Browsing by Subject "COUNTY"

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  • Kettunen, Karoliina; Nevas, Mari; Lunden, Janne (2017)
    We surveyed Finnish local food control officials' opinions about the use and challenges of administrative enforcement measures. Responses to the questionnaire were received from a total of 129 food control officials, covering 72.6% of the 62 local food control units in Finland. In the opinion of 42.7% of the respondents, enforcement measures are not used often enough in their unit to ensure forod safety. Based on our results, large units have better practical tools such as templates for enforcement decisions and guidelines that facilitate the use of enforcement measures than small units, but uncertain practices and a lack of routine appear to impede the use of the measures in many units. Particular challenges highlighted by the officials were related to laboriousness and slowness of the administrative process and reasoning for using enforcement measures. Moreover, impairment of cooperation with the food business operator as a consequence of using enforcement measures was of concern for many officials. The officials assessed the expertise of the head of the unit more positively in the units in which enforcement measures were used than in the units in which enforcement measures were not used, and participation in trainings was the strongest explanatory factor for the use of enforcement measures among the inspectors. Our results indicate that development of operating procedures and provision of specific training on administrative procedure with a practical approach play a key role in strengthening officials' expertise and confidence in using enforcement measures. Moreover, merging the small units with the large ones may promote uniform practices and better capabilities to use enforcement measures in all units. (C) 2017 Elsevier Ltd. All rights reserved.
  • Siuko, Mika; Kivela, Tero T.; Setala, Kirsi; Tienari, Pentti J. (2018)
    Purpose: To estimate the population-based incidence of acute idiopathic optic neuritis (ON) and analyse its differential diagnosis in patients referred with symptoms suggestive of ON. Methods: Patients with suspected ON referred to the Helsinki University Hospital, serving a population of 1.5 million in Southern Finland, were reviewed between 1st May 2008 and 14th April 2012. Brain and optic nerve magnetic resonance imaging (MRI) was performed within 24 hours in 83% of patients. Results: Of 291 referred patients, 184 (63%; 95% confidence interval [CI], 57-69%) were diagnosed with ON whereas 107 (37%) had another condition. The estimated crude incidence of ON in Southern Finland was 3.0 (95% CI 2.8-3.3) per 100,000 (females, 4.6 and males, 1.4). Mean age was 34years (range 15-61), 76% were female. Two (1%) were diagnosed with neuromyelitis optica. ON as the first demyelinative episode was diagnosed in 108 (59%) patients, and MRI showed demyelinating lesions (MRI+) in 82% (95% CI, 75-89) of them. MRI+ predicted the development of multiple sclerosis (MS): 54% of MRI+vs. 5% MRI-patients were diagnosed as MS during a mean follow-up of 7.7years. The most common differential diagnosis was non-arteritic anterior ischemic optic neuropathy (12%). Six (2%) intracranial compressive lesions were found upon MRI scan. Conclusions: More than a third of patients with symptoms suggestive of ON had another condition. Demyelinative lesions on MRI indicated higher risk of developing MS. We recommend the use of MRI to improve the differential diagnostic accuracy of ON and to identify patients with high risk of MS.