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Sleep problems are common in psychotic disorders and are associated with worse quality of life and disease prognosis. Genome-wide association studies (GWAS) have revealed genetic influences for schizophrenia and sleep, but polygenic scores (PGSs) for sleep traits have not been evaluated systematically in patients with psychotic disorders.
Methods
This study investigated the associations between PGSs for sleep traits (insomnia, PGSINS; sleep duration, PGSSD; short sleep duration, PGSSS; long sleep duration; PGSLS), diurnal preference (eveningness, PGSME), and schizophrenia (PGSSZ) with clinical features of psychotic disorders in the Finnish SUPER study comprising 8,232 patients with psychotic disorders. The measures included self-reported sleep and well-being, cognitive assessments, clozapine use, and functional outcomes. Using FinnGen data of 356,077 individuals, we analyzed the distributions of PGSs in psychotic and bipolar disorders and the general population.
Results
PGSINS associated with more sleep problems and worse well-being (e.g. worse health-related quality of life [β = −0.07, CI = −0.09, −0.05, p < .001]). High PGSSZ is associated with better sleep quality, worse clinical outcomes, and performance in cognitive tests (e.g. more errors in paired-associated learning [β = 0.07, CI = 0.04, 0.09, p < .001]). PGSINS was higher in affective psychotic and bipolar disorders, while PGSSD and PGSME were higher in schizophrenia as compared with individuals with no psychiatric disorders.
Conclusion
Genetic risks for sleep and diurnal preference vary between non-affective psychosis, affective psychosis, and the general population. The findings in this study emphasize the heterogeneity in genetic etiology of the objective features of disease severity and the more subjective measures related to well-being and self-reported measures of sleep.
This article explores the political trajectories of the early twentieth-century Grand Duchy of Finland and the Kingdom of Poland in the context of the “global parliamentary moment,” when the constitutional script of revolution competed with the more daring script of social revolution. We scrutinize contrastive political choices of socialist parties in these two western borderlands of the Russian Empire. Finland and Poland emerged as independent parliamentary states in 1917–1918 but under manifestly different circumstances. The Finnish socialist party had enjoyed a stable foothold in the formally democratic but practically impotent national parliament since 1907, whereas the Polish socialists boycotted the Russian Duma and envisioned a democratic legislature as a guaranty of a Poland with true people’s power. The Finnish socialists later abandoned parliamentarism in favor of an armed revolution, in 1918, whereas most of their Polish counterparts used the parliamentary ideal of popular sovereignty to restrain the revolutionary upsurge. We argue that the socialist understandings of parliamentarism and revolution were of crucial importance at this juncture. We draw from a broad corpora of political press reports, handwritten newspapers, and leaflets to show how the diachronic sequence of events and synchronic power relations inside the Russian Empire made certain stances toward parliamentarism and revolution more likely at different points in time.
In numerous countries, emergency medical services (EMS) students receive curriculum training in effective patient–provider communication, but most of this training assumes patients have intact communication capabilities, leading to a lack of preparedness to interact with patients, who have communication disorders. In such cases, first responders could end up delivering suboptimal care or possibly wrong procedures that could harm the disabled person.
Method:
A quasi-experimental design (pretest–posttest) was used to assess the knowledge of EMS students both before and after a translation workshop on how to deal with patients who have hearing and communication disorders during emergencies. Comparisons between pretest and posttest scores were examined using the Wilcoxon signed rank test. The level of knowledge scores was compared before and after the workshop.
Results:
The results indicated that EMS students’ scores improved after the workshop. There was a 0.763 increase in the average score of knowledge level. The results of this study show that knowledge translation workshops are a useful intervention to enhance the level of knowledge among EMS students when interacting with hearing and communication patients.
Conclusions:
Our results show that such training workshops lead to better performance. Communication is a vital element in a medical encounter between health care providers and patients at all levels of health care but specifically in the prehospital arena. Insufficient or lack of communication with a vulnerable population, who may suffer from various disabilities, has a significant impact on the outcome of treatment or emergency management.
