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  • Virtanen, Laura (Helsingin yliopisto, 2015)
    Water quality in streams usually changes fast, and sensitive biological indicators are essential for monitoring these changes. Diatoms are widely used in biological stream quality assessments. However, there are temporal and spatial variations in diatom communities that may result in unreliable quality assessments. Under different kinds of environmental stressors, diatoms can produce deformed frustules. Heavy metals are among the most common causes of these teratological forms. In addition to eutrophication and organic pollution, diatoms could potentially be used for indicators of heavy metal enrichment. The aim here was to examine the interannual and intra-annual turnover of stream diatom communities. The focus of this study was on whether specific species traits and species local abundance and regional distribution affected temporal occurrence of diatom species. The study also included an examination of how stable diatom inferred stream classifications are in time and if pure spatial variation in diatoms should be considered when assessing stream water quality based on diatoms. The final aspect of the study was to determine which heavy metals, and to what extent, trigger the occurrence of deformations in diatom Achnanthidium minutissimum. Our results imply that abundant and widely distributed species with larger niches and the ability to attach to the substratum sustain persistent populations in varying environmental conditions typical for streams. The most persistent species are thus perhaps the most reliable species to be used as indicators of water quality. The stream classification based on diatoms resulted in temporally stable and statistically distinct community types. Thus, the results suggest that sampling of diatoms in every three years seems to be a reliable procedure to assess biological water quality. The investigation also revealed that study regions differ in their diatom species composition more than in their environmental features indicating that diatoms are structured not only by the local environment but also by large-scale processes, possibly related to climate, dispersal and history. As diatom species composition varies between regions, future bioassessments would benefit from regional stratification. Finally, study results indicated that two metals, copper and zinc, and a metalloid, antimony, were the most likely triggers of A. minutissimum deformations. The definition of their morphological and quantitative characteristics, along with a better taxonomic circumscription of the affected species, should allow the use of deformations as a reliable indicator of heavy metal enrichment in freshwater habitats.
  • Kaprio, Tuomas (Helsingin yliopisto, 2015)
    Background and aims Colorectal cancer (CRC) is one of the world s three most common cancers, and its incidence is rising. Novel biomarkers are essential for diagnostic and prognostic tools and to identify patients for targeted and individualized therapy. Covering all human cells, the carbohydrate units of glycoproteins, glycolipids, and proteoglycans are glycans. Carcinoma-related glycan structures are potential cancer biomarkers, since glycosylation evolves during carcinogenesis. Suggested to play a role in carcinogenesis are glycoproteins podocalyxin (PODXL) and regenerating islet-derived gene (REG) 4. PODXL s aberrant expression or allelic variation or both associate in different cancers with poor prognosis and unfavourable clinicopathological characteristics. Up-regulated REG4 expression occurs in inflammatory bowel diseases and also in gastrointestinal cancers. Reports on the association of REG4 expression with CRC prognosis have been mixed, however. Material and Methods Comparison of the N-glycan profiles of 5 rectal adenomas and 18 rectal carcinomas of different stages was by matrix-assisted laser desorption-ionization time-of-flight mass spectrometry. Tumour expression of REG4 and PODXL was evaluated by immunohistochemistry in 840 consecutive CRC patients surgically treated between 1983 and 2001. In addition we evaluated in a subgroup of 220 consecutively surgically treated CRC patients the tumour expression of MUC1, MUC2, MUC5AC, synapthophysin, chromogranin, sialyl Lewis a (sLea), and pauci-mannose. All patients were treated at Helsinki University Hospital (HUH). Results Rectal adenomas and carcinomas can be distinguished from one another based on their N-glycosylation profile. Differences in N-glycosylation existed also between carcinomas of different stages. Based on these results pauci-mannose and sLea were chosen for immunohistochemical analysis: in CRC sLea correlated with poor prognosis, and in advanced CRC, pauci-mannose expression correlated with poor prognosis. PODXL was an independent marker of poor prognosis in CRC. The two antibodies showed similar prognostic profiles, but their staining patterns differed, and they recognized different groups of patients with a poor prognosis. Combination of the two PODXL antibodies identified a group of patients with even worse prognosis. REG4 expression associated with MUC1, MUC2, and MUC5AC expression in CRC and was a marker of favourable prognosis in non-mucinous CRC. Conclusion Mass spectrometry identified several carcinoma-related glycans and a method of transforming these results into immunohistochemistry was demonstrated. PODXL was a marker of poor prognosis in CRC, whereas REG4 expression predicted a favourable prognosis in non-mucinous CRC.
