Regional trends in avoidable hospitalisations due to complications among population with diabetes in Finland in 1996-2011 : a register-based cohort study

Objectives: Diabetes requires continuous medical care including prevention of acute complications and risk reduction for long-term complications. Diabetic complications impose a substantial burden on public health and care delivery. We examined trends in regional differences in hospitalisations due to diabetes-related complications among the total diabetes population in Finland. Research design: A longitudinal register-based cohort study 1996-2011 among a total population with diabetes in Finland. Participants: All persons with diabetes identified from several administrative registers in Finland in 1964-2011 and alive on 1 January 1996. Outcome measures: We examined hospitalisations due to diabetes-related short-term and long-term complications, uncomplicated diabetes, myocardial infarction, stroke, lower extremity amputation and end-stage renal disease (ESRD). We calculated annual age-adjusted rates per 10 000 person years and the systematic component of variation. Multilevel models were used for studying time trends in regional variation. Results: There was a steep decline in complication-related hospitalisation rates during the study period. The decline was relatively small in ESRD (30%), whereas rates of hospitalisations for short-term and long-term complications as well as uncomplicated diabetes diminished by about 80%. The overall correlation between hospital district intercepts and slopes in time was -0.72 (p Conclusions: Our study suggests that the prevention of complications among persons with diabetes has improved in Finland between 1996 and 2011. The results further suggest that the prevention of complications has become more uniform throughout the country.Peer reviewe

Hyvinvoinnin turvaamisen rajat : Näköaloja talouskriisiin ja hyvinvointivaltion kehitykseen Suomessa

Miten syksyllä 2008 alkanut globaali talouskriisi vaikuttaa pitkällä aikavälillä suomalaiseen hyvinvointivaltioon? Jos olisimme antiikin Kreikassa, voisimme mennä Delfoin oraakkelin luo Apollonin temppeliin ja esittää tämän kysymyksen ennuspapittarelle. Eräänä lokakuun päivänä 2009 Kelan tiloihin kokoontui joukko suomalaisia hyvinvointivaltion huippuasiantuntijoita. He kertoivat julkisen talouden, kansalaisten toimeentulon ja terveyden näkökulmista kolmelle ”professori-oraakkelille” eli tanskalaiselle Nina Smithille, ruotsalaiselle Johan Fritzellille ja saksalaisille Karl Hinrichsille Suomen kokemuksista edellisestä, 1990-luvun alun lamasta, sen jälkeisestä kehityksestä sekä omista tulevaisuuden arvioistaan. Seuraavana päivänä oraakkelit lausuivat ennustuksensa, joka paljastetaan tässä raportissa.10,00 euro

An Overview of the Current Research on Stability of Ships and Ocean Vehicles: the STAB2018 Perspective

Manuscrito aceptado[Abstract]: The paper provides an insight into contemporary research on ship stability and identifies the possible directions for future research by reviewing a selection of papers published in STAB 2015, ISSW 2016 & 2017. These works have been organized in different sections, according to the main thematic areas of research, covering intact and damage stability, regulatory issues including probabilistic approaches, advanced numerical methods for ship motion and stability failure prediction including roll damping, operational issues related to ship stability and environmental modelling. Furthermore, the educational potential of STAB/ISSW is exemplified. This review paper is a joint effort within the SRDC (Stability R&D Committee).This collaborative effort has been undertaken by a group of members of the “Stability R&D Committee” (www.shipstab.org/stability-r-d-committee-srdc/). Stability R&D Committee (SRDC) is an international committee created for promoting and supporting research, collaboration and exchange of information in the field of ship stability, particularly among, but not limited to, young individuals. The authors would like to express their sincere thanks to the organizers of the 13th International Conference on Stability of Ships and Ocean Vehicles (STAB 2018, Kobe, Japan) for the opportunity to present the original version of this work

Transient response of a ship to an abrupt flooding accounting for the momentum flux

Numerical non-linear time domain simulation method for damaged ship motionsis presented. Floodwater motion modelling is based on the lumpedmass method with a moving free surface. The ship and floodwater motionsare fully coupled. The variation of the floodwater mass is accounted for. Amodel to account for the flooding ingress transporting the momentum is presented.The experiments of abrupt flooding have shown that the ship mayexperience the first large roll towards the undamaged side, especially when alarge undivided compartment is flooded. The presented time domain modelis validated against the experimental data on the roll damping of the floodedship and transient flooding. Two different initial stability conditions andtwo different compartment layouts are studied. Viscous dissipation of thefloodwater motions is modelled with an equivalent friction coefficient. Theimpact of the viscous damping is studied. Transient flooding tests show thatthe inflow momentum has to be accounted for when the undivided compartment is flooded. The simulation model is capable of capturing the impact of the inflooding jet and the first roll on the opposite side of the damage is reproduced.Peer reviewe