Analyysi maatalouden ympäristötukijärjestelmästä 2000-2006

Hankkeessa pyrittiin tuottamaan arvio Suomessa v. 2000 - 2006 käytössä olleen ympäristötukijärjestelmän vaikuttavuudesta ympäristöön. Työssä arvioitiin yksittäisiä toimenpiteitä sekä järjestelmää kokonaisuutena. Järjestelmän toimivuutta peilattiin sille asetettuja tavoitteita vastaan ja etsittiin parannusmahdollisuuksia. Toimenpiteiden vesiensuojelullisen kustannustehokkuuden lisäksi tarkasteltiin monimuotoisuuskustannustehokkuutta ja kehitettiin siihen liittyvää arviointimenetelmää. Hankkeessa myös kehitettiin menetelmää toimenpiteiden ympäristövaikutusten yhdennettyyn arviointiin. Vesiensuojelullisen tehon lisäämiseksi lannoitukseen ja kasvipeitteisyyteen liittyviä toimenpiteitä tulee edelleen tehostaa ja kohdentaa. Varsinkin lannan käyttöä tulee tehostaa. Väkilannoitteiden pintalannoituksesta tulisi pystyä luopumaan ja lannan levityksessä nopea multaus on tärkeää. Kasvipeitteisyyden lisääminen maan etelä- ja länsiosissa ja varsinkin jyrkillä rantapelloilla on eroosion torjunnan kannalta tärkeää. Korkeita maan helppoliukoisen fosforin pitoisuuksia on alennettava. Luonnon monimuotoisuuden edistämisen kannalta olisi oleellista kehittää perustukeen kuuluva laajasti toteutettava ja vaikuttava toimenpide. Pientareet ja suojakaistat –toimenpiteen merkitys monimuotoisuuden edistämisessä paranisi, jos se sisältäisi vesistöjen reunojen lisäksi myös muita reuna-alueita. Taantuneen ja uhanalaisen maatalousalueiden lajiston säilyttämiseksi perinnebiotooppien erityistuki on periaatteiltaan hyvin toimiva tukimuoto. Hoidettavien perinnebiotooppien määrää tulee edelleen lisätä koko maassa

Psychiatric disorders are a common prognostic marker for worse outcome in patients with idiopathic intracranial hypertension

Objective Idiopathic intracranial hypertension (IIH) is aetiologically unknown disorder that associates with endocrinological disturbances, including dysfunction of hypothalamic-pituitary-adrenal-axis. Neuroendocrinological dysfunctions have also been characterized in psychiatric disorders, and therefore we investigated the presence of psychiatric disorders of patients with IIH in a well-defined cohort. Patients and Methods A total of 51 patients with IIH were included. Patient demographics, symptoms, imaging data, ophthalmological and clinical findings were collected. Results At the time of diagnosis the mean age was 32.5years (SD 10.7), the body mass index was 37.1 kg/m2 (SD 7.4), and the opening pressure 29.1 mmHg (SD 6.2). A total of 88.2% of patients were female and 45.1% were diagnosed with a psychiatric co-morbidity prior to IIH diagnosis. The mean follow-up time was 4.4 years (SD 5.4). The overall treatment outcome was significantly poorer on a group of patients with psychiatric diagnosis when compared to individuals without such history (p = 0.001), but there were no differences in the resolution of papilledema (p = 0.405). Patients with IIH and psychiatric disorders had more often empty sella on their imaging at diagnosis when compared to patients without psychiatric co-morbidity (p = 0.044). Conclusion Psychiatric disorders are highly prevalent in patients with IIH and associate with worse subjective outcomes. These findings advocate for monitoring the mental health of patients with IIH and warrant further multidisciplinary research to understand the potentially underlying psychosocial and neuroendocrinological mechanisms.Peer reviewe

Serum 25-hydroxyvitamin D and fatty acids in relation to the risk of microbial infections in children : The TRIGR Divia study

Peer reviewe

Cerebrospinal fluid dynamics in idiopathic intracranial hypertension : a literature review and validation of contemporary findings

