Insolvency Insurance for Private Plans

This essay is about the use of narrative in video games, and the discussion surrounding it. For years ludologists (game researchers) and narratologists (narrativity researchers) have been arguing about how to analyze narrativity in games. While ludologists have chosen to see games as a product by itself, and therefore something to be analyzed separately, narratologists instead see games as a narrative medium alongside film, theater and books. This essay starts by taking a look at the arguments from both sides, and then introduces three questions regarding narrative in games, and how this phenomenon has changed over the past 13 years. To answer these questions, five case studies are carried out, analyzing games with the help of a new framework built on narrative theory. The essay’s conclusion then reveals how the development of game narrativity has progressed, and what this could mean for the future of narrative games

Nurses' and Patients' Perceptions about Psychiatric Intensive Care-An Integrative Literature Review

This integrative literature review describes nurses's and patients' perceptions of care in psychiatric intensive care units (PICU). The database search was conducted in April 2020. PRISMA checklist and Mixed Method Appraisal Tool guided the identification and evaluation of the studies (n = 21). Data was analyzed with qualitative content analysis. Nurses perceived PICU as a challenging work environment where their primary task was to ensure the unit's safety. Patients views on their treatment varied from positive to negative. Patients wished to have more privacy and supportive interaction. Findings can be used as a basis in developing care practices and staff's further education in PICUs

Developing Policy Pathways : Redesigning Transition Arenas for Mid-range Planning

Sustainability transitions require new policy pathways that significantly reduce the environmental impacts caused by, for example, energy production, mobility and food production. Transition management (TM) is one of the approaches aiming at the creation of new ways to govern transitions. It uses transitions arenas (TA) as a key process and platform where new policy pathways are created in collaboration with multiple (frontrunner) stakeholders. TM’s ambitious and demanding agenda is not easy to implement. There is a continued need for testing and developing new ways of carrying out its key processes. We redesigned the TA process in the context of energy system change in Finland by 2030, focusing on interim goals, mid-range change pathways and developing a new notation system that allows participants to directly create the pathways. The resulting renewed TA process results in more specific and detailed mid-range pathways that provide more concreteness to how to implement long-term transition goals. It helps to bridge long-term national visions/strategies and low carbon experiments that are already running. The Finnish TA work created eight ambitious change pathways, pointing towards new and revised policy goals for Finland and identifying specific policy actions. Evaluation of the TA, 6–9 months after its completion underscores that an effective TA needs to be embedded by design in the particular political context that it seeks to influence. It is too early to say to what degree the pathways will be followed in practice but there are positive signs already

PATH2030 – An Evaluation of Finland’s Sustainable Development Policy

The PATH2030 project has produced an evaluation of Finland’s sustainable development policy and formulated concrete recommendations for the future. The evaluation is based on multidisciplinary meth-ods and broad and diverse material in the form of indicators, documents, and expert views gathered through surveys, interviews and workshops. The evaluation focused particularly on the time after the 2030 Agenda entered into force in 2016. No country has yet presented a credible plan for how to reach the goals of the 2030 Agenda. Finland has various national targets and programmes that point in the right direction, but the policy could be more transformative and coherent. Finland’s sustainable development policy has succeeded in being inclusive, which shows that sustainable development has become a broadly accepted aim in society. Reaching the 2030 goals requires, however, many system-level changes and the mediation of conflicts of interest. The evaluation shows that sustainable development policy should focus on climate change, environmental questions, consumption and increasing inequality. It is recommended that sustainable development should become the basis of future Government Programmes, that a roadmap for how to reach the goals should be created and that, for example, the indicators and the Expert Panel on Sustainable Development should be revised. Appendix 1-13 PATH2030: Detailed descriptions of the evaluations and documentation of data collection (separate document, in Finnish) Appendix 14 PATH2030: The 2030 Agenda, foreign policy and human rights (separate document, in Finnish)This publication is part of the implementation of the Government Plan for Analysis, Assessment and Research (tietokayttoon.fi). The content is the responsibility of the producers of the information and does not necessarily represent the view of the Government

