Facilitators and barriers to implementing lifestyle intervention programme to prevent cognitive decline.

BACKGROUND: The Finnish Intervention Study to Prevent Cognitive Impairment and Disability is a randomized controlled trial that has tested the efficacy of a multidomain intervention targeting modifiable risk factors to prevent cognitive impairment/dementia. A combination of healthy diet, physical, social and cognitive activity, and management of cardiovascular risks was shown to be an effective model to promote brain health among older people. The aim of this qualitative study was to explore healthcare professionals' perceptions of facilitators and barriers to implementing this lifestyle programme into health care. METHODS: Four semi-structured focus group interviews were conducted among healthcare professionals working in primary care and in non-governmental organizations (N=27). Participants were asked to discuss their perceptions of facilitators and barriers for implementing the multidomain intervention into clinical practice. Interviews were analyzed using content analysis. RESULTS: Barriers and facilitators described by the healthcare professionals were related to infrastructure and resources, client's personal characteristics and the lifestyle intervention itself. These main categories included several sub-categories related to knowledge, motivation, resources, individualization and collaboration. The interviewees pointed out that more education on dementia prevention is needed, the work should be coordinated efficiently, resources to provide preventive health care should be adequate and multiprofessional collaboration is needed. CONCLUSIONS: Transferring a lifestyle intervention from a trial-setting to real life requires knowledge about the factors that influence effective implementation. Identifying drivers and constraints of successful implementation helps to design and tailor future prevention programmes, increases motivation and adherence and supports system change.

Assessing mining impacts: The influence of background geochemical conditions on diatom and macroinvertebrate communities in subarctic streams.

Mining has changed landscapes locally in northern Fennoscandia and there is an increasing pressure for exploitation of the remaining mineral deposits of the region. Mineral deposits, even if unmined, can strongly influence stream water chemistry, stream biological communities and the ability of organisms to tolerate stressors. Using data sampled from six mining areas with three active (gold and chrome), two closed (gold) and one planned mine (phosphate), we examined how mineral deposits and mining influence water chemistry and diatom and macroinvertebrate communities in subarctic streams in Finnish Lapland. We supplemented the data by additional samples compiled from databases and further assessed how variation in background geological conditions influences bioassessments of the impacts arising from mining. We found that water specific conductivity was elevated in our study streams draining through catchments with a high mineral potential. Mining effects were mainly seen as increased concentration of nitrogen. Influence of mineral deposits was detected in composition of diatom and macroinvertebrate communities, but communities in streams in areas with a high mineral potential were as diverse as those in streams in areas with a low mineral potential. Mining impacts were better detected for diatoms using a reference condition based on sites with a high than low mineral potential, while for macroinvertebrates, the responses were generally less evident, likely because of only minor effects of mining on water chemistry. Community composition and frequencies of occurrence of macroinvertebrate taxa were, however, highly similar between mine-influenced streams and reference streams with a high potential for minerals indicating that the communities are strongly structured by the natural influence of mineral deposits. Incorporating geochemistry into the reference condition would likely improve bioassessments of both taxonomic groups. Replicated monitoring in potentially impacted sites and reference sites would be the most efficient framework for detecting environmental impacts in streams draining through mineral-rich catchments.

Elevated nutrient concentrations in headwaters affected by drained peatland.

Nutrient export from drained peatland has significant impacts on aquatic environments in Nordic catchments. Spatial information on variations in nutrient concentrations across different landscapes and land uses is needed to design measures for achieving the good ecological status of the EU Water Framework Directive. In this study we determined background concentrations in natural peatland-dominated streams and examined effects of peatland use practices on water quality in headwater catchments. We quantified sources for different elements by joint analysis of water chemistry, isotopes, and hydrology for 62 small catchments in North Ostrobothnia, Finland. Concentrations of nutrients and suspended solids were relatively high in catchments containing drained peatland. In particular, dissolved nitrogen and phosphorus concentrations were elevated during baseflow conditions when flow likely originated from deeper soil layers. Total concentrations of nutrients, suspended solids, and loss on ignition also showed elevated values, and changes in the ratio of dissolved and particulate forms, especially the C/N ratio, were observed. Past drainage had a stronger effect on organic matter and nutrients concentrations than local hydroclimate conditions. These results strongly indicate that current water protection methods are not sufficient to capture all seasonal variations in nutrient and suspended solid loads from drained peatland. Thus, more effort and actions are needed for water protection in such areas.