Distribution and habitat ecology of the threatened forest lichen Lobaria pulmonaria in Estonia

Lobaria pulmonaria is a widely used as an indicator species of undisturbed old-growth forests ecosystems, but the knowledge about its habitat ecology is still highly fragmented. To quantify the distribution, habitat preference and host tree specificity of Lobaria pulmonaria we utilised data from databases and field surveys in Estonia. The number of L. pulmonaria localities is the highest in the densely forested regions, concentrated mainly in small forest patches defined as ‘ecologically highly valuable’. The species grows mostly on deciduous trees, particularly on aspen (Populus tremula). L. pulmonaria is most common in oligo-mesotrophic boreal, eutrophic boreo-nemoral and in eutrophic paludifying forests, and prefers forests with an average age of trees more than 100 years. In addition, we found that younger stands could be suitable habitats for L. pulmonaria if the structure of the stand is comparable to mature stands. In spite of the many localities of L. pulmonaria in Estonia, the species is still threatened because (1) the rotation period of tree stands is short, (2) it is abundant in forest types which are rare or under strong economic pressure, (3) and it prefers host trees which have a restricted distribution in Estonia or are not favoured in forest management practice.

Qualitative research thrives in primary care with the support of research training and mentoring

Non peer reviewe

A one-year follow-up study of chronic pain in community-dwelling older adults with and without neuropathic pain

Background: Chronic, mostly musculoskeletal pain is common among older adults. Little is known about the prognosis of chronic pain and the neuropathic pain qualities in older adults. We studied a cohort of community-dwelling older adults, clinically assessed their pain states, classified their type of pain (nociceptive, neuropathic or combined) and followed them up for a year. Methods: At baseline, a geriatrician clinically examined all study patients and classified their type of pain in collaboration with a pain specialist. Pain, quality of life and mental health were measured by questionnaires (BPI, GDS-15, BAI and SF-36) and reassessed after 1 year. Results: Despite chronic pain, all patients from the baseline cohort continued to live independently at 1 year. A total of 92 of 106 (87%) patients returned the follow-up questionnaire. Nociceptive pain on its own was present in 48 patients, whereas 44 patients also had neuropathic pain. Most patients (96%) had several pain states at baseline, and 13 patients reported a new pain state at follow-up. On average, there were no significant changes in the pain intensity, pain interference, mood or quality of life in either group between baseline and follow-up. Changes in pain were observed at the individual level, and both intensity and interference of pain at the follow-up had a negative correlation with the baseline value. Conclusions: On average, chronic pain was persistent in our patients, but they were able to live independently despite their pain. At the individual level, both relief and exacerbation of pain were observed, supporting the notion that pain is not inevitable and unremitting among older adults.Peer reviewe

Patient and public attitudes to and awareness of clinical practice guidelines : a systematic review with thematic and narrative syntheses

Article Accepted Date: 15 July 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Acknowledgements The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 258583 (DECIDE project). The Health Services Research Unit, Aberdeen University, is funded by the Chief Scientist Office of the Scottish Government Health Directorates. The authors accept full responsibility for this paper and the views expressed in it are those of the authors and do not necessarily reflect those of the Chief Scientist Office. NS receives funding through a Knowledge Translation Fellowship from the Canadian Institutes of Health Research. No funding bodies had a role in the manuscript. We would like to thank Healthcare Improvement Scotland and the University of Dundee for support, including access to literature. We would also like to thank Lorna Thompson (Healthcare Improvement Scotland), for her help with the protocol for this review.Peer reviewedPublisher PD

Dispersal ecology of the endangered woodland lichen Lobaria pulmonaria in managed hemiboreal forest landscape

Changes in the forest management practices have strongly influenced the distribution of species inhabiting old-growth forests. The epiphytic woodland lichen Lobaria pulmonaria is frequently used as a model species to study the factors affecting the population biology of lichens. We sampled 252 L. pulmonaria individuals from 12 populations representing three woodland types differing in their ecological continuity and management intensity in Estonia. We used eight mycobiont-specific microsatellite loci to quantify genetic diversity among the populations. We calculated the Sørensen distance to estimate genetic dissimilarity among individuals within populations. We revealed that L. pulmonaria populations have significantly higher genetic diversity in old-growth forests than in managed forests and wooded meadows. We detected a significant woodland-type-specific pattern of genetic dissimilarity among neighbouring L. pulmonaria individuals, which suggests that in wooded meadows and managed forests dominating is vegetative reproduction. The vegetative dispersal distance between the host trees of L. pulmonaria was found to be only 15-30m. Genetic dissimilarity among individuals was also dependent on tree species and trunk diameter. Lobaria pulmonaria populations in managed forests included less juveniles compared to old-growth forests and wooded meadows, indicating that forest management influences life stage structure within populations. We conclude that as intensive stand management reduces the genetic diversity of threatened species in woodland habitats, particular attention should be paid to the preservation of remnant populations in old-growth habitats. Within managed habitats, conservation management should target on maintenance of the stand's structural diversity and availability of potential host tree