  • Karjalainen, Katja (Helsingin yliopisto, 2015)
    Acute myeloid leukemia (AML), although rare, is highly malignant neoplasms that account for a majority of leukemia-associated deaths. AML results from an over-growth of immature myeloid cells in the bone marrow. These cells are functionally abnormal and interfere with the production of normal hematopoietic cells. Despite apparent phenotypic uniformity, AML is a heterogeneous group of myeloid malignancies, in which multiple genetic and epigenetic aberrations accumulate in hematopoietic stem or progenitor cells leading to disturbed cellular growth, proliferation, and differentiation. The nature and number of these AML-associated molecular abnormalities can vary widely among patients. Accordingly, the survival rate also fluctuates greatly, with an average ~25% overall survival rate. Chemotherapy is currently the mainstay treatment option for the patient with AML. However, although required to induce initial remission, chemotherapy contributes to new mutations and clonal evolution, which often leads to disease relapse. Consequently, targeted therapies are urgently needed to eradicate AML cells. One of the major challenges in clinical oncology today is that therapeutic agents cannot be selectively delivered to tumor site without causing toxicity to rest of the body. In addition, tumor microenvironment has a key role in mediating drug efficacy and resistance, which hampers the discovery of clinically relevant drugs. Therefore, functional screening platforms that can identify cancer-specific targets as well as assess the therapeutic relevance of drug candidates within the appropriate disease microenvironment are fundamental in identification of novel targets and therapeutic agents with better attributes than conventional chemotherapy drugs. In our studies, we have used two discovery approaches: (i) a phage display technology that allows the identification of ligands binding to physiologically relevant targets, and (ii) a novel ex vivo screening assay, which allows identification of candidate drugs against leukemia that are effective in the presence of human blood and bone marrow components. Specifically, our studies have elucidated the function of the leukemia invadosome a supramolecular complex containing certain β2 integrins and matrix metalloproteinases in the context of extramedullary leukemia. We show that this complex is essential for extravasation of leukemia cells as well as for leukemia cell growth, and that blocking the function of this complex possesses potent anti-leukemia and anti-invasion effects. We also demonstrate new roles for neuropilin-1 and interleukin-11 receptors in the pathogenesis of leukemia. We show that these membrane-associated proteins are highly expressed in leukemia cell lines as well as in bone marrow samples from leukemia patients. In addition, we show that the ligands binding to these receptors can be utilized in targeted drug delivery. Finally, we developed a new functional ex vivo screening assay to identify candidate anti-leukemia agents in the presence of human blood or bone marrow under hypoxic conditions. Under these conditions, leukemic cells deplete oxygen faster than normal cells causing a shift in the hemoglobin oxygenation state. This shift, detected by measuring the optical density at 600 nm (OD600) after an appropriate incubation time, directly correlates with leukemic cell counts. Thereby, the oxygenation state of native hemoglobin serves as a reliable and reproducible built-in indicator of leukemia cell growth and/or viability. Our study showed that this assay is highly amenable for high-throughput screening against leukemia. Our results support the idea that this new methodology could be a tool for the prediction of drug efficacy and/or response in leukemia patients.
  • Korkka, Heli (Suomalainen Lakimiesyhdistys, 2015)
    The proceeds of crime shall be ordered forfeit to the State (Penal Code Chapter 10 Section 2 subsection 1). Crime shall not pay. Therefore, the offender or another person or entity that benefited from the offence must be ordered to forfeit the illegal proceeds. This doctoral thesis establishes a theoretically justified model on how the amount of the illegal proceeds should be quantified (the Theoretical Model). The doctoral thesis also demonstrates how the Theoretical Model functions in practice. The thesis analyses forfeiture in the context of corporate crime. A corporate offence is defined as an offence committed within legitimate business operations or in a business environment, for example, in the securities market. Forfeiture plays an important role as a consequence of a corporate offence, as the offence type typically generates considerable economic benefit. An activity qualifying as a corporate offence often produces both legal and illegal benefit. The Theoretical Model adopted in the doctoral thesis separates legal and illegal benefit and, thus, enables limiting the forfeiture to the illegal benefit only. The thesis is divided into three parts. The first part (Presentation of the Research Problem) sets out the regulatory basis of the Theoretical Model. Chapter 1 considers relevant regulation and the related main rules of interpretation. Chapter 2 analyses the nature of forfeiture as sanction by comparing forfeiture and punishment. The comparison is useful as, under the Finnish law, forfeiture cannot be used as a punishment. Chapter 3 establishes an interpretation method applied in the thesis. The provision on forfeiture entails an interpretative tension. On the other hand, forfeiture must not be used as a punishment (forfeiture must be limited to the benefit generated by an offence and not by other factors related to an offence), but, on the other hand, the crime cannot pay (forfeiture must cover all benefit an offence has generated, including indirect benefit). This tension between restrictive and expansive interpretation is managed in the thesis by forming two principles of interpretation: the prohibition of enrichment and the prohibition of punishment. The balance of the principles is relevant throughout the thesis, as it helps to calibrate the set of differing arguments applicable in a concrete situation. The second part of the thesis is devoted to the construction of the Theoretical Model. The model consists of four criteria: the causality requirement between an offense and benefit (Chapter 5), deductibility of expenses resulting from an offence (Chapter 6), estimation of the amount of the illegal proceeds (Chapter 7) and adjustment of forfeiture (Chapter 8). Amongst the criterion, the causality requirement is the most essential, as the causation criteria defines the subject of the forfeiture, i.e. the property a priori considered illegal proceeds to be ordered forfeit. The doctoral thesis adopts a two-phase causality model. At the first phase, the factual causality analyses empirically observable events. The aim is to establish what has happened and which factor in the surrounding world has had such a strong impact for the resulting event (here, illegal proceeds) that the factor can be considered a cause to the consequence. The latter phase analyses to what extent the factual causal connection established at the first phase is judicially relevant (the judicial relevance of the factual causality). At the second phase, the factual causal connection between the offence and the benefit is assessed against the objectives of the provision on forfeiture in order to establish whether the factual causal connection is relevant and, thus, whether the benefit qualifies as illegal proceeds under the Penal Code and, therefore, can be ordered forfeit. The third part of the thesis contextualises the Theoretical Model to the connection of selected corporate offences, i.e. abuse of insider information (Chapter 10) and environmental offences (Chapter 11). The aforementioned offences are selected due to their distinct nature as corporate offences. Abuse of insider information is committed in the business environment, i.e. in the securities market, whereas the environmental offences are most often committed within legal business operations. The contextualisation demonstrates the functionality of the Theoretical Model in practice. The different operational environment of the offences also entails diverging mechanisms of profit generation, which enables an analysis on how the theoretical model works in context of different types of offences. Through the Theoretical Model and its contextualisation, the doctoral thesis establishes that the forfeiture of proceeds of crime can and should be applied in accordance with certain general principles that are neutral as to the type of offence in question however, taking into account the diverging mechanisms of profit generation in different types of offences. The thesis guides the expedient and efficient application of the forfeiture of criminal proceeds, as well as furthers the consistency of legal practice in this respect.
