Correlates of frailty, prediction of functional decline and preventative approaches - selected results from the lausanne cohort 65+ (lc65+) study (Switzerland) (Lausanne) and the longitudinal urban cohort ageing study (Lucas) (Germany)

Overall introduction.- Longitudinal studies have been designed to investigate prospectively, from their beginning, the pathway leading from health to frailty and to disability. Knowledge about determinants of healthy ageing and health behaviour (resources) as well as risks of functional decline is required to propose appropriate preventative interventions. The functional status in older people is important considering clinical outcome in general, healthcare need and mortality. Part I.- Results and interventions from lucas (longitudinal urban cohort ageing study). Authors.- J. Anders, U. Dapp, L. Neumann, F. Pröfener, C. Minder, S. Golgert, A. Daubmann, K. Wegscheider,. W. von Renteln-Kruse Methods.- The LUCAS core project is a longitudinal cohort of urban community-dwelling people 60 years and older, recruited in 2000/2001. Further LUCAS projects are cross-sectional comparative and interventional studies (RCT). Results.- The emphasis will be on geriatric medical care in a population-based approach, discussing different forms of access, too. (Dapp et al. BMC Geriatrics 2012, 12:35; http://www.biomedcentral.com/1471-2318/12/35): - longitudinal data from the LUCAS urban cohort (n = 3.326) will be presented covering 10 years of observation, including the prediction of functional decline, need of nursing care, and mortality by using a self-filling screening tool; - interventions to prevent functional decline do focus on first (pre-clinical) signs of pre-frailty before entering the frailty-cascade ("Active Health Promotion in Old Age", "geriatric mobility centre") or disability ("home visits"). Conclusions.- The LUCAS research consortium was established to study particular aspects of functional competence, its changes with ageing, to detect pre-clinical signs of functional decline, and to address questions on how to maintain functional competence and to prevent adverse outcome in different settings. The multidimensional data base allows the exploration of several further questions. Gait performance was exmined by GAITRite®-System. Supported by the Federal Ministry for Education and Research (BMBF Funding No. 01ET1002A). Part II.- Selected results from the lausanne cohort 65+ (Lc65 + ) Study (Switzerland). Authors.- Prof Santos-Eggimann Brigitte, Dr Seematter-Bagnoud Laurence, Prof Büla Christophe, Dr Rochat Stéphane. Methods.- The Lc65+ cohort was launched in 2004 with the random selection of 3054 eligible individuals aged 65 to 70 (birth year 1934-1938) in the non-institutionalized population of Lausanne (Switzerland). Results.- Information is collected about life course social and health-related events, socio-economics, medical and psychosocial dimensions, lifestyle habits, limitations in activities of daily living, mobility impairments, and falls. Gait performance are objectively measured using body-fixed sensors. Frailty is assessed using Fried's frailty phenotype. Follow-up consists in annual self-completed questionnaires, as well as physical examination and physical and mental performance tests every three years. - Lausanne cohort 65+ (Lc65 + ): design and longitudinal outcomes. The baseline data collection was completed among 1422 participants in 2004-2005 through self-completed questionnaires, face-to-face interviews, physical examination and tests of mental and physical performances. Information about institutionalization, self-reported health services utilization, and death is also assessed. An additional random sample (n = 1525) of 65-70 years old subjects was recruited in 2009 (birth year 1939-1943). - lecture no 4: alcohol intake and gait parameters: prevalent and longitudinal association in the Lc65+ study. The association between alcohol intake and gait performance was investigated.