Publisher Copyright: © 2021, The Author(s).Background: Idiopathic intracranial hypertension (IIH) is a rare disease of unknown aetiology related possibly to disturbed cerebrospinal fluid (CSF) dynamics and characterised by elevated intracranial pressure (ICP) causing optic nerve atrophy if not timely treated. We studied CSF dynamics of the IIH patients based on the available literature and our well-defined cohort. Method: A literature review was performed from PubMed between 1980 and 2020 in compliance with the PRISMA guideline. Our study includes 59 patients with clinical, demographical, neuro-ophthalmological, radiological, outcome data, and lumbar CSF pressure measurements for suspicion of IIH; 39 patients had verified IIH while 20 patients did not according to Friedman’s criteria, hence referred to as symptomatic controls. Results: The literature review yielded 19 suitable studies; 452 IIH patients and 264 controls had undergone intraventricular or lumbar CSF pressure measurements. In our study, the mean CSF pressure, pulse amplitudes, power of respiratory waves (RESP), and the pressure constant (P0) were higher in IIH than symptomatic controls (p < 0.01). The mean CSF pressure was higher in IIH patients with psychiatric comorbidity than without (p < 0.05). In IIH patients without acetazolamide treatment, the RAP index and power of slow waves were also higher (p < 0.05). IIH patients with excess CSF around the optic nerves had lower relative pulse pressure coefficient (RPPC) and RESP than those without (p < 0.05). Conclusions: Our literature review revealed increased CSF pressure, resistance to CSF outflow and sagittal sinus pressure (SSP) as key findings in IIH. Our study confirmed significantly higher lumbar CSF pressure and increased CSF pressure waves and RAP index in IIH when excluding patients with acetazolamide treatment. In overall, the findings reflect decreased craniospinal compliance and potentially depleted cerebral autoregulation resulting from the increased CSF pressure in IIH. The increased slow waves in patients without acetazolamide may indicate issues in autoregulation, while increased P0 could reflect the increased SSP.Peer reviewe

Enterovirus Infections Are Associated With the Development of Celiac Disease in a Birth Cohort Study

Enterovirus and adenovirus infections have been linked to the development of celiac disease. We evaluated this association in children who developed biopsy-proven celiac disease (N = 41) during prospective observation starting from birth, and in control children (N = 53) matched for the calendar time of birth, sex, and HLA-DQ genotype. Enterovirus and adenovirus infections were diagnosed by seroconversions in virus antibodies in longitudinally collected sera using EIA. Enterovirus infections were more frequent in case children before the appearance of celiac disease-associated tissue transglutaminase autoantibodies compared to the corresponding period in control children (OR 6.3, 95% CI 1.8-22.3; p = 0.005). No difference was observed in the frequency of adenovirus infections. The findings suggest that enterovirus infections may contribute to the process leading to celiac disease

Safety, tolerability and immunogenicity of PRV-101, a multivalent vaccine targeting coxsackie B viruses (CVBs) associated with type 1 diabetes : a double-blind randomised placebo-controlled Phase I trial

Aims/hypothesis: Infection with coxsackie B viruses (CVBs) can cause diseases ranging from mild common cold-type symptoms to severe life-threatening conditions. CVB infections are considered to be prime candidates for environmental triggers of type 1 diabetes. This, together with the significant disease burden of acute CVB infections and their association with chronic diseases other than diabetes, has prompted the development of human CVB vaccines. The current study evaluated the safety and immunogenicity of the first human vaccine designed against CVBs associated with type 1 diabetes in a double-blind randomised placebo-controlled Phase I trial. Methods: The main eligibility criteria for participants were good general health, age between 18 and 45 years, provision of written informed consent and willingness to comply with all trial procedures. Treatment allocation (PRV-101 or placebo) was based on a computer-generated randomisation schedule and people assessing the outcomes were masked to group assignment. In total, 32 participants (17 men, 15 women) aged 18–44 years were randomised to receive a low (n=12) or high (n=12) dose of a multivalent, formalin-inactivated vaccine including CVB serotypes 1–5 (PRV-101), or placebo (n=8), given by intramuscular injections at weeks 0, 4 and 8 at a single study site in Finland. The participants were followed for another 24 weeks. Safety and tolerability were the primary endpoints. Anti-CVB IgG and virus-neutralising titres were analysed using an ELISA and neutralising plaque reduction assays, respectively. Results: Among the 32 participants (low dose, n=12; high dose, n=12; placebo, n=8) no serious adverse events or adverse events leading to study treatment discontinuation were observed. Treatment-emergent adverse events considered to be related to the study drug occurred in 37.5% of the participants in the placebo group and 62.5% in the PRV-101 group (injection site pain, headache, injection site discomfort and injection site pruritus being most common). PRV-101 induced dose-dependent neutralising antibody responses against all five CVB serotypes included in the vaccine in both the high- and low-dose groups. Protective titres ≥8 against all five serotypes were seen in >90% of participants over the entire follow-up period. Conclusions/interpretation: The results indicate that the tested multivalent CVB vaccine is well tolerated and immunogenic, supporting its further clinical development. Trial registration: ClinicalTrials.gov NCT04690426. Funding: This trial was funded by Provention Bio, a Sanofi company. Graphical Abstract: (Figure presented.)Peer reviewe

