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Sökning: WFRF:(Heikkilä Kristiina)

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1.
  • Alakukku, Laura, et al. (författare)
  • Maatalouden ympäristötuen vaikuttavuuden seurantatutkimus (MYTVAS 3) : loppuraportti
  • 2014
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Since 1995, agri-environmental support partly funded by the EU has formed the core of Finland’s agri-environmental policy. This system has had a variety of impacts on the relationship between agriculture and the environment. Today’s agri-environmental support is one of the packages included in the Rural Development Programme for Mainland Finland (2007–2013/2014), which both in itself and through the underlying EU legislation requires monitoring of the impacts of the measures implemented. The study monitoring the impact of the 2nd Finnish agri-environmental scheme (MYTVAS 3), which ran from 2008 to 2013, forms part of this monitoring. The MYTVAS 3 monitoring study was also financed by the Ministry of the Environment. The monitoring study was carried out by a consortium coordinated by MTT Agrifood Research Finland and including the Finnish Environment Institute (SYKE), the University of Helsinki, the Finnish Game and Fisheries Research Institute and the University of Turku.The purpose of the MYTVAS 3 monitoring study was to find out how agri-environmental support and its various measures have affected the state of the environment in agricultural areas, how agri-environmental support has affected the potential for farming and how agri-environmental support should be developed to increase its impact. The monitoring focused on the impacts of agri-environmental support on the nutrient load from agriculture on the waterways and on biodiversity. When evaluating the findings presented, we should remember that while monitoring data shows that something happened, it does not necessarily explain what caused it. It is not always possible to show that particular developments were a specific outcome of the current agri-environmental support system and the implementation of its measures. The delay between a measure and its observed impact is often long, and the cause-and-effect relationships are complicated and partly unknown. Also, other agricultural policy and fluctuations on the market may affect the state of the agricultural environment directly or indirectly.The monitoring data show that agri-environmental support has not had a detrimental impact on the potential for farming. Despite a slight increase in the incidence of weeds, they do not cause problems of the kind that would require amendments to the content of agri-environmental measures. Carbon levels in the surface stratum of arable land seems to be continuing their slow decline, and there is still need for measures to preserve organic material in the soil.Compliance with the fertilisation limits in the agri-environmental support system would seem to have had very little impact on crop quality. Variations in the weight and protein content per hectolitre and per 1,000 seeds were of the same order between 2006 and 2012 as they were between 1995 and 2005. Crop quantities have also not been noticeably affected by compliance with the fertilisation limits. Average crop yields remained stable between 1986 and 2013, and no clearly different crop years were observed in the 2000s. It is possible, however, that the lower fertilisation levels could have lowered crop potential in the years with advantageous weather conditions in the 2000s and that protein contents have been lower in advantageous years.The monitoring data also show that the nutrient load potential of agriculture, measured by nutrient balances, has decreased continuously for nitrogen and particularly for phosphorus. The decrease in the nutrient load potential is due above all to a decrease in the use of synthetic fertilisers. The decline in nitrogen fertilisation has bottomed out in recent years, and low protein levels measured in high crop yield years show that there is no point in further reducing nitrogen fertilisation. Optimising nitrogen fertilisation according to how advantageous the growing season is and effectively using the soluble nitrogen in cattle manure are key measures in achieving reasonable nitrogen balances and good crop quality despite fluctuations in growing season conditions. New crop variants have been found to make more efficient use of nitrogen than old ones, and thus the introduction of new variants should be promoted. Despite the decrease in the nutrient balances, there are indications that nutrient loads in runoff water from domestic animal production sites are becoming an increasing problem. Indeed, the fundamental problem with the nutrient load from agriculture is the diversification of livestock farming and crop farming, which has made it more difficult to use nutrients appropriately. Therefore attention must be paid to measures that both boost the use of nutrients in manure and reduce the levels of nutrients that end up in manure. Based on nutrient