Integroitua päästöjen hallintamallia soveltavan öljynjalostamon normaalitoiminnan ja monitoroinnin määrittäminen

Tässä diplomityössä määritettiin Nesteen Suomen jalostamoiden normaalitoiminta ja integroidun päästöjen hallintamallin mukainen monitorointi. Työn ensimmäisenä tavoitteena oli selvittää määritelmä integroidun päästöjen hallintamallin mukaiselle normaalitoiminnalle öljynjalostamolla. Toisena tavoitteena oli löytää ratkaisut integroidun päästöjen hallintamallin monitoroinnin heikosti ohjeistettuihin kohtiin. Jalostamoiden normaalitoiminnan määrittäviä kohteita selvitettiin keskustelemalla jalostamon käyttöhenkilökunnan kanssa kriittisistä kohteista päästöjenhallinnan sekä jalostamokokonaisuuden toiminnan kannalta. Keskusteluissa esiin tulleiden kohteiden hyödyllisyyttä jalostamon normaalitoiminnan määrittämiseksi tutkittiin Nesteen jalostamoiden automaatiojärjestelmän historiatietojen perusteella. Selkeästi normaalista poikkeavaksi toiminnaksi lisääntyneiden päästöjen takia tunnistettiin polttoaineiden ja savukaasujen puhdistusprosessien häiriöt sekä Porvoon jalostamolla voimalaitoksen höyryntuotantohäiriöt. Lisäksi jalostamon normaalitoiminnan kuvaajaksi tunnistettiin toiminnassa olevien yksiköiden määrä. Monitoroinnin ohjeistuksen puutteisiin etsittiin ratkaisua olemassa olevista muiden soveltamisalojen ohjeistuksista. Integroidun päästöjen hallintamallin monitorointitarpeista tunnistettiin paljon samaa päästökaupan monitoroinnin kanssa. Monitoroinnin lisäohjeistuksena suositeltiin käyttämään päästökaupan monitorointiohjetta ja sieltä löytyviä määräyksiä. Integroidussa päästöjen hallintamallissa tunnistettiin uusia haasteita viranomaisseurannan toteuttamisessa.

Tutorías fuera del horario escolar

En Finlandia, las clases de lengua materna y los clubes de deberes son herramientas esenciales de inclusión social para el alumnado inmigrante. La enseñanza de la lengua materna favorece la autoestima de niños y niñas y les ayuda a desarrollar destrezas cognitivas. En una cultura educativa que relaciona éxito escolar con trabajo en casa, los clubes son un instrumento imprescindible y cuentan con una eficaz red de voluntariado.

Seasonal patterns of viral and bacterial infections among children hospitalized with community-acquired pneumonia in a tropical region

Community-acquired pneumonia (CAP) is a common cause of morbidity among children. Evidence on seasonality, especially on the frequency of viral and bacterial causative agents is scarce; such information may be useful in an era of changing climate conditions worldwide. To analyze the frequency of distinct infections, meteorological indicators and seasons in children hospitalized for CAP in Salvador, Brazil, nasopharyngeal aspirate and blood were collected from 184 patients aged < 5 y over a 21-month period. Fourteen microbes were investigated and 144 (78%) cases had the aetiology established. Significant differences were found in air temperature between spring and summer (p = 0.02) or winter (p < 0.001), summer and fall (p = 0.007) or winter (p < 0.001), fall and winter (p = 0.002), and on precipitation between spring and fall (p = 0.01). Correlations were found between: overall viral infections and relative humidity (p = 0.006; r = 0.6) or precipitation (p = 0.03; r = 0.5), parainfluenza and precipitation (p = 0.02; r = -0.5), respiratory syncytial virus (RSV) and air temperature (p = 0.048; r = -0.4) or precipitation (p = 0.045; r = 0.4), adenovirus and precipitation (p = 0.02; r = 0.5), pneumococcus and air temperature (p = 0.04; r = -0.4), and Chlamydia trachomatis and relative humidity (p = 0.02; r = -0.5). The frequency of parainfluenza infection was highest during spring (32.1%; p = 0.005) and that of RSV infection was highest in the fall (36.4%; p < 0.001). Correlations at regular strength were found between several microbes and meteorological indicators. Parainfluenza and RSV presented marked seasonal patterns.

Procalcitonin is useful in identifying bacteraemia among children with pneumonia

Empirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN-alpha) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infiltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN-alpha were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN-alpha (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56-7.56), non-bacteraemic typical bacterial (1.47; 0.24-4.07), atypical bacterial (0.18; 0.06-1.03) and only viral (0.65; 0.11-2.22) subgroups was significant (p = 0.02). PCT was >= 2 ng/ml in 52 (33%) cases. The presence of IFN-alpha was associated with PCT <2 ng/ml (90% vs. 64%, p = 0.02). The negative predictive value (95% confidence interval) of PCT >= 2 ng/ml was 95% (89-100%), 89% (78-100%), 93% (85-100%) for differentiation of bacteraemic from viral, atypical bacterial and non-bacteraemic typical bacterial infection, respectively, and 58% (49-68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN-alpha was uncommonly detected.

The role of respiratory viral infections among children hospitalized for community-acquired pneumonia in a developing country

We report an investigation for 16 bacteria and viruses among 184 children hospitalized with pneumonia in Salvador, Brazil. Etiology was established in 144 (78%) cases. Viral, bacterial, and mixed infections were found in 110 (60%), 77 (42%), and 52 (28%) patients, respectively. Rhinovirus (21%) and Streptococcus pneumoniae (21%) were the most common pathogens. Our results demonstrate the importance of viral and pneumococcal infections among those patients.