Enterovirus infection during pregnancy is inversely associated with atopic disease in the offspring

Background: Prenatal environment has been shown to influence child's risk of atopic diseases. Laboratory-confirmed data about the role of maternal infections during pregnancy is scarce. Objective: The aim of this study was to determine the associations between serologically confirmed maternal infections during pregnancy and atopic disease in the offspring. Methods: This was a nested case-control study within a prospective birth cohort study. Altogether 202 atopic case children and 333 matched non-atopic control children were included. Atopic outcome was defined as having an atopic disease and IgE sensitization by the age of 5 years. We analysed serologically acute enterovirus (EV), influenza virus A (IAV) and Mycoplasma pneumoniae (M. pneumoniae) infections during pregnancy, and mother's seropositivity against human cytomegalovirus (CMV) and Helicobacter pylori. Results: Maternal EV infection during pregnancy was inversely associated with atopic outcome in the offspring (odds ratio 0.43; 95% confidence interval: 0.23-0.80, P = 0.008). Acute IAV or M. pneumoniae infections or seropositivity against CMV or Helicobacter pylori were not associated with the atopic outcome. Conclusions and Clinical Relevance: Our results suggest that maternal EV infections during pregnancy are inversely associated with atopic disease in the offspring. Our finding provides further support to the previous studies suggesting an important role of the in utero environment in the development of atopic diseases.Peer reviewe

Cerebrospinal fluid dynamics in idiopathic intracranial hypertension: a literature review and validation of contemporary findings

Background Idiopathic intracranial hypertension (IIH) is a rare disease of unknown aetiology related possibly to disturbed cerebrospinal fluid (CSF) dynamics and characterised by elevated intracranial pressure (ICP) causing optic nerve atrophy if not timely treated. We studied CSF dynamics of the IIH patients based on the available literature and our well-defined cohort. Method A literature review was performed from PubMed between 1980 and 2020 in compliance with the PRISMA guideline. Our study includes 59 patients with clinical, demographical, neuro-ophthalmological, radiological, outcome data, and lumbar CSF pressure measurements for suspicion of IIH; 39 patients had verified IIH while 20 patients did not according to Friedman's criteria, hence referred to as symptomatic controls. Results The literature review yielded 19 suitable studies; 452 IIH patients and 264 controls had undergone intraventricular or lumbar CSF pressure measurements. In our study, the mean CSF pressure, pulse amplitudes, power of respiratory waves (RESP), and the pressure constant (P0) were higher in IIH than symptomatic controls (p p p p Conclusions Our literature review revealed increased CSF pressure, resistance to CSF outflow and sagittal sinus pressure (SSP) as key findings in IIH. Our study confirmed significantly higher lumbar CSF pressure and increased CSF pressure waves and RAP index in IIH when excluding patients with acetazolamide treatment. In overall, the findings reflect decreased craniospinal compliance and potentially depleted cerebral autoregulation resulting from the increased CSF pressure in IIH. The increased slow waves in patients without acetazolamide may indicate issues in autoregulation, while increased P0 could reflect the increased SSP.</p

Maternal gluten, cereal, and dietary fiber intake during pregnancy and lactation and the risk of islet autoimmunity and type 1 diabetes in the child

