Erityiskorvattaviin lääkkeisiin oikeuttava sairaudet 31.12.2010

Vaikean ja pitkäaikaisen sairauden perusteella myönnetään tämän sairauden lääkkeisiin erityiskorvausoikeus, mikä tarkoittaa, että lääkkeistä maksetaan sairausvakuutuskorvauksena peruskorvausta (42 % lääkevalmisteen hinnasta) suurempi korvaus.

Helsingin Östersundomin pienvesien kartoitus

The area of Östersundom (29,1 square kilometers) was attached to Helsinki in the beginning of the year 2009. Östersundom is formed mostly from the municipality of Sipoo, and partly from the city of Vantaa. Nowadays Östersundom is still quite rural, but city planning has already started, and there are plans to develop Östersundom into a district with 45 000 inhabitants. In this study, the headwaters, streams and small lakes of Östersundom were studied to produce information as a basis for city planning. There are six main streams and five small lakes in Östersundom. The main methodology used in this study was the examination of the physical and the chemical quality of the water. The hygienic quality of the water was also studied. It was also examined whether the waters are in their natural state, or have they been treated and transformed by man. In addition, other factors affecting the waters were examined. Geographical information data was produced as a result of this work. Östersundom is the main area looked at in this study, some factors are examined in the scope of the catchment areas. Water samples were collected in three sampling periods: 31.8 4.9.2009, 3. 4.2.2010, and 10. 14.4.2010. There were 20 sampling points in Östersundom (5 in small lakes, 15 in streams). In the winter sampling period, only six samples were collected, from which one was taken from a small lake. Field measurements associated with water sampling included water temperature, oxygen concentration, pH and electoral conductivity. Water samples were analyzed in the Laboratories of Physical Geography in the University of Helsinki for the following properties: total suspended solids (TSS), total dissolved substances (TDS), organic matter, alkalinity, colour, principal anions and cations and trace elements. Metropolilab analyzed the amount of faecal coliform bacteria in the samples. The waters in Östersundom can be divided to three classes according to water quality and other characteristics: the upper course of the streams, the lower course of the streams and the small lakes. The streams in their upper course are in general acidic, and their acid neutralization capacity is low. The proportion of the organic matter is high. Also the concentrations of aluminium and iron tend to be high. The streams in the lower course have acidity closer to neutral, and the buffering capacity is good. The amounts of TSS and TDS are high, and as a result, the concentrations of many ions and trace elements are high as well. Bacteria were detected at times in the streams of the lower course. Four of the five small lakes in Östersundom are humic and acidic. TSS and TDS concentrations tend to be low, but the proportion of organic matter is often high. There were no bacteria in the small lakes. The fifth small lake (Landbonlampi) differs from the others by its water colour, which is very clear. This lake is very acidic, and its buffering capacity is extremely low. Compared to the headwaters in Finland in general, the concentrations of many ions and trace elements are higher in Östersundom. On the other hand, the characteristics of water were different according to the classification upper course streams, lower course streams, and small lakes. Generally, the best water quality was observed in the stream of Gumbölenpuro and in the lakes Storträsk, Genaträsk, Hältingträsk and Landbonlampi. Several valuable waters in their natural state were discovered from the area. The most representative example is the stream of Östersundominpuro in its lower course, where the stream flows through a broad-leaf forest area. The small lakes of Östersundom, and the biggest stream Krapuoja, with its meandering channel, are also valuable in their natural state.

Viemärilaitokset 31.12.1972

Water works and sewage plants 31.12.1974.

Vesilaitokset 31.12.1972

Water utilities 31.12.1972

Vesihuoltolaitokset 31.12.1974

Water supply and sewer systems 31.12.1974.

Change detection and controlling forest information using multi-temporal Landsat TM imagery.

A method was developed for relative radiometric calibration of single multitemporal Landsat TM image, several multitemporal images covering each others, and several multitemporal images covering different geographic locations. The radiometricly calibrated difference images were used for detecting rapid changes on forest stands. The nonparametric Kernel method was applied for change detection. The accuracy of the change detection was estimated by inspecting the image analysis results in field. The change classification was applied for controlling the quality of the continuously updated forest stand information. The aim was to ensure that all the manmade changes and any forest damages were correctly updated including the attribute and stand delineation information. The image analysis results were compared with the registered treatments and the stand information base. The stands with discrepancies between these two information sources were recommended to be field inspected.

