Madot tappoivat suden Hämeessä : kuolemaan johtanut Alaria sp. -imumatoinfektio sudella

Summary: Alaria sp. causing fatal enteritis in a wolf

Patient hand hygiene compliance in the hemodialysis environment

Hand hygiene compliance of patients receiving hemodialysis treatment is a contemporary discussion topic among health care professionals in the Nephrology Clinic of Helsinki University City Hospital. The purpose of the Final Thesis is to review patient hand hygiene in terms of risks its lack entails and based on the evidence based findings to design an end product as a poster. The poster can be utilised in the Nephrology Clinic's nursing environment to educate and motivate patients to pay specifid attention to the importance of hand hygiene. The method used was a systematic literature review. The most important evidence based findings were extracted from the chosen thirteen scientific articles. All articles were searched from the Cumulative Index to Nursing and Allied Health Literature electronic database. The gathered information was then used to build the content of a patient education tool that for this project was defined as a Poster. The findings in this study showed that transmission of bloodborne infections, like Hepatitis B or C virus can occur through a vascular access and that the consequences of this can be very fatal. Additionally, environmental surfaces such as furniture, door knobs and dialysis machine control knobs were all possible infection sources for the patient receiving hemodialysis treatment. Adherence to good hand hygiene behaviour lowered the risk for infections. The end product of this study is a poster that is targeted to patients undergoing hemodialysis treatment. Using a health promotion agenda in the Poster, it is hoped that patients will pay more attention to the importance of hand hygiene and that they will be more motivated to use aseptic methods such as alcohol based hand rubs in the hemodialysis setting.

Dynamic Simulations of Rotors during Drop on Retainer Bearings

The active magnetic bearings have recently been intensively developed because of noncontact support having several advantages compared to conventional bearings. Due to improved materials, strategies of control, and electrical components, the performance and reliability of the active magnetic bearings are improving. However, additional bearings, retainer bearings, still have a vital role in the applications of the active magnetic bearings. The most crucial moment when the retainer bearings are needed is when the rotor drops from the active magnetic bearings on the retainer bearings due to component or power failure. Without appropriate knowledge of the retainer bearings, there is a chance that an active magnetic bearing supported rotor system will be fatal in a drop-down situation. This study introduces a detailed simulation model of a rotor system in order to describe a rotor drop-down situation on the retainer bearings. The introduced simulation model couples a finite element model with component mode synthesis and detailed bearing models. In this study, electrical components and electromechanical forces are not in the focus. The research looks at the theoretical background of the finite element method with component mode synthesis that can be used in the dynamic analysis of flexible rotors. The retainer bearings are described by using two ball bearing models, which include damping and stiffness properties, oil film, inertia of rolling elements and friction between races and rolling elements. Thefirst bearing model assumes that the cage of the bearing is ideal and that the cage holds the balls in their predefined positions precisely. The second bearing model is an extension of the first model and describes the behavior of the cageless bearing. In the bearing model, each ball is described by using two degrees of freedom. The models introduced in this study are verified with a corresponding actual structure. By using verified bearing models, the effects of the parameters of the rotor system onits dynamics during emergency stops are examined. As shown in this study, the misalignment of the retainer bearings has a significant influence on the behavior of the rotor system in a drop-down situation. In this study, a stability map of the rotor system as a function of rotational speed of the rotor and the misalignment of the retainer bearings is presented. In addition, the effects of parameters of the simulation procedure and the rotor system on the dynamics of system are studied.

