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Introduction: The 2-year Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multidomain lifestyle intervention trial (NCT01041989) demonstrated beneficial effects on cognition. We investigated whether sociodemographics, socioeconomic status, baseline cognition, or cardiovascular factors influenced intervention effects on cognition. Methods: The FINGER recruited 1260 people from the general Finnish population (60–77 years, at risk for dementia). Participants were randomized 1:1 to multidomain intervention (diet, exercise, cognition, and vascular risk management) and regular health advice. Primary outcome was change in cognition (Neuropsychological Test Battery z-score). Prespecified analyses to investigate whether participants’ characteristics modified response to intervention were carried out using mixed-model repeated-measures analyses. Results: Sociodemographics (sex, age, and education), socioeconomic status (income), cognition (Mini–Mental State Examination), cardiovascular factors (body mass index, blood pressure, cholesterol, fasting glucose, and overall cardiovascular risk), and cardiovascular comorbidity did not modify response to intervention (P-values for interaction > .05). Conclusions: The FINGER intervention was beneficial regardless of participants’ characteristics and can thus be implemented in a large elderly population at increased risk for dementia.

Kaupunkiseutujen roolin vahvistaminen on keskeinen tavoite aluekehittämisessä ja -suunnittelussa. Vapaaehtoisuuteen perustuva kaupunkiseutujen suunnittelu edellyttää uudenlaisten kumppanuuksien ja yhteistyörakenteiden muodostamista. Tässä työssä tarkastellaan Turun kaupunkiseudun rakennemallityön puitteissa tehtyä seudullista suunnitteluyhteistyötä. Rakennemalli on neljäntoista Turun kaupunkiseudun kunnan sekä seudullisten toimijoiden yhteistyössä laatima strateginen maankäytön suunnitelma. Rakennemalli on esimerkki uudenlaisista alueellisen hallinnan malleista, joiden mukaisesti alueellisen kysymysten, kuten aluerakenteen kehityksen hallinta tapahtuu hierarkkisen hallinnon sijaan eri toimijoiden muodostamissa yhteistyöverkostoissa. Tutkimuksessa tarkastellaan, miten rakennemallityötä varten muodostettu yhteistyöverkosto toimii seudullisen suunnittelun näkökulmasta Turun kaupunkiseudulla. Tutkimuksessa yhteistyöverkoston toimintaa ja siihen vaikuttaneita tekijöitä tarkastellaan sosiaalisen pääoman ja verkostoteorian kautta. Työssä eritellään verkostotoimintaan liittyviä piirteitä sekä avataan sosiaalisen pääoman merkitystä yhteistyötä helpottavana resurssina rakenteellisen ja kognitiivisen sosiaalisen pääoman käsitteiden kautta. Lisäksi selvitetään, miten rakennemallityö vaikuttaa yhteistyöhön ja luottamuksen kehittymiseen seudulla. Työn empiirinen aineisto koostuu syksyllä 2012 kerätyistä Turun kaupunkiseudun rakennemallityössä mukana olleiden kuntien sekä seudullisten organisaatioiden edustajien haastatteluista. Työssä hyödynnetään myös rakennemallityöhön liittyviä suunnittelu- ja muita asiakirjoja. Aineiston analyysissä käytetään laadullista sisällönanalyysiä. Rakennemallityössä on mukana kuntien viranhaltijoita, luottamushenkilöitä, seudullisia toimijoita ja muita sidosryhmiä. Rakennemallia pidetään Turun kaupunkiseudulla hyvänä saavutuksena huomioiden suuren osanottajajoukon ja kuntien aiemmat vaikeat yhteistyösuhteet. Prosessissa nousee esiin sekä rakenteellisen että kognitiivisen sosiaalisen pääoman merkitys. Rakennemallin laatimista helpottavat aiemman yhteistyön kautta eri osapuolten välille muodostuneet siteet ja tavat työskennellä. Eri osapuolten sitoutumista prosessiin sekä yhteistä tahtotilaa ja näkemyksiä seudun kehittämisen suhteen vahvistetaan laajan osallisuuden kautta. Valtion rooli rakennemallin kaltaisissa seudullisissa yhteistyöhankkeissa on merkittävä. Turun kaupunkiseudun rakennemallia ei olisi laadittu ilman valtion ohjausta. Tutkimuksessa nousevat esiin verkostoihin liittyvät ongelmat, kuten vapaaehtoisuudesta johtuva epävarmuus, odotus toiminnan vastavuoroisuudesta sekä epätasaiset valtasuhteet. Suurin avoin kysymys rakennemallien kohdalla on niiden epämuodollisuus ja asettuminen maankäyttö- ja rakennuslain ulkopuolelle. Käytännössä mallin tavoitteiden toteutuminen on kuntien tahdon varassa. Sosiaalisen pääoman eli luottamuksen ja vastavuoroisuuden normien merkitys korostuu, kun mallin tavoitteita siirretään käytäntöön kuntien omien sitovien suunnitelmien kautta. Epävarmuus ja epäluottamus voivat kuitenkin estää rakennemallissa yhteisesti hyväksyttyjen tavoitteiden toteuttamisen. Vaikka rakennemallin pitkän aikavälin vaikutusta maankäyttöön on mahdotonta arvioida tässä vaiheessa, koetaan työn vaikuttaneen myönteisesti yhteistyöhön ja luottamuksen kehittymiseen seudulla. Rakennemallit toimivat välineinä, joilla luodaan pohjaa tulevaisuuden yhteistyölle ja vahvistetaan toimijoiden sosiaalista pääomaa seuduilla. Verkostojen soveltumista maankäytön suunnitteluun tulisi kuitenkin tarkastella kriittisesti, sillä vuorovaikutus seuduilla on aina paikallisesti määrittynyttä.