Korkeakoulutetun väestön sijoittuminen pääkaupunkiseudulla

Tutkielmassa käsitellään korkeakoulutetun väestön sijoittumista pääkaupunkiseudulla. Se asettuu osaksi seutua koskevaa empiiristä keskustelua sekä osaksi bourdieuläistä keskustelua luokkamauista ja kulttuurisesta pääomasta. Ensiksi mainittua se täydentää keskittyen vähemmälle huomiolle jääneeseen ylemmän keskiluokan tutkimukseen, jälkimmäistä kehystäen teoriaa uuden tyyppisellä empiirisellä tarkastelulla. Tutkielmassa pyritään ensin esittämään seudun erilaistumista yleisellä tasolla korkean koulutuksen ja aiemman tutkimuksen perusteella relevanteiksi rajattujen muiden tekijöiden osalta. Tämän jälkeen suhteutetaan korkeasti koulutettujen sijoittumista muuhun erilaistumiseen. Tässä ajatuksena on löytää korkeakoulutettujen osuudeltaan muut tekijät huomioon ottaen korkeita alueita. Teoreettisella tasolla pyritään kulttuurisen pääoman paikantamiseen kartalle. Tutkielma on osa Helsingin yliopiston Geotieteiden ja Maantieteen laitoksen Mari Vaattovaaran johtamaa projektia ja siinä käytetään Tilastokeskuksen vuoden 2008 ruututietokanta-aineistoa. Pääkaupunkiseutu on jaettu aineistossa sivultaan 250 metrin neliönmuotoisiin ruutuihin. Tämä mahdollistaa pääkaupunkiseudun varsin hienojakoisen tarkastelun. Erilaistumisen muotoja pyritään suhteuttamaan toisiinsa regressiomalleilla. Näissä käytetään painotetun neliösumman menetelmää. Menetelmällä pyritään vastaamaan havaittuun varianssin heteroskedastisuusongelmaan. Pääasiallisesti tulokset esitetään karkeina karttakuvauksina ja ehdollisina hajonta- ja jakaumakuvioina. Korkeakoulutettujen sijoittumisen havaittiin noudattavan aikaisemmissa tutkimuksissa esitettyjä suuntalinjoja. Kuten hyvätuloisetkin, sijoittuvat korkeakoulutetut seudulla länsipainotteisesti ja merenrantaa myötäillen. Vakioitaessa väestön muuta sijoittumista, huomattiin erojen tasoittuvan. Mielenkiintoista oli tasoittuminen vahvasti niin talotyyppien, itä–länsi-akselin kuin kaupunkienkin osalta. Kaikilla näillä mittareilla oli suorissa tarkasteluissa havaittavissa eroja, mutta suuri osa havaittavista eroista selittyi pois tulojen, ikäryhmien ja perhetyyppien alueellisella jakautumisella. Näiltä osin korkeakoulutettujen sijoittuminen seudulla näyttäisi liittyvän sijoittumiseen muilla tekijöillä. Moranin I:llä mitattuna selittyi korkeakoulutettujen suhteellisten osuuksien välinen autokorrelaatio osin lisättäessä muita tekijöitä malliin, mutta silti viimeisenkin mallin virhetermeillä oli havaittavaa autokorrelaatiota. Tämä saattaisi viitata kulttuurisen pääoman paikantumiseen kartalle, mutta saattaa myös olla tulosta mallin heikkouksista. Kaikkiaan tutkielman anti on sekä näkökulmaltaan että menetelmältään uudenlaisissa kuvauksissa, jotka auttavat asettamaan korkeakoulutetun väestön sijoittumisen paremmin muun seudullisen erilaistumisen kontekstiin. Nämä kuvaukset poikkeavat aikaisemmista osin näkökulmansa ja osin menetelmien osalta.