Harmonising the Modular Product Range

Työn tavoitteena on analysoida KONEen hissien ovituoteperheitä ja harmonisoida modulaarista ovituotevalikoimaa niin, että tulos olisi mahdollisimman suotuisa KONEelle sekä sen sidosryhmille. Harmonisointi toteutetaan, koska KONEen tuotevalikoima on erittäin laaja ja monimutkainen ja siitä syystä erittäin kallis ja vaikea hallita ja ylläpitää. Tavoitteena on selvittää myös termejä modulaarisuus ja tuotealusta olennaisen kirjallisuuden pohjalta. Nykyään yritysten täytyy kehittää tuotevalikoimaa jatkuvasti. Yrityksen koko tuotevalikoiman varioituvuus tulisi kuitenkin pitää järkevissä rajoissa. Moduuleita ja tuotealustoja pitäisi käyttää jakamaan tuotteiden avainelementtejä ja lisäämään varioituvuutta helposti hallittavalla tavalla. Kannattamattomat ja matalavolyymiset tuotteet kuluttavat yrityksen niukkoja resursseja. Tällaiset tuotteet tulisi poistaa tuotevalikoimasta, mutta ei ilman harkintaa. Kannattama-tonkin tuote voi olla erittäin arvokas asiakkaalle ja tällaisen tuotteen hylkääminen voi olla yritykselle pitkällä tähtäimellä erittäin kohtalokasta. Työn tuloksena oli harmonisointiehdotus KONEen AMD-oville ja selvitys harmonisoinnin vaikutuksista. Harmonisointi KONEella päätettiin toteuttaa siten, että matalavolyymiset tuotteet siirrettiin erikoistuotteiden valikoimaan. Myös kustannusanalyysi tukee harmonisointipäätöstä laskentajärjestelmän puutteista huolimatta.

Avainhenkilöihin keskittyneen tietopääoman katoamisen riski ja sen hallinta pk-yrityksissä

Tutkielmassa selvitetään pienten ja keskisuurten yritysten avainhenkilöihin keskittyneen tietopääoman katoamisen riskiä ja pyritään löytämään keinoja riskin hallintaan. Pk-yrityksissä yrityksen kannalta kriittinen tieto on usein harvoihin henkilöihin keskittynyttä. Tällaisten avainhenkilöiden työpanoksen ja osaamisen menettäminen kokonaan saattaa olla yrityksen toiminnalle kohtalokasta. Väliaikainen osaamisen menettäminen voi myös vaikeuttaa toimintoja. Tietopääoman katoamisen riskin pienentäminen onnistuu joko avainhenkilön tiedon siirtämisellä toisiin henkilöihin tai huolehtimalla avainhenkilön työsuhteen mahdollisimman pitkästä jatkumisesta. Tiedon siirtämisen menetelmät riippuvat tiedon laadusta: onko se hiljaista vai eksplisiittistä. Avainhenkilön pysyvyyteen vaikuttaa yrityksen henkilöstöpolitiikka, jonka mukaisesti työntekijät saavat korvauksen työstään ja sitoutuvat yritykseen. Myös työntekijän työkyvystä huolehtiminen vaikuttaa tiedon pysymiseen yrityksen käytössä. Esimerkkiyrityksen haastatteluissa voidaan todeta yhtymäkohtia tutkimuksen muissa osissa käsiteltyihin tietojohtamisen ongelmiin.

Determining risk potential through accidents and near-accidents: an empirical study in a steel factory

Fatal and permanently disabling accidents form only one per I cent of all occupational accidents but in many branches of industry they account for more than half the accident costs. Furthermore the human suffering of the victim and his family is greater in severe accidents than in slight ones. For both human and economic reasons the severe accident risks should be identified befor injuries occur. It is for this purpose that different safety analysis methods have been developed . This study shows two new possible approaches to the problem.. The first is the hypothesis that it is possible to estimate the potential severity of accidents independent of the actual severity. The second is the hypothesis that when workers are also asked to report near accidents, they are particularly prone to report potentially severe near accidents on the basis of their own subjective risk assessment. A field study was carried out in a steel factory. The results supported both the hypotheses. The reliability and the validity of post incident estimates of an accident's potential severity were reasonable. About 10 % of accidents were estimated to be potentially critical; they could have led to death or very severe permanent disability. Reported near accidents were significantly more severe, about 60 $ of them were estimated to be critical. Furthermore the validity of workers subjective risk assessment, manifested in the near accident reports, proved to be reasonable. The studied new methods require further development and testing. They could be used both in routine usage in work places and in research for identifying and setting the priorities of accident risks.

