Clinical usefulness of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) scale in patients with type I bipolar disorder

Background: The relevance of persistent cognitive deficits to the pathogenesis and prognosis of bipolar disorders (BD) is understudied, and its translation into clinical practice has been limited by the absence of brief methods assessing cognitive status in Psychiatry. This investigation assessed the psychometric properties of the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) for the detection of cognitive impairment in BD. Methods: After short training, psychiatrists at 40 outpatient clinics administered the SCIP three times over two weeks to a total of 76 consecutive type I BD admissions. Experienced psychologists also administered a comprehensive battery of standard neuropsychological instruments to clinical sample and 45 healthy control subjects. Results: Feasibility was supported by a brief administration time (approximately 15 minutes) and minimal scoring errors. The reliability of the SCIP was confirmed by good equivalence of forms, acceptable stability (ICC range 0.59 to 0.87) and adequate internal consistency (Chronbach's alpha of 0.74). Construct validity was granted by extraction of a single factor (accounting 52% of the variance), acceptable correlations with conventional neuropsychological instruments, and a clear differentiation between bipolar I and normal samples. Efficiency was also provided by the adequate sensitivity and specificity. Limitations: The sample size is not very large. The SCIP and the neurocognitive battery do not cover all potentially relevant cognitive domains. Also, sensitivity to change remains unexplored. Conclusion: With minimal training, physicians obtained a reliable and valid estimate of cognitive impairment in approximately 15 minutes from an application of the SCIP to type I BD patients.

Clinical usefulness of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) scale in patients with type I bipolar disorder

Background: The relevance of persistent cognitive deficits to the pathogenesis and prognosis of bipolar disorders (BD) is understudied, and its translation into clinical practice has been limited by the absence of brief methods assessing cognitive status in Psychiatry. This investigation assessed the psychometric properties of the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) for the detection of cognitive impairment in BD. Methods: After short training, psychiatrists at 40 outpatient clinics administered the SCIP three times over two weeks to a total of 76 consecutive type I BD admissions. Experienced psychologists also administered a comprehensive battery of standard neuropsychological instruments to clinical sample and 45 healthy control subjects. Results: Feasibility was supported by a brief administration time (approximately 15 minutes) and minimal scoring errors. The reliability of the SCIP was confirmed by good equivalence of forms, acceptable stability (ICC range 0.59 to 0.87) and adequate internal consistency (Chronbach's alpha of 0.74). Construct validity was granted by extraction of a single factor (accounting 52% of the variance), acceptable correlations with conventional neuropsychological instruments, and a clear differentiation between bipolar I and normal samples. Efficiency was also provided by the adequate sensitivity and specificity. Limitations: The sample size is not very large. The SCIP and the neurocognitive battery do not cover all potentially relevant cognitive domains. Also, sensitivity to change remains unexplored. Conclusion: With minimal training, physicians obtained a reliable and valid estimate of cognitive impairment in approximately 15 minutes from an application of the SCIP to type I BD patients.

Producció d'un disc de música electrònica

Aquest projecte final explica algunes tècniques de producció relacionades amb la música electrònica, que també són aplicables a la música pop en general. Es descriuen els processos realitzats en dues parts, que parteixen de la producció de dos singles, Stars i Never mind. En la descripció del primer single s'hi expliquen tots els processos relacionats amb la coproducció i mescla d'una cançó de música electrònica, explorant-ne les possibilitats tant a nivell tècnic com artístic. El segon single, de composició pròpia i dut a terme majoritàriament a l'estudi de gravació, comprèn processos compositius a partir d'instruments virtuals i la seva posterior re-interpretació amb instruments acústics en diferents sessions de gravació, així com les tècniques utilitzades per la seva postproducció. L'objectiu principal ha estat aprendre a definir un so propi com a productor a partir de la combinació d'elements acústics i electrònics, i també repassar algunes tècniques de producció apreses durant la meva estada a l'ESMUC. La feina com a sonòleg i compositor queda documentada amb la descripció de tots aquests processos, deixant-ne constància per a futurs treballs.