Paratextuality in Manuscript and Print : Verbal and Visual Presentation of the Middle English Polychronicon

This study investigates the verbal and visual presentation of text across manuscript and print media through the concept of paratext. The term collectively refers to the various textual and visual elements which surround the main text in a book, and guide its use and reception. The aim of the study is to critically evaluate the paratext framework in the context of handwritten and printed English texts from the late medieval and early modern periods, and to further develop the theoretical and methodological applications of the paratext framework to this material. In addition to the theory of paratext, this dissertation contributes to the wider study of the materiality of text and our understanding of late medieval and early modern authorship. The approach taken in this study is philological and informed by textual scholarship; palaeographical and codicological methods are also used in the analyses. The material for the study comprises fifteen manuscript copies and three early printed editions of John Trevisa’s Middle English translation (1387) of Ranulph Higden’s Polychronicon. By comparing the paratextual matter across the different material manifestations of the work, the study explores how authors and book producers conceptualised paratextuality and attempted to guide the readers. The analyses focus on four major paratextual devices: prefatory and end matter, indices, marginal annotation, and elements of page layout, which includes text-organising devices as well as decoration and illustration. The study shows that pre-modern book producers had an understanding of paratextuality as a phenomenon related to but separate from textuality. Various paratextual elements demonstrate how scribes, printers and other producers of the new copies balanced between producing the abstract text of the work accurately and improving the usability or desirability of the physical copy. Possibly for this reason, the indices were found to be particularly prone to changes. The producers’ interpretations of the structure of the text, and the relationships between text and paratext, are visible in the visual and textual presentation.Väitöstutkimuksessa tarkastellaan paratekstikäsitteen avulla tekstin sanallisen ja visuaalisen esittämisen keinoja käsikirjoituksissa ja varhaisissa painetuissa kirjoissa. Parateksti viittaa kaikkiin kirjassa varsinaista tekstiä ympäröiviin tekstuaalisiin ja visuaalisiin elementteihin, jotka ohjaavat lukijan tulkintaa ja kirjan käyttöä. Tutkimuksen tavoitteena on tarkastella kriittisesti paratekstiviitekehyksen soveltuvuutta käsikirjoitusten ja kirjapainon varhaisvaiheiden aikakaudella tuotettuun englanninkieliseen aineistoon sekä kehittää viitekehyksen teoreettisia ja metodologisia sovelluksia tässä aineistossa. Paratekstiteorian lisäksi tutkimus tarjoaa uutta tietoa materiaalisesta tekstistä sekä tekijyydestä myöhäiskeskiajalla ja varhaismodernilla ajalla. Tutkimuksen alana on filologia ja sen teoreettinen viitekehys ammentaa tekstuaalitieteistä. Aineiston analysoinnissa käytetään myös paleografisia ja kodikologisia menetelmiä. Tutkimuksessa käytetty aineisto koostuu John Trevisan latinasta keskienglanniksi kääntämän Polychronicon-maailmanhistorian (1387) käsikirjoituskopioista, yhteensä viisitoista käsikirjoitusta, ja kolmesta varhaisesta painetusta laitoksesta. Vertailemalla paratekstin piirteitä yhden teoksen eri materiaalisissa ilmentymissä tutkimus selvittää, miten teoksen tekijät ja kirjatuottajat käsittivät paratekstuaalisuuden ja hyödynsivät sitä lukijoita ohjatessaan. Analyysi keskittyy erityisesti neljään paratekstityyppiin: alku- ja loppusanat, hakemistot, reunahuomautukset sekä sivun asettelun piirteet, joihin sisältyvät tekstin jäsentäminen sekä koristelu ja kuvitus. Tutkimus osoittaa, että varhaisilla tekstintuottajilla oli käsitys paratekstuaalisuudesta tekstiin liittyvänä mutta siitä erillisenä ilmiönä. Eri paratekstielementit osoittavat, miten kopioitsijat, painajat ja muut kirjatuottajat pyrkivät toisaalta toisintamaan teoksen tekstin tarkasti, toisaalta parantamaan fyysisen kirjan käytettävyyttä tai houkuttelevuutta. Luultavasti tästä johtuu, että hakemistot olivat aineistossa erityisen alttiita muutoksille. Tuottajien omat tulkinnat tekstin rakenteesta sekä tekstin ja paratekstin suhteista tulevat esiin visuaalisissa ja tekstiä jäsentävissä elementeissä