Salivary gland cancer in Finland: Incidence, histological distribution, outcome and prognostic factors

Salivary gland cancer (SGC) is a rare cancer. The histological classification of SGC is complex and its biological behavior highly variable: it may vary from a low-grade tumor to a high-grade and often fatal malignancy. These circumstances make this cancer a diagnostic and therapeutic challenge. Older age and exposure to ionizing radiation are known risk factors. The mainstay of treatment is surgery combined with adjuvant radiation therapy, when appropriate. In addition to the histological type, the only well known prognostic factor is the TNM classification, which describes the tumor size and the amount of metastases. This study was performed using a full population-based nationwide cohort of SGC patients and tumors diagnosed in Finland in 1991-1996. The annual incidence of SGC in the entire population was, on average, 47.7 per year. By histological re-evaluation of 237 specimens the most frequent histological types were the adenoid cystic carcinoma (n=65; 27%), the mucoepidermoid carcinoma (n=45; 19%) and the acinic cell carcinoma (n=41; 17%). The highest 10-year disease-specific survival rate occurred among patients with acinic cell carcinoma (90%), followed by mucoepidermoid carcinoma (81%) and adenoid cystic carcinoma (60%). A high volume-corrected index (VCI) of Ki-67 correlated with worse survival of patients with SGC. Computer-assisted morphometric analyses of CD34-positive vessels indicated an unfavorable prognosis for patients with mucoepidermoid carcinoma and an association with poor survival among patients with acinic cell carcinoma. A high level of expression of matrix metalloproteinase-9 (MMP-9) showed a trend for a poorer prognosis in salivary duct carcinoma, and a high level of MMP-13 and a low level of MMP-1 had a trend for a poorer prognosis of patients with SGC. A low level of MMP-7 was associated with a poor prognosis of patients with acinic cell and mucoepidermoid carcinoma.

Epidemiology of Cytochrome P450-mediated Drug-Drug Interactions

Drug-drug interactions (DDIs) comprise an important cause of adverse drug reactions leading to excess hospitalizations. Drug metabolism is catalyzed by 75% by cytochrome P450 (CYP) enzymes and thus they are often involved in pharmacokinetic DDIs. In general, DDIs are studied in randomized controlled clinical trials in selected study populations. The overall aim of the present studies was to perform observational pharmacoepidemiological surveys on CYP-mediated DDIs in diseases important at the population level. The prevalence of co-administrations of four prodrugs (losartan, codeine, tramadol, and clopidogrel), three sulphonylureas (glibenclamide, glimepiride, and glipizide), or two statins (lovastatin and simvastatin) with well established agents altering CYP activity, as well as of statins with fibrates, was studied in Finland utilizing data from a university hospital medication database (inpatients) and the National Prescription Register of the Social Insurance Institution of Finland, Kela (outpatients). Clinical consequences of potential DDIs were estimated by reviewing laboratory data, and information from hospital care and cause-of-death registers. Concomitant use of study substrates with interacting medication was detected in up to one fifth of patients in both hospital and community settings. Potential CYP3A4 interactions in statin users did not manifest in clear adverse laboratory values but pharmacodynamic DDIs between statins and fibrates predisposed patients to muscular toxicity. Sulphonylurea DDIs with CYP2C9 inhibitors increased the risk of hypoglycaemia. CYP3A4 inhibitor use with clopidogrel was not associated with significant changes in mortality but non-fatal thrombosis and haemorrhage complications were seen less often in this group. Concomitant administration of atorvastatin with clopidogrel moderately attenuated the antithrombotic effect by clopidogrel. The overall mortality was increased in CYP3A4 inducer and clopidogrel co-users. Atorvastatin used concomitantly with prodrug clopidogrel seems to be beneficial in terms of total and LDL cholesterol concentrations, and overall mortality compared with clopidogrel use without interacting medication. In conclusion, CYP-mediated DDIs are a common and often unrecognized consequence of irrational drug prescribing.

