Impacte d'un programa d'informació sobre l'elaboració del document de voluntats anticipades

Tot i que en el nostre territori comptem des de els anys 80 amb diferents models de Document de Voluntats Anticipades (DVA), aquests continuen essent desconeguts tant per la ciutadania com pels professionals de la salut. Aquesta situació ha fet que ens plantegem com a objectiu d’aquest estudi descriure si existeix la correlació entre el fet de proporcionar informació sobre el DVA i la motivació per la seva realització. En aquest estudi hem agafat com a mostra els usuaris del servei de psicogeriatria de la Fundació Sociosanitaria de Manresa l’Hospital de Sant Andreu de Manresa, tenint en compte les recomanacions del Document Sitges del 2005 i d’altres autors que recomanen fer el DVA en situació de demència lleu o moderada. També s’ha tingut present l’elevada prevalença d’aquesta patologia. S'ha dissenyat un assaig clínic comunitari amb aleatorització de dos consultoris d'un servei de psicogeriatria. Els metges del consultori assignat al grup control feien el tractament habitual en relació al DVA, és a dir, no informar els pacients atesos sobre l'existència i característiques del DVA, i els metges del consultori assignat al grup intervenció donaven informació reglada als seus pacients sobre el DVA. En el moment de la inclusió es registrava informació sociodemogràfica i clínica per poder classificar els participants i, també a tots els subjectes inclosos en l'assaig, al cap de tres setmanes se'ls feia una enquesta telefònica per avaluar l'opinió i el coneixement sobre el DVA. De les respostes de l’enquesta podem extreure com a resultats que més del 90% dels subjectes del grup control no coneixen el DVA. També s’observa de manera significativa com les persones del grup intervenció parlen amb el metge,la infermera i/o la família sobre la dependència i la mort, tenint en compte que la mort i la dependència continuen sent un tema tabú, i que la majoria de la població de l’estudi no planifiquen com volen ser atesos. Tanmateix s’observa com un 2’3 % tenia fet el DVA i un 22’7% manifesten la seva voluntat de realitzar-lo. Amb aquest estudi es conclou que el fet de proporcionar informació sobre el DVA als usuaris del servei de psicogeriatria afavoreix que aquests estiguin motivats per la realització d’aquest document; al mateix temps també afavoreix la planificació de les cures i el parlar sobres temes com la mort i/o la dependència amb la família, el metge la infermera.

Assessment of Coals from Russia and Countries of Former Soviet Union for Utility Fluidized Bed Boilers

With the occurrence of fossil fuels such as oil, gas and coal we found new sources of energy that have played a critical role in the progress of our modern society. Coal is very ample compared to the other two fossil fuels. Global coal reserves at the end of 2005 were estimated at 847,5 billion tones. Along with the major energy sources, coal is the most fast growing fuel on a global basis, it provides 26% of primary energy needs and remains essential to the economies of many developed and developing countries. Coal-fired power generation accounts for 41% of the world‘s total electricity production and in some countries, such as South Africa, Poland, China, Australia, Kazakhstan and India is on very high level. Still, coal utilization represents challenges related to high emissions of air pollutants such as sulphur and nitrogen dioxides, particulate matter, mercury and carbon dioxide. In relation to these a number of technologies have been developed and are in marketable use, with further potential developments towards ―Near Zero Emission‖ coal plants. In present work, coals mined in Russia and countries of Former Soviet Union were reviewed. Distribution of coal reserves on the territory of Russia and the potential for power generation from coal-fired plants across Russia was shown. Physical and chemical properties of coals produced were listed and examined, as main factor influencing on design of the combustion facility and incineration process performance. The ash-related problems in coal-fired boilers were described. The analysis of coal ash of Russia and countries of Former Soviet Union were prepared. Feasible combustion technologies also were reviewed.