The Therapeutic Engagement Questionnaire (TEQ) has been developed and validated in partnership with service users (SUs), registered mental health nurses (RMHNs) and nurse academics in the UK in accordance with psychometric theory. The TEQ is highly relevant and useful to clinical practice. The TEQ measures therapeutic engagement (TE) in two contexts - 1-1 interactions between SUs and RMHNs, as well as the overall environment and atmosphere of the units - from the perspective of both SUs and RMHNs. The TEQ has been translated into Finnish by two expert panels and was pre-tested and validated in ten adult acute psychiatric in-patient units in two hospitals in Finland.
Objectives
To measure TE in Finnish adult acute in-patient psychiatric settings from the perspectives of both SUs and RMHNs.
Methods
The Finnish version of the TEQ (Hoidollinen yhteistyö) will be completed by RMHNs and SUs in 15 adult acute psychiatric in-patient units. Nine of the units are within the University Hospital and six in a municipal psychiatric hospital. The data will be collected within a 3-month period (October - December 2020). The coordinating nurse of each unit will organise the operational side of the study including obtaining consent from SUs. The nurses will participate in the survey via Webropol which includes nurses’ consent. Sociodemographic information will be collected from the SUs and nurses.
Results
The results of the measurement study will be reported at the 29th European Congress of Psychiatry.
Conclusions
The conclusions of the measurement study will be reported at the 29th European Congress of Psychiatry.
Conflict of interest
This study is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London).
The circular economy action plan promotes more efficient utilisation of material resources. In order to pursue the objectives of the circular economy, the use of waste-based substances and objects should be promoted by creating a level playing field between them and virgin raw materials. However, due to the lack of legal certainty in the commodification of waste materials, many operators prefer virgin raw materials over waste-based ones. Nonetheless using waste-based materials often provides environmentally better outcomes when one takes into account the whole lifecycle of the product.
Due to the scope of application of the waste legislation, the question of whether a substance or object is considered to be waste is crucial. Essentially, waste legislation applies to “waste”, whereas product legislation applies to “non-waste”. Article 3(1) of Directive 2008/98/EC (Waste Framework Directive, WFD) defines waste as any substance or object which the holder discards or intends or is required to discard. However Article 6 of the WFD provides a set of criteria to determine whether the material has ceased to be waste (end-of-waste, EoW):
Member States shall take appropriate measures to ensure that waste which has undergone a recycling or other recovery operation is considered to have ceased to be waste if it complies with the following conditions:
a) the substance or object is to be used for specific purposes;
b) a market or demand exists for such a substance or object;
c) the substance or object fulfils the technical requirements for the specific purposes and meets the existing legislation and standards applicable to products; and
d) the use of the substance or object will not lead to overall adverse environmental or human health impacts.
These criteria introduce a clear distinction between waste and non-waste: they separate safe recovered materials from those that still require the governance of waste legislation in order to control the risks involved in their utilisation. Therefore, the EoW criteria and their interpretation play a key role in the stemisation of circular economy.
The legislation that applies to similar non-waste products applies, instead of waste legislation, to materials after they cease to be waste. Usually this legislation regulates both the suitability of the material for the use to which it is being put and, through various kinds of product standards and limit values, the risks related to such use.
Mountain birch forests in the northern areas of Sápmi, the Saami homeland, serve as pastures for semi-domesticated reindeer. Recent reindeer management of the area has, to date, proceeded with little involvement of reindeer herders or their knowledge. To get more in-depth understanding of recent changes, we present together herders’ knowledge and scientific knowledge concerning the impacts of herbivory and climate change on mountain birch forests in three Saami communities in Norway and in Finland. Most of the herders interviewed reported changes in weather during the preceding decades. Herders agreed that the canopy and understorey of mountain birch forests have changed. The observed transformations in the quality of pastures have increased the financial costs of reindeer husbandry. Our study demonstrates that herders have practical knowledge of the present state and recent changes of birch forests, and of the responses of reindeer caused by these. This knowledge generally coincides with scientific knowledge. We call for better integration of knowledge systems and a better protocol for co-production of knowledge as it relates to more adaptive future reindeer management regimes. Such integration will facilitate understanding of cultural adaptation within rapidly changing social-ecological systems in which sustainable reindeer husbandry continues to be an important livelihood.
