In-depth characterization of exhaust particles performed on-board a modern cruise ship applying a scrubber.

To comply with environmental regulations, ship operators may adopt exhaust after-treatment devices such as scrubbers or selective catalytic reduction (SCR). Beyond gaseous emission control, these technologies impact the exhaust particles emitted from marine engines to the atmosphere. This study characterizes comprehensively the chemical composition and physical properties of exhaust aerosol particles upstream and downstream a hybrid scrubber operating in open loop mode on-board a modern cruise ship. The study considers two engines, one equipped with SCR and both with scrubber, during engine load conditions of 75 % and 40 %, and the influence of marine gas oil (MGO) use in addition to heavy fuel oil (HFO). At least 4 different particle types were observed in the exhaust based on transmission electron microscopy (TEM) studies both upstream and downstream scrubber, and both scrubber and SCR affected the particle number size distribution (PSD). The geometric mean diameter (GMD) of the particles increased over scrubber both due to removal of nucleation mode particles and particle growth in the scrubber. The scrubber effectively decreased particle number (PN) and, also, non-volatile particles, but the effect depended on particle size and no significant decrease was observed in number of particles above 50 nm, typically comprising black carbon (BC) and in the case of HFO combustion, also asymmetrical metal containing particles. In addition to PN, concentrations of PAH compounds were reduced in the scrubber. The results may be further utilized when including the exhaust aerosol characteristics from ships applying scrubbers to emission inventories, as well as climate and air quality models.

Medicine use in people with intellectual disabilities: a Finnish nationwide register study.

BACKGROUND: People with intellectual disability (ID) are a vulnerable group in our society; many of them depend on other people for assistance in their everyday lives. Compared with the general population, people with ID have poorer general health and, therefore, need more healthcare services and use more medicines. The aim of this study is to define the population of all Finnish people with ID using administrative data and to compare their medicine use and expenditure on medicines to those of the age-matched and sex-matched controls. METHODS: People with ID and their age-matched and sex-matched controls (1:1) were extracted from nationwide healthcare and social allowance registers. Administrative register data on all prescription medicine purchases in 2019 were used to determine the prevalence of medicine use in both groups on a general level and by medicine categories. The differences in the prevalence of medicine use between the two groups were analysed using the logistic regression model. In addition, we studied the total expenditure on reimbursable medicine purchases covered by the National Health Insurance between people with ID and control group. RESULTS: The subpopulation of people with ID consisted 37 196 individuals, of whom 82.7% purchased prescription medicines in 2019. The corresponding share of individuals purchasing prescription medicines in the control group was 70.3%. The differences in the prevalence of medicine use between the two populations were highest in the younger age groups (0-6, 7-12 and 13-17). In the study population, 28.1% (OR = 12.28; 95% CI: 11.54-13.07) of the people used antipsychotics, making it the most used medicine category in people with ID. In the control group, 3.3% of people used antipsychotics. Compared with the control group, the use of antiepileptics, drugs for constipation, mineral supplements and anxiolytics was four to seven times higher among people with ID. Furthermore, the median expenditure on medicine use among people with ID was four times higher than in the control group. CONCLUSIONS: Compared with the control group, people with ID used more medicines, especially psychotropics, and their expenditure on medicine use was higher.

Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work.

BACKGROUND: The use of facilities such as disability pension, psychiatric care, health care and services for people with intellectual disabilities and borderline intellectual functioning (BIF) were compared with the general population and two other study groups comprising people with mild intellectual disabilities (MIDs) and learning problems (LPs). METHODS: The population-based sample (N = 416,973), 'Finland-in-Miniature', was gathered in 1962 and followed until 1998. For the purpose of the present study, three groups were formed: BIF (n = 416), MID (n = 312) and LP (n = 284). The use of services was examined with the help of national registers. RESULTS: As compared with the general population, people with BIF had been granted disability pension 2.7 times more often and had been patients in psychiatric care 3.4 times more often. They had also systematically used more services than people with LP. CONCLUSIONS: People with BIF are at risk of inability to work and facing severe mental health problems. They also seem to have more severe psychiatric problems than people with MID and LP. There is, therefore, a crucial need for increasing the awareness in society of BIF. Although this study's follow-up data were collected about 20 years ago, it is still relevant because people with BIF are a neglected group and still face growing demands in school and work life with no marked changes in services.

Life expectancy of people with intellectual disability: a 35-year follow-up study.

A 35-year follow-up study based on a nation-wide population study of the life expectancy of people with intellectual disability (ID) was undertaken. The study population consisted of a total of 60,969 person-years. A prospective cohort study with mortality follow-up for 35 years was used and the life expectancy of people with ID was calculated for different levels of intelligence. Proportional hazard models were used to assess the influence of level of intelligence and associated disorders on survival. People with mild ID did not have poorer life expectancy than the general population and subjects with mild ID did not have lower life expectancy in the first 3 decades of life. In cases with profound ID, the proportion of expected life lost was > 20% for almost all age groups. The female preponderance was manifested from the age of 60 years onwards, 25 years later than in the general population. Respectively, survival between sexes differed less. Epilepsy and/or hearing impairment increased the relative risk of death for all levels of ID. The prevalence of people with ID over 40 years was 0.4%. People with ID now live longer than previously expected, and the ageing of people with mild ID appears to be equal to that of the general population, posing new challenges to health care professionals.

Acquiescence in quality-of-life interviews with adults who have mental retardation.

Acquiescence was studied in a group of 616 persons with mental retardation. When an item-reversal technique with four pairs of oppositely worded questions was used, 11.1% to 36.3% of respondents answered acquiescently. The rates of acquiescence were much lower than we expected on the basis of the results of Sigelman, Budd, Spanhel, and Schoenrock (1981). No significant correlations between acquiescence and level of mental retardation were found. Women acquiesced more than men did. A significant relation was found between acquiescence and gender combination of an interviewee and an interviewer.

Perspectives on poor dental health and its determinants.

This paper is based on a cross-sectional study of 35-64-year-old Finnish adults. In the study poor dental health was defined in three ways: (1) high prevalence of dental diseases; (2) edentulousness; and (3) subjects' dissatisfaction with their dental appearance or function. The aim of the study was to determine the relationship of these conditions to certain sociodemographic background factors which are known to be associated with health. Statistical analysis was carried out by means of logistic regression analysis. The background factors associated with poor dental health varied according to the condition under consideration. Education was a factor that was associated with each of them and other associated background factors are also discussed.