  • Vastamäki, Heidi Anita (Helsingin yliopisto, 2015)
    ABSTRACT Vastamäki, Heidi Anita The long-term outcome of frozen shoulder Helsinki: University of Helsinki, 2015, 77 p. Publications of the ORTON Research Institute, A:39 The purpose of the current study was to assess and report the long-term outcome of frozen shoulder. The 234 patients with 257 frozen shoulders were clinically followed up for a mean 9.7 years (range, 2-30). The study includes five peer-reviewed articles. The specific aims of this project were to study: 1) the long-term outcome of the natural course of idiopathic frozen shoulder, 2) the very long-term outcome of manipulation under anesthesia (MUA), 3) the incidence and long-term outcome of postoperative frozen shoulder, 4) any influence of timing on the outcome of MUA, and 5) the long-term outcome of diabetic frozen shoulder. In general, patients with frozen shoulder recovered spontaneously over a mean duration of 15 months. After 9 year follow-up, 94% of shoulders showed a range of motion (ROM) similar to that of the contralateral, non-affected shoulder; 51% were totally pain-free, and 43% had pain ≤3/10 on the Visual Analogue Scale (VAS). In the long-term follow-up, diabetic patients shoulder ROM remained inferior to that of non-diabetic individuals. However, diabetic individuals frozen shoulders recovered to the patients own contralateral level. The very long-term outcome of manipulation under anesthesia was slightly inferior to the outcome of spontaneous recovery i.e. the natural course. After a mean 23 years follow-up of MUA, 47% of the shoulders had no pain at all. Even though ROM deteriorated between the last two follow-ups (7 vs. 23 years after MUA) the once-manipulated shoulder did reach the ROM level of the contralateral shoulder. Timing of MUA was statistically significantly associated with the outcome after manipulation of the idiopathic frozen shoulder. Optimal timing for MUA may be between 6 and 9 months from the beginning of symptoms. However, this finding may not be clinically significant. Concerning postoperative frozen shoulder after an open rotator cuff repair (RCR), the incidence was 20%. Compared to patients with no postoperative stiffness in their shoulders, the delay to postoperative healing was 3-6 months. The external rotation resolved first. One year after the surgery, the abduction and the flexion corresponded to that of the control patients shoulders. Patient age during RCR and the condition of the biceps tendon were related to the postoperative stiffness. In conclusion, the long-term outcome of frozen shoulder is good.
  • Eronen-Rasimus, Eeva (Helsingin yliopisto, 2015)
    Sea ice, at its maximum extent, is one of the largest biomes on Earth. In addition to the polar oceans, it covers extensive sea areas at lower latitudes such as the Baltic Sea and the Sea of Okhotsk. During ice formation, organic and inorganic components in the parent seawater are concentrated into saline brines within the ice, which serve as a habitat for diverse auto- and heterotrophic organisms, including bacteria. Sea-ice bacteria are responsible for many biogeochemical processes, such as decomposition of particulate organic matter, recycling of dissolved organic matter and remineralization of nutrients, analogously to bacterially driven biogeochemical processes in the water column. Since bacterial groups vary by their metabolic traits and participation in biogeochemical processes, knowledge of the bacterial community structure and its seasonal variation is essential for an understanding of ice biogeochemistry. This thesis characterises sea-ice bacterial communities during ice formation and during the winter/spring transition phase when the community composition is poorly known. Bacterial communities in Arctic and Baltic sea ice during the winter/spring transition were studied and compared. In addition, the effect of the dissolved organic matter regime on bacterial community formation was investigated in an experimental sea-ice system with North Sea water. The main methods applied were terminal-restriction fragment length polymorphism and/or Illumina Miseq sequencing together with bacterial production and abundance measurements. During the early stages of sea-ice formation, the bacterial communities were similar to the parent water communities, suggesting that the parent water determines the initial sea-ice bacterial community composition. After congealment of the sea ice, the bacterial communities changed towards communities typical of sea ice in spring. During the winter/spring transition, members of the classes Flavobacteriia (formerly Flavobacteria), Gammaproteobacteria and Alphaproteobacteria were predominant both in Baltic and Arctic sea ice. The Baltic and Arctic sea-ice bacterial communities were significantly different; however, a few members of common sea-ice bacterial genera, such as Polaribacter and Shewanella, were closely related, pointing to similar selection in ice, regardless of differences in the prevailing environmental conditions. In the experimental system, the bacterial communities were able to respond to altered substrate availability immediately after ice formation. This indicates successful adaptation of sea-ice bacteria to major shifts in temperature and salinity during ice formation. The results of this thesis suggest that sea-ice bacterial community formation and dynamics is defined by a combination of changes in environmental conditions during sea-ice maturation and its associated substrate availability, as well as resource competition. The sea-ice habitat provides an example of the enormous capacity of bacteria to adapt to changing environments and how minor members of the bacterial community can become predominant when environmental conditions change.
