Alikasvoksen mittaus ja kartoitus laserkeilauksella

Tasaikäisen metsän alle muodostuvilla alikasvoksilla on merkitystä puunkorjuun, metsänuudistamisen, näkemä-ja maisema-analyysien sekä biodiversiteetin ja hiilitaseen arvioinnin kannalta. Ilma-aluksista tehtävä laserkeilaus on osoittautunut tehokkaaksi kaukokartoitusmenetelmäksi varttuneiden puustojen mittauksessa. Laserkeilauksen käyttöönotto operatiivisessa metsäsuunnittelussa mahdollistaa aiempaa tarkemman tiedon tuottamisen alikasvoksista, mikäli alikasvoksen ominaisuuksia voidaan tulkita laseraineistoista. Tässä työssä käytettiin tarkasti mitattuja maastokoealoja ja kaikulaserkeilausaineistoja (discrete return LiDAR) usealta vuodelta (1–2 km lentokorkeus, 0,9–9,7 pulssia m-2). Laserkeilausaineistot oli hankittu Optech ALTM3100 ja Leica ALS50-II sensoreilla. Koealat edustavat suomalaisia tasaikäisiä männiköitä eri kehitysvaiheissa. Tutkimuskysymykset olivat: 1) Minkälainen on alikasvoksesta saatu lasersignaali yksittäisen pulssin tasolla ja mitkä tekijät signaaliin vaikuttavat? 2) Mikä on käytännön sovelluksissa hyödynnettävien aluepohjaisten laserpiirteiden selitysvoima alikasvospuuston ominaisuuksien ennustamisessa? Erityisesti haluttiin selvittää, miten laserpulssin energiahäviöt ylempiin latvuskerroksiin vaikuttavat saatuun signaaliin, ja voidaanko laserkaikujen intensiteetille tehdä energiahäviöiden korjaus. Puulajien väliset erot laserkaiun intensiteetissä olivat pieniä ja vaihtelivat keilauksesta toiseen. Intensiteetin käyttömahdollisuudet alikasvoksen puulajin tulkinnassa ovat siten hyvin rajoittuneet. Energiahäviöt ylempiin latvuskerroksiin aiheuttivat alikasvoksesta saatuun lasersignaaliin kohinaa. Energiahäviöiden korjaus tehtiin alikasvoksesta saaduille laserpulssin 2. ja 3. kaiuille. Korjauksen avulla pystyttiin pienentämään kohteen sisäistä intensiteetin hajontaa ja parantamaan kohteiden luokittelutarkkuutta alikasvoskerroksessa. Käytettäessä 2. kaikuja oikeinluokitusprosentti luokituksessa maan ja yleisimmän puulajin välillä oli ennen korjausta 49,2–54,9 % ja korjauksen jälkeen 57,3–62,0 %. Vastaavat kappa-arvot olivat 0,03–0,13 ja 0,10–0,22. Tärkein energiahäviöitä selittävä tekijä oli pulssista saatujen aikaisempien kaikujen intensiteetti, mutta hieman merkitystä oli myös pulssin leikkausgeometrialla ylemmän latvuskerroksen puiden kanssa. Myös 3. kaiuilla luokitustarkkuus parani. Puulajien välillä havaittiin eroja siinä, kuinka herkästi ne tuottavat kaiun laserpulssin osuessa puuhun. Kuusi tuotti kaiun suuremmalla todennäköisyydellä kuin lehtipuut. Erityisen selvä tämä ero oli pulsseilla, joissa oli energiahäviöitä. Laserkaikujen korkeusjakaumapiirteet voivat siten olla riippuvaisia puulajista. Sensorien välillä havaittiin selviä eroja intensiteettijakaumissa, mikä vaikeuttaa eri sensoreilla hankittujen aineistojen yhdistämistä. Myös kaiun todennäköisyydet erosivat jonkin verran sensorien välillä, mikä aiheutti pieniä eroavaisuuksia kaikujen korkeusjakaumiin. Aluepohjaisista laserpiirteistä löydettiin alikasvoksen runkolukua ja keskipituutta hyvin selittäviä piirteitä, kun rajoitettiin tarkastelu yli 1 m pituisiin puihin. Piirteiden selitysvoima oli parempi runkoluvulle kuin keskipituudelle. Selitysvoima ei merkittävästi alentunut pulssitiheyden pienentyessä, mikä on hyvä asia käytännön sovelluksia ajatellen. Lehtipuun osuutta ei pystytty selittämään. Tulosten perusteella kaikulaserkeilausta voi olla mahdollista hyödyntää esimerkiksi ennakkoraivaustarpeen arvioinnissa. Sen sijaan alikasvoksen tarkempi luokittelu (esim. puulajitulkinta) voi olla vaikeaa. Kaikkein pienimpiä alikasvospuita ei pystytä havaitsemaan. Lisää tutkimuksia tarvitaan tulosten yleistämiseksi erilaisiin metsiköihin.