Development of dissolution method for benznidazole tablets

The aim of this work was the development of a dissolution method for benznidazole (BNZ) tablets. Three different types of dissolution media, two stirring speeds and apparatus 2 (paddle) were used. The accomplishment of the drug dissolution profiles was compared through the dissolution efficiency. The assay was performed by spectrophotometry at 324 nm. The better conditions were: sodium chloride\hydrochloride acid buffer pH 1.2 with stirring speed of 75 rpm, volume of 900 mL and paddle as apparatus. Ahead of the results it can be concluded that the method developed consists in an efficient alternative for assays of dissolution for benznidazole tablets.

Maakaapelien kuntomittaukset

Kandidaatintyössä on luotu katsaus maakaapelirakenteisiin ja erilaisiin maakaapelien kuntomittausmenetelmiin, kuten osittaispurkausmittaus ja dielektrisen vasteen mittaaminen. Työssä on myös esitelty muutamat yleisimmät mittauslaitteistot ja sivuttu lyhyesti mittausten hyödyntämistä kunnossapidossa.

Cognitively Empowering Internet-Based Patient Education for Ambulatory Orthopaedic Surgery Patients

Tiedollista voimavaraistumista tukeva internet-perustainen ohjaus päiväkirurgisille ortopedisille potilaille Tutkimuksen tarkoituksena oli kehittää tiedollista voimavaraistumista tukeva Internetperustainen potilasohjausohjelma sekä arvioida sitä. Tutkimusprosessi jaettiin kahteen vaiheeseen. Ensimmäisessä vaiheessa luotiin sisältö tiedollista voimavaraistumista tukevalle Internet-perustaiselle ohjaukselle päiväkirurgisia ortopedisia potilaita varten. Toisessa vaiheessa arvioitiin Internet-perustaisen ohjauksen (koeryhmä) hyväksyttävyyttä käyttäjien arvioimana ja ohjauksen tuloksia sekä verrattiin Internet-perustaisen ohjauksen (koeryhmä) tuloksia tiedollisesti voimavaraistumista tukevan sairaanhoitajan välittämään ohjauksen (kontrolliryhmä) tuloksiin. Tutkimuksen tavoitteena oli luoda uusi potilasohjausmuoto joka tarjoaa yksilöllisen, osallistavan ja aikaan ja paikkaan sitomattoman ohjauksen päiväkirurgiseen ortopediseen leikkaukseen tulevalle potilaalle. Tutkimuksen ensimmäisessä vaiheessa käytettiin kuvailevaa ja vertailevaa tutkimusmenetelmää (ennen ja jälkeen testaus). Tutkimukseen osallistui 120 päiväkirurgista ortopedista potilasta joiden tiedon odotuksia ja heille välitettyä tietoa tarkasteltiin. Tutkimuksen ensimmäisen vaiheen tuloksien ja aikaisemman voimavaraistumista käsittävän tiedon perusteella luotiin sisältö tiedollista voimavaraistumista tukevalle Internet-perustaiselle ohjaukselle. Sisältö rakentui voimavaraistavan tiedon kuudesta eri osa-alueesta. Tutkimuksen toisessa vaiheessa käytettiin randomoitua kokeellista tutkimusasetelmaa. Päiväkirurgiseen ortopediseen leikkaukseen tulevat potilaat randomoitiin koeryhmään (n=72) Internetperustaiseen ohjaukseen ja kontrolliryhmään (n=75) sairaanhoitajan välittämään ohjaukseen. Aineisto kerättiin strukturoitujen mittareiden avulla ja tulokset analysoitiin tilastollisesti. Tutkimuksen tulokset osoittavat, että kehitettyä tiedollisesti voimavaraistumista tukevaa Internet-perustaista potilasohjausmenetelmää voidaan suositella käytettäväksi ortopedisten päiväkirurgisten potilaiden ohjauksessa ja potilailla on hyvät mahdollisuudet voimavaraistua tiedollisesti sen avulla. Monipuolista tietoa sisältävä Internet-perustainen ohjaus osoittautui käyttäjien näkökulmasta hyväksyttäväksi. Vaikka Internet ohjauksen hyväksyttävyys koettiin osittain heikommaksi kuin sairaanhoitajan välittämän ohjauksen, potilaat käyttivät nettisivustoa ongelmitta ja arvioivat sen helppokäyttöiseksi. Ohjausmuodolla ei ollut vaikutusta hoidosta aiheutuneisiin kustannuksiin. Sen sijaan kustannuksista organisaatiolle voitiin puolittaa sairaanhoitajan ohjaukseen käyttämä aika Internet-perustaisen ohjauksen avulla. Internet-perustaiseen ohjaukseen osallistuneiden potilaiden tiedon taso ja kokemus tiedon riittävyydestä lisääntyivät ohjauksen jälkeen enemmän kuin sairaanhoitajan välittämään potilasohjaukseen osallistuneiden potilaiden tiedot. Ohjausmuodolla ei ollut vaikutusta potilaiden kokemien tunteiden ja oireiden voimakkuuteen. Yhteenvetona voidaan todeta, että tiedollisesti voimavaraistava Internet-perustaista ohjausta voidaan suositella vaihtoehtoiseksi menetelmäksi sairaanhoitajan välittämälle ohjaukselle päiväkirurgiseen ortopediseen leikkaukseen tuleville potilaille.

