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Psychosocial risk factors for revictimization in intimate partner violence against women
No full textNaisiin kohdistuva parisuhdeväkivalta on kansanterveydellisesti merkittävä ongelma, vakava loukkaus naisten ihmisoikeuksia vastaan ja sillä on merkittävät vaikutukset naisten terveyteen. Tutkimusten mukaan jopa yli puolet naisista Suomessa kokee parisuhdeväkivaltaa elämänsä aikana ja maailmanlaajuisesti noin joka kolmas naisista on elämänsä aikana kokenut fyysistä ja/tai seksuaalista väkivaltaa nykyisen tai entisen kumppanin toimesta. Parisuhdeväkivallan kokeminen kerran lisää riskiä joutua uudelleen väkivallan kohteeksi samassa tai uudessa parisuhteessa.
Tämän systemaattisen kirjallisuuskatsauksen tavoitteena on vastata tutkimuskysymykseen: Mitkä psykososiaaliset riskitekijät ovat yhteydessä toistuvaan naisiin kohdistuvaan parisuhdeväkivaltaan? Katsauksen tulokset viittaavat siihen, että useat psykososiaaliset tekijät kuten sosiaaliset ja emotionaaliset resurssit, mielenterveys ja persoonallisuus, haavoittuvuustekijät sekä traumahistoria ja kiintymyssuhde ovat osaltaan yhteydessä kohonneeseen riskiin joutua uudelleen parisuhdeväkivallan uhriksi.
Vaikka parisuhdeväkivaltaa on tutkittu jo laajasti, toistuvan parisuhdeväkivallan uhriksi joutumisen psykososiaalisten riskitekijöiden tutkimus on puutteellista, eikä tutkimuksissa tarkastella väkivallan toistuvuutta tai psykososiaalisia riskitekijöitä ilmiön taustalla. Tutkimuksen pohjalta voidaan auttaa kehittämään tehokkaampia tukitoimia parisuhdeväkivallan ehkäisemiseksi, uhrien tukemiseksi ja riskien tunnistamisen edistämiseksi. Tutkimus tarjoaa lisää tietoa parisuhdeväkivallan uhrien parissa työskenteleville sosiaali- ja terveysalan ammattilaisille
Cold exposure and human metabolism: A heterogeneous response across tissues and organs
No full textAbstract
Cold-induced metabolic responses across human organs and tissues vary markedly and do not regulate metabolism uniformly. The magnitude and nature of these responses differ depending on the type of cold exposure, ranging from mild surface cooling and beta-adrenergic stimulation to deep tissue cooling impacting intracellular biophysical and metabolic properties. Upregulating brown adipose tissue (BAT) activity has been proposed to improve whole-body metabolism. Despite its high metabolic activity, BAT mass is typically only 50–100 g and may contribute less than 1% of total heat production during thermogenesis. In contrast, skeletal muscles and white adipocytes may play greater roles in thermogenic and metabolic regulation. Cold exposure triggers a cascade of metabolic responses across tissues, extending beyond fuel partitioning and the regulation of uncoupling proteins. It also alters gene expression, protein synthesis, and metabolic pathways. In response to cold, the body increases sympathetic nervous system activity, leading to peripheral vasoconstriction and energy substrate mobilization. Brown adipocytes increase mitochondrial uncoupling to produce heat, while skeletal muscle contributes through shivering and non-shivering thermogenesis. The liver adjusts glucose production and lipid metabolism, the heart and circulatory system adapt to altered hemodynamic demands, and the kidneys modify fluid balance. Endocrine systems, including the thyroid, amplify thermogenic capacity, and the brain integrates thermal sensing with behavioral responses. Cold exposure also modulates immune function, cytokine profiles and inflammatory pathways across tissues, and shifts in gut microbiome composition influence nutrient absorption, bile acid metabolism and energy homeostasis. These coordinated tissue-specific adaptations enable the maintenance of core temperature during cold stress.Abstract