  • Akhgari, Amir (VTT Technical Research Centre of Finland Ltd, 2015)
    Rhazya stricta Decne. (Apocynaceae) is a traditional medicinal plant in the Middle East and South Asia. It produces a large number of terpenoid indole alkaloids(TIAs), some of which possess important pharmacological properties. This study focused on the establishment of biotechnological production tools of R. stricta, namely undifferentiated cell cultures, and an Agrobacterium rhizogenes-mediated transformation method to obtain hairy roots expressing heterologous genes from the early TIA pathway. As Rhazya alkaloids comprise a wide range of structures and polarities it was necessary first to develop different analytical methods to determine the alkaloid contents and changes in their profiles in transgenic cultures and after various treatments. Targeted and non-targeted analyses from cell andorgan cultures were carried out using gas chromatography-mass spectrometry(GC-MS), high performance liquid chromatography (HPLC), ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) and nuclear magnetic resonance (NMR) spectroscopy. Callus cultures were successfully initiated from five different explants onmodified B5 medium containing phytohormones. The phenotypes of the calli varied, but as was expected the callus cultures accumulated lower levels of alkaloids than wild type hairy roots and adventitious roots. Surprisingly, calli derived from stems had elevated levels of strictosidine lactam compared to other cultures. Transformation experiments revealed that only leaves but not cotyledons, hypocotyls or stem segments were susceptible to Agrobacterium infection and subsequent root induction. The transformation efficiency varied from 22% to 83% depending on the gene. Wild type and gus hairy root clones contained twofold higher amounts of alkaloids than adventitious roots. A total of 17 TIAs, including glycosylated alkaloids, were identified from hairy root extracts by UPLC-MS. GC-MS analysis allowed the separation of the most volatile and non-polar alkaloids in a single run. The composition of typical non-polar alkaloids indicated the occurrence of 20 TIAs belonging to nine different groups. The quantities of these alkaloids varied between clones in the order eburenine, vincanine, vallesiachotamine and yohimbine isomer II. The occurrence of pleiocarpamine, fluorocarpamine, vincamine, ajmalicine, and yohimbine isomers, analysed by GC-MS, and serpentine and its isomer, tetrahydrosecodinol as well as tabersonine, analysed by UPLC-MS, is reported here for the first time from R. stricta. Methyl jasmonate, a well-known elicitor, caused a significant increase in the total alkaloid content of wild type hairy roots as determined by NMR analyses. Detailed targeted analyses by GC-MS showed that the contents of eight out of ten studied alkaloids increased compared to non-elicited cultures. Another studied elicitor, chitosan, did not have any effect on individual alkaloid contents. Transgenic hairy root clones did not exhibit phenotype differences. Multivariate analysis from NMR data showed a clear discrimination between transformed and wild type/gus cultures. This was most probably due to differences in primary metabolites, as the total alkaloid content did not vary between different hairy roots and controls. In general, the production of individual TIAs, analysed by HPLC, was repressed in hairy roots transformed with geraniol synthase(ges) and geraniol 8-oxidase (g8o) genes compared to the wild types. Overexpression of the strictosidine synthase (str) gene resulted in a higher accumulation of serpentine, whereas the production of strictosidine lactam was decreased. There were no significant differences in the contents of other alkaloids compared to the wild type hairy roots. In conclusion, a simple and efficient gene transfer method is reported for R. stricta for the first time. New analytical methods were established which enabled comprehensive investigation of the alkaloids. These data might serve as a basis for further utilization of biotechnological methods for R. stricta and its further metabolic engineering.
  • Ikonen, Tiina (Diakonia-ammattikorkeakoulu, 2015)
    This study examines international diaconia in the diocesan and central administration of the Evangelical Lutheran Church of Finland in the years 1993−2004. The research question of this study consists of three parts. 1) What meanings has international diaconia had, and what international aspects have been included in diaconia within the diocesan and central administration? 2) What actions have been included in international diaconia within the diocesan and central administration, and what reasons have been given for these actions? 3) How do the decisions of the diocesan and central administration express the idea of international diaconia in the church? This data-based study has been carried out through the methodological means of qualitative content analysis with aspects of historical analysis. Methods of grounded theory have been applied in the research process. The main data of the study consists of administrative documents of the church s diocesan and central administration. As a result of this study, a model of international diaconia in the church administration was formed. In the model, international diaconia was divided into three dimensions and three factors. The factors are seen in every dimension. The three dimensions of international diaconia are called the position of international diaconia in the church administration, diaconia meeting national borders, and intercultural diaconia. The three factors apparent in these dimensions are called the theology of international diaconia, the praxis of international diaconia and the question of neighbors in international diaconia. The study found major changes in international diaconia during the research period. First, the theology of international diaconia was discussed in relation to the theology of the missionary practice of the church. International diaconia was found to be an integral part of the church s mission. The new understanding of international diaconia made clear that the church should act as a subject of international diaconia and that there is a wider understanding of international responsibility to be found. Second, intercultural diaconia was introduced and increased in a rapid manner. Half of the international diaconia praxis was organized for national intercultural diaconia. This change was due to increasing migration to Finland. Third, international diaconia was challenged by the question of neighborliness. Within international diaconia, the church worked in order to help people in need both in international and national contexts. Neighbors were often considered strangers or others by the church and as objects of international diaconia. It was common for international diaconia − both outside and inside national borders − to work for strangers rather than with them.
  • Anttila, Jani (Helsingin yliopisto, 2015)
    Environmental opportunist pathogens are a class of organisms that are able to both infect multicellular hosts and grow in the outside-host environment as free-living organisms. Environmental opportunism differs from obligate parasitism in that direct host-to-host contact is not necessary for disease transmission and that there are environmental pathogen reservoirs which in suitable conditions act as sources of infection. Because of this, environmental opportunist pathogens form a persistent threat to human health, livestock, and wildlife, and cannot be eradicated by treating hosts. Three well-known examples of pathogens of this class are Vibrio cholerae, Flavobacterium columnare, and Bacillus anthracis, all of which cause sporadic outbreaks. Between infections, these pathogens are subject to multiple biotic and abiotic environmental pressures in the outside-host environment. While environmental opportunist pathogens are not dependent on live hosts for transmission and thus benefit from increased virulence, balancing between the two environments, within-host and outside-host, might incur trade-offs and thus limitations to their spread. In this thesis I have developed mathematical models of environmental opportunist pathogen dynamics and studied the effects of environmental variation and outsidehost interactions on patterns of pathogen outbreaks. The studies included in the thesis address (i) the origin of a sigmoidal dose-dependent infectivity response, (ii) the effect of competition in the outside-host environment on opportunist pathogen outbreaks, (iii) the effect of environmental variation on environmental opportunist dynamics, and (iiii) how environmental variation enables invasions of emerging opportunist pathogen strains. The modelling approach has enabled identification of factors such as alleviation of competitive pressure and certain kinds of environmental variation as outside-host environmental factors that promote outbreaks. Additionally, modelling results can be used to suggest control strategies to reduce the probability of environmental opportunist pathogen outbreaks.