Flood Plain Management & Hazard Mitigation Task Force Report, August 2008

The Flood Plain Management and Hazard Mitigation Task Force emphasizes the long-term benefits of mitigation and management to the entire state in preventing or reducing damages from floods and other hazards faced in Iowa. Investments in efforts to manage watershed areas and to mitigate any damages from floods or other disaster events benefit individuals, families, communities, agriculture, business and industry, and certainly public entities and infrastructure. The Task Force encourages the Rebuild Iowa Advisory Commission to balance the immediate needs for rebuilding to include the beginning of the investments required to effectively mitigate future damage and maintain effective policy in Iowa’s watersheds. The significance of the damage seen in Iowa from the tornadoes, storms, and floods of 2008 include the loss of eighteen Iowans in disaster-related events. This alone should inspire investment in mitigation efforts for all hazards. Much of the damage resulting from the disasters can be tied to floodplain management and hazard mitigation, pointing the way toward enhanced efforts and new initiatives to safeguard lives, property, and communities’ economic health. Even so, it must be recognized that the weather events throughout last winter and spring added impetus to the rains and storms that ultimately resulted in record flooding. Some perspective must be maintained as planning progresses and significant investments in mitigation are considered to meet a specific level of safety and protection from future threats. The Task Force identified a number of issues, and four were agreed-upon as those with the highest priority to be addressed by the Task Force through a set of recommendations.

Supplemental Information to the August 2008 Flood Plain Management & Hazard Mitigation Task Force Report, August 2008

The Flood Plain Management and Hazard Mitigation Task Force emphasizes the long-term benefits of mitigation and management to the entire state in preventing or reducing damages from floods and other hazards faced in Iowa. Investments in efforts to manage watershed areas and to mitigate any damages from floods or other disaster events benefit individuals, families, communities, agriculture, business and industry, and certainly public entities and infrastructure. The Task Force encourages the Rebuild Iowa Advisory Commission to balance the immediate needs for rebuilding to include the beginning of the investments required to effectively mitigate future damage and maintain effective policy in Iowa’s watersheds. The significance of the damage seen in Iowa from the tornadoes, storms, and floods of 2008 include the loss of eighteen Iowans in disaster-related events. This alone should inspire investment in mitigation efforts for all hazards. Much of the damage resulting from the disasters can be tied to floodplain management and hazard mitigation, pointing the way toward enhanced efforts and new initiatives to safeguard lives, property, and communities’ economic health. Even so, it must be recognized that the weather events throughout last winter and spring added impetus to the rains and storms that ultimately resulted in record flooding. Some perspective must be maintained as planning progresses and significant investments in mitigation are considered to meet a specific level of safety and protection from future threats. The Task Force identified a number of issues, and four were agreed-upon as those with the highest priority to be addressed by the Task Force through a set of recommendations. Supplemental Information to the August 2008

Forensic intelligence for medicine anti-counterfeiting

Medicine counterfeiting is a crime that has increased in recent years and now involves the whole world. Health and economic repercussions have led pharmaceutical industries and agencies to develop many measures to protect genuine medicines and differentiate them from counterfeits. Detecting counterfeit is chemically relatively simple for the specialists, but much more information can be gained from the analyses in a forensic intelligence perspective. Analytical data can feed criminal investigation and law enforcement by detecting and understanding the criminal phenomenon. Profiling seizures using chemical and packaging data constitutes a strong way to detect organised production and industrialised forms of criminality, and is the focus of this paper. Thirty-three seizures of a commonly counterfeited type of capsule have been studied. The results of the packaging and chemical analyses were gathered within an organised database. Strong linkage was found between the seizures at the different production steps, indicating the presence of a main counterfeit network dominating the market. The interpretation of the links with circumstantial data provided information about the production and the distribution of counterfeits coming from this network. This forensic intelligence perspective has the potential to be generalised to other types of products. This may be the only reliable approach to help the understanding of the organised crime phenomenon behind counterfeiting and to enable efficient strategic and operational decision making in an attempt to dismantle counterfeit network.

Collaboration entre médecin de famille et psychiatre pour les problèmes de santé mentale [Family physicians and psychiatrists' collaborative care for mental health problems].

The burden of disease linked to mental disorders represents more than one-fifth of years lived with disability in the world. Less than half of people suffering from mental disorders are adequately treated. Three quarter of those who receive treatment are followed by primary care. Collaborative care aims to increase the efficiency of direct general practitioner's treatment. Main components are sustainable and individualized consultation-liaison relationship (1/2 day of psychiatrist by 15 days for 10-15 general practitioners), and support of a clinical case manager for complex situations. Collaboration is bidirectional: early or crisis access to specialist care and long-term followup by general practitioner. This model is a challenge for the doctor-patient dual relationship and requires incentives in a public health perspective.