Critical leg ischaemia with tissue loss : a challenge for the vascular surgeon

There is a widespread reporting habit of combining the outcomes for patients with rest pain (Fontaine III) and tissue loss (Fontaine IV) under the single category of critical leg ischaemia (CLI). This study focused on patients with ischaemic tissue loss treated with infrainguinal bypass surgery (IBS). All patients included in the study were treated at Helsinki University Central Hospital in 2000-2007. First, ulcer healing time after IBS and factors influencing healing time were prospectively assessed in 2 studies including 148 and 110 patients, respectively. Second,the results of redo IBS were retrospectively evaluated in 593 patients undergoing primary IBS for CLI with tissue loss . Third,long-term outcome were retrospectively analysed in 636 patients who underwent IBS for CLI with tissue loss . Fourth, the outcome of IBS was retrospectively compared with endovascular treatment (PTA) of the infrapopliteal arteries in 1023 CLI patients. Fifth, the influence multidrug resistant Pseudomans aeruginosa (MDR Pa) bacteria contamination in CLI patients treated with IBS was retropectively assessed. Sixty-four patients with positive MDR Pa -culture were matched with 64 MDR Pa - negative controls. Complete ulcer healing rate, including the ischemic ulcers and incisional wounds, was 40% at 6 months after IBS and 75% at one year. Diabetes was a risk factor for prolonged complete ulcer healing time. Ischaemic tissue lesions located in mid-and hindfoot healed poorly. At one year after IBS 50% of the patients were alive with salvaged leg and completely healed ulcers. The absence of gap between tertiary graft patency and leg salvage rates indicates the importance of a patent infrainguinal graft to save a leg with ischaemic tissue loss. Long-term survival for patients with ischaemic tissue loss was poor, 38% at 5 years. Only 30% of the patients were alive without amputation at 5 years. Several of the patient comorbidities increased independently the mortality risk; coronary artery disease, renal insufficiency, chronic obstructive lung disease and high age. When both PTA and bypass is feasible, infrapopliteal PTA as a first-line strategy is expected to achieve similar long-term results to bypass surgery in CLI when redo surgery is actively utilized. MDR Pa in a patient with CLI should be considered as a serious event with increased risk of early major amputation or death. Conclusion: Despite a successful infrainguinal bypass healing of the ischaemic ulcers and incisional wounds ulcer healing is a slow process especially in diabetics. Bypass surgery and PTA improve the outcome of the ischaemic leg but the mortality rate of the patients is high due to their severe comorbidities.