  • Hyytiäinen, Heli (Helsingin yliopisto, 2015)
    Stifle dysfunction is one of the most common reasons for canine hindlimb lameness and an indication for dogs referral to physiotherapy. Until now, there has been a lack of testing batteries in animal physiotherapy, although these are an important part of the evaluation process in various patient groups in human physiotherapy. Using 64 dogs, 43 with stifle dysfunction and 21 healthy dogs, congruity between fourteen physiotherapeutic evaluation methods, commonly used in dogs with stifle dysfunction, and six evaluation methods used by a veterinarian was evaluated. The eight best methods were chosen as items constituting a testing battery, the Finnish Canine Stifle Index (FCSI). The numerical scale of the testing battery was 0-263. Cronbach s alpha for the internal reliability of the total FCSI score was good (0.727). Two cut-offs for the total score were set: 60 and 120, separating adequate, compromised and severely compromised performance level, based on their high sensitivities and specificities. Another 57 dogs, 29 with some type of stifle dysfunction, 17 with some musculoskeletal disease other than stifle dysfunction and 11 healthy dogs, were used to further study the psychometric properties of the testing battery. The dogs with stifle dysfunction showed a significant (P < 0.001) decrease in FCSI total score (93.3 ± 62) compared with the two other groups (29.5 ± 39.6 and 11.7 ± 21.0), demonstrating good responsiveness of the FCSI. Also the inter-tester reliability was excellent (ICC 0.784), with no significant differences between three physiotherapists performing the FCSI. In conclusion, the overall functionality and outcome of rehabilitation in dogs with stifle dysfunction can be reliably evaluated with the new testing battery, the FCSI, developed here.
  • Wissel, Gloria (Helsingin yliopisto, 2015)
    The main goal of this dissertation is to identify novel modulators acting on ATP Binding Cassette subfamily C member 2 (ABCC2) transporters and α2-adrenoceptors subtypes. With the purpose of identifying novel modulators and their mode of action, a combination of experimental and computational approaches have been used. The first protein presented in this dissertation is the ABCC2 transporter, also known as the multidrug resistance associated protein 2 (MRP2), an efflux transporter expressed in polarized cells where it effluxes a variety of both endogenous and exogenous molecules out of the cell. The most common way to study the interactions between small molecules and ABCC2 transporter is by a vesicle transport assay. Three assays are commercially available, which use different probes to define the ABCC2- transport. With the intent to define the different assays and identify the effect that small molecules have on the ABCC2-transport, a small set of eight compounds and, subsequently a larger library of compounds were tested with the different assays. Additionally, the aim was to identify and characterise novel ABCC2 inhibitors, 16 inhibitors have been identified from the larger library and classification models were built to identify important descriptors that were able to discriminate inhibitors from inactive molecules. Instant structure-activity relationships (SAR) of four scaffolds of ABCC2 modulators are also presented. In addition, some unpublished results are presented, the homology model of ABCC2 and further insights into the SAR of ABCC2 modulators. The other proteins included in this dissertation are the three subtypes of the α2-adrenoceptors, G-protein coupled receptors, involved in the signalling pathway of adrenaline and noradrenaline. A clear subtype characterization/profile of these proteins is not available. Selective molecules could be used in treatment of high blood pressure, in the alleviation of withdrawal symptoms, and as anaesthetic with fewer side effects than the current drugs. To define the affinity of a small set of antagonists and outline the involvement of the first transmembrane helix in ligand binding, a competition binding assay has been used with chimera receptors where the first transmembrane helix has been swapped between the three subtypes. Molecular modelling has been used to explain the different binding affinities to the chimera receptors. Additionally, the aim was to identify novel α2B-adrenoceptor selective compounds, thus a mid-sized library has been screened using a miniaturized binding assay. Hierarchical classification and chemoinformatics analysis has been used to visualize and analyse the screening results.
  • Neittaanmäki-Perttu, Noora (Helsingin yliopisto, 2015)
    ABSTRACT Background and purpose: As the skin cancer burden continues to increase, there is an urgent need for novel methods for the early detection of skin cancers, and for new cost-effective treatments. The hyperspectral imaging system (HIS) is a novel technique which offers the dual advantages of allowing the imaging of large skin areas rapidly and non-invasively. Daylight photodynamic therapy (DL-PDT), with the advantages of excellent tolerability and convenience, is an attaractive therapy for actinic keratoses (AK) and field cancerization.This thesis aimed to enable early and effective treatment of common premalignancies of photo-damaged skin.The first purpose of this thesis was to evaluate the feasibility of HIS in the detection of field cancerized skin and in the detection of ill-defined borders of lentigo maligna (LM) and lentigo maligna melanoma (LMM). In addition, this thesis aimed to further develop the treatment of field cancerized skin with photodynamic therapy using a novel photosensitizer in combination with daylight (DL-PDT), and to evaluate the cost-effectiveness of DL-PDT. Methods: This thesis included four non-sponsored prospective clinical studies. The novel prototype HIS, used in studies I-II, was developed for the study at the VTT Technical Research Centre of Finland. The technique enabled in vivo imaging of the skin prior to surgical procedures and produced abundance maps of the affected skin areas. The results were verified by histopathology. Study III was randomized double-blinded intra-individual split-face trial comparing novel photosensitizer formulation, 5-aminolaevulinate nanoemulsion (BF-200 ALA) with methyl-5-aminolaevulinate (MAL) in DL-PDT of AKs. In addition to blinded clinical and histological treatment efficacy, tolerability of the treatment was assessed. Study IV evaluated the cost-effectiveness of MAL-DL-PDT compared to conventional MAL-LED-PDT. Results: In studies I-II HIS showed its feasibility in both the detection of subclinical borders of ill-defined lentigo malignas (LM) and lentigo maligna melanomas (LMM), and in the detection of early subclinical actinic keratoses (AK). In study I HIS accurately detected 20 of 23 (87%) of the LM/LMM borders as confirmed by histology. HIS was useful i.e. detected the lesion borders more accurately