Pikkunäppäriä ajatuksia territoriaalisuudesta

Kirjallisuusarvostelu

The impact of the law 10,267/2001 in the brazilian rural registration

The publication of the Law 10,267 of 08/28/2001 changed the paradigm of rural registration in Brazil, because this law known as the "Law of Georeferencing" has created the National Registration of Rural Property, that unifies in a common basis different registrations present in several government agencies, such as the National Institute for Colonization and Agrarian Reform (INCRA), the Secretariat of Federal Revenue, the Brazilian Institute of Environment and Natural Resources, and the National Indian Foundation. Also, this new registration system has a graphical component which has not existed until such date, where the boundaries of rural property are georeferenced to the Brazilian Geodetic System. This new paradigm has resulted in a standardization of the survey and its representation of rural properties according to the Technical Standard for Georeferencing of Rural Properties, published by INCRA in compliance with the new legislation. Due to the georeferencing, the creation of a public GIS of free access on the Internet was possible. Among the difficulties found it may be observed the great Brazilian territory, the need for specialized professionals, and especially the certification process that INCRA has to perform for each georeferenced property. It is hoped that this last difficulty is solved with the implementation of the Land Management System that will allow automated and online certification, making the process more transparent, agile and fast.

Study of carotid disease in patients with peripheral artery disease

Objective: To study the stenosis of the carotid arteries in patients with symptomatic peripheral arterial disease.Methods: we assessed 100 consecutive patients with symptomatic peripheral arterial disease in stages of intermittent claudication, rest pain or ulceration. Carotid stenosis was studied by echo-color-doppler, and considered significant when greater than or equal to 50%. We used univariate analysis to select potential predictors of carotid stenosis, later taken to multivariate analysis.Results: The prevalence of carotid stenosis was 84%, being significant in 40% and severe in 17%. The age range was 43-89 years (mean 69.78). Regarding gender, 61% were male and 39% female. Half of the patients had claudication and half had critical ischemia. Regarding risk factors, 86% of patients had hypertension, 66% exposure to smoke, 47% diabetes, 65% dyslipidemia, 24% coronary artery disease, 16% renal failure and 60% had family history of cardiovascular disease. In seven patients, there was a history of ischemic cerebrovascular symptoms in the carotid territory. The presence of cerebrovascular symptoms was statistically significant in influencing the degree of stenosis in the carotid arteries (p = 0.02 at overall assessment and p = 0.05 in the subgroups of significant and non-significant stenoses).Conclusion: the study of the carotid arteries by duplex scan examination is of paramount importance in the evaluation of patients with symptomatic peripheral arterial disease, and should be systematically conducted in the study of such patients.

Russian metals for arctic offshore structures

With an increasingly growing demand for natural resources, the Arctic region has become an attractive area, holding about 15% of world oil. Ice shrinkage caused by global warming encourages the development of offshore and ship-building sectors. Russia, as one of the leading oil and gas production countries is participating actively in cold resistant materials research, since half of its territory belongs to the Arctic environment, which held considerable stores of oil. Nowadays most Russian offshore platforms are located in the Sakhalin Island area, which geographically does not belong to the Arctic, but has com-parable environmental conditions. Russia recently has manufactured several offshore platforms. It became clear that further development of the Arctic off-shore structures with necessary reliability is highly depending on the materials employed. This work pursues the following objectives:  to provide a comprehensive review on Russian metals used for Arctic offshore structures on the base of standards, books, journal articles and companies reports  to overview various Arctic offshore structures and its structural characteristics  briefly discuss materials testing methods for low temperatures Master`s thesis focuses on specifications and description of Russian metals which are already in use and can be used for Arctic offshore structures. Work overviews several groups of steel, such as low carbon, low alloy, chromium containing steels, stainless steels, aluminium and nanostructured steels. Materials under discussion are grouped based on the standards, for instance the work covers shipbuilding and structural steels at the different sections. This paper provides an overview of important Russian Arctic offshore projects built for use in Russia and ordered by foreign countries. Future trends in development of the Arctic materials are discussed. Based on the information provided in this Master`s thesis it is possible to learn about Russian metals used for ships and offshore platforms operated in the Arctic region. Paper can be used as the comprehensive review of current materials, such as various steels, aluminium and nanomaterials.