Forensic intelligence for medicine anti-counterfeiting

Medicine counterfeiting is a crime that has increased in recent years and now involves the whole world. Health and economic repercussions have led pharmaceutical industries and agencies to develop many measures to protect genuine medicines and differentiate them from counterfeits. Detecting counterfeit is chemically relatively simple for the specialists, but much more information can be gained from the analyses in a forensic intelligence perspective. Analytical data can feed criminal investigation and law enforcement by detecting and understanding the criminal phenomenon. Profiling seizures using chemical and packaging data constitutes a strong way to detect organised production and industrialised forms of criminality, and is the focus of this paper. Thirty-three seizures of a commonly counterfeited type of capsule have been studied. The results of the packaging and chemical analyses were gathered within an organised database. Strong linkage was found between the seizures at the different production steps, indicating the presence of a main counterfeit network dominating the market. The interpretation of the links with circumstantial data provided information about the production and the distribution of counterfeits coming from this network. This forensic intelligence perspective has the potential to be generalised to other types of products. This may be the only reliable approach to help the understanding of the organised crime phenomenon behind counterfeiting and to enable efficient strategic and operational decision making in an attempt to dismantle counterfeit network.

Detection and chemical profiling of medicine counterfeits by Raman spectroscopy and chemometrics

Raman spectroscopy combined with chemometrics has recently become a widespread technique for the analysis of pharmaceutical solid forms. The application presented in this paper is the investigation of counterfeit medicines. This increasingly serious issue involves networks that are an integral part of industrialized organized crime. Efficient analytical tools are consequently required to fight against it. Quick and reliable authentication means are needed to allow the deployment of measures from the company and the authorities. For this purpose a method in two steps has been implemented here. The first step enables the identification of pharmaceutical tablets and capsules and the detection of their counterfeits. A nonlinear classification method, the Support Vector Machines (SVM), is computed together with a correlation with the database and the detection of Active Pharmaceutical Ingredient (API) peaks in the suspect product. If a counterfeit is detected, the second step allows its chemical profiling among former counterfeits in a forensic intelligence perspective. For this second step a classification based on Principal Component Analysis (PCA) and correlation distance measurements is applied to the Raman spectra of the counterfeits.

Konfiguroituvan tuotteen tuoterakennesystematiikan kehittäminen

Ponsse Oyj:n kaltainen konfiguroituvaa, monimutkaista tuotetta valmistava yhtiö tarvitsee ehdottomasti nykyaikaisen modulaarisuuteen perustuvan tuoterakennesystematiikan. Käyttämällä osioita eri modulaarisuusmalleista ja soveltamalla niitä Ponssen näkökulmasta kaikkein edullisimmalla tavalla, on kehitetty ensimmäinen case - tapaus ja sen myötä mahdollisimman yksinkertainen toimintamalli. Mallissa on otettu huomioon myös useat tuoterakenteen kanssa vuorovaikutuksessa olevat tekijät. Myyntitilanteen valinnat ovat listattu konfigurointimatriisiin ja ne voivat olla itsenäisiä tai sulkea pois joitakin toisia valintoja. Kun sopiva koneyksilö on muodostettu, saadaan matriisista samantien tulostettua valintojen mukainen tuoteyksilö. Tuoteyksilön moduulirakenne toimii kyseisen, yksittäisen koneen työmääräimenä sekä koneenvalmistuksen dokumenttina, sillä luettelon yksi moduuli on yhden valmistettavantyövaiheen moduulipiirustus alimoduuleineen ja osineen. Moduulipiirustusten on siis otettava huomioon tuotannon, oston, suunnittelun ja dokumentoinnin näkökulmat. Piirustuksen laatijan on tiedettävä kyseisen moduulin valmistus eli koottavan komponenttikokoelman laajuus sekä tuotantolinjan että osto-osaston intressien mukaisesti. Piirustuksen on nivouduttava sitä kutsuvaan matriisiin ja kyseisen moduulin valinnan kytköksiin muihin moduuleihin nähden. Kaiken lisäksi piirustuksen on toimittava kokoonpano-ohjeena sekä jälkimarkkinoinnin työkaluna. Tässä työssä muodostettiin metsätraktorin ohjaamosta esimerkkitapaus. Case tapauksessa käytettiin työssä esitettyä uutta tuoterakennesystematiikkaa uuden modulaarisuussäännöstön käytöstä, laskettu sen aiheuttamat muutokset ja sen tuotantoon otosta on kerätty ensimmäiset kommentit. Esimerkillä pyrittiin saavuttamaan modulaarisen tuoterakenteen mahdollistamat edut ja projektia on jatkettu Ponsse Oyj:llä käsittämään muitakin tuotekokonaisuuksia.