Pre-industrial money supply typically consisted of multiple, often foreign currencies. Standard economic theory implies that this entails welfare loss due to transaction costs imposed by currency exchange. Through a study of novel data on Finnish nineteenth-century parish-level currency conditions, we show that individual currencies had principal areas of circulation, with extensive co-circulation restricted to the boundary regions in between. We show that trade networks, defined here through the regional co-movement of grain prices, proved crucial in determining the currency used. Market institutions and standard price mechanisms had an apparent role in the spread of different currencies and in determining the dominant currency in a given region. Our findings provide a caveat for the widely held assumption that associates multi-currency systems with negative trade externalities.
This chapter is about how the concept of partial organization can contribute to our understanding of the specificity of organizing collective action through social media. Empirically, it is a story about how a small group of activists via Facebook could raise 9 million Swedish crowns (around 900 000 Euros) in just over a week to a private bank account, and also about the ensuing challenges involved in allocating the funds and packing and distributing the tons of clothes and other items they collected. Theoretically, we want to propose that the undecided order of a social media initiative may hold sufficient power to initiate it, but it may become too strenuous to manage in the long run without legitimate authority. In turn, pressures to incorporate standardized practices of membership, leadership, and monitoring may risk the very basis of the large-scale engagement that the partialness of the social media initiative has enabled.
Objectives: The aim of this work was to study the change in different cognitive domains after stroke during a 2-year follow-up. Method: We evaluated both neuropsychologically and neurologically a consecutive cohort of working-age patients with a first-ever stroke at baseline (within the first weeks), 6 months, and 2 years after stroke-onset. A total of 153 patients participated in all examinations and were compared to 50 healthy controls. Results: Forty-nine percent of the patients were cognitively impaired at baseline, 41% at 6 months, and 39% at 2-year follow-up. We analyzed seven cognitive domains (impairment rates at baseline and 2-year follow-up): psychomotor speed (34%; 23%), executive functions (27%; 17%), visual memory (21%; 4%), visuospatial function (20%; 14%), verbal memory (18%; 12%), basic language processing (baseline 11%; 6 months 5%), and reasoning (2 years 14%). The patients who were cognitively impaired at baseline improved more within 6 months, than either the controls or cognitively intact patients in all cognitive domains (all p<.05). Later on, between 6 months and 2 years, the domain-specific change scores did not differ between patients who were cognitively intact and impaired at 6 months. Also, the cognitive status (intact or impaired) remained the same in 90% of patients between 6-month and 2-year follow-ups. At 2 years, half of the patients, who were categorized cognitively impaired, were rated as well-recovered according to neurological evaluation. Conclusions: Most of the cognitive improvement took place within 6 months. Long-lasting cognitive impairment was common even after good neurological recovery. An early neuropsychological examination is essential in evaluating cognitive dysfunction and need for rehabilitation. (JINS, 2018, 24, 117–127)
We describe existing research infrastructures relevant for space weather and open issues of space weather research including the need for sustainable observation networks and for high-quality data products as basis for model development. The local relevance in Europe for studies of the ionosphere at high latitude is described. We propose as possible a way forward to sustain space weather research in Europe to establish a European research infrastructure project for space weather research and observations.