Mädätys- ja kompostointilaitoshankkeen teknis-taloudellinen vertailu Lakeuden Ympäristöhuollossa

Työssä selvitettiin teknis-taloudellisen vaihtoehto Lakeuden Ympäristöhuollon keräämän biojätteen ja Seinäjoen lähialueella syntyvän hevosenlannan käsittelyyn. Nykyisin Lakeuden Ympäristöhuolto Oy:n keräämä biojäte kuljetetaan paikallisen jätehuoltoyhti-ön biokaasulaitokseen ja hevosenlantaa ei alueelta vielä kerätä olleenkaan. Työn lähtö-kohtana oli vertailla mahdollisesti rakennettavan oman biokaasulaitoksen ja rumpu-kompostointilaitoksen kannattavuutta toisiinsa. Kannattavuuden laskennassa käytettiin annuiteettimenetelmää. Työn kirjallisuusosiossa kerrotaan eloperäisten jätteiden ominaisuuksista mädätyksen ja kompostoinnin kannalta, mädätys- ja kompostointiprosessista, mädätys- ja kompostoin-titekniikoista sekä menetelmien eduista sekä haitoista. Työssä perehdyttiin myös mädä-tyksen ja kompostoinnin lopputuotteiden hyödyntämiseen. Vaihtoehtojen vaertailussa kumpikaan hankkeista ei ollut taloudellisesti kannattava. Vaikka prosesseihin saataisiin nykyään kerättävän biojätteen määrän lisäksi 2000 tonnia hevosenlantaa, se ei tee hankkeista kannattavia. Edes herkkyystarkastelussa laskettu korkeampi hevosenlannan porttimaksun määrä ei vaikuttanut kannattavuuteen. Lakeuden Ympäristöhuollon näin ollen on viisainta olla investoimatta kumpaakaan hankkeeseen.

First identification of natural infection of Rickettsia rickettsii in the Rhipicephalus sanguineus tick, in the State of Rio de Janeiro

The Brazilian Spotted Fever (BSF) is a zoonotic disease caused by Rickettsia rickettsii and transmitted by ticks of the genus Amblyomma, more frequently, Amblyomma cajennense. The aim of this paper was to report the first molecular detection of R. rickettsii on R. sanguineus naturally infected in Rio de Janeiro, Brazil. Ticks were collected from dogs in a rural region of Resende municipality, Rio de Janeiro State, Brazil (22º30'9.46"S, 44º42'44.29"WO), where occurred five human cases of BSF in 2006. The ticks were identified under a stereoscopic microscope and separated in pools by stages, species and sex. DNA extraction was carried out using QIAamp DNA Mini Kit (QIAGEN®). The DNA was submitted to PCR amplification using 04 set of primers: Rr190.70p/Rr190.602n (OmpA, 532bp), BG1-21/BG2-20 (OmpB, 650bp), Tz15/Tz16 (17 kDa protein-encoding gene, 246bp) and RpCS.877p/RpCS.1258n (gltA, 381bp). PCR products were separated by electrophoresis on 1% agarose gels and visualized under ultraviolet light with ethidium bromide. PCR products of the expected sizes were purified by QIAquick® and sequenced by ABI PRISM®. The generated nucleotide sequences were edited with using Bioedit® software and compared with the corresponding homologous sequences available through GenBank, using Discontiguous Mega Blast (http://www.ncbi.nlm.nih.gov). It was confirmed R. rickettsii by sequencing of the material (GenBank FJ356230). The molecular characterization of R. rickettsii in the tick R. sanguineus emphasizes the role of dogs as carriers of ticks from the environment to home. Moreover, this result suggests that there is a considerable chance for active participation of R. sanguineus as one of tick species in the transmission of R. ricketsii to human being in the Brazilian territory.