Accessibility as a determinant of opportunities : A case study from Peruvian Amazonia

Accessibility is a crucial factor for interaction between areas in economic, cultural, political and environmental terms. Therefore, information concerning accessibility is relevant for informed decision making, planning and research. The Loreto region in the Peruvian Amazonia provides an interesting scene for an accessibility study. Loreto is sparsely populated and because there are few roads in the region, in practice all movement and transportation happens along the river network. Due to the proximity of the Andes, river dynamics are strong and annual changes in water level combined with these dynamic processes constantly reshape accessibility patterns of the region. Selling non-timber forest products (NTFP) and agricultural products (AP) in regional centres is an important income source for local rain forest dwellers. Thus, accessibility to the centres is crucial for the livelihood of local population. -- In this thesis I studied how accessible the regional centre Iquitos is from other parts of Loreto. In addition, I studied the regional NTFP/AP trade patterns and compared them with patterns of accessibility. Based on GPS-measurements, using GIS, I created a time-distance surface covering Loreto. This surface describes the time-distance to Iquitos, along the river network. Based on interview material, I assessed annual changes to accessibility patterns in the region. The most common regional NTFP/AP were classified according to the amount of time they can be preserved, and based on the accessibility surface, I modelled a catchment area for each of these product classes. -- According to my results, navigation speeds vary considerably in different parts of the river network, depending on river types, vessels, flow direction and season. Navigating downstream is, generally, faster than upstream navigation. Thus, Iquitos is better accessible from areas situated south and south west of the city, like along the rivers Ucayali and Marañon. Differences in accessibility between different seasons are also substantial: during the dry season navigation is slower due to lower water levels and emerging sand bars. Regularly operating boats follow routes only along certain rivers and close to Iquitos transport facilities are more abundant than in more distant areas. Most of the products present in Iquitos market places are agricultural products, and the share of NTFP is significantly smaller. Most of the products were classified in product class 2, and the catchment area for these products is rather small. Many products also belonged to class 5, and the catchment area for these products reaches up to the edges of my study area, following the patterns of the river network. -- The accessibility model created in this study predicts travel times relatively well, although in some cases the modelled time-distances are substantially shorter than observed time-distances. This is partly caused by the fact that real-life navigation routes are more complicated than the modelled routes. Rain forest dwellers having easier access to Iquitos have more opportunities in terms of the products they decide to market. Thus, they can better take advantage of other factors affecting the market potential of different products. -- In all, understanding spatial variation in accessibility is important. In the Amazonian context it is difficult to combine the accessibility-related needs of the local dwellers with conservation purposes and the future challenge lies in finding solution that satisfy both of these needs.

Biomarkers in acute respiratory failure

Acute respiratory failure (ARF) is the most common type of organ failure leading to the need for intensive care. It is often secondary to acute lung injury (ALI) and its more severe form, acute respiratory distress syndrome (ARDS). ARF, and especially ALI and ARDS, cause increased morbidity, and mortality rates remain high (up to 40%). These disorders are characterised by inflammatory reaction and tissue damage. In some cases, inflammation continues and leads to an overwhelming repair process with ongoing fibrosis, accompanied by organ dysfunction and eventually a loss of function. Measuring the magnitude of the inflammation, and the repair process, would theoretically offer information concerning outcome. Early identification of patients whose disease process is likely to proceed unfavourably, would help clinicians to optimise their treatment. The aim of this study was to evaluate the epidemiology of ARF, its treatment, and outcome in Finland, with special interest in biomarkers, and their value in the prediction of mortality. Altogether, 958 adult patients treated with ventilatory support were prospectively included in this study during an eight week period in 2007 in 25 intensive care units. Plasma aminoterminal pro-brain natriuretic peptide (NT-pro-BNP) was assessed in 602 patients, and plasma cell-free DNA in 580 patients, to evaluate their prognostic value in ARF. Markers of collagen metabolism were studied in longitudinal serum samples in 68 patients in order to evaluate their evolution in ARF and the association to multiple organ dysfunction (MOD). Ventilatory support was used in 39% of all ICU patients. The estimated incidence of ARF was 149.5/100 000 per year. Median tidal volumes used were higher than recommended. Overall mortality at 90 days was 31%. Plasma NT-pro-BNP and cell-free DNA were highly increased in the majority of patients. Both markers were independent predictors of 90-day mortality, but their discriminative power was at most moderate when used separately. The mortality was highest in those patients, in whom both biomarkers were over their separate cut-off values. Thus, combined use of these biomarkers may increase their clinical value in the mortality prediction. The markers of collagen metabolism changed significantly over time in surviving patients. None of these markers did associate with MOD in these patients.