Musikalisk lärandemiljö : planerade musikaktiviteter med småbarn i daghem

A musically stimulating nvironment is of great significance when considering the opportunities for development and learning that are offered to children in day nurseries. Moreover, the quality of musical activities also has great significance for the musical development of growing children. Young children are always striving to create meaning and understanding; they influence and are influenced by the context in which they are situated. The purpose of this study is to investigate the planned music activities in the musical learning environment of seven toddler’s groups in day nurseries, based on four different aspects: the texts of children’s songs, the melodies of children’s songs, the basic elements of music and the use of instrumentation. The data has been gathered by video observation of the planned music activities. The age of the children studied ranged from 11 months to 3 years and 11 months, and on average there were 13 children in each group. The study involved a total of just over 90 children and nine educators. The methodological approaches are hermeneutic as well as videographic, and they are applied to the analysis as required. The approaches are well suited to an understanding of the planned music activities where the individual’s communications and actions are studied. The results of the study show that educators impart a cultural heritage to the children in the form of old traditional songs, but they also act as intermediaries for newer children's songs. They focus on actively on the text content of the children’s songs in their interaction with the children, but do not address the meaning of the text. Furthermore, while the educators use music sessions for the children to develop, among other things, an understanding of language and social skills, they do not use the sessions to develop the children’s musical skills. The educators could, to a much greater extent than they now do, direct the children's attention to the basic elements of music, and conduct meta-cognitive dialogues with the children. They use a large repertoire of children's songs, which are, however, often too demanding for the children’s voices to cope with. In addition, the educators do not plan, in any significant way, activities for the toddlers in order to help them develop the accuracy of their vocal tones. With regard to the use of instruments, the educators focus, in their interaction with the children, is placed on both the usage of the instruments and knowledge about the instruments. Regarding the use of instruments the study shows that the children’s musical expression takes place in an environment that includes both melody and rhythm instruments. It is clear that children are actively interested in the constructed instrument environment, because for long periods of time they independently play and experiment with instruments.

Hevonen irtaimen kaupan tapauksena - laatuvirhe ja siihen varautuminen

Tutkimuksessa tarkastellaan hevoskauppaa ja sen erityispiirteitä suhtees-sa irtaimen kauppaa säätelevään lainsäädäntöön. Tavoitteena on tuoda esiin hevosesta johtuvia erityispiirteitä ja pohtia sovellettavan lainsäädän-nön soveltuvuutta hevosen kauppaan. Tarkastelu kohdentuu erityisesti hevoselle ominaisiin laatuvirheen muotoihin, kuten sairauksiin ja fyysisiin vikoihin. Lisäksi tarkastellaan, miten esiin nostettuihin erityispiirteisiin on varauduttu hevoskauppaan tarkoitetuissa kauppasopimusmalleissa. Hevoskauppaan pätee sama lainsäädäntö kuin minkä tahansa muun ir-taimen tavaran kauppaan. Virheeseen varautuminen yksityiskohtaisesti sopimalla korostuu hevoskaupassa, koska täydellistä ja virheetöntä hevosta ei ole olemassakaan. Myyjän näkökulmasta onnistuneessa kauppaprosessissa neuvotellaan virheen mahdollisuus niin pieneksi kuin se on mahdollista. Tähän instrumentit antavat lainsäädäntö ja erityisesti sopimusoikeudelliset keinot. Ostajan näkökulmasta onnistuneessa kaupassa hän on kyennyt asiantuntijoihin tukeutuen tunnistamaan ennalta hevosen viat ja muut epämieluisat ominaisuudet. Nämä tiedostaen ostaja määrittää, mitä virheitä on valmis hyväksymään. Hevoskaupassa riidan välittömät ja välilliset kustannukset suhteessa maksettuun kauppahintaan voivat nousta korkeiksi. Hevoskaupassa usein ainoa kirjallinen dokumentti on omistajanvaihdosilmoitus, eikä kauppasopimuksen laatiminen kirjallisena ole itsestäänselvyys. Yksinomaan hevoskauppaan liittyvien juridisten kysymysten tekeminen näkyväksi on tärkeää. Irtaimen kauppaa säätelevä lainsäädäntö ei kuitenkaan tunnista riittävällä tarkkuudella hevosen erityispiirteitä persoonaesineenä, vaan väliin tarvi-taan vakiosopimusten kaltaisia apuvälineitä kaupan osapuolten tueksi.