The Environmental Status of the Port of HaminaKotka

This study is a part of the Ecologically Friendly Port Ust-Luga (EFP) project. The purpose of this study is to examine the environmental status of the Finnish ports and, more specifically, the Port of HaminaKotka. An analysis of the environmental status is performed mainly as a literature review, because the Finnish ports must comply with Finnish and EU legislation and with the binding international regulations and conventions created by different organizations. The International Maritime Organisation (IMO) has done groundbreaking work in the field of maritime safety and maritime environmental protection. The MARPOL convention has a great impact on decreasing pollution from international shipping and it applies to 99% of the world’s merchant tonnage. Pollution prevention covers: Oil pollution, Chemical pollution, Air pollution and GHG Emissions, Dumping of Wasted and Other Matters, Garbage, Sewage, Port Reception Facilities, Special Areas under MARPOL and Particularly Sensitive Sea Areas. There is also Pollution Prevention for other treaties like anti-fouling systems used on ships, the transfer of alien species by ships’ ballast water and the environmentally sound recycling of ships. There are more than twenty different EU and international regulations that influence ports and port operations in Finland. In addition, there is also national legislation that has an effect on Finnish ports. For the most part, the legislation for ports is common in the EU area, but the biggest and most important difference between the legislation in Finland and other EU countries is due to the Act on Environmental Impact Assessment Procedure. The Act states that the environmental impact assessment procedure shall be applied to projects that may have significant adverse environmental impacts, due to the special features of Finland`s nature and environment. In this Act, the term environmental impact refers to the direct and indirect effects inside and outside Finnish territory of a project or operations on human health, living conditions and amenity; soil, water, air, climate, organisms, interaction between them and biodiversity; community structure, buildings, landscape, townscape and cultural heritage; utilization of natural resources. In Finland, the Environmental Permit requires that ports collect all necessary information concerning environmental effects and make required reports to the Finnish authorities, stakeholders and the public. Commonly, environmental reporting is public and environmental achievements are emphasized in reporting and in media. At the moment, the problem in environmental reporting is that it’s difficult to compare data from different ports. There is enough data concerning the environmental effects and performance, but the manner of reporting and the quality of the data varies between ports. There are differences in the units and codes used, in some cases the information is not sufficient and it can even be rather unreliable. There are also differences regarding the subjects that are emphasized in reporting.

Hyökkäyksestä puolustukseen : taktiikan kehittymisen ensimmäiset vuosikymmenet Suomessa

This study deals with the development of military tactics in Finland from independence to the early 1950s. The research is divided into three periods: the time before the Winter and Continuation wars and the time after the wars. Based mainly on archive sources each period and subject is dealt with in chronological order. The objective was to study the development features in Finnish tactics and the foreign impact on its development. Before the Winter War, offence was regarded as the only course of action that could redress the balance of power in a possible war against the Soviet Union. Defence lacked the depth considered essential in European thinking because the troops were few and the heavily forested terrain prevented the deployment of automatic weapons in echelon. Delaying action was most clearly based on Finnish concepts. Between the world wars, Finnish tactics was very pan-European. Mainly through German influence, the overall thinking followed the emphases of the international mainstream with many influences from other European countries, mainly from Sweden. However, the principles of the mainstream were adapted to suit the circumstances and position of Finland. The short Winter War against the Soviet Union proved that Finnish tactics was on the right track in its basic principles. During the Continuation War it was determined that tactical thinking could not rely solely on offence, but should be based to a greater extent on terms dictated by defensive tactics. During the static phase of the Continuation War, Finland did not receive adequate intelligence on the advances in the offensive capabilities of the Soviet Union. This was why defence tactics was influenced by German combat experiences against the Red Army. In repelling the massive Soviet attack, the use of deeper echelons was adopted as the basic principle in Finland. After the war, the East - West confrontation put Finland in a totally new position. Because combat deep inside Finnish territory in future war seemed probable, Finland adopted a doctrine of territorial defence. Army tactics expanded to more effectively include combat on the coast, in centers of population and in the northern areas of the country. The years after the wars had very little effect on Finnish tactics: development of defence tactics continued further toward defence in depth as a combat model. During the period of the present study, Finnish tactics developed from mainly offensive thinking to emphasizing defensive combat.