load monitoring in the catchment areas of rivers, the phosphorus load per hectare of cropland has decreased in each programme period, being about 80% of the level of the first period (1995–1999) in the third period (2007–2013). Because of the increase in the area of cropland, the nitrogen load on waterways from agriculture continued to grow during the second programme period (2000–2006) but peaked in the third (2007–2013). A similar trend was found in the nitrogen load per hectare of cropland.The most important threat to biodiversity is caused by the development of landscape structure, typically involving a decrease in the number of open or half-open areas excluded from actual cultivation. The consequence of the clearing of margins and ecological islands located in crop fields, drainage measures aimed at increasing arable land and all rationalisation of cultivated areas is the diminishing of exactly those areas that are the most important from the perspective of the biodiversity of the agricultural environment. However, the measure-specific findings in the monitoring study show that biodiversity benefits have been locally achieved where measures have been implemented on a broad enough scale (biodynamic farming, traditional biotopes, wetlands, buffer zones, green fallow / nature management areas). Particular care should therefore be taken that all cultivated land continues to have a sufficient percentage of non-cultivated areas, whether they be natural meadows, nature management areas, biodiversity strips, buffer zones, filter strips, headlands, ecological islands, etc. Including the rather popular nature management areas as a new voluntary measure under basic measures was a significant contribution to biodiversity.Regarding the rural landscape, it may be noted that by visual inspection the area of cropland has remained largely unchanged, at the level of the landscape as a whole it is far more common for the landscape to become more closed than to become more open. This trend was also observed in the visual inspection of traditional biotopes, even if the openness of the meadows monitored largely remained unchanged.The only measures that directly address the reduction of gaseous emissions in the agri-environmental support system are the longterm grass cultivation on peat fields and special aid agreements for slurry injection in cropland. While other measures have indirectly affected gaseous emissions, the impact of agri-environmental support as a whole on reducing gaseous emissions from agriculture has been negligible. In general, we may conclude that the goals, content and support levels of agri-environmental support measures must be increasingly adapted and customised by region, by type of farming and by farm, because both the state of the agricultural environment and the needs of society differ greatly between different types of rural area.
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2.
  • Aaltonen, Kirsimari, et al. (författare)
  • Familial breast cancers without mutations in BRCA1 or BRCA2 have low cyclin E and high cyclin D1 in contrast to cancers in BRCA mutation carriers
  • 2008
  • Ingår i: Clinical Cancer Research. - 1078-0432 .- 1557-3265. ; 14:7, s. 1976-83
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: We analyzed the expression of critical cell cycle regulators cyclin E and cyclin D1 in familial breast cancer, focusing on BRCA mutation-negative tumors. Cyclin E expression in tumors of BRCA1 or BRCA2 carriers is higher, and cyclin D1 expression lower, than in sporadic tumors. In familial non-BRCA1/2 tumors, cyclin E and cyclin D1 expression has not been studied. EXPERIMENTAL DESIGN: Cyclin E and cyclin D1 immunohistochemical expression was studied in tissue microarrays consisting of 53 BRCA1, 58 BRCA2, 798 familial non-BRCA1/2, and 439 sporadic breast tumors. RESULTS: In univariate analysis, BRCA1 tumors had significantly more frequently high cyclin E (88%) and low cyclin D1 (84%) expression than sporadic (54% and 49%, respectively) or familial non-BRCA1/2 (38% and 45%, respectively) tumors. BRCA2 tumors had significantly more frequently low cyclin D1 expression (68%) than sporadic or familial non-BRCA1/2 tumors and significantly more frequently high cyclin E expression than familial non-BRCA1/2 tumors. In a logistic regression model, cyclin expression, early age of onset, and estrogen receptor (ER) and human epidermal growth factor receptor-2 (HER2) status were the independent factors most clearly distinguishing tumors of BRCA1 mutation carriers from other familial breast cancers. High cyclin E and low cyclin D1 expression were also independent predictors of BRCA2 mutation when compared with familial non-BRCA1/2 tumors. Most interestingly, lower frequency of high cyclin E expression independently distinguished familial non-BRCA1/2 tumors also from sporadic ones. CONCLUSIONS: Cyclin E and cyclin D1 expression distinguishes non-BRCA1/2 tumors from both sporadic and BRCA1- and BRCA2-associated tumors and may reflect different predisposition and pathogenesis in these groups.