The bovine spongiform encephalopathy (BSE) saga has made painfully evident the limitations of risk communication as a one-way avenue, where information to the public about the risks they face comes after critical policy decisions have already been made. In fact, communication has even been identified as one of the key elements of what went wrong and generated the loss of trust in government discourse and in beef in Europe. This book deals with risk communication as an evolving and interactive process between decision-makers and their publics and underlines the critical importance of creating mechanisms for interaction between policy-makers and stakeholders at all stages of policy-making, in order for risk communication to be effective. The book – the result of a research project carried out in four countries (Italy, Finland, Germany, Great Britain) by an international team of researchers in 2000-2002, supported by the European Commission DG Research and led by the World Health Organization – reports on research into the strategies used by different actors to communicate about BSE and Creutzfeldt-Jakob disease (CJD) in four European countries between 1985 and 2000. These actors include the mass media, health information systems, and political actors. The research also assessed the way people construct their perceptions about risk, who they listen to and how they make decisions on risk avoidance. A range of qualitative and quantitative methods used to describe what was said as well as was the perspectives and framework assumptions espoused by those different actors. This chapter addresses an important question raised by BSE/CJD: to what extent can the mass media be used as an index of public perception by policy-makers? The chapter presents results of empirical analysis of mass media coverage of the BSE/CJD issue in the four study countries since the early days of BSE. The analysis included the assessment of content, intensity and timing of media coverage, and the trajectory of the issues and frames used by the media. On a practical level, the chapter provides a methodology for the analysis of mass media reporting on risks, and tests the feasibility of implementing it in the four countries. On a conceptual level, the chapter looks beyond the case of BSE/CJD and surveillance systems in general to explore the idea of a "parallel epidemiology". It is conceived as "parallel" because, in addition to surveillance of BSE in the animal population and CJD in humans, there appears to be value in monitoring social representations of the problem. This is not an indicator of public perception but a measure of the waves of change in discourse by the media that have an impact on the public sphere and that both affect and draw from public perceptions. The chapter discusses the dual role of the media as a mirror of public opinion and as a contributor to the formation of public perceptions (including setting the public agenda).

The bovine spongiform encephalopathy (BSE) saga has made painfully evident the limitations of risk communication as a one-way avenue, where information to the public about the risks they face comes after critical policy decisions have already been made. In fact, communication has even been identified as one of the key elements of what went wrong and generated the loss of trust in government discourse and in beef in Europe. This book deals with risk communication as an evolving and interactive process between decision-makers and their publics and underlines the critical importance of creating mechanisms for interaction between policy-makers and stakeholders at all stages of policy-making, in order for risk communication to be effective. The book – the result of a research project carried out in four countries (Italy, Finland, Germany, Great Britain) by an international team of researchers in 2000-2002, supported by the European Commission DG Research and led by the World Health Organization – reports on research into the strategies used by different actors to communicate about BSE and Creutzfeldt-Jakob disease (CJD) in four European countries between 1985 and 2000. These actors include the mass media, health information systems, and political actors. The research also assessed the way people construct their perceptions about risk, who they listen to and how they make decisions on risk avoidance. A range of qualitative and quantitative methods used to describe what was said as well as was the perspectives and framework assumptions espoused by those different actors. The research reported in this specific chapter begins by exploring the availability of survey data regarding perceptions of risk and trust in information sources relevant to BSE/CJD in the four countries. It reports on what part of the existing information is available, and on the findings of the few accessible results. It goes on to present results of secondary analysis, in which data from 11 Eurobarometer surveys in each of the four countries were acquired and re-analysed, along with an EU survey that included data on meat-purchasing behaviour by consumers. The chapter provides a useful discussion of issues such as public knowledge and awareness of food safety issues, public trust in various sources of information (including food producers and distributors, scientists, health officials, etc.) and of food consumption, especially of meat. The chapter also discusses in detail the strengths and weaknesses of survey methods as tools in public policy-making on food and related issues. Finally, it illuminates the important issue of what use is made by policy-makers of existing and easily accessible information on risk perceptions and trust in information sources.