Kohti kestävää liikkumista ja liikennettä 2035 : Vaasan murrosareenan tulokset

Vaasan murrosareena on syksyllä/talvella 2018/2019 järjestetty työpajasarja, johon osallistui yhteiskunnan eri sektoreita edustava asiantuntijaryhmä. Murrosareenatyöskentely perustuu systeemisen muutoksen suuntaamisen malliin (eng. Transition Management), jossa tulevaisuuden muutoksia pyritään ohjaamaan systemaattisesti kestävämpään suuntaan. Areenan aiheena oli tulevaisuuden liikkuminen ja liikenne Vaasassa. Tässä raportissa esitellään areenan tuloksia työpajasarjan rakenteen mukaan. Työskentelyssä tunnistettiin ensin murroksen keskeiset ajurit, haasteet ja epävarmuudet. Sen jälkeen keskusteltiin visiosta, joka kiteytettiin neljäksi muutostavoitteeksi. Näiden saavuttamiseksi luotiin muutospolut nykypäivään. Poluilta identifioitiin yhteensä 26 välitöntä muutostoimea, joiden avulla hidas systeeminen muutos kohti hiilineutraalia Vaasaa 2035 voi lähteä toteutumaan. Vaasan murrosareenan keskeiset viestit ovat: 1. Joukkoliikenteen käyttäjämäärä nelinkertaiseksi vuoteen 2035 mennessä 2. Pyöräilyn kulkumuoto-osuus kolminkertaiseksi vuoteen 2035 mennessä 3. Tieliikenteen päästöjä vähennetään 90% vuoteen 2035 mennessä 4. Suunnittelun koordinointi uudelle tasolle 5. Energiapääkaupunki näkyväksi Vaasan arjessa 6. Vähähiilisyys ykkösprioriteetiksi infrastruktuurin kehittämisessä 7. Kestävä (työmatka)liikkuminen yritysten ja organisaatioiden agendalle 8. Murroksen suuntaamisen menetelmät ja työkalut käyttöönVasa omställningsarena är en serie workshoppar som arrangerades hösten/vintern 2018/ 2019. I arenan deltog en grupp experter som representerade olika sektorer i samhället. Arbetet i en omställningsarena grundar sig på Transition management -ansatsen som utgår ifrån att man med systematiskt och aktivt arbete kan styra omställningar i en mera hållbar riktning. Ämnet för Vasa omställningsarena var framtida mobilitet. I denna rapport presenteras arenans resultat utgående från workshopseriens struktur. På arenan identifierades inledningsvis centrala drivkrafter, utmaningar och osäkerheter för omställning. Efter det diskuterades arenans vision, vilket utmynnade i formuleringen av fyra omställningsmål. För att målen skall kunna nås utarbetades omställningsvägar utgående från nuläget. På basen av omställningsvägarna identifierades 26 omedelbara åtgärder för att den långsamma systemiska omställningsprocessen mot ett kolneutralt Vasa 2035 skall kunna inledas. Vasa omställningsarenas centrala budskap är: 1. Användningen av kollektivtrafiken bör fyrdubblas fram till år 2035 2. Cykeltrafikens färdsättsandel bör tredubblas fram till år 2035 3. Vägtrafikens utsläpp bör minska med 90% fram till år 2035 4. Koordineringen av planeringen bör lyftas till en ny nivå 5. Energihuvudstaden bör synas i Vasas vardag 6. Koldioxidsnåla lösningar bör ha högsta prioritet vid utvecklingen av infrastruktur 7. Företag och organisationer bör främja hållbar (arbetsplats)mobilitet 8. Transition management -ansatsens metoder och redskap bör användas i högre gradVaasa Transition Arena is a workshop series carried out in autumn/winter 2018/1029. A group of experts representing different societal sectors participated in the arena work. The arena work is based on the Transition management approach according to which the direction and pace of transitions can be influenced through systematic efforts. The topic of Vaasa Transition Arena was future mobility. This report present the results of the transition arena according to the arena structure. Initially, transition drivers, challenges and uncertainties were identified. Next, the vision was discussed and captured in four change targets. As a further step, transition pathways from the current stage were developed to achieve the set targets. Based on the pathways, 26 immediate actions were identified in order to speed up the transition process towards a carbon neutral Vaasa 2035. The main messages of Vaasa Transition Arena are: 1. Public transportation ridership should be quadrupled until 2035 2. The cycling modal share should be tripled until 2035 3. Traffic emissions should be reduced by 90% until 2035 4. Coordination of planning should be taken to a new level 5. Increase the energy capital visibility in Vaasa’s daily life 6. Give low-carbon solutions the highest priority in infrastructure development 7. Put sustainable commuting/mobility on companies’ and organisations’ agenda 8. Use Transition management methods and tools to a larger extentfi=vertaisarvioimaton|en=nonPeerReviewed