Forensic intelligence framework-Part I: induction of a transversal model by comparing illicit drugs and false identity documents monitoring

Forensic intelligence is a distinct dimension of forensic science. Forensic intelligence processes have mostly been developed to address either a specific type of trace or a specific problem. Even though these empirical developments have led to successes, they are trace-specific in nature and contribute to the generation of silos which hamper the establishment of a more general and transversal model. Forensic intelligence has shown some important perspectives but more general developments are required to address persistent challenges. This will ensure the progress of the discipline as well as its widespread implementation in the future. This paper demonstrates that the description of forensic intelligence processes, their architectures, and the methods for building them can, at a certain level, be abstracted from the type of traces considered. A comparative analysis is made between two forensic intelligence approaches developed independently in Australia and in Europe regarding the monitoring of apparently very different kind of problems: illicit drugs and false identity documents. An inductive effort is pursued to identify similarities and to outline a general model. Besides breaking barriers between apparently separate fields of study in forensic science and intelligence, this transversal model would assist in defining forensic intelligence, its role and place in policing, and in identifying its contributions and limitations. The model will facilitate the paradigm shift from the current case-by-case reactive attitude towards a proactive approach by serving as a guideline for the use of forensic case data in an intelligence-led perspective. A follow-up article will specifically address issues related to comparison processes, decision points and organisational issues regarding forensic intelligence (part II).

Allianssit metsä- ja ICT -sektoreilla vuosina 1990-2005 - globaalin kehityksen analyysi

Pro gradu -tutkielman tavoitteena on tarkastella metsä- ja ICT-sektorin allianssien kehitystä vuosina 1990-2005. Lisäksi tarkoituksena on tutkia, voidaanko osoittaa yhteys allianssien ja yrityksen taloudellisen menestymisen välillä. Yhteyden testaamissa käytetään lineaarista regressiota. Aineisto perustuu SDC Platinum -tietokannasta haettuihin allianssitietoihin sekä Thomson One Banker -tietokannan tilinpäätöstietoihin, jotka koskevat 70 liikevaihdoltaan maailman suurinta metsäyritystä ja 43 liikevaihdoltaanmaailman suurinta ICT-yritystä. Hypoteesit vahvistuivat osittain. Toimialan kehitysvaihetta ja alliansseja koskevat hypoteesit vahvistuivat kahta lukuun ottamatta, eli toimialan luonne ja kehitysvaihe vaikuttavat allianssimääriin ja -laatuun. Allianssien ja taloudellisen menestymisen yhteyttä koskevat hypoteesit vahvistuivat osittain. Testauksessa löydettiin positiivinen, tilastollisesti merkitsevä yhteys allianssien ja liikevaihdon välillä sekä sijoitetunpääoman tuoton väliltä. Allianssien yhteismäärä vaikutti positiivisesti liikevaihdon kasvuprosenttiin ICT- ja yhdistelmäaineistossa. Uusien allianssien osuus vaikutti positiivisesti vain sijoitetun pääoman tuottoon. Strategisten allianssien osalta saatiin vain ristiriitaisia tuloksia. Metsäaineistossa ne vaikuttivat negatiivisesti liikevaihdon kasvuun, mutta yhdistelmäaineistossa löydettiin positiivinen yhteys. Liiketuottoprosentin ja allianssien välillä ei voitu osoittaa lainkaan yhteyttä.