than a clinician using Wood s light in 11 of 23 (47.8%) cases. Six re-excisions could have been avoided with HIS. In 3/23 cases (13%) HIS was not in concordance with the histopathology, which in two cases HIS showed lesion extension which was not verified histologically (wrong positive) and in one case HIS missed the subclinical extension (wrong negative). In study II with 12 patients and 52 clinical AKs, HIS accurately detected all the clinical lesions in addition to numerous areas of subclinical damage. HIS findings matched the histopathological findings in all 33 biopsied areas (AK, n=28, photo-damaged skin, n=5), revealing 16 subclinical lesions of which 10 were not detected by fluorescence diagnosis. In study III (13 patients, 177 lesions) in a per patient (half-face) analysis BF-200 ALA cleared thin AKs more effectively than did MAL (p=0.027). In per lesion analysis the complete clearance rates were 84.5% for BF-200 ALA, and 74.2% for MAL (p=ns). The area response rates, including also the new appeared lesions (i.e.preventive effect), were 79.8% for BF-200 ALA and 65.6% for MAL, p=0.044. Histologically, DL-PDT effectively cleared all the signs of dysplasia in 61.5% lesions treated with BF-200 ALA and in 38.5% with MAL (p=ns). The mean decrease in p53 expression was 54.4% with BF-200 ALA, 34 % with MAL (p=ns). DL-treatment was nearly painless with both photosensitizers. BF-200 ALA and MAL DL-treatments were similarly tolerated as regards to adverse reactions. In study IV 70 patients (210 target lesions) randomized to receive DL-PDT or LED-PDT with MAL, at six months the patient complete response rates were 15 of 35 (42.9%) and 24 of 35 (68.6%), (p=0.030) and lesion clearance rates were 72.4% and 89.2%, respectively (p=0.0025). DL-PDT required significantly less time at the clinic (p less than 0.0001) and could be used with lower total costs ( 132) compared to conventional LED-PDT ( 170), p=0.022. However, in terms of cost-effectiveness MAL-DL-PDT was found to give less value for money compared to MAL-LED-PDT. The incrementl cost-effectiveness ratio (ICER) showed the monetary gain of 147 per unit of effectiveness lost. Thus, the use of DL-PDT instead of LED-PDT would decrease the healing probability but only low incremental cost savings would be achieved. The costs per complete responder were 308 for MAL DL-PDT and 248 for MAL LED-PDT, p= 0.004. Conclusions: The more accurate pre-surgical assessment of the subclinical borders of LM and LMM with HIS could lead to fewer re-excixions, which furthermore could reduce the burden to both patients and clinics. In addition, the early non-invasive detection of skin field cancerization could enhance the treatment process by revealing the as yet subclinical areas in need of treatment, and could possibly aid the monitoring of treatment efficacy. Even though HIS was found to be useful in these two indications, more studies are warranted to qualify the optimal mathematical algorithms for diagnostic use.The use of novel a photosensitizer formulation, BF-200 ALA, in DL-PDT could lead in lower costs and increase the efficacy. Interestingly, the efficacy of DL-PDT with BF-200 ALA was approaching the efficacy achieved with conventional LED-PDT. As field cancerized skin should be treated as a chronic disease requiring repeated treatments, DL-PDT offers a painless and convenient option for this purpose. However, DL-PDT with MAL provided less value for money compared to conventional MAL-PDT. The cost-effectiveness of BF-200 ALA in DL-PDT for AKs needs further studies.
  • Kislin, Mikhail (Helsingin yliopisto, 2015)
    Acute brain trauma and ischemia are severe injuries that have no adequate treatment to date. In vivo two-photon microscopy allows studying longitudinally the process of injury development and brain recovery. This thesis summarizes the work on: i) animal model of acute brain injury and role of extracellular matrix in neuronal recovery and plasticity, ii) investigation of mitochondria during physiological/pathological calcium elevations in vitro and further implementation of quantitative microscopic analysis of neuronal mitochondrial morphology in vivo, iii) mitochondrial damage and recovery in animal models of acute neurodegenerative disorders in the neocortex of anesthetized mice, iv) a novel approach for awake head-fixed recordings. The results described in this work provide novel approaches for intravital morphological analysis of neurons and of their mitochondria, increase our understanding of pathogenesis after traumatic and ischemic injury in neocortex of rodents, and enable the development of novel therapies for CNS injuries.
  • Reijula, Jere (Helsingin yliopisto, 2015)
    Exposure to tobacco smoke significantly increases the risk of several diseases including cancer, cardiovascular and pulmonary diseases. Prohibition of smoking in workplaces effectively protects workers against occupational exposure to secondhand smoke (SHS). However, Finnish restaurant employees have still been exposed to SHS at work until recent years. In 2000, a reform in tobacco legislation was launched in Finland according to which restaurants had to reserve non-smoking areas for their clients. Smoking restrictions proceeded gradually so that in 2007 a total ban on smoking was enacted in Finnish restaurants. In this study, nationwide survey data concerning occupational exposure to ETS in restaurants was used to assess the impact of tobacco legislation. Additionally, the risk of restaurant waiting personnel to develop cancer was evaluated in five Nordic countries. AIM OF THE STUDY: The overall purpose of the present study was to assess the impact of tobacco legislation on the occupational exposure to tobacco smoke in Finnish restaurants. The aim was to compare the effects of partial restrictions and a total prohibition of smoking in reducing the exposure to SHS among restaurant workers. Another objective of the study was to evaluate the risk of restaurant workers to develop cancer compared to that of the general population. MATERIAL AND METHODS: The present thesis collects the data concerning exposure to SHS in restaurant work using national questionnaire surveys conducted in 1999, 2001, 2003, 2007, 2009 and 2010 among Finnish restaurant workers (I, II and III). Each year the surveys were sent to an average of 3000 restaurant employees belonging to the Service Union United (PAM). Study I assessed the data collected with the first four questionnaires (1999-2007). In study II, the main focus was in the results of the questionnaires conducted before and after the launch of the smoke free tobacco legislation (i.e., 2007 and 2009). Study III included data from the questionnaires conducted in 2003, 2007, 2009 and 2010, respectively. Exposure to SHS in restaurant work was assessed also by measuring indoor nicotine concentrations in restaurants in three towns (Helsinki, Jyväskylä and Lappeenranta). The