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3.
  • Aaltonen, Kirsimari, et al. (författare)
  • High cyclin B1 expression is associated with poor survival in breast cancer
  • 2009
  • Ingår i: British Journal of Cancer. - : Springer Science and Business Media LLC. - 0007-0920 .- 1532-1827. ; 100:7, s. 1055-60
  • Tidskriftsartikel (refereegranskat)abstract
    • Cyclin B1 regulates the G(2)-M transition of the cell cycle. Cyclin B1 expression is higher in premalignant and malignant than normal breast lesions. Correlation of cyclin B1 expression with other histopathological variables and prognostic role in breast cancer are not fully understood. Traditionally used prognostic criteria identify large subset of patients to receive adjuvant chemotherapy and to be exposed to adverse effects. A reliable and simple method helping prognostic evaluation in breast cancer is needed. We analysed cyclin B1 expression on 1348 invasive breast cancers and studied correlations with other histopathological variables and survival. High cyclin B1 correlated with high tumour grade, large tumour size and positive nodal status, oestrogen and progesterone receptor negativity, positive HER2 and p53 status, young age at diagnosis, and high cyclin E, cyclin A and Ki67 expression. Among patients not given adjuvant chemotherapy high cyclin B1 was a strong predictor of shorter overall and metastasis-free survival (RR 3.74, P<0.0005 and RR 3.51, P<0.0005, respectively), and remained as an independent prognostic factor also in multivariate analysis (RR 1.80, P=0.04 and RR 2.31, P=0.02, respectively). This study suggests high cyclin B1 associates with aggressive phenotype and is an independent prognostic factor in breast cancer.
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4.
  • Bartkova, Jirina, et al. (författare)
  • Aberrations of the MRE11-RAD50-NBS1 DNA damage sensor complex in human breast cancer : MRE11 as a candidate familial cancer-predisposing gene
  • 2008
  • Ingår i: Molecular Oncology. - : Wiley. - 1574-7891. ; 2:4, s. 296-316
  • Tidskriftsartikel (refereegranskat)abstract
    • The MRE11, RAD50, and NBS1 genes encode proteins of the MRE11-RAD50-NBS1 (MRN) complex critical for proper maintenance of genomic integrity and tumour suppression; however, the extent and impact of their cancer-predisposing defects, and potential clinical value remain to be determined. Here, we report that among a large series of approximately 1000 breast carcinomas, around 3%, 7% and 10% tumours showed aberrantly reduced protein expression for RAD50, MRE11 and NBS1, respectively. Such defects were more frequent among the ER/PR/ERBB2 triple-negative and higher-grade tumours, among familial (especially BRCA1/BRCA2-associated) rather than sporadic cases, and the NBS1 defects correlated with shorter patients' survival. The BRCA1-associated and ER/PR/ERBB2 triple-negative tumours also showed high incidence of constitutively active DNA damage signalling (gamma H2AX) and p53 aberrations. Sequencing the RAD50, MRE11 and NBS1 genes of 8 patients from non-BRCA1/2 breast cancer families whose tumours showed concomitant reduction/loss of all three MRN-complex proteins revealed two germline mutations in MRE11: a missense mutation R202G and a truncating mutation R633STOP (R633X). Gene transfer and protein analysis of cell culture models with mutant MRE11 implicated various destabilization patterns among the MRN complex proteins including NBS1, the abundance of which was restored by re-expression of wild-type MRE11. We propose that germline mutations qualify MRE11 as a novel candidate breast cancer susceptibility gene in a subset of non-BRCA1/2 families. Our data have implications for the concept of the DNA damage response as an intrinsic anti-cancer barrier, various components of which become inactivated during cancer progression and also represent the bulk of breast cancer susceptibility genes discovered to date.
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5.
  • Berglund, Annika, et al. (författare)
  • Factors facilitating or hampering nurses identification of stroke in emergency calls
  • 2015
  • Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 71:11, s. 2609-2621
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims. To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position.Background. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke.Design. A qualitative study using interpretive phenomenology.Methods. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position.Findings. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own.Conclusion. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke.