Cold-induced metabolic responses across human organs and tissues vary markedly and do not regulate metabolism uniformly. The magnitude and nature of these responses differ depending on the type of cold exposure, ranging from mild surface cooling and beta-adrenergic stimulation to deep tissue cooling impacting intracellular biophysical and metabolic properties. Upregulating brown adipose tissue (BAT) activity has been proposed to improve whole-body metabolism. Despite its high metabolic activity, BAT mass is typically only 50–100 g and may contribute less than 1% of total heat production during thermogenesis. In contrast, skeletal muscles and white adipocytes may play greater roles in thermogenic and metabolic regulation. Cold exposure triggers a cascade of metabolic responses across tissues, extending beyond fuel partitioning and the regulation of uncoupling proteins. It also alters gene expression, protein synthesis, and metabolic pathways. In response to cold, the body increases sympathetic nervous system activity, leading to peripheral vasoconstriction and energy substrate mobilization. Brown adipocytes increase mitochondrial uncoupling to produce heat, while skeletal muscle contributes through shivering and non-shivering thermogenesis. The liver adjusts glucose production and lipid metabolism, the heart and circulatory system adapt to altered hemodynamic demands, and the kidneys modify fluid balance. Endocrine systems, including the thyroid, amplify thermogenic capacity, and the brain integrates thermal sensing with behavioral responses. Cold exposure also modulates immune function, cytokine profiles and inflammatory pathways across tissues, and shifts in gut microbiome composition influence nutrient absorption, bile acid metabolism and energy homeostasis. These coordinated tissue-specific adaptations enable the maintenance of core temperature during cold stress
Cast immobilisation versus surgery for unstable lateral malleolus fractures (SUPER-FIN): randomised non-inferiority clinical trial
No full textAbstract
Objective:
To compare cast immobilisation with surgery using open reduction and internal plate fixation for unimalleolar Weber B ankle fractures with a congruent mortise on initial radiography but deemed unstable by external rotation stress testing.
Design:
Randomised, pragmatic, non-inferiority, clinical trial.
Setting:
One specialist university hospital trauma centre in Finland, 16 January 2013 to 7 July 2021.
Participants:
840 skeletally mature patients (age ≥16 years) with an isolated Weber B fibula fracture on static radiographs. Fracture instability was assessed by standard external rotation stress test under fluoroscopy. 714 participants were excluded (569 with stable fracture, mortise incongruency, or fracture dislocation) and the remaining 126 patients with a congruent but unstable ankle mortise were randomised.
Interventions Participants were randomly allocated to receive either conventional cast immobilisation for six weeks (n=62) or surgical treatment with open reduction and internal plate fixation followed by cast immobilisation for six weeks (n=64).
Main outcome measures:
The primary, non-inferiority outcome was the Olerud-Molander Ankle Score (OMAS; range 0-100 points; higher scores indicating better outcomes and fewer symptoms) at two years. The predefined non-inferiority margin for the primary outcome was set at −8 points. Secondary outcomes were ankle function, pain, health related quality of life, ankle range of motion, and radiographic outcome. Treatment related adverse events were also recorded.
Results:
121 out of 126 randomised participants (96%) completed the study. In the primary intention-to-treat analysis of 121 participants completing two year follow-up, the mean OMAS was 89 in the cast immobilisation group and 87 in the surgery group (between group mean difference 1.3 points, 95% confidence interval −4.8 to 7.3). No statistically significant between group differences were observed in any secondary outcomes. One participant in each group had radiographic evidence of non-union. In the surgery group, one participant had a superficial wound infection, one had delayed wound healing, and nine underwent procedures to remove hardware, two of whom developed postoperative infections (one deep and one superficial).
Conclusions:
Cast immobilisation proved non-inferior to surgery for the treatment of unimalleolar Weber B ankle fractures with a congruent mortise on initial radiography but deemed unstable by external rotation stress testing. Overall, fewer treatment related harms occurred with cast immobilisation compared with surgery.
Trial registration:
ClinicalTrials.gov NCT01758796.Abstract
Objective:
To compare cast immobilisation with surgery using open reduction and internal plate fixation for unimalleolar Weber B ankle fractures with a congruent mortise on initial radiography but deemed unstable by external rotation stress testing.
Design:
Randomised, pragmatic, non-inferiority, clinical trial.
Setting:
One specialist university hospital trauma centre in Finland, 16 January 2013 to 7 July 2021.