measurements were done in each year when the questionnaire surveys were carried out. Altogether 730 measurements were carried out between 2004 and 2010, approximately 60 measurements in each type of restaurant each year. The measurements were done with sampling devices that were placed for 4 hours in three different types of restaurants, i.e., dining restaurants, pubs and nightclubs, and bar desks. In order to assess the risk of cancer among restaurant workers, data were collected from the database of the Nordic Occupational Cancer (NOCCA) study. It consists of those 14.9 million persons aged 30-64 years who participated in any computerized census in the five Nordic countries, in 1990 or earlier. The longest follow up times were from 1961 to 2005. Among this study population, we focused on the group of waiters, comprising 16,134 males and 81,838 females. Altogether 3,100 cancer cases among male and 16,288 cancer cases among female waiters were found in study IV. Standardized incidence ratios (SIRs) for 35 common cancer sites were then calculated as ratios of the observed number and the expected number of cancer cases assuming that the cancer incidence among male and female waiters would be the same as found in the respective national populations. The numbers of excess cancer cases for each cancer site were calculated by subtracting the expected numbers of cancer cases from the observed ones. RESULTS: The prevalence of restaurant workers who were not exposed to SHS at work increased from 34% to 54% during 1999-2007. The prevalence of those who reported more than 4 hours of exposure to tobacco smoke during their work shift decreased from 46% to 24%. Between 2007 and 2009, the prevalence of restaurant workers who were not exposed to SHS at work increased from 54% to 82%. The highest increase was among workers in pubs and nightclubs (from 7% to 69%). The prevalence of restaurant workers who were exposed to SHS more than 4 hours a day at work decreased from 24% to 4%. Between 2007 and 2009, the prevalence of work-related respiratory symptoms decreased from 18% to 4% and that of eye symptoms from 23% to 6%. The median nicotine concentration in restaurants decreased from 11.7 μg/m³ to 0.1 μg/m³ between 2004 and 2010. The highest decrease in median nicotine concentration was found in pubs, where the median nicotine concentration decreased from 16.1 μg/m³ to 0.1 μg/m³. The reported exposure to SHS (at least 1 hour per work shift) decreased from 59% to 11% during 2004-2010. The cancer incidence among male and female waiters was higher than among the general population in the Nordic countries. During the study period (1961-2005), the overall risk of cancer among male waiters was 1.46 (95% confidence interval 1.41-1.51) and among female waiters 1.09 (1.07-1.11). The highest SIRs were found in cancer sites that are related to alcohol consumption. The highest numbers of excess cases among male waiters were in lung cancer (n=282) and cancer of the pharynx (n=92). Among female waiters the highest numbers of excess cancer cases were in lung cancer (n=718) and in cancer of the cervical uterus (n=314). CONCLUSION: The reform of Finnish tobacco legislation in 2000 that only partially prohibited smoking in restaurants until 2007 decreased occupational exposure to SHS but was not fully effective in protecting restaurant workers from exposure to SHS at work, whereas the total prohibition of smoking in 2007 significantly decreased restaurant workers exposure to SHS. The total ban on smoking in restaurants also decreased the prevalence of work-related respiratory and eye symptoms among restaurant workers, which most likely was associated with the decrease of exposure to SHS at work. In the follow-up, the positive effects of the strict tobacco legislation remained intact. The risk of cancer among male and female waiters was higher than among the general population in the five Nordic countries. This may be explained by high prevalence of smoking, heavy occupational exposure to tobacco smoke and high alcohol consumption among the subjects.
  • Häme (née Häkkinen), Silja (Helsingin yliopisto, 2015)
    Aerosol particles are important atmospheric constituents. They exist in both polluted and remote areas but the sizes and concentrations of these particles vary greatly depending on location. Aerosol particles damage human health via inhalation, reduce visibility with high mass loadings, and among all, contribute to climate change. Particles directly scatter and absorb solar radiation. In addition, particles that are large enough can participate in cloud formation and affect cloud properties by acting as cloud condensation nuclei (CCN). A notable fraction of submicron atmospheric aerosol mass consists of organic compounds, and a large fraction of this material has been formed through condensation of organic vapors onto aerosol particles (secondary organic aerosol, SOA). Most of the global SOA mass is deemed to be biogenic in origin, but recent studies suggest that a significant fraction of it may be controlled by anthropogenic pollution. However, due to poor understanding of this anthropogenic enhancement in biogenic SOA formation, it is not systematically accounted for in current atmospheric models. Due to these kind of uncertainties in global SOA mass burden and lack of detailed knowledge of chemical, physical and optical properties of SOA, estimates of organic aerosol effect on the climate are highly uncertain. To decrease the uncertainty in the climate effects of the organic aerosol, an improved understanding of the formation mechanisms and properties of SOA is needed. In addition, nanoparticle growth to CCN-sizes by condensation of secondary organic matter needs to be accurately described in atmospheric models. In this thesis the formation of SOA is investigated in the presence of both biogenic and anthropogenic compounds. The chemical and physical properties volatility and hygroscopicity of SOA are examined via field and laboratory experiments combined with process modeling. The thesis introduces improvements for the treatment of SOA related to nanoparticle growth in atmospheric models and evaluates their performance. The thesis shows that interactions between atmospheric biogenic and anthropogenic aerosol components can form aerosol material of low-volatility. For instance organic salt formation via chemical reactions between organic acids and inorganic salts can lower aerosol volatility. Particulate-phase processing may also alter aerosol hygroscopic properties. Description of nanoparticle growth by low-volatility secondary organics is important in improving the estimates of particle and CCN numbers. The thesis highlights the significance of biogenic organic matter formed under anthropogenic influence in the nanoparticle growth. This warrants future studies focusing on the formation mechanisms and properties of anthropogenically driven biogenic organic aerosol.