Infecções por micobactérias de crescimento rápido resistentes a desinfetantes: uma problemática nacional?

Rapidly growing mycobacteria (RGM) are opportunistic microorganisms and widely distributed into aqueous environment and soil. Human RGM infections are usually associated with contaminated solutions or medical instruments used during invasive procedures. RGM postsurgical infections have recently emerged in Brazil and have caused national alert, considering the risk factors and epidemiological aspects. This study aimed at analysing the main factors linked to the recent RGM outbreaks, with focus on the national epidemic of Mycobacterium massiliense infections related to the BRA100 strains resistant to 2% glutaraldehyde commercial solutions commonly used for preoperative high-level disinfection. Based on previous studies and laboratorial results of assays and colaborations, it has been observed that the cases have been associated with videolaparoscopy for different applications and elective esthetic procedures, such as lipoaspiration and mammary prosthesis implant. Furthermore, outbreaks between 2004 and 2008 and the epidemic in Rio de Janeiro state may be considered particular Brazilian events. Although there are a few epidemiological published studies, some hypotheses based on common aspects related to most national nosocomial occurrences are possible, such as lack of protocols for cleaning and high-level disinfection, use of 2% glutaraldehyde as high-level disinfectant for surgical instruments, and dissemination of M. massiliense BRA100 by unknown mechanisms.

Interdependence of Emerging Eastern European stock markets

One of the main developments in the global economy during the past decades has been the growth of emerging economies. Projections for their long-term growth, changes in the investment climate, corporate transparency and demography point to an increasing role for these emerging economies in the global economy. Today, emerging economies are usually considered as financial markets offering opportunities for high returns, good risk diversification and improved return-to-risk ratios. However, researchers have noted that these advantages may be in decline because of the increasing market integration. Nevertheless, it is likely that certain financial markets and specific sectors will remain partially segmented and somewhat insulated from the global economy for the year to come. This doctoral dissertation investigates several stock markets in Emerging Eastern Europe (EEE), including the ones in Russia, Poland, Hungary, the Czech Republic, Bulgaria and Slovenia. The objective is to analyze the returns and financial risks in these emerging markets from international investor’s point of view. This study also examines the segmentation/integration of these financial markets and the possibilities to diversify and hedge financial risk. The dissertation is divided into two parts. The first includes a review of the theoretical background for the articles and a review of the literature on EEE stock markets. It includes an overview of the methodology and research design applied in the analysis and a summary of articles from the second part of this dissertation and their main findings. The second part consists of four research publications. This work contributes to studies on emerging stock markets in four ways. First, it adds to the body of research on the pricing of risk, providing new empirical evidence about partial stock market segmentation in EEE. The results suggest that the aggregate emerging market risk is a relevant driver for stock market returns and that this market risk can be used to price financial instruments and forecast their performance. Second, it contributes to the empirical research on the integration of stock markets, asset prices and exchange rates by identifying the relationships between these markets through volatility and asset pricing. The results show that certain sectors of stock markets in EEE are not as integrated as others. For example, the Polish consumer goods sector, the Hungarian telecommunications sector, and the Czech financial sector are somewhat isolated from their counterparts elsewhere in Europe. Nevertheless, an analysis of the impact of EU accession in 2004 on stock markets suggests that most of the EEE markets are becoming increasingly integrated with the global markets. Third, this thesis complements the scientific literature in the field of shock and volatility spillovers by examining the mechanism of spillover distribution among the EU and EEE countries. The results illustrate that spillovers in emerging markets are mostly from a foreign exchange to the stock markets. Moreover, the results show that the effects of external shocks on stock markets have increased after the enlargement of the EU in 2004. Finally, this study is unique because it analyzes the effects of foreign macroeconomic news on geographically closely related countries. The results suggest that the effects of macroeconomic announcements on volatility are significant and have effect that varies across markets and their sectors. Moreover, the results show that the foreign macroeconomic news releases, somewhat surprisingly, have a greater effect on the EEE markets than the local macroeconomic news. This dissertation has a number of implications for the industry and for practitioners. It analyses financial risk associated with investing in Emerging Eastern Europe. Investors may use this information to construct and optimize investment portfolios. Moreover, this dissertation provides insights for investors and portfolio managers considering asset allocation to protect value or obtain higher returns. The results have also implications for asset pricing and portfolio selection in light of macroeconomic news releases.