Background &amp; aims: Maternal gluten intake in relation to child's risk of type 1 diabetes has been studied in few prospective studies considering the diet during pregnancy but none during lactation. Our aim was to study whether gluten, cereals, or dietary fiber in maternal diet during pregnancy and lactation is associated with the risk of islet autoimmunity or type 1 diabetes in the offspring. Methods: We included 4943 children with genetic susceptibility to type 1 diabetes from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study, born between 1996 and 2004. Maternal intake of gluten, different types of cereals, and dietary fiber were derived from a semi-quantitative validated food frequency questionnaire covering the eighth month of pregnancy and the third month of lactation. Children were monitored for islet autoantibodies up to age of 15 years and type 1 diabetes until year 2017. Risk of islet autoimmunity and clinical type 1 diabetes were estimated using Cox regression model, adjusted for energy intake, child's sex, HLA genotype, and familial diabetes. Results: Altogether 312 children (6.4%) developed islet autoimmunity at median age of 3.5 (IQR 1.7, 6.6) years and 178 children (3.6%) developed type 1 diabetes at median age of 7.1 (IQR 4.3, 10.6) years. Gluten intake during pregnancy was not associated with islet autoimmunity (HR 0.96; 95% CI 0.68, 1.35), per 1&nbsp;g/MJ increase in intake nor type 1 diabetes (HR 0.96; 95% CI 0.62, 1.50) in the offspring. Higher barley consumption during lactation was associated with increased risk of type 1 diabetes (HR 3.25; 95% CI 1.21, 8.70) per 1&nbsp;g/MJ increase in intake. Maternal intake of other cereals or dietary fiber was not associated with the offspring outcomes. Conclusions: We observed no association between maternal intake of gluten, most consumed cereals, or dietary fiber during pregnancy or lactation and the risk of islet autoimmunity or type 1 diabetes in children from a high-risk population

Puolustusvoimien henkilöstöalan sähköisten palveluiden käytettävyyden parantaminen

Tutkimuksen keskeisenä tavoitteena oli selvittää Puolustusvoimien sähköisten palveluiden käytettävyys ja esittää toimenpiteitä käytettävyyden parantamiseksi. Tutkimus selvittää mitä ovat Puolustusvoimien sähköiset palvelut. Tämän lisäksi tutkimuksessa tarkastellaan sitä, mistä käytettävyys muodostuu, mitkä tekijät vaikuttavat käytettyyden kokemukseen ja mitä ovat hyvän käytettävyyden ominaisuudet. Sähköisten palveluiden käytettävyyttä arvioitiin useilla menetelmillä. Tutkimus on luonteeltaan laadullinen tutkimus, jossa tutkittiin käytettävyyttä ilmiönä aikaisempien tutkimusten ja muun kirjallisen aineiston pohjalta. Sähköisten palveluiden käytettävyyttä tutkittiin sekä laadullisin että määrällisin menetelmin. Tutkimuksessa käytettyjä tiedonkeruumenetelmiä olivat haastattelut ja kysely. Käytettävyyden arviointimenetelminä olivat haastatteluina toteutettu asiantuntija-arviointi ja kyselynä toteutettu loppukäyttäjäarviointi sekä loppukäyttäjäarviointiin sisältynyt System Usability Scale -kysely. Haastatteluissa ja kyselyssä ongelmanratkaisumenetelmänä oli kahdeksan ominaisuuden heuristiikka. Heuristiikat sopivat sellaisten monimutkaisten ongelmien ratkaisemiseen, joita ei voida kattavasti määritellä, eikä niihin ole olemassa vain oikeaa tai väärää, tai vain hyvää tai huonoa vaihtoehtoa. Mittausmenetelmänä kyselyssä käytettiin sisäistä ja samanaikaista triangulaatiota. Haastatteluiden ja kyselyn avointen kysymysten aineiston analyysimenetelmänä oli aineistolähtöinen sisällönanalyysi. Kyselyn suljettuja kysymyksiä analysoitiin lisäksi tilastollisesti kuvailevalla analyysillä ja tilastollisella päättelyllä. Tutkimuksen tuloksena osoitettiin, että sähköisten palveluiden käytettävyydessä on parannettavaa. Arvioinneissa löydettiin useita käytettävyysongelmia. Ongelmista osa oli myös sellaisia kriittisiä ongelmia, joiden seurauksena voi syntyä virheellistä tietoa tai ne voivat vaarantaa henkilötietosuojan. Tutkimuksen tuloksena kuvattiin toimenpiteitä, joita toteuttamalla sähköisten palveluiden käytettävyyttä voidaan parantaa merkittävästi. Lisäksi kyselystä kyettiin laatimaan sellainen käytettävyyden mittaus- ja arviointimenetelmä, jota voidaan käyttää myös muiden järjestelmien käytettävyysarvioinneissa