Evolution of Bordetella pertussis post vaccination

Evolution of Bordetella pertussis post vaccination Whooping cough or pertussis is caused by the gram-negative bacterium Bordetella pertussis. It is a highly contiguous disease in the human respiratory tract. Characteristic of pertussis is a paroxysmal cough with whooping sound during gasps of breath after coughing episodes. It is potentially fatal to unvaccinated infants. The best approach to fight pertussis is to vaccinate. Vaccinations against pertussis have been available from the 1940s. Traditionally vaccines were whole-cell pertussis (wP) preparations as part of the combined diphtheria-tetanus-pertussis (DTP) vaccines. More recently acellular pertussis (aP) vaccines have replaced the wP vaccines in many countries. The aP vaccines are less reactogenic and can also be administered to school children and adults. There are several publications reporting variation in the i>B. pertussis virulence factors that are also aP vaccine antigens. This has occurred in the genes coding for pertussis toxin and pertactin about 15 to 30 years after the introduction of pertussis vaccines to immunisation programs. Resurgence of pertussis has also been reported in many countries with high vaccination coverage. In this study the evolution of B. pertussis was investigated in Finland, the United Kingdom, Poland, Serbia, China, Senegal and Kenya. These represent countries with a long history of high vaccination coverage with stable vaccines or changes in the vaccine formulation; countries which established high vaccination coverage late; and countries where vaccinations against pertussis were started late. With bacterial cytotoxicity and cytokine measurements, comparative genomic hybridisation, pulsed-field gel electrophoresis (PFGE), genotyping and serotyping it was found that changes in the vaccine composition can postpone the emergence of antigenic variants. It seems that the change in PFGE profiles and the loss of genetic material in the genome of B. pertussis are similar in most countries and the vaccine-induced immunity is selecting non-vaccine type strains. However, the differences in the formulation of the vaccines, the vaccination programs and in the coverage of pertussis vaccination have affected the speed and timing of these changes.

Tuotantostrateginen Make or buy -päätöksenteko metalliteollisuusalan yrityksessä

Tuotantostrategiaan perustuvien ostaa-valmistaa, eli Make or buy -päätösten merkitys on korostunut yritysten dynaamisen toimintaympäristön myötä. Päätöksissä tehdyt virheet voivat olla kohtalokkaita yrityksen kilpailukyvylle. Diplomityön tavoitteena on luoda Make or buy -päätöksentekoa ohjaava viitekehys yrityksen kansainväliseen käyttöön. Tavoitteeseen sisältyy luodun Make or buy -mallin toimivuuden todentaminen case-tutkimuksella. Make or buy -päätöksenteossa korostuvat talouden, osaamisen ja riskien näkökulmat. Tehtyjä päätöksiä tulee uudelleenarvioida ja tarvittaessa päivittää toimintaympäristön muuttuessa. Päätöksentekomallin tulee siis olla toistuvaa käyttöä ajatellen selkeä ja helppokäyttöinen. Työssä kehitetty kirjallisuusaineistoon perustuva Make or buy –päätöksenteon viitekehys ohjaa yritystä strategisen, taktisen ja operatiivisen tason päätöksissä. Lisäksi malli ohjaa organisaatiota päätöksentekoroolien määrittämisessä. Viitekehys sisältää strukturoidun päätöksentekomallin strategisiin ja taktisiin päätöksiin sekä yksinkertaisen valintamallin operatiivisiin päätöksiin. Operatiivisen tason eriyttämisellä pyritään helpottamaan mallien käyttöä. Työssä rakennetun strukturoidun viitekehyksen toimivuuden testaus esitetään empiirisessä vaiheessa.

Element speciation and behaviour in metal-rich Boreal river and estuarine systems using ultrafiltration and chemical modelling

The bioavailability of metals and their potential for environmental pollution depends not simply on total concentrations, but is to a great extent determined by their chemical form. Consequently, knowledge of aqueous metal species is essential in investigating potential metal toxicity and mobility. The overall aim of this thesis is, thus, to determine the species of major and trace elements and the size distribution among the different forms (e.g. ions, molecules and mineral particles) in selected metal-enriched Boreal river and estuarine systems by utilising filtration techniques and geochemical modelling. On the basis of the spatial physicochemical patterns found, the fractionation and complexation processes of elements (mainly related to input of humic matter and pH-change) were examined. Dissolved (<1 kDa), colloidal (1 kDa-0.45 μm) and particulate (>0.45 μm) size fractions of sulfate, organic carbon (OC) and 44 metals/metalloids were investigated in the extremely acidic Vörå River system and its estuary in W Finland, and in four river systems in SW Finland (Sirppujoki, Laajoki, Mynäjoki and Paimionjoki), largely affected by soil erosion and acid sulfate (AS) soils. In addition, geochemical modelling was used to predict the formation of free ions and complexes in these investigated waters. One of the most important findings of this study is that the very large amounts of metals known to be released from AS soils (including Al, Ca, Cd, Co, Cu, Mg, Mn, Na, Ni, Si, U and the lanthanoids) occur and can prevail mainly in toxic forms throughout acidic river systems; as free ions and/or sulfate-complexes. This has serious effects on the biota and especially dissolved Al is expected to have acute effects on fish and other organisms, but also other potentially toxic dissolved elements (e.g. Cd, Cu, Mn and Ni) can have fatal effects on the biota in these environments. In upstream areas that are generally relatively forested (higher pH and contents of OC) fewer bioavailable elements (including Al, Cu, Ni and U) may be found due to complexation with the more abundantly occurring colloidal OC. In the rivers in SW Finland total metal concentrations were relatively high, but most of the elements occurred largely in a colloidal or particulate form and even elements expected to be very soluble (Ca, K, Mg, Na and Sr) occurred to a large extent in colloidal form. According to geochemical modelling, these patterns may only to a limited extent be explained by in-stream metal complexation/adsorption. Instead there were strong indications that the high metal concentrations and dominant solid fractions were largely caused by erosion of metal bearing phyllosilicates. A strong influence of AS soils, known to exist in the catchment, could be clearly distinguished in the Sirppujoki River as it had very high concentrations of a metal sequence typical of AS soils in a dissolved form (Ba, Br, Ca, Cd, Co, K, Mg, Mn, Na, Ni, Rb and Sr). In the Paimionjoki River, metal concentrations (including Ba, Cs, Fe, Hf, Pb, Rb, Si, Th, Ti, Tl and V; not typical of AS soils in the area) were high, but it was found that the main cause of this was erosion of metal bearing phyllosilicates and thus these metals occurred dominantly in less toxic colloidal and particulate fractions. In the two nearby rivers (Laajoki and Mynäjoki) there was influence of AS soils, but it was largely masked by eroded phyllosilicates. Consequently, rivers draining clay plains sensitive to erosion, like those in SW Finland, have generally high background metal concentrations due to erosion. Thus, relying on only semi-dissolved (<0.45 μm) concentrations obtained in routine monitoring, or geochemical modelling based on such data, can lead to a great overestimation of the water toxicity in this environment. The potentially toxic elements that are of concern in AS soil areas will ultimately be precipitated in the recipient estuary or sea, where the acidic metalrich river water will gradually be diluted/neutralised with brackish seawater. Along such a rising pH gradient Al, Cu and U will precipitate first together with organic matter closest to the river mouth. Manganese is relatively persistent in solution and, thus, precipitates further down the estuary as Mn oxides together with elements such as Ba, Cd, Co, Cu and Ni. Iron oxides, on the contrary, are not important scavengers of metals in the estuary, they are predicted to be associated only with As and PO4.

Development and characterization of thin printed films for gas sensing applications

The monitoring and control of hydrogen sulfide (H2S) level is of great interest for a wide range of application areas including food quality control, defense and antiterrorist applications and air quality monitoring e.g. in mines. H2S is a very poisonous and flammable gas. Exposure to low concentrations of H2S can result in eye irritation, a sore throat and cough, shortness of breath, and fluid retention in the lungs. These symptoms usually disappear in a few weeks. Long-term, low-level exposure may result in fatigue, loss of appetite, headache, irritability, poor memory, and dizziness. Higher concentrations of 700 - 800 ppm tend to be fatal. H2S has a characteristic smell of rotten egg. However, because of temporary paralysis of olfactory nerves, the smelling capability at concentrations higher than 100 ppm is severely compromised. In addition, volatile H2S is one of the main products during the spoilage of poultry meat in anaerobic conditions. Currently, no commercial H2S sensor is available which can operate under anaerobic conditions and can be easily integrated in the food packaging. This thesis presents a step-wise progress in the development of printed H2S gas sensors. Efforts were made in the formulation, characterization and optimization of functional printable inks and coating pastes based on composites of a polymer and a metal salt as well as a composite of a metal salt and an organic acid. Different processing techniques including inkjet printing, flexographic printing, screen printing and spray coating were utilized in the fabrication of H2S sensors. The dispersions were characterized by measuring turbidity, surface tension, viscosity and particle size. The sensing films were characterized using X-ray photoelectron spectroscopy, X-ray diffraction, atomic force microscopy and an electrical multimeter. Thin and thick printed or coated films were developed for gas sensing applications with the aim of monitoring the H2S concentrations in real life applications. Initially, a H2S gas sensor based on a composite of polyaniline and metal salt was developed. Both aqueous and solvent-based dispersions were developed and characterized. These dispersions were then utilized in the fabrication of roll-to-roll printed H2S gas sensors. However, the humidity background, long term instability and comparatively lower detection limit made these sensors less favourable for real practical applications. To overcome these problems, copper acetate based sensors were developed for H2S gas sensing. Stable inks with excellent printability were developed by tuning the surface tension, viscosity and particle size. This enabled the formation of inkjet-printed high quality copper acetate films with excellent sensitivity towards H2S. Furthermore, these sensors showed negligible humidity effects and improved selectivity, response time, lower limit of detection and coefficient of variation. The lower limit of detection of copper acetate based sensors was further improved to sub-ppm level by incorporation of catalytic gold nano-particles and subsequent plasma treatment of the sensing film. These sensors were further integrated in an inexpensive wirelessly readable RLC-circuit (where R is resistor, L is inductor and C is capacitor). The performance of these sensors towards biogenic H2S produced during the spoilage of poultry meat in the modified atmosphere package was also demonstrated in this thesis. This serves as a proof of concept that these sensors can be utilized in real life applications.

Suorituskyvyn analysointijärjestelmä teknologiateollisuuden pk-yritykselle

Monesti yritysjohtajan on vaikea hahmottaa, mitä kaikkia ulottuvuuksia ja menetelmiä suorituskyvyn analysointiin liittyy. Pelkkään talouteen keskittyvä johtaminen edustaa hyvin kapeaa näkökulmaa yrityksen toiminnasta ja voi lopulta johtaa yrityksen vääriin valintoihin ja hyvin kohtalokkaisiin virhearviointeihin. Suorituskyvyn mittaamisella ja analysoimisella saadaan kokonaisvaltainen näkemys yrityksen toiminnasta ja sen tilasta. Yrityksen suorituskykyä pystytään tarkastelemaan hyvin monella tavalla ja erilaisista näkökulmista. Tutkimuksen päätavoitteena on selvittää millainen suorituskyvyn analysointijärjestelmä soveltuu teknologiateollisuuden pk-yritykselle. Alatavoitteena on tutkia millaiset mittaus- ja johtamistarpeet ovat toimialalle tyypillisiä (1) sekä miten toiminnanohjausjärjestelmä ja suori-tuskyvyn mittaristo voidaan integroida toisiinsa (2). Case-yritykselle rakennetaan suorituskyvyn mittaristo ja verrataan sitä toiminnanohjausjärjestelmään sekä selvitetään mittariston tarpeellisuutta Case-yritykselle. Teknologiateollisuuden pk-yrityksille ei voida suoraan määrittää sopivaa suorituskyvyn ana-lysointijärjestelmää. BSC osoittautui kuitenkin parhaimmaksi valinnaksi. BSC pakottaa pk-yrityksiä huomioimaan useampi suorituskyvyn osa-alue. BSC ei myöskään tarvitse montaa mittaria kuvaamaan suorituskyvyn osa-alueita. Tutkimuksessa selvisi hyvin paljon suorituskykyyn vaikuttavia tekijöitä. Projektiluonteisuuden vuoksi case-yrityksen projektiseurantaa kehitettiin ja rakennettiin BSC-pohjainen suorituskyvyn analysointijärjestelmä.

Leveiden keskimerkintöjen liikenneturvallisuusvaikutusten arviointi

Tämän raportin tavoitteena oli käsitellä leveiden keskimerkintöjen liikenneturvallisuusvaikutuksia, toteuttaa mielipidekysely kantatie 54 kokeiluosuuden vaikutusalueella sekä esitellä aiemmin tehdyt tutkimukset ja leveiden keskimerkintöjen taustaa. Raportin on laatinut Eino Lahtinen Hämeen ammattikorkeakoulusta opinnäytetyönään. Työn taustateoriaksi syvennyttiin leveiden keskimerkintöjen historiaan Suomessa ja ulkomailla sekä Suomessa tehtyihin tutkimuksiin aiheesta. Suomessa ja ulkomailla on havaittu jo vuosikymmenten ajan korkealuokkaisten teiden liikenneturvallisuuden heikentyneen liikenteen lisääntyessä. Kohtaamis- ja ohitusonnettomuuksien jäljet ovat usein raakaa katseltavaa ja luettavaa. Huoli kohtaamis- ja ohitusonnettomuuksien määristä ja niiden vakavuuksista painostaa etsimään ratkaisuja tämän kaltaisten onnettomuuksien vähentämiseksi. Tästä syystä on 1980-luvulta lähtien aktiivisesti etsitty liikenneturvallisuutta parantavia kustannustehokkaita ratkaisuja. Visuaalisia vaikutuksia arvioidessa havaittiin jo varhain kaistan leveyden visuaalisen kaventamisen johtavan ajonopeuksien laskuun, joka vähentää onnettomuuksia ja niiden vakavuuksia. Yhdeksi ratkaisuksi esitettiin leveää keskimerkintää, josta on ollut erilaisia kokeiluja ulkomailla 1996 ja Suomessa 2009 lähtien. Työn tuloksena voidaan esittää, että leveiden keskimerkintöjen vaikutukset ajokäyttäytymiseen ovat melko vähäiset, sillä lähes puolet kyselyyn vastanneista ei havainnut muutosta omassa tai muiden ajokäyttäytymisessä. Työn perusteella arvioidaan, että leveät keskimerkinnät vähensivät henkilövahinkoon johtaneita ohitus-, kohtaamis- ja vasemmalle suistumisonnettomuuksia 17 – 21 %. Tutkimuksen perusteella voidaan todeta, että leveitä keskimerkintöjä käytettäessä on varmistuttava riittävästä piennarleveydestä (vähintään 1 m). Leveää keskimerkintää voidaan käyttää alueilla, jossa tien päällysteen leveys on vähintään 10 m, KVL vähintään 1500 ajon/vrk ja tiejakson pituus vähintään 10 km. Leveän keskialueen tulisi olla metrin levyinen.