Microbial diversity within the vicinity of the Antarctic Concordia Station - an analog for human exploration sites on Mars or the icy moons of Jupiter or Saturn

The extreme terrestrial environment of the Antarctic ice sheet serves as an excellent probing ground for the adaptation of extremotolerant microorganisms. To inhabit this hostile environment, microorganisms resist sub-zero temperatures, wide temperature fluctuations, high incidence of solar UV radiation, desiccation, and very low nutrient availability. Located on a 3200 meter-high plateau in Antarctica, the Concordia Station is a remote, isolated habitat, providing an ideal location to monitor the indigenous microbial diversity and human-associated bacterial dispersal on the surface snow. In this study, (ESA project No. AO-13-Concordia-23) surface snow was sampled monthly at three areas varying in proximity (10 m, 500 m, and 1 km) to the Concordia Station across two years (March 2015 to December 2016). Snow samples from the months January, March, May, July, September, and November of both years (n=33) were phylogenetically profiled via sequencing of the 16S rRNA gene to identify microbial presence and abundance with respect to seasonal changes and human activity. While harboring low microbial diversity, the surface snow samples were characterized by heterogeneous microbiomes. Interestingly, snow samples were found to have a core microbiome consisting of the genera Acinetobacter, Micrococcus, Delftia, Bacillus, Enhydrobacter, Cutibacterium, and Alcanivorax, which persisted regardless of the measured environmental factors and level of human activity. Ultimately, this study will further inform improvements or modifications to the existing techniques to interrogate the microbial ecology in extreme (sub-zero) environments as well as provide suggestions for future life-detection driven space missions

Nordic Innovative Trials to Evaluate osteoPorotic Fractures (NITEP) Collaboration : The Nordic DeltaCon Trial protocol-non-operative treatment versus reversed total shoulder arthroplasty in patients 65 years of age and older with a displaced proximal humerus fracture: a prospective, randomised controlled trial

Introduction The proximal humerus fracture (PHF) is one of the most common fractures in the elderly. The majority of PHFs are treated non-operatively, while 15%-33% of patients undergo surgical treatment. Recent randomised controlled trial (RCT) and meta-analyses have shown that there is no difference in outcome between non-operative treatment and locking plate or hemi-arthroplasty. During the past decade, reverse total shoulder arthroplasty (RTSA) has gained popularity in the treatment of PHF, although there is a lack of RCTs comparing RTSA to non-operative treatment. Methods This is a prospective, single-blinded, randomised, controlled, multicentre and multinational trial comparing RTSA with non-operative treatment in displaced proximal humeral fractures in patients 65-85 years. The primary outcome in this study is QuickDASH-score measured at 2 years. Secondary outcomes include visual analogue scale for pain, grip strength, Oxford shoulder score, Constant score and the number of reoperations and complications. The hypothesis of the trial is that operative treatment with RTSA produces better outcome after 2 and 5 years measured with QuickDASH. Ethics and dissemination In this protocol, we describe the design, method and management of the Nordic DeltaCon trial. The ethical approval for the trial has been given by the Regional Committee for Medical and Health Research Ethics, Norway. There have been several examples in orthopaedics of innovations that result in failure after medium-term follow-ups. In order to prevent such failures and to increase our knowledge of RSTA, we feel a large-scale study of the effects of the surgery on the outcome that focuses on the complications and reoperations is warranted. After the trial 2-year follow-up, the results will be disseminated in a major orthopaedic publication.Peer reviewe