Participants:
840 skeletally mature patients (age ≥16 years) with an isolated Weber B fibula fracture on static radiographs. Fracture instability was assessed by standard external rotation stress test under fluoroscopy. 714 participants were excluded (569 with stable fracture, mortise incongruency, or fracture dislocation) and the remaining 126 patients with a congruent but unstable ankle mortise were randomised.
Interventions Participants were randomly allocated to receive either conventional cast immobilisation for six weeks (n=62) or surgical treatment with open reduction and internal plate fixation followed by cast immobilisation for six weeks (n=64).
Main outcome measures:
The primary, non-inferiority outcome was the Olerud-Molander Ankle Score (OMAS; range 0-100 points; higher scores indicating better outcomes and fewer symptoms) at two years. The predefined non-inferiority margin for the primary outcome was set at −8 points. Secondary outcomes were ankle function, pain, health related quality of life, ankle range of motion, and radiographic outcome. Treatment related adverse events were also recorded.
Results:
121 out of 126 randomised participants (96%) completed the study. In the primary intention-to-treat analysis of 121 participants completing two year follow-up, the mean OMAS was 89 in the cast immobilisation group and 87 in the surgery group (between group mean difference 1.3 points, 95% confidence interval −4.8 to 7.3). No statistically significant between group differences were observed in any secondary outcomes. One participant in each group had radiographic evidence of non-union. In the surgery group, one participant had a superficial wound infection, one had delayed wound healing, and nine underwent procedures to remove hardware, two of whom developed postoperative infections (one deep and one superficial).
Conclusions:
Cast immobilisation proved non-inferior to surgery for the treatment of unimalleolar Weber B ankle fractures with a congruent mortise on initial radiography but deemed unstable by external rotation stress testing. Overall, fewer treatment related harms occurred with cast immobilisation compared with surgery.
Trial registration:
ClinicalTrials.gov NCT01758796
Impact of preheating on the friction drilling characteristics of A356 aluminum alloy
No full textAbstract
Friction drilling, or thermal drilling, is a non-conventional method used to create holes with bushings in thin-walled materials by applying axial pressure and heat generated through friction between the tool and the workpiece. Although widely employed in automotive and aerospace industries, thermal drilling is less commonly applied to brittle metals, especially as-cast A356 aluminum alloy, due to the tendency for bushings to develop cracks, radial fractures, and petal formations. This study investigates the effects of preheating on the characteristics of friction-drilled as-cast A356 aluminum alloy, specifically examining how preheating influences defect formation at various rotational speeds (2000–4000 rpm) and feed rates (40–80 mm/min). Preheating was conducted at 100 °C, 150 °C, and 200 °C to improve material deformation during the drilling process. The results highlight the evolution of petal formation, bushing dimensions, surface roughness, and hardness in both room temperature and preheated conditions. The results showed that cracking was mitigated in the preheated conditions processed at a rotational speed of 4000 rpm and a feed rate of 40 mm/min. However, bushing thicknesses were decreased in the preheated conditions, for example the average thickness of the friction drilled specimens without preheating recorded an average of 2.2 ± 0.2 mm, whereas the average thickness of the preheated specimens was 1.7 ± 0.2 mm. Furthermore, the surface roughness deteriorated with a preheating temperature rise. In addition, hardness values were increased near the edge of the drilled bushing (stirring zone, SZ) as compared to the base metal due to formations of very fine structures resulting from the severe plastic deformation in the SZ.Abstract
Friction drilling, or thermal drilling, is a non-conventional method used to create holes with bushings in thin-walled materials by applying axial pressure and heat generated through friction between the tool and the workpiece. Although widely employed in automotive and aerospace industries, thermal drilling is less commonly applied to brittle metals, especially as-cast A356 aluminum alloy, due to the tendency for bushings to develop cracks, radial fractures, and petal formations. This study investigates the effects of preheating on the characteristics of friction-drilled as-cast A356 aluminum alloy, specifically examining how preheating influences defect formation at various rotational speeds (2000–4000 rpm) and feed rates (40–80 mm/min). Preheating was conducted at 100 °C, 150 °C, and 200 °C to improve material deformation during the drilling process. The results highlight the evolution of petal formation, bushing dimensions, surface roughness, and hardness in both room temperature and preheated conditions. The results showed that cracking was mitigated in the preheated conditions processed at a rotational speed of 4000 rpm and a feed rate of 40 mm/min. However, bushing thicknesses were decreased in the preheated conditions, for example the average thickness of the friction drilled specimens without preheating recorded an average of 2.2 ± 0.2 mm, whereas the average thickness of the preheated specimens was 1.7 ± 0.2 mm. Furthermore, the surface roughness deteriorated with a preheating temperature rise. In addition, hardness values were increased near the edge of the drilled bushing (stirring zone, SZ) as compared to the base metal due to formations of very fine structures resulting from the severe plastic deformation in the SZ
Innovation Competence in Healthcare: Individual, Environmental and Organisational Factors-A Mixed-Method Systematic Review
No full textAbstract
Aims:
To identify healthcare professionals' experiences of innovation competence and the factors associated with it; and to examine the instruments developed to assess innovation competence and its associated factors among healthcare professionals.