Objectives: Executive dysfunction is associated with impaired memory performance, but controversies remain about which aspects of memory are involved and how general intelligence influences these connections. We aimed to clarify these connections in stroke patients by comparing various memory measures in patients with and without executive impairment. Methods: Our consecutive cohort included patients with a first-ever ischemic stroke. Neuropsychological assessments were completed 6 months and 2 years after stroke. We classified patients as executively impaired, when at least two of five executive measures were defective at 6 months. At both 6 months and 2 years, we compared list learning of unrelated words, story recall, and recall of geometric figures in patients with and without executive impairment, while controlling for general intelligence. Results: Patients with executive impairment (n=66; 37%) performed worse in list learning (p=.001; partial η2=.058) and immediate recall of a logical passage (p=.010; partial η2=.037) 6 months after stroke compared to executively intact patients (n=113). At the end of the 2-year follow-up period, the patients who were executively impaired at 6 months (n=53; 37%) still performed worse than executively intact patients (n=92) in list learning (p<.001; partial η2=.096), and additionally in delayed recall of the list (p=.006; partial η2=.052) and immediate recall of geometric figures (p=.007; partial η2=.050). Conclusions: In our working-aged stroke patients, executive impairment was common. Executive impairment was associated with memory tasks that provided less inherent structure and required the use of active memory strategies. Clinicians should remember this role of executive dysfunction when interpreting memory performance. (JINS, 2016, 22, 1–10)
This study aimed to identify and reach consensus among primary health care participants [registered nurses (RNs) who receive clients, directors of nursing, senior physicians, health promotion officers, and local councillors] on the types of service provider that RNs who receive clients represent in the implementation of health promotion practices in primary health care in Eastern Finland.
Background
There is an increasing focus on public health thinking in many countries as the population ages. To meet the growing needs of the health promotion practices of populations, advance practice has been recognized as effective in the primary health care setting. The advance practice nurses share many common features, such as being RNs with additional education, possessing competencies to work independently, treating clients in both acute and primary care settings, and applying a variety of health promotion practices into nursing.
Methods
The two-stage modified Delphi method was applied. In round one, semi-structured interviews were conducted among primary health care participants (n=42) in 11 health centres in Eastern Finland. In round two, a questionnaire survey was conducted in the same health centres. The questionnaire was answered by 64% of those surveyed (n=56). For data analysis, content analysis and descriptive statistics were used.
Findings
This study resulted in four types of service provider that RNs who receive clients represented in the implementation of health promotion practices in the primary health care setting in Eastern Finland. First, the client-oriented health promoter demonstrated four dimensions, which reached consensus levels ranging between 82.1 and 89.3%. Second, the developer of health promotion practices comprised four dimensions, which reached consensus levels between 71.4 and 85.7%. Third, the member of multi-professional teams of health promotion practices representing three dimensions, with consensus levels between 69.6 and 82.1%. Fourth, the type who showed interest towards health policy reached a consensus level of 55.4% in this study.
This paper analyses the effects of receiver non-linearity on the performance of the most commonly utilized signal detectors in cognitive radio systems. The analysis covers both self-modulation products of a single orthogonal frequency-division multiplexing (OFDM) signal and intermodulation (IM) products of two OFDM signals, and also their contribution to the probability of false detections. As a result, this work presents the linearity requirements for the spectrum sensor receiver front-end as a function of the sensitivity of the signal detector. Furthermore, we show that the cyclostationary feature detectors are more robust than the energy detectors against IM products of multiple interferers. Theoretical results are verified in measurements with a cyclostationary feature detector using digital video broadcasting – terrestrial (DVB-T) signals as an example.
The price and ISBN in the book review (Turunen, 2014) refer to the hardcover of the book. The price of the softcover is £37.50 with the ISBN 978-0-19-955941-1. We apologise for this mistake.
VTT has implemented the demand of energy and resource efficiency in the framework of Ecodesign concept covering the whole material life cycle from material sources to material design and manufacturing, component life time optimisation and finally recycling concepts. The vision of the virtually supported Ecodesign concept is to create optimized and efficient machine and device components regarding their whole lifecycle by evolving multiscale modelling.
In this presentation we will introduce our development work within our Ecodesign concept by giving two case examples including Cu flow in electrical motor and Ni flow in waste incinerator. In the first case we will discuss raw material scarcity based design criteria, technological challenges and possibilities of Cu substitution and finally energy efficiency in system level. In the latter we will discuss multiscale modelling approach starting from raw materials and new design criteria regarding performance, life time, maintenance strategies and energy efficiency in system level operation.
Background: The cost-effectiveness of triptans in the treatment of migraine has not been assessed since generic sumatriptan entered the Finnish market in 2008.