Parasitic Order Machine. A Sociology and Ontology of Information Securing

This study examines information security as a process (information securing) in terms of what it does, especially beyond its obvious role of protector. It investigates concepts related to ‘ontology of becoming’, and examines what it is that information securing produces. The research is theory driven and draws upon three fields: sociology (especially actor-network theory), philosophy (especially Gilles Deleuze and Félix Guattari’s concept of ‘machine’, ‘territory’ and ‘becoming’, and Michel Serres’s concept of ‘parasite’), and information systems science (the subject of information security). Social engineering (used here in the sense of breaking into systems through non-technical means) and software cracker groups (groups which remove copy protection systems from software) are analysed as examples of breaches of information security. Firstly, the study finds that information securing is always interruptive: every entity (regardless of whether or not it is malicious) that becomes connected to information security is interrupted. Furthermore, every entity changes, becomes different, as it makes a connection with information security (ontology of becoming). Moreover, information security organizes entities into different territories. However, the territories – the insides and outsides of information systems – are ontologically similar; the only difference is in the order of the territories, not in the ontological status of entities that inhabit the territories. In other words, malicious software is ontologically similar to benign software; they both are users in terms of a system. The difference is based on the order of the system and users: who uses the system and what the system is used for. Secondly, the research shows that information security is always external (in the terms of this study it is a ‘parasite’) to the information system that it protects. Information securing creates and maintains order while simultaneously disrupting the existing order of the system that it protects. For example, in terms of software itself, the implementation of a copy protection system is an entirely external addition. In fact, this parasitic addition makes software different. Thus, information security disrupts that which it is supposed to defend from disruption. Finally, it is asserted that, in its interruption, information security is a connector that creates passages; it connects users to systems while also creating its own threats. For example, copy protection systems invite crackers and information security policies entice social engineers to use and exploit information security techniques in a novel manner.

Vasopressor mechanisms in acute aortic coarctation hypertension

Angiotensin II (ANG II) and vasopressin (AVP) act together with the mechanical effect of aortic constriction in the onset of acute aortic coarctation hypertension. Blockade of ANG II and AVP V1 receptors demonstrated that ANG II acts on the prompt (5 min) rise in pressure whereas AVP is responsible for the maintenance (30-45 min) of the arterial pressure elevation during aortic coarctation. Hormone assays carried out on blood collected from conscious rats submitted to aortic constriction supported a role for ANG II in the early stage and a combined role for both ANG II and AVP in the maintenance of proximal hypertension. As expected, a role for catecholamines was ruled out in this model of hypertension, presumably due to the inhibitory effect of the sinoaortic baroreceptors. The lack of afferent feedback from the kidneys for AVP release from the central nervous system in rats with previous renal denervation allowed ANG II to play the major role in the onset of the hypertensive response. Median eminence-lesioned rats exhibited a prompt increase in proximal pressure followed by a progressive decline to lower hypertensive levels, revealing a significant role for the integrity of the neuroaxis in the maintenance of the aortic coarctation hypertension through the release of AVP. In conclusion, the important issue raised by this model of hypertension is the likelihood of a link between some vascular territory - probably renal - below the coarctation triggering the release of AVP, with this vasoconstrictor hormone participating with Ang II and the mechanical effect of aortic constriction in the acute aortic coarctation hypertension

Ampumaratojen kunnostustarpeen selvittäminen

Suomessa arvioidaan olevan kaikkiaan 2000 - 2500 ampumarataa joista aktiivisessa käytössä on noin 1000 kpl. Useimmat ulkoradat on perustettu paljon ennen nykyisten ympäristölakien voimaantuloa. Tästä syystä ammunnan ympäristövaikutukset melua lukuun ottamatta, eivät varmaan ole olleet tarkasteltavien asioiden listan kärjessä ampumaratoja suunniteltaessa. Sopivan maa alueen saatavuus sopivalla paikalla rakennuskustannusten minimoimiseksi on täytynyt olla yksi tärkeimmistä kriteereistä. Joissakin tapauksissa tämä valitettavasti on johtanut siihen, että ratojen paikoiksi on valittu sellaisia, mitä tämän päivän tietämyksellä ei suositeltaisi, kuten esimerkiksi pohjaveden muodostumisalueet. Ampumaratojen, etenkin haulikkoratojen, on todettu aiheuttaneen paikallisesti varsin laajaa maaperän pilaantumista. Toiminnan jatkuessa, runsaasti raskasmetalleja kertyy maahan ja taustapenkkoihin josta se rapautuu ja kulkeutuu alueelta pohjavesiin. Pohjaveden mukana haitta-aineet saattavat kulkeutua vedenpuhdistamoihin muodostaen riskiä paikallisasukkaiden terveydelle sekä jossain määrin alueen kasvillisuudelle ja faunalle. Vuoden 2007 valtioneuvoston PIMA-asetus muutti joitakin ohje-arvoja, joten näitä uusia arvoja on otettavaa huomioon niin riskiarvioinnissa kuin alueen käyttömahdollisuuksien kannalta tulevaisuudessa. Asetuksen voimaantulo edellyttää tapauskohtaisten riskiarviointien tekemistä ampumarata-alueiden kunnostuksen yhteydessä jolloin saavutetaan mahdollisemman tehokasta hyöty-kustannustasoa. Tutkimuksen tarkoituksena on kartoittaa uuden asetuksen mukaisesti ampumaratojen muodostamaa riskiä sekä rajata kunnostettavat alueet ja valita sopivammat kunnostusvaihtoehdot. Esimerkkitapauksina käytetään Kokkolan kaupungin alueella sijaitsevaa ampumarata-aluetta.