Design:
A mixed-methods systematic review.
Methods:
Researchers independently screened original studies by title and abstract (n = 2996) and then full text (n = 189). Eighteen studies were included: 16 quantitative and two qualitative. Qualitative data were analysed using inductive content analysis, and quantitative data were tabulated and synthesised narratively.
Data Sources:
The review followed the Joanna Briggs Institute Mixed Methods Systematic Review methodology. Searches were conducted in Scopus, CINAHL, Ovid Medline, ProQuest, Web of Science, PsycArticles, and Medic. Articles published in English or Finnish with no date restrictions were included. The search covered records from database inception to August 2024.
Results:
From qualitative studies, we identified three categories describing experiences of innovation competence: Competences for Innovation in Healthcare, Application and Impact of Innovation in Healthcare, and Challenges and Strategies for Implementing Innovation. Quantitative studies identified three conceptual domains: Individual Capacities in Innovation, Innovation-related Competence Behaviours, and Social and Organisational Enablers. Four categories of factors associated with innovation competence emerged: sociodemographic, career-related, organisational, and academic factors.
Conclusions:
Healthcare professionals' innovation competence is a multifaceted construct encompassing individual abilities, behavioural expressions, and social and organisational engagement. A systematic and multilevel approach that targets both personal attributes and organisational enablers is needed to strengthen competence. Enhancing innovation competence can improve the healthcare sector's ability to respond to complex challenges and sustain innovation capacity.
Impact:
Findings inform the development of education programmes and leadership strategies to enhance innovation competence among healthcare professionals, supporting innovation implementation in healthcare organisations.
Patient or Public Contribution:
No patient or public involvement was included in this study.
Trial Registration:
PROSPERO: CRD42024614551Abstract
Aims:
To identify healthcare professionals' experiences of innovation competence and the factors associated with it; and to examine the instruments developed to assess innovation competence and its associated factors among healthcare professionals.
Design:
A mixed-methods systematic review.
Methods:
Researchers independently screened original studies by title and abstract (n = 2996) and then full text (n = 189). Eighteen studies were included: 16 quantitative and two qualitative. Qualitative data were analysed using inductive content analysis, and quantitative data were tabulated and synthesised narratively.
Data Sources:
The review followed the Joanna Briggs Institute Mixed Methods Systematic Review methodology. Searches were conducted in Scopus, CINAHL, Ovid Medline, ProQuest, Web of Science, PsycArticles, and Medic. Articles published in English or Finnish with no date restrictions were included. The search covered records from database inception to August 2024.
Results:
From qualitative studies, we identified three categories describing experiences of innovation competence: Competences for Innovation in Healthcare, Application and Impact of Innovation in Healthcare, and Challenges and Strategies for Implementing Innovation. Quantitative studies identified three conceptual domains: Individual Capacities in Innovation, Innovation-related Competence Behaviours, and Social and Organisational Enablers. Four categories of factors associated with innovation competence emerged: sociodemographic, career-related, organisational, and academic factors.
Conclusions:
Healthcare professionals' innovation competence is a multifaceted construct encompassing individual abilities, behavioural expressions, and social and organisational engagement. A systematic and multilevel approach that targets both personal attributes and organisational enablers is needed to strengthen competence. Enhancing innovation competence can improve the healthcare sector's ability to respond to complex challenges and sustain innovation capacity.