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8.
  • Berlin Hallrup, Leena, 1967-, et al. (författare)
  • Care workers´ experiences of working in a Swedish institutional care setting
  • 2010
  • Ingår i: Learning Disability Practice journal. - United Kingdom : Royal College of Nursing (RCN). - 1465-8712 .- 2047-8968. ; 13:7, s. 21-25
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite the general move to support people with learning disabilities in their own homes or in home-like settings, many institutional settings still exist and little research has been carried out on the role of the care workers who work in them. In this study, participant observations over a 16-month period describe care workers’ experiences of working in an institutional care setting in Sweden, and 18 care workers were interviewed. The three main themes to emerge from the thematic analysis were: care workers were engaged in creating a family-like atmosphere; they were engaged in making the everyday ordered and structured; and they were exposed to stress factors. It became evident that care workers need additional support, training and opportunities for reflection to handle their complex work situation.
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9.
  • Dalvandi, Asghar, et al. (författare)
  • Everyday Life Condition in Stroke Survivors and Their Family Caregivers in Iranian Context
  • 2013
  • Ingår i: International Journal of Community Based Nursing & Midwifery. - Tehran. - 2322-2476. ; 1:1, s. 3-15
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundStroke is an unexpected major life incident that effect on physical functioning and can lead tochanges in lifestyle and inability to manage self care, work or leisure. To explore the everydaylife situation as experienced by stroke survivors, and their family caregivers, this study wasconducted 3-6 month after stroke.MethodsTwelve stroke survivors and thirteen family caregivers were interviewed and a qualitativecontent analysis was conducted to analyze data.ResultsThe results were categorized into two central themes that were identified as; (1) Being challengedby changes in everyday life situation including; the struggle with physical dysfunctions,inappropriate daily plan for leisure activities, changes in mood, being faced with economicalproblems and being worried about changing roles (2) striving to cope with new conditionsincluding; trying to preserve self-worth, seeking to support from spirituality, learning andre-learning and regaining independency.ConclusionPhysical dysfunction was the major concern for both the survivors and their family caregiversin their everyday life situation. This problem led to, and forced them, to be dependent on others.Training is needed to teach stroke survivors and their families strategies of how to cope withand overcome ongoing challenges of everyday life after stroke and to re-organize their livesand improve skills of the survivors to deal with the new situation at home.A daily plan for spending their time and leisure activities would ease this work. Moreinvestigation will be needed to clarify the process of life after stroke to cover this gap.
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10.
  • Dalvandi, Asghar, et al. (författare)
  • Lack of continuity of rehabilitation care for stroke survivors : Iranian family caregivers' experience
  • 2011
  • Ingår i: Middle East Journal of Age and Aging. - 1449-8677. ; 8:4, s. 28-34
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and Objective: Stroke is a common disabling disorder that requires the involvement of family caregivers to successfully encourage the patient's rehabilitation. This is especially true in Iran, where the family members commonly have the main responsibility of care of disabled persons. The aim of this study was to explore the Iranian family caregivers' experience of providing rehabilitation care at home. Method: A grounded theory approach and the main tenets of constant comparative method were used. Twelve participants were interviewed using semi-structured in-depth interviews. Findings: The core concept was identified as "lack of continuity of rehabilitation care". Seven main categories were identified. Three of them were related to the problems family caregivers faced, including inadequate knowledge and skills, inappropriate accessibility to rehabilitative services, and inadequate social insurance. Four categories were about the strategies that family caregivers used to deal with the major concerns; modifying home environment, managing coexisting medical conditions, improving nurses' roles and, relying on family unity. Conclusion: Family caregivers need continuity of rehabilitative care besides their family engagement, to enable access to care. They also need support from adequate social insurance and increased access to rehabilitation care. Undergoing rehabilitation at home gives people the advantage of practicing skills and developing compensatory strategies in the context of their own living environment by training and helping family caregivers and stroke survivors in terms of modifying home environment and managing coexisting medical conditions. Here, nurses can have an important role by helping the family caregivers with education and training.
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