A comparative study of ballpoint ink ageing parameters using GC/MS.

For more than a decade scientists tried to develop methods capable of dating ink by monitoring the loss of phenoxyethanol (PE) over time. While many methods were proposed in the literature, few were really used to solve practical cases and they still raise much concern within the scientific community. In fact, due to the complexity of ink drying processes it is particularly difficult to find a reliable ageing parameter to reproducibly follow ink ageing. Moreover, systematic experiments are required in order to evaluate how different factors actually influence the results over time. Therefore, this work aimed at evaluating the capacity of four different ageing parameters to reliably follow ink ageing over time: (1) the quantity of solvent PE in an ink line, (2) the relative peak area (RPA) normalising the PE results using stable volatile compounds present in the ink formulation, (3) the solvent loss ratio (R%) calculated from PE results obtained by the analyses of naturally and artificially aged samples, (4) a modified solvent loss ratio version (R%*) calculated from RPA results. After the determination of the limits of reliable measurements of the analytical method, the repeatability of the different ageing parameters was evaluated over time, as well as the influence of ink composition, writing pressure and storage conditions on the results. Surprisingly, our results showed that R% was not the most reliable parameter, as it showed the highest standard deviation. Discussion of the results in an ink dating perspective suggests that other proposed parameters, such as RPA values, may be more adequate to follow ink ageing over time.

Komposiittivaipan moderni optimisuunnittelu ja toteutus

Tavoitteena tällä tutkimuksella on soveltaa modernin optimisuunnittelun keinoja komposiittimuovisen nestesäiliön lieriömäisen vaipparakenteen suunnittelemiseksi optimaalisen tyydyttäviksi valmistustekniikan ja kustannusten kannalta. Kuormituksia on kahdenlaisia. Säiliön sisällä on neste, joka tuottaa hydrostaattisen painekuorman ja järjestelmään kytketty puhallin tuottaa ulkoisen ylipaineen. Säiliöt ovat pystysäiliöitä ja ne tukeutuvat alustaan suoran pohjalaatan avulla. FEM- malleissa kuoren alaosat ovat jäykästi kiinnitettyjä ja yläosissa säteensuuntaiset siirtymät ovat estettyjä. Materiaaleiksi kuoreen on valittu kahdella eri menetelmällä lujitetut komposiittimateriaalit. Kantavan kerroksen toimintona on kantaa kuormat. Sulkukerros toimii korroosiosuojana ja sen lujuus on kantavaa kerrosta pienempi. Keinoina käytetään ensin innovatiivista suunnittelua optimaalisten lähtövaihtoehtojen ideoimiseksi ja valitsemiseksi jatkokehittelyä varten. Tavoitteena on asiakkaan tyytyväisyyden maksimointi huomioiden tuotteen kustannukset ja kesto. Yhtenä suunnittelun keinona on käytetty kuoriteoriaa ja komposiittien materiaalimalleja. Kestoehtoina on sovellettu komposiiteille soveltuvia kriteerejä. Toisena keinona käytetään FEM-laskentaa. Elementtityypiksi on valittu kaksiulotteinen kuorielementti, jossa on ortotrooppisen ainemallin mukaiset materiaaliominaisuudet. Jännitystuloksien merkittävyys keston kannalta selvitettiin Tsai-Hillin kriteerillä. Tuloksina saatiin ensin innovoitua rakenteelle kaksi päävaihtoehtoa, joita alettiin optimoida. Valitussa ratkaisussa on huomioitu kokonaisuus ja eri yksityiskohdat, kuten paino, jäykisteet kustannustehokkuus, valmistusnopeus, laatu, hävikit, päästöt, lujuus ja kilpailukykyinen myyntihinta. Yhteenvetona voidaan todeta, että käytetyt keinot ovat hyvin tehokkaita ja niillä voidaan suunnitella ja toteuttaa komposiittirakenteita, jotka tyydyttävät optimaalisesti loppukäyttäjän teknis- taloudelliset vaatimukset. Lisäksi tulokset osoittavat, että standardin ja FEM-laskennan ennustukset ovat lähellä toisiaan sylinterimäisillä kuoriosilla, mutta standardit suosittavat suurempia mittoja itse jäykisteille.