The progress made in the conservation of European elm genetic resources since the 1st International Elm Conference is reviewed, and the complementarity of in situ and ex situ methods is discussed. The financial support of the European Union to RESGEN project CT96-78 has permitted to co-ordinate and rationalize the ex situ conservation of elms. The project, which involved 17 partner institutes in nine west European countries, aimed at a better evaluation, conservation and utilisation of the existing collections of native elm clones. Main achievements are: establishing a common database of about 2,000 clones; characterizing over 500 clones through RAPDs and chloroplast DNA PCR-RFLPs molecular markers; completing and rationalizing the existing collections; establishing a long-term core collection of 850 clones; cryo-preserving a subset of 444 clones; and identifying clones of interest for breeding and prudent use in the reconstruction of countryside hedges. The «Noble Hardwoods» network of the pan-European programme EUFORGEN groups members representative of 31 countries, and promotes the dynamic conservation of the genetic resources of several genera of broadleaf forest trees, including Ulmus spp. Strategies for the conservation of the adaptive potential of elm resources were defined and will be disseminated among foresters and conservationists through «Guidelines» leaflets. Some countries have already started implementing conservation measures for U. laevis, associating in situ preservation and the establishment of seed orchards. Others are undertaking inventories, or acquiring genetic knowledge on target populations., Se discute el progreso realizado en la conservación de los olmos europeos desde la primera conferencia Internacional del Olmo y los métodos complementarios de conservación in situ y ex situ. El apoyo financiero de la Unión Europea al proyecto RESGEN CT96-78 ha permitido coordinar y racionalizar la conservación ex situ de los olmos. El proyecto, en el cual están involucrados 17 instituciones participantes en nueve países de Europa Occidental, tiene por objetivo una mejor evaluación, conservación y utilización de las colecciones actualmente existentes de clones nativos de olmo. Los principales logros son: el establecimiento de una base de datos común de aproximadamente 2.000 clones; la caracterización de más de 500 clones usando RAPD y marcadores moleculares PCR-RFLP de ADN cloroplástico; la finalización y racionalización de las colecciones existentes; el establecimiento a largo plazo de una colección central con 850 clones; la criopreservación de un conjunto de 444 clones; y la identificación de clones de interés para la mejora y para su uso en la restauración de setos en campo. La red «Noble Hardwoods» del programa pan-europeo EUFORGEN agrupa a miembros representantes de 31 países, y promueve la conservación dinámica de los recursos genéticos de varios géneros de árboles planifolios, incluido Ulmus spp.. Las estrategias para la conservación del potencial adaptativo de los recursos de los olmos se definieron y se dieron a conocer entre forestales y conservacionistas a través de folletos guía. Algunos países han comenzado ya a implementar medidas de conservación para U. laevis mediante el uso de la preservación in situ y el establecimiento de huertos semilleros. Otros están elaborando inventarios, o adquiriendo información genética de poblaciones de interés.

Considerable efforts have been made to enhance conservation of forest genetic resources and to promote sustainable forest management in Europe over the past decade. The need to enhance genetic conservation emerged from a concern about the impacts of environmental pollution and genetic erosion on forest ecosystems in the late 1980s. The concept of sustainable forest management, in a roader sense, gained ground in Europe after the United Nations Conference on Environment and Development in 1992 paid special attention to the role of forest ecosystems in maintaining and conserving biological diversity. Several Ministerial Conferences on the Protection of Forests in Europe were organised in the 1990s and this was a major political process pushing forward improvements in these two areas. In 1994, the European Forest Genetic Resources Programme was set up as an implementation mechanism of the Strasbourg Resolution (1990) on the conservation of forest genetic resources. In the same year, Pan-European Criteria and Indicators for Sustainable Forest Management were also adopted following the Helsinki Resolution (1993) on sustainable forest management. In many European countries, however, more resources have been channelled into habitat and species conservation while fewer resources have been allocated to the development of national programmes on forest genetic resources. Less than 30% of European countries have such programmes, which are necessary for implementing gene conservation in practical forestry. Subsequently, these programmes should be better linked with the overall national forest programmes, which are developing policies for the whole forest sector and also allocating resources for implementing sustainable forest management. The pan-European criteria and indicators include genetic indicators in rather operational ways, but there is a need to improve monitoring of genetic sustainability by developing commonly agreed technical terminology. This would facilitate the collection of relevant data and make the data comparable internationally.

International audience; The second EUFORGEN Noble Hardwoods Network meeting was held from 22 to 25 March1997. The workplan established at the previous meeting (held in Escherode, Germany, in March 1996) was revised during the working sessions of the meeting. The individual activities listed in the workplan resulted in outputs such as the European gene conservation strategy for four genera and groups of species, the common list of descriptors, literature reviews, overview of ongoing research projects, summary of the evaluation methods for genetic resources and a public awareness leaflet. Most of these outputs are provided in this volume and are also available electronically on the Internet.

The clinical, radiographic and operative findings in 64 consecutive acute dislocations of the patella were analyzed. Both patellofemoral joints were symptomless before dislocation in 58 patients. The sulcus angle of the femur on the affected side was larger than on the contralateral side in one half, and a fresh marginal patellar fracture was demonstrated in one third of the cases. The stability of the patella could not be reliably estimated in tangential views taken with the knee in 20 degrees flexion; especially false negative findings were numerous.