Suitability of LiDAR technology for forest inventory in Russia

LiDAR is an advanced remote sensing technology with many applications, including forest inventory. The most common type is ALS (airborne laser scanning). The method is successfully utilized in many developed markets, where it is replacing traditional forest inventory methods. However, it is innovative for Russian market, where traditional field inventory dominates. ArboLiDAR is a forest inventory solution that engages LiDAR, color infrared imagery, GPS ground control plots and field sample plots, developed by Arbonaut Ltd. This study is an industrial market research for LiDAR technology in Russia focused on customer needs. Russian forestry market is very attractive, because of large growing stock volumes. It underwent drastic changes in 2006, but it is still in transitional stage. There are several types of forest inventory, both with public and private funding. Private forestry enterprises basically need forest inventory in two cases – while making coupe demarcation before timber harvesting and as a part of forest management planning, that is supposed to be done every ten years on the whole leased territory. The study covered 14 companies in total that include private forestry companies with timber harvesting activities, private forest inventory providers, state subordinate companies and forestry software developer. The research strategy is multiple case studies with semi-structured interviews as the main data collection technique. The study focuses on North-West Russia, as it is the most developed Russian region in forestry. The research applies the Voice of the Customer (VOC) concept to elicit customer needs of Russian forestry actors and discovers how these needs are met. It studies forest inventory methods currently applied in Russia and proposes the model of method comparison, based on Multi-criteria decision making (MCDM) approach, mainly on Analytical Hierarchy Process (AHP). Required product attributes are classified in accordance with Kano model. The answer about suitability of LiDAR technology is ambiguous, since many details should be taken into account.

A year after Crimea: continuity and change of Finnish-Russian relations reflected in the views of the government officials of Finland and Russia

This thesis discusses the dynamism of bilateral relations between Finland and Russia and their interconnection with wider EU-Russia relations in the sight of the recent conflict in Ukraine. In particular, incorporation of Crimea in the territory of Russia in March 2014 is believed to have triggered a series of disputes between the European Union and Russia and thus, have impacted the course of the bilateral Finnish-Russian relations. The study leans on a premise that there are some historical traditions and regularities in the Finnish foreign policy course towards Russia which make the bilateral Finnish-Russian relations special. These traditions are distinguished and described in the book “Russia Forever? Towards Pragmatism in Finnish/Russian relations” (2008) edited by H. Rytövuori-Apunen. Assuming that the featured traditions take place in modern relations between Finland and Russia, the aim of the thesis is to find out how these traditions reappear during the year shaped by the events in Ukraine. In order to do that, author follows the timeline of happenings around the Ukraine crisis starting with Crimea’s referendum on independence, and exams the way these events were commented on and evaluated by the key government officials and political institutions of Finland and Russia. The main focus is given to the Finnish official discourse on Russia during the study period. The data collection, consisting of mostly primary sources (ministerial press releases and comments, statements, speeches and blog posts of individual policy makers) is processed using the thematic analysis supported by the content analysis. The study reveals that the consequences of the Ukraine crisis have brought, among others, complications to the economic cooperation between Finland and Russia, and have stimulated the increased attention of the Finnish decision makers to the country’s security questions. As a result, the character and importance of some historical regularities of the Finnish foreign policies on Russia, like the Continental Dilemma, have taken new shape.