Impact:
Findings inform the development of education programmes and leadership strategies to enhance innovation competence among healthcare professionals, supporting innovation implementation in healthcare organisations.
Patient or Public Contribution:
No patient or public involvement was included in this study.
Trial Registration:
PROSPERO: CRD4202461455
The effect of maintenance on production efficiency
No full textKunnossapidon merkitys teollisuudessa on kasvanut merkittävästi toisen maailmansodan jälkeen tuotantolaitteiden ja elektroniikan kehityksen seurauksena.
Tämän kandidaatintyön tarkoituksena on käsitellä kunnossapitoa ja sen vaikutusta tuotannon tehokkuuteen kirjallisuuden avulla. Työssä määritellään, mitä kunnossapito tarkoittaa, sen historiaa pääosin 1900-luvulla ja kunnossapitolajeja. Työssä käsitellään myös erilaisia strategioita kunnossapidon suunnitteluun ja suorittamiseen sekä tuotannon tehokkuuden mittareita, kuten KNL, mihin kunnossapidolla on merkittävä vaikutus. Tutkielmassa ilmeni, että yksi kunnossapidon tavoitteista on korkea KNL-arvo. Koska tuotannon tehokkuutta voidaan mitata kyseisellä KNL-arvolla, on kunnossapidolla siihen myös suora vaikutus
Waste management–related trust, acceptance, and reputation: A multidisciplinary big data analysis across knowledge domains
No full textAbstract
Addressing global waste management challenges requires understanding not only the technical capabilities of products and technologies but also the factors shaping their development and deployment across the waste hierarchy. Deployment outcomes are strongly influenced by acceptance, reputation, and trust, distinct yet interrelated constructs whose dynamics remain insufficiently understood. Deepening this understanding can enhance stakeholder engagement and improve decision-making in waste management. This study examines waste-to-energy incineration as a representative case to investigate these dynamics across global, regional, and local levels. A multidisciplinary, data-driven approach is applied, combining artificial intelligence, big data analytics, opinion mining, Correspondence Analysis on Generalized Aggregated Lexical Tables, and content classification to assess acceptance, trust, and reputation in multiple knowledge domains. The analysis clarifies these constructs as interwoven but individually influential factors shaping technology deployment and explores their interplay with public perception. A novel method is also introduced for generating indicative reputation scores derived from sentiment analysis. The findings show that AI-enhanced analytical tools, when integrated with established methods, yield valuable insights into stakeholder sentiment and public discourse. These insights can inform more targeted stakeholder engagement and strategic communication in waste management planning. Overall, the study demonstrates the potential of emerging analytical tools to produce timely, structured indicators of trust, acceptance, and reputation, key dimensions for navigating the socio-political challenges of technology deployment in the waste sector.Abstract
Addressing global waste management challenges requires understanding not only the technical capabilities of products and technologies but also the factors shaping their development and deployment across the waste hierarchy. Deployment outcomes are strongly influenced by acceptance, reputation, and trust, distinct yet interrelated constructs whose dynamics remain insufficiently understood. Deepening this understanding can enhance stakeholder engagement and improve decision-making in waste management. This study examines waste-to-energy incineration as a representative case to investigate these dynamics across global, regional, and local levels. A multidisciplinary, data-driven approach is applied, combining artificial intelligence, big data analytics, opinion mining, Correspondence Analysis on Generalized Aggregated Lexical Tables, and content classification to assess acceptance, trust, and reputation in multiple knowledge domains. The analysis clarifies these constructs as interwoven but individually influential factors shaping technology deployment and explores their interplay with public perception. A novel method is also introduced for generating indicative reputation scores derived from sentiment analysis. The findings show that AI-enhanced analytical tools, when integrated with established methods, yield valuable insights into stakeholder sentiment and public discourse. These insights can inform more targeted stakeholder engagement and strategic communication in waste management planning. Overall, the study demonstrates the potential of emerging analytical tools to produce timely, structured indicators of trust, acceptance, and reputation, key dimensions for navigating the socio-political challenges of technology deployment in the waste sector