Methods: Using systematic review and mixed treatment comparison, the effectiveness of triptans was estimated with regard to 2-hour response, 2-hour pain-free, recurrence, and any adverse event, using published clinical data. Direct and indirect costs (2010 EUR, societal perspective) and quality-adjusted life-years (QALYs) were evaluated over one acute migraine attack using a decision-tree model.
Results: The meta-analysis combined data from fifty-six publications. The highest probability of achieving the primary outcome, “sustained pain-free, no adverse event” (SNAE), was estimated for eletriptan 40 mg (20.9 percent). Sumatriptan 100 mg was the treatment with lowest estimated costs (€20.86), and the incremental cost-effectiveness ratio of eletriptan 40 mg compared with sumatriptan 100 mg was €43.65 per SNAE gained (€19,659 per QALY gained).
Conclusion: Depending on the decision-maker's willingness-to-pay threshold, either sumatriptan 100 mg or eletriptan 40 mg is likely to be cost-effective.
Our aim was to investigate whether fish consumption is associated with the consumption of other healthy foods. The study population consisted of 2605 men and 3199 women from the nationally representative Health 2000 survey and 114 professional fishermen and 114 fishermen's wives (the Fishermen substudy) in Finland. Dietary data were collected using a calibrated (i.e. determined to have relative validity) FFQ. Model-adjusted means for food consumption and P values for linear trend were calculated across fish consumption tertiles. Those with the highest fish consumption had the highest consumption of vegetables, fruit and berries, potatoes, oil and wine even after adjusting for other food groups. The consumption of red meat and sausages had a tendency to decrease across fish consumption tertiles but the associations were inconsistent in the study populations. In conclusion, fish consumption had a positive linear association with the consumption of some other healthy foods such as vegetables, fruit, berries, and oil both in the general population of Finland and in a population with high fish consumption. Additional adjustment for other food groups had a clear effect on some of the studied associations. Therefore, when evaluating the health effects of fish consumption, confounding by other foods characterising a healthy diet needs to be considered.
Dietary fish is the main source of methylmercury (MeHg) for man, and fish consumption has been used as a measure of MeHg exposure. However, other dietary sources of exposure exist and MeHg metabolism may also be modified by nutritional factors. The aim of the present study was to examine the association between blood MeHg concentration and consumption of different foods in a Finnish population with high fish consumption.
Design
Blood samples, a detailed FFQ and additional frequency data on fish consumption were collected. MeHg was analysed from whole blood by the isotope dilution method with high-resolution MS. The consumption of different foods was calculated by MeHg quartiles and tested for linear trend.
Setting
Finnish southern and south-western coast of the Baltic Sea.
Subjects
Two hundred and ninety-nine professional fishermen, their spouses and other family members.
Results
Mean (range) blood MeHg concentration was 4·6 (0·21–22) μg/l among men and 2·8 (<0·15–20) μg/l among women. Fish had the strongest positive association with MeHg (P for linear trend <0·001 among both men and women). Among men, positive associations were also observed for fruit vegetables, wheat and wine. Among women, positive associations were observed for root vegetables, legumes, potato and game, but adjustment for fish consumption attenuated these trends.
Conclusions
The study shows that, besides fish, MeHg may have other dietary sources that should be taken into account in risk assessment studies. Due to the observed high blood MeHg concentration, a thorough exposure assessment among the general Finnish population is recommended.
According to present acts and regulations, farmed foxes shall have a gnawing or other enrichment object in their cages. However, research on the welfare effects of gnawing objects has been scarce. We assessed physiology and health, that is weight development, urinary cortisol-creatinine ratio, serum cortisol level after adrenocorticotropic hormone administration, internal organ masses and incidence of gastric ulcerations as well as dental and overall oral health, in pair-housed juvenile blue foxes that were housed either with or without a possibility to interact with bones (cattle femur) during their growing season (July to December). The results show that the physiological effects of the possibility to interact with bones were either non-significant or suggested that competition for bones may jeopardize the welfare of subordinate individuals. However, the results clearly show that gnawing bones are beneficial for the dental health of farmed foxes.