Managing functional disorders : opportunities and threats

Non peer reviewe

Work ability meetings-a survey of Finnish occupational physicians

Background Work ability meetings (WAMs) are planned discussions between an employee, a manager and an occupational physician (OP) to support work ability and return to work (RTW). During the last decade, WAMs become a popular intervention in Finnish occupational healthcare, although research on their content is lacking. Aims To describe the practice of WAMs in Finland. Methods We sent an internet survey by e-mail to members of the Finnish Society of Occupational Health Physicians in August 2014. We asked them to describe the last WAM they had attended, the employee the meeting concerned, the reason why it was convened, the content of the meeting and the action plan developed. Results A total of 303 of 1304 OPs responded (24%) to the survey. The meetings were most often arranged for employees in manual or clerical work (71%). There were several overlapping reasons for convening a WAM, including a worker's reduced work ability (57%), functional ability (42%) or long-term sickness absence (38%). The meetings consisted of RTW planning, clarification of the situation and a dialogue between the three parties. In half of the cases, the action plans dealt with modifications of work tasks. A third of cases were forwarded to vocational rehabilitation, while permanent disability pension was considered in 6% of cases. Conclusions The focus of WAMs was on workplace adjustments to support workers to remain at work. The WAMs dealt mostly with early interventions for RTW: work modifications, adjustments and vocational rehabilitation.Peer reviewe

Patients, health information, and guidelines:a focus-group study

Background. Evidence-based clinical guidelines could support shared decision-making and help patients to participate actively in their care. However, it is not well known how patients view guidelines as a source of health information. This qualitative study aimed to assess what patients know about guidelines, and what they think of their presentation formats. Research question. What is the role of guidelines as health information for patients and how could the implementation of evidence-based information for patients be improved? Methods. A qualitative study with focus groups that were built around a semi-structured topic guide. Focus groups were audiotaped and transcribed and analysed using a phenomenographic approach. Results. Five focus groups were carried out in 2012 with a total of 23 participants. Patients searched for health information from the Internet or consulted health professionals or their personal networks. The concepts of guidelines included instructions or standards for health professionals, information given by a health professional to the patient, and material to protect and promote the interests of patients. Some patients did not have a concept for guidelines. Patients felt that health information was abundant and its quality sometimes difficult to assess. They respected conciseness, clarity, clear structure, and specialists or well-known organizations as authors of health information. Patients would like health professionals to deliver and clarify written materials to them or point out to them the relevant Internet sites. Conclusions. The concept of guidelines was not well known among our interviewees; however, they expressed an interest in having more communication on health information, both written information and clarifications with their health professionals

Narrative Escalation and the Dynamics of Violence in Post-Reunification German Literature

The article aims to show how escalation narratives in contemporary German literature dissect the dynamics of violence in the twentieth and twenty-first centuries by dealing with outbreaks of violence and making visible hidden forms of violence, both in the modes of latency and drastic depiction. Whereas in Nullerjahre (2022) by Hendrik Bolz and Wir waren wie Brüder (2022) by Daniel Schulz the post-reunification period is reflected through different modes of escalation, depicting publicly visible violence, Anne Rabe’s novel Die Möglichkeit von Glück (2023) shifts this setting to the family level, where different forms of violence appear to be a consequence of the structural violence inherent in the authoritarian system of the GDR. Antje Rávik Strubel’s novel Blaue Frau (2021) addresses similar issues but focuses on the political situation in Europe, describing a young woman’s journey from East to West, filled with exploitation and assault. All texts expose narratives of violent (but sometimes invisible) excesses in the post-reunification period in relating them both to past, but in parts still intact forms of structural and symbolic violence that remain visible as traces – or return in the mode of direct, physical violence