aboveground and belowground plant litter input. Peatlands drained for forestry release soil C as CO2 because the drainage deepens the oxic peat layer prone to SOM decomposition. IPCC Guidelines provide default CO2 emission factors for different climatic zones and the defaults or locally adapted static emission factors are commonly in use in GHG inventory reporting for drained peatlands. In this paper, we describe a new dynamic method to estimate the CO2 balance of drained peatland forest soils in Finland. Contrary to static emission factors, the annual CO2 release from soil is in our method estimated using empirical regression models driven by time series of tree basal area (BA), derived from the national forest inventories in Finland, time series of air temperature and the drained peatland forest site type. Aboveground and belowground litter input is also estimated using empirical models with newly acquired turnover rates for tree fine roots and BA as a dynamic driver. All major components of litter input from ground vegetation and live, harvested and naturally died trees are included. Our method produces an increasing trend of emissions from 1.4 to 7.9 Mt CO2 for drained peatland forest soils in Finland for the period 1990&ndash;2021, with a statistically significant difference between years 1990 and 2021. Across the period 1990&ndash;2021, annual emissions are on average 3.4 Mt and &minus;0.3 Mt in southern and northern parts of Finland, respectively. When combined with data of the CO2 sink created by trees, it appears that in 2021 drained peatland forest ecosystems were a source of 2.3 Mt CO2 in southern Finland and a sink of 2.5 Mt CO2 in northern Finland. We compare the emissions produced by the new method with those produced by the old GHGI method of Finland and discuss the strengths and vulnerabilities of our method in comparison to static emission factors.</p

Training of adult psychiatrists and child and adolescent psychiatrists in europe : a systematic review of training characteristics and transition from child/adolescent to adult mental health services

BACKGROUND:Profound clinical, conceptual and ideological differences between child and adult mental health service models contribute to transition-related discontinuity of care. Many of these may be related to psychiatry training. METHODS:A systematic review on General Adult Psychiatry (GAP) and Child and Adult Psychiatry (CAP) training in Europe, with a particular focus on transition as a theme in GAP and CAP training. RESULTS:Thirty-four full-papers, six abstracts and seven additional full text documents were identified. Important variations between countries were found across several domains including assessment of trainees, clinical and educational supervision, psychotherapy training and continuing medical education. Three models of training were identified: i) a generalist common training programme; ii) totally separate training programmes; iii) mixed types. Only two national training programs (UK and Ireland) were identified to have addressed transition as a topic, both involving CAP exclusively. CONCLUSION:Three models of training in GAP and CAP across Europe are identified, suggesting that the harmonization is not yet realised and a possible barrier to improving transitional care. Training in transition has only recently been considered. It is timely, topical and important to develop evidence-based training approaches on transitional care across Europe into both CAP and GAP training

Effect of managed transition on mental health outcomes for young people at the child–adult mental health service boundary : a randomised clinical trial

Background: Poor transition planning contributes to discontinuity of care at the child–adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). Methods: A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome Scale for Children and Adolescents) score 15-months post-entry to the trial. Results: The mean difference in HoNOSCA scores between the MT and UC arms at 15 months was −1.11 points (95% confidence interval −2.07 to −0.14, p = 0.03). The cost of delivering the intervention was relatively modest (€17–€65 per service user). Conclusions: MT led to improved mental health of YP after the SB but the magnitude of the effect was small. The intervention can be implemented at low cost and form part of planned and purposeful transitional care

Transition from Child and Adolescent to Adult Mental Health Services in Young People with Depression: On What Do Clinicians Base their Recommendation?

BACKGROUND: Clinicians in Child and Adolescent Mental Healthcare Services (CAMHS) face the challenge to determine who is at risk of persistence of depressive problems into adulthood and requires continued treatment after reaching the CAMHS upper age limit of care-provision. We assessed whether risk factors for persistence were related to CAMHS clinicians’ transition recommendations. METHODS: Within the wider MILESTONE cohort study, 203 CAMHS users were classified with unipolar depressive disorder by their clinician, and 185 reported clinical levels of depressive problems on the DSM-oriented Depressive Problems scale of the Achenbach Youth Self Report. Logistic regression models were fitted to both subsamples to assess the relationship between clinicians’ transition recommendations and risk factors for persistent depression. RESULTS: Only clinicianrated severity of psychopathology was related to a recommendation to continue treatment for those classified with unipolar depressive disorder (N = 203; OR = 1 45, 95% CI (1.03–2.03), p = 044) and for those with self-reported depressive problems on the Achenbach DSM-oriented Depressive Problems scale (N = 185; OR = 1 62, 95% CI (1.12–2.34), p = 012). CONCLUSION: Transition recommendations and need for continued treatment are based on clinical expertise, rather than self-reported problems and needs

The importance of clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their mental health services in Europe

Background: To study clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their Child and Adolescent Mental Health Service (CAMHS) and its association with mental health indicators, transition recommendations and mental health service (MHS) use. Methods: 763 CAMHS users from eight European countries were assessed using multi-informant and standardised assessment tools at baseline and nine months follow-up. Separate ANCOVA's and pairwise comparisons were conducted to assess whether clinicians' and parents' awareness of young people's suicidal behaviour were associated with mental health indicators, clinician's recommendations to continue treatment and MHS use at nine months follow-up. Results: 53.5 % of clinicians and 56.9 % of parents were unaware of young people's self-reported suicidal behaviour at baseline. Compared to those whose clinicians/parents were aware, unawareness was associated with a 72–80 % lower proportion of being recommended to continue treatment. Self-reported mental health problems at baseline were comparable for young people whose clinicians and parents were aware and unaware of suicidal behaviour. Clinicians' and parents' unawareness were not associated with MHS use at follow-up. Limitations: Aspects of suicidal behaviour, such as suicide ideation, -plans and -attempts, could not be distinguished. Few young people transitioned to Adult Mental Health Services (AMHS), therefore power to study factors associated with AMHS use was limited. Conclusion: Clinicians and parents are often unaware of suicidal behaviour, which decreases the likelihood of a recommendation to continue treatment, but does not seem to affect young people's MHS use or their mental health problems

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Training of adult psychiatrists and child and adolescent psychiatrists in europe

Background: Profound clinical, conceptual and ideological differences between child and adult mental health service models contribute to transition-related discontinuity of care. Many of these may be related to psychiatry training. Methods: A systematic review on General Adult Psychiatry (GAP) and Child and Adult Psychiatry (CAP) training in Europe, with a particular focus on transition as a theme in GAP and CAP training. Results: Thirty-four full-papers, six abstracts and seven additional full text documents were identified. Important variations between countries were found across several domains including assessment of trainees, clinical and educational supervision, psychotherapy training and continuing medical education. Three models of training were identified: i) a generalist common training programme; ii) totally separate training programmes; iii) mixed types. Only two national training programs (UK and Ireland) were identified to have addressed transition as a topic, both involving CAP exclusively. Conclusion: Three models of training in GAP and CAP across Europe are identified, suggesting that the harmonization is not yet realised and a possible barrier to improving transitional care. Training in transition has only recently been considered. It is timely, topical and important to develop evidence-based training approaches on transitional care across Europe into both CAP and GAP training

Cohort profile : demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Purpose: The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports. Participants: Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at. Findings to date: This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year. Future plans: Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared. Trial registration number: NCT03013595

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions