The effect of the birth hospital and the time of birth on the outcome of Finnish very preterm infants

The purpose of this study was to evaluate the effect of the birth hospital and the time of birth on mortality and the long-term outcome of Finnish very low birth weight (VLBW) or very low gestational age (VLGA) infants. This study included all Finnish VLBW/VLGA infants born at <32 gestational weeks or with a birth weight of ≤1500g, and controls born full-term and healthy. In the first part of the study, the mortality of VLBW/VLGA infants born in 2000–2003 was studied. The second part of the study consisted of a five-year follow-up of VLBW/VLGA infants born in 2001–2002. The study was performed using data from parental questionnaires and several registers. The one-year mortality rate was 11% for live-born VLBW/VLGA infants, 22% for live-born and stillborn VLBW/VLGA infants, and 0% for the controls. In live-born and in all (including stillbirths) VLBW/VLGA infants, the adjusted mortality was lower among those born in level III hospitals compared with level II hospitals. Mortality rates of live-born VLBW/VLGA infants differed according to the university hospital district where the birth hospital was located, but there were no differences in mortality between the districts when stillborn infants were included. There was a trend towards lower mortality rates in VLBW/VLGA infants born during office hours compared with those born outside office hours (night time, weekends, and public holidays). When stillborn infants were included, this difference according to the time of birth was significant. Among five-year-old VLBW/VLGA children, morbidity, use of health care resources, and problems in behaviour and development were more common in comparison with the controls. The health-related quality of life of the surviving VLBW/VLGA children was good but, statistically, it was significantly lower than among the controls. The median and the mean number of quality-adjusted life-years were 4.6 and 3.6 out of a maximum five years for all VLBW/VLGA children. For the controls, the median was 4.8 and the mean was 4.9. Morbidity rates, the use of health care resources, and the mean quality-adjusted life-years differed for VLBW/VLGA children according to the university hospital district of birth. However, the time of birth, the birth hospital level or university hospital district were not associated with the health-related quality of life, nor with behavioural and developmental scores of the survivors at the age of five years. In conclusion, the decreased mortality in level III hospitals was not gained at the expense of long-term problems. The results indicate that VLBW/VLGA deliveries should be centralized to level III hospitals and the regional differences in the treatment practices should further be clarified. A long-term follow-up on the outcome of VLBW/VLGA infants is important in order to recognize the critical periods of care and to optimise the care. In the future, quality-adjusted life-years can be used as a uniform measure for comparing the effectiveness of care between VLBW/VLGA infants and different patient groups

Kuljettajien työn turvallisuus ja sen kehittäminen energia-alan kuljetustoiminnoissa

Työ kuuluu osana työn ja työliikenteen turvallisuuden kehittämishankkeeseen tavarankuljetusalalla. Hankkeen tavoitteena on selvittää kuorma-autonkuljettajan työpaikkatapaturmatilanteet ja tapaturmavaarat muun tutkimuksen pohjaksi. Diplomityössä kiinnitetään huomio tutkimushanketta tarkemmin energia-alan kuljetusten turvallisuustekijöihin. Diplomityön ja koko työn ja työliikenteen turvallisuuden kehittämishankkeen lähtökohtana on kuljettajan työnkuvan ongelmallisuus ja laajeneminen. Kuljettajien työ on tiukasti aikataulutettua ja työolot usein varsin vaihtelevia. Kuljettajien työ on yksintyöskentelyä vierailla paikoilla ja usein yötyötä. Työmääräykset kuljettajille tulevat lyhyellä varoitusajalla. Kuljettajien työturvallisuutta selvitettiin kirjallisuustutkimuksella, kenttätyöllä, kyselytutkimuksella kuljetusyrityksille sekä tilastoja tarkastelemalla.

Solar Twins and Solar Analogues in Galactic Surveys.

The Sun is a crucial benchmark for how we see the universe. Especially when it comes to the visible range of the spectrum, stars are commonly compared to the Sun, as it is the most thoroughly studied star. In this work I have focussed on two aspects of the Sun and how it is used in modern astronomy. Firstly, I try to answer the question on how similar to the Sun another star can be. Given the limits of observations, we call a solar twin a star that has the same observed parameters as the Sun within its errors. These stars can be used as stand-in suns when doing observations, as normal night-time telescopes are not built to be pointed at the Sun. There have been many searches for these twins and every one of them provided not only information on how close to the Sun another star can be, but also helped us to understand the Sun itself. In my work I have selected _ 300 stars that are both photometrically and spectroscopically close to the Sun and found 22 solar twins, of which 17 were previously unknown and can therefore help the emerging picture on solar twins. In my second research project I have used my full sample of 300 solar analogue stars to check the temperature and metallicity scale of stellar catalogue calibrations. My photometric sample was originally drawn from the Geneva-Copenhagen-Survey (Nordström et al. 2004; Holmberg et al. 2007, 2009) for which two alternative calibrations exist, i.e. GCS-III (Holmberg et al. 2009) and C11 (Casagrande et al. 2011). I used very high resolution spectra of solar analogues, and a new approach to test the two calibrations. I found a zero–point shift of order of +75 K and +0.10 dex in effective temperature and metallicity, respectively, in the GCS-III and therefore favour the C11 calibration, which found similar offsets. I then performed a spectroscopic analysis of the stars to derive effective temperatures and metallicities, and tested that they are well centred around the solar values.

Characteristics of urban heat island (UHI) in a high latitude coastal city - a case study of Turku, SW Finland

The term urban heat island (UHI) refers to the common situation in which the city is warmer than its rural surroundings. In this dissertation, the local climate, and especially the UHI, of the coastal city of Turku (182,000 inh.), SW Finland, was studied in different spatial and temporal scales. The crucial aim was to sort out the urban, topographical and water body impact on temperatures at different seasons and times of the day. In addition, the impact of weather on spatiotemporal temperature differences was studied. The relative importance of environmental factors was estimated with different modelling approaches and a large number of explanatory variables with various spatial scales. The city centre is the warmest place in the Turku area. Temperature excess relative to the coldest sites, i.e. rural areas about 10 kilometers to the NE from the centre, is on average 2 °C. Occasionally, the UHI intensity can be even 10 °C. The UHI does not prevail continuously in the Turku area, but occasionally the city centre can be colder than its surroundings. Then the term urban cool island or urban cold island (UCI) is used. The UCI is most common in daytime in spring and in summer, whereas during winter the UHI prevails throughout the day. On average, the spatial temperature differences are largest in summer, whereas the single extreme values are often observed in winter. The seasonally varying sea temperature causes the shift of relatively warm areas towards the coast in autumn and inland in spring. In the long term, urban land use was concluded to be the most important factor causing spatial temperature differences in the Turku area. The impact was mainly a warming one. The impact of water bodies was emphasised in spring and autumn, when the water temperature was relatively cold and warm, respectively. The impact of topography was on average the weakest, and was seen mainly in proneness of relatively low-lying places for cold air drainage during night-time. During inversions, however, the impact of topography was emphasised, occasionally outperforming those of urban land use and water bodies.