"Oma entinen on palannut takaisin elämään" : Kuntoutuksen vaikuttavuus aikuisena kuuroutuneiden henkilöiden elämänhallintaan ja psykososiaaliseen hyvinvointiin

Objective The objective of this study was to learn about the psychosocial well-being and life management of Finnish adults with late deafness or hearing loss and to observe the effectiveness of the rehabilitation courses they participated in. Methods For my study I used indicators which were suitable for the evaluation of life management and psychosocial well-being of late-deafened adults. The first part of the study was conducted during 2009 as a questionnaire on three rehabilitation courses in Kopola, a course center of the Finnish Federation of Hard of Hearing. The follow-up study was done at the third period of the courses during 2009 2010. The questionnaire contained both open and structured questions. The questionnaire consisted of five areas concerning life management and psychosocial well-being: sense of coherence (life management), human relations and social support, mood, self-esteem and satisfaction with life. I also asked the participants to reflect on their experiences of group rehabilitation. Results and conclusions The participants consisted of seven women and three men. They were approximately 63 years old and were all retired. Loss of hearing was described to have affected their social life, free time, and in general made their lives more difficult. From the course the participants hoped to gain new skills such as signed speech and lip-reading, uplift their mood, accept their loss of hearing and experience peer support. After the courses they replied that they had more close relations with whom they also were a little more in contact with. More participants were satisfied with e.g. their ability to take care of themselves, their free time, financial situation, family life, mental resources and physical shape. Majority of the participants showed symptoms of depression when the courses started, but at the end of the courses these signs had moderated or disappeared for most of them. The participants felt that during the rehabilitation they had been heard, respected, accepted and been taken care of. The course provided the possibility for confiding, and the discussions gave the participants support and consolidation. In conclusion, the course affected positively on the acclimatization to the hearing loss and the empowerment of the participants. The results of this study can be utilized in disability services, the development of rehabilitation and in the social- and health services of senior citizens.

The Home of Hearing : George Lindbeck's understanding of community

The aim of this thesis was to examine the understanding of community in George Lindbeck s The Nature of Doctrine. Intrinsic to this question was also examining how Lindbeck understands the relation between the text and the world which both meet in a Christian community. Thirdly this study also aimed at understanding what the persuasiveness of this understanding depends on. The method applied for this task was systematic analysis. The study was conducted by first providing an orientation into the nontheological substance of the ND which was assumed useful with respect to the aim of this study. The study then went on to explore Lindbeck in his own context of postliberal theology in order to see how the ND was received. It also attempted to provide a picture of how the ND relates to Lindbeck as a theologian. The third chapter was a descriptive analysis into the cultural-linguistic perspective, which is understood as being directly proportional to his understanding of community. The fourth chapter was an analysis into how the cultural-linguistic perspective sees the relation between the text and the world. When religion is understood from a cultural-linguistic perspective, it presents itself as a cultural-linguistic entity, which Lindbeck understands as a comprehensive interpretive scheme which structures human experience and understanding of oneself and the world in which one lives. When one exists in this entity, it is the entity which shapes the subjectivities of all those who are at home in this entity which makes participation in the life of a cultural linguistic entity a condition for understanding it. Religion is above all an external word that moulds and shapes our religious existence and experience. Understanding faith then as coming from hearing, is something that correlates with the cultural-linguistic depiction of reality. Religion informs us of a religious reality, it does not originate in any way from ourselves. This externality linked to the axiomatic nature of religion is also something that distinguishes Lindbeck sharply from liberalist tendencies, which understand religion as ultimately expressing the prereflective depths of the inner self. Language is the central analogy to understanding the medium in which one moves when inhabiting a cultural-linguistic system because language is the transmitting medium in which the cultural-linguistic system is embodied. The realism entailed in Lindbeck s understanding of a community is that we are fundamentally on the receiving end when it comes to our identities whether cultural or religious. We always witness to something. Its persuasiveness rests on the fact that we never exist in an unpersuaded reality. The language of Christ is a self-sustaining and irreducible cultural-linguistic entity, which is ontologically founded upon Christ. It transmits the reality of a new being. The basic relation to the world for a Christian is that of witnessing salvation in Christ: witnessing Christ as the home of hearing the message of salvation, which is the God-willed way. Following this logic, the relation of the world and the text is one of relating to the world from the text, i.e. In Christ through the word (text) for the world, because it assumes it s logic from the way Christ ontologically relates to us.