Strategic Innovation Management Based on Three Dimensions

This thesis examines innovation development needs of firms in a remote rural region. The perspective of the study is in strategic innovation management and three dimensions of innovation development: innovation environment, value delivery and innovation capability. The framework is studied with a theoretical and methodological approach in the context of the development of a regional innovation system and the defining of innovation development needs. The thesis is based on existing innovation management literature, expanding it by examining the features of the three dimensions. The empirical data of the study comprise 50 purposefully selected firms within the region of Pielinen Karelia located in Eastern Finland. Most of the firms (70%) included in the study represent manufacturing firms, and over 90% are small and medium-sized enterprises. The research data consist of two questionnaires and an interview, which were done during 2011 in the connection of a regional development project. The point of view of the research is in regional development and harnessing the innovation capability of the firms within the region. The principal research approach applies soft systems methodology. The study explores the means to foster the innovativeness of firms from the viewpoints of innovation environment, innovation capability and value delivery. In closer detail, the study examines relations between the innovation capability factors, differences in innovation development needs within the value delivery system, between sectors and between firm size categories. The thesis offers three major contributions. First, the study extends earlier research on strategic innovation management by connecting the frameworks of innovation capability, innovation environment and value delivery process to the defining of innovation development needs at the regional level. The results deepen knowledge especially concerning practice-based innovation, peripheral regions and smaller firms. Second, the empirical work, based on a case study, confirms the existence of a structural connection integrating five factors of innovation capability. Statistical evidence is provided especially for the positive impacts of the improvement of absorption capability, marketing capability and networking capability, which are the main weaknesses of firms according to the study. Third, the research provides a methodological contribution by applying the innovation matrix in the defining of the innovation development needs of firms. The study demonstrates how the matrix improves possibility to target policy instruments and innovation services more efficiently through indicating significant differences between the innovation support needs regarding various time horizons and phases of innovation process.

Evaluation of a model for induction of periodontal disease in dogs

There are several methods for inducing periodontal disease in animal models, being the bone defect one of the most reported. This study aimed to evaluate this model, through clinical, radiographic, tomographic and histological analyzes, thus providing standardized data for future regenerative works. Twelve dogs were subjected to the induction protocol. In a first surgical procedure, a mucoperiosteal flap was made on the buccal aspect of the right third and fourth premolars and a defect was produced exposing the furcation and mesial and distal roots, with dimensions: 5mm coronoapical, 5mm mesiodistal, and 3mm buccolingual. Periodontal ligament and cementum were curetted and the defect was filled with molding polyester, which was removed after 21 days on new surgical procedure. Clinical and radiographic examinations were performed after the two surgeries and before the collection of parts for dental tomography and histological analysis. All animals showed grade II furcation exposure in both teeth. Clinical attachment level increased after induction. Defect size did not change for coronoapical and buccolingual measurements, while mesiodistal size was significantly higher than at the time of defect production. Radiographic analysis showed decreased radiopacity and discontinuity of lamina dura in every tooth in the furcation area. The horizontal progression of the disease was evident in micro-computed tomography and defect content in the histological analysis. Therefore, it is concluded that this method promotes the induction of periodontal disease in dogs in a standardized way, thus being a good model for future work.