A comparative study of ballpoint ink ageing parameters using GC/MS

For more than a decade scientists tried to develop methods capable of dating ink by monitoring the loss of phenoxyethanol (PE) over time. While many methods were proposed in the literature, few were really used to solve practical cases and they still raise much concern within the scientific community. In fact, due to the complexity of ink drying processes it is particularly difficult to find a reliable ageing parameter to reproducibly follow ink ageing. Moreover, systematic experiments are required in order to evaluate how different factors actually influence the results over time. Therefore, this work aimed at evaluating the capacity of four different ageing parameters to reliably follow ink ageing over time: (1) the quantity of solvent PE in an ink line, (2) the relative peak area (RPA) normalising the PE results using stable volatile compounds present in the ink formulation, (3) the solvent loss ratio (R%) calculated from PE results obtained by the analyses of naturally and artificially aged samples, (4) a modified solvent loss ratio version (R%*) calculated from RPA results. After the determination of the limits of reliable measurements of the analytical method, the repeatability of the different ageing parameters was evaluated over time, as well as the influence of ink composition, writing pressure and storage conditions on the results. Surprisingly, our results showed that R% was not the most reliable parameter, as it showed the highest standard deviation. Discussion of the results in an ink dating perspective suggests that other proposed parameters, such as RPA values, may be more adequate to follow ink ageing over time.

Työturvallisuus- ja työterveysriskien arviointi Vianor Oy:ssä

Tämän diplomityön tavoitteena oli kehittää Vianor Oy:lle soveltuva työterveys- ja työturvallisuusriskien arviointimalli ja sen jälkeen tehdä se viidessä toimipaikassa. Tämän lisäksi selvitettiin kaikki käytössä olevat kemikaalit sekä arvioitiin niiden käytön terveys-, turvallisuus-, ja ympäristövaikutuksia käyttöturvallisuustiedotteiden tietojen perusteella. Aluksi tutustuttiin rengasalaan liittyviin vaaroihin kirjallisuuden ja aikaisemmin sattuneiden tapaturmien avulla. Tämän jälkeen tutustuttiin työterveys- ja työturvallisuusriskien arvioinnin periaatteisiin sekä jo olemassa oleviin menetelmiin. Näiden perusteella laadittiin Vianor Oy:lle soveltuva riskien arviointimalli. Kemikaalien osalta tutustuttiin kemikaalien terveys-, turvallisuus- ja ympäristövaaroihin. Tämän jälkeen tehtiin malli, jonka avulla kemikaalit voidaan luokitella vaarallisuuden mukaan käyttöturvallisuustiedotteiden tietojen avulla. Toimipaikkoja pyydettiin selvittämään kaikki käytössä olevat kemikaalit. Toimipaikkojen käytössä olevien kemikaalien valikoimaa yhtenäistettiin ja kemikaalien käyttöturvallisuustiedotteet siirrettiin sisäiseen intranettiin. Lopuksi laadittiin joidenkin työterveys- ja työturvallisuusriskien hallitsemiseksi menettelytapoja ja mietittiin toimenpiteitä työturvallisuuden jatkuvalle parantamiselle. Työterveys- ja työturvallisuusriskien arviointi päätettiin käyttää yhtenä työturvallisuuden kehittämisen välineen ja tehdä se jokaisessa Vianor Oy:n toimipaikassa. Joidenkin kemikaalien osalta suoritetaan tarkempi vaaranarviointi.