Kattilan ja kanaviston eristykset 3D-laitossuunnitteluohjelmassa

Työn tavoitteena oli kehittää kanavistojen ja kattilan eristyksien mallintamista 3D-laitossuunitteluohjelmassa sekä siitä saatavia materiaalilistoja. Kanavistojen eristeitä kuvastavaa geometriaa muokattiin vastaamaan eristyksen todellista tilanvarausta. Kattilan eristyksen mallintaminen on aikaisemmin jouduttu tekemään manuaalisesti, työssä kehitettiin työkalu, jonka avulla eristysten materiaalitiedot ja oikeat tilanvaraukset saadaan lisättyä 3D-malliin. Kaikkia eristyksen mallintamista ei kuitenkaan pystytä mielekkäästi toteuttamaan automaattisesti työkalujen avulla, näitä kohteita ovat tukikehikkorakenteet kuten kattilan vinttikehikko. Lisäksi täytyi selvittää, mitä tietoja eristyksien materiaalimäärälistoille vaaditaan, ja kuinka nämä tiedot saataisiin listoihin mukaan. Jotta kaikki eristettävät kohteet saadaan tuotettaviin materiaalilistoihin, on ohjelmaan lisättävä käytettäväksi uusia komponentteja. Näitä ovat uudet kanavistojen osat sekä muun muassa venturit ja huoltoluukut kanavistoille. Kattilaan asennettavat laitteet kuten näkölasit ja polttimet vaativat tukirakenteen, joka samalla toimii kotelona putkistojen taivutuksille. Näitä kohteita on aikaisemmin tuotu vanhoista projekteista tai ne on tehty suunnittelijan toimesta uusiksi. Työssä esitettiin uusi tapa mallintaa kattilan pinnat, jolloin niihin voidaan liittää koteloita erillisestä komponenttikirjastosta. Kanavistojen eristyksien materiaalimäärälistojen tuottaminen suoraan ohjelmasta auto-matisoitiin. Kattilan ja siihen liittyvien eristyskehysrakenteiden listojen tuotanto kuitenkin vaatii yhteisten toimintamallien kehittämistä. Tämän työn uudet menetelmät mahdollistavat yhä uusien työkalujen kehittämisen, esimerkiksi automaattisen eristysten teknisten piirustusten kuvatuotannon tulevaisuudessa.

Background for Designing an Improved Digital Musical Keyboard Instrument

Electrical keyboard instruments and computer-aided music-making generally base on the piano keyboard that was developed for a tuning system no longer used. Alternative keyboard layout offers at least easier playing, faster adopting, new ways to play and better ergonomics. This thesis explores the development of keyboard instruments and tunings, and different keyboard layouts. This work is preliminary research for an electrical keyboard instrument to be implemented later on.

Ravinnekierron sulkemisen haasteet suomalaisessa ruokaketjussa

Suomi on sitoutunut pyrkimään ravinnetalouden mallimaaksi. Tämä diplomityö on osa Suomi kes-tävän ravinnetalouden mallimaaksi -hanketta. Diplomityön tarkoituksena on kartoittaa ravin-teidenkäytön tehokkuuteen liittyvät ongelmakohdat suomalaisessa ruokaketjussa ja selvittää oh-jauskeinot, joilla näihin pullonkauloihin voitaisiin puuttua. Ravinnehäviöt aiheuttavat suuria ympä-ristöhaittoja ja käytettävät primääriravinteet pohjaavat uusiutumattomiin luonnonvaroihin. Ravinnehäviöitä syntyy ruokaketjun jokaisessa osassa, ja ravinnetehokkuutta voidaan parhaiten edistää pyrkimällä kokonaisvaltaisiin ratkaisuihin. Tutkimus suoritettiin haastattelemalla 20:tä ruokaketjun asiantuntijaa. Haastatteluaineistoa tarkasteltiin laadullisen analyysin menetelmin. Haastatteluiden perusteella ruokaketjun suurimmat ongelmakohdat ovat alkutuotannossa, panos-teollisuudessa ja kulutuksessa. Sekä hallinnollisilla, taloudellisilla että informatiivisilla ohjauskei-noilla on kaikilla tärkeä rooli ravinnetehokkuuden edistämisessä.