  • Kolmeder, Carolin (Helsingin yliopisto, 2015)
    Human physiological processes are complemented by those of the microbiota, the collection of all microbes living in and on our body. The human intestinal microbiota is one of the most prominent representatives and many associations with a wide spectrum of human diseases have been identified. Analysing faecal material with nucleic acid based approaches revealed the species richness of the intestinal microbiota and its individuality, being unique to each human being. In addition, to date approximately ten million unique genes have been identified from the human intestinal microbiota. These genes add an enormous additional genetic potential to the human genome, but little is known about which of these genes can be expressed into proteins and the conditions under which the protein synthesis occurs. The focus of this thesis work was to increase the knowledge of the biological processes taking place in-vivo, and to establish a baseline of these functions in the intestine of a healthy adult. Faecal material was used to study the metabolic reactions in the lower intestine, thus avoiding invasive sampling like biopsies. The proteins contained in the faecal material, which represent the molecules of most biological reactions, were targeted. At first, a method to access and analyse faecal proteins was developed, a so called metaproteomics approach. Proteins were analysed by mass spectrometry and the vast amount of resulting data was analysed with a wide range of computational methods to get a comprehensive overview of the intestinal functions. Altogether, 81 biological samples collected from 48 adults were analysed. As the main result, it was shown that individuals can be separated by their specific faecal protein profiles. This, in turn, indicates that the collection of intestinal microbial functions taking place in each of us are unique. In addition, the faecal protein profiles from obese individuals were found to be different from those of non-obese individuals. On a phylum level, it appeared that in obese individuals Bacteroidetes were biologically more active than the phylogenetic analysis suggested. This thesis work has identified several core intestinal proteins and helps to understand the functional significance of the intestinal microbiota. Next, we have to address these proteins in well concerted studies and still need to learn more about many of the encoded functions contained in the intestinal microbial genes.
  • Leppimaa, Sanna (2015)
    Työssä käsitellään opetuspelejä ja motivaatiota matematiikan opetuksessa. Tarkastelun kohteena ovat motivaatiota lisäävien seikkojen ja pelien ominaisuuksien yhtenevyydet. Apuna käytetään kaupunkisuunnistusta ja mobiiliteknologiaa yhdistävää peliä, jonka sisältö laadittiin lukion lyhyen matematiikan opetukseen sopivaksi. Pelistä saatiin käytännön kokemuksia peliä johtamalla ja kyselyiden avulla sitä pelanneelta lukioryhmältä. Työssä pohditaan tämän pelin mahdollisuuksia matematiikan opetuksessa ja motivaation lisäämisessä. Luku 2 alkaa pelejä käsittelevällä osuudella, jossa kerrotaan, minkälaisia ominaisuuksia peleillä on ja mitä nämä ominaisuudet tarkoittavat pelaajan näkökulmasta. Pelejä voidaan kutsua organisoiduksi leikiksi: niillä on leikinomaisia piirteitä, mutta niiden säännöt ovat leikkiä selkeämmät. Lisäksi peleissä on jokin tavoite, johon pääsemistä edeltävät erilaiset haasteet tai vastustajat. Leikin tavoin peleissä on vuorovaikutusta, joka voi olla ihmisten tai ihmisen ja tietokoneen välistä. Pelit myös kertovat tarinoita, olivat ne sitten monimutkaisia juonia tai kahden henkilön välistä kilpailua. Luvussa 2 käsitellään pelien lisäksi motivaatiota. Motivaatiota tutkittaessa etsitään vastausta siihen, miksi ihmiset toimivat niin kuin toimivat. Työssä huomio keskittyy siihen, kuinka motivaatiota voidaan lisätä. Tätä tarkastellaan sen kannalta, millaisen toiminnan on todettu olevan houkuttelevaa. Esiin nousee neljä ominaisuutta: onnistumiskokemuksien tuottaminen, uteliaisuuden herättäminen, itseilmaisuun kannustaminen ja ihmissuhteiden vaaliminen. Luvussa 3 käydään lyhyesti läpi työn ja sitä varten pelatun pelin tausta. Luku 4 jatkaa luvun 3 lyhyestä taustaselvityksestä kertomalla tarkemmin pelin kulusta ja säännöistä. Luvussa 5 käsitellään pelistä saatuja kokemuksia, joita kerättiin kyselyillä, joihin vastasivat peliä pelanneet opiskelijat sekä peliä vetämässä ollut opettaja. Opiskelijat ja opettaja vastasivat yhteen kyselyyn ennen peliä ja toiseen pelin jälkeen. Kyselyjen perusteella opiskelijoilla oli pelistä melko positiivinen kuva niin ennen peliä kuin sen jälkeenkin. Opettaja suhtautui ennen peliä hiukan epäileväisesti, mutta pelin jälkeen hänen mielikuvansa olivat muuttuneet positiivisemmiksi. Vastauksista todetaan löytyvän seikkoja, joiden perusteella voidaan arvella opiskelijoiden nähneen pelissä houkuttelevan tekemisen ominaisuuksia. Pelin käytännön onnistumista tarkastellessa havaitaan tämä sama tulos. Luvussa 6 pyritään yhdistämään motivaation ja pelien teoriat pelatun pelin kanssa. Tarkastelun kohteena on se, kuinka hyvin työtä varten pelattu peli onnistui toteuttamaan houkuttelevan tekemisen ominaisuuksia. Kaikkien näiden ominaisuuksien toteutumisen mahdollisuuksia voidaan kasvattaa. Työtä varten pelattu peli ja pelit yleensä todetaan perutelluksi osaksi matematiikan opetusta. Erityisesti pelien arvellaan lisäävän opiskelijoiden innostusta osallistua tunnin kulkuun ja näin saavan myös lisää mahdollisuuksia innostua matematiikasta.
  • Zou, Xiaochen (Helsingin yliopisto, 2015)
    Leaf angle distribution (LAD) is one of the most important parameters used to describe the structure of horizontally homogeneous vegetation canopies, such as field crops. LAD affects how incident photosynthetically active radiation is distributed on plant leaves, thus directly affecting plant productivity. However, the LAD of crops is difficult to quantify; usually it is assumed to be spherical. The purpose of this dissertation is to develop leaf angle estimation methods and study their effect on leaf area index (LAI) and chlorophyll a and b content (Cab) measured from optical observation. The study area was located in Viikki agricultural experimental field, Helsinki, Finland. Six crop species, faba bean, narrow-leafed lupin, turnip rape, oat, barley and wheat, were included in this study. A digital camera was used to take photographs outside the plot to record crop LAD. LAI and Cab were determined for each plot. Airborne imaging spectroscopy data was acquired using an AISA Eagle II imaging spectrometer covering the spectral range in visible and near-infrared (400 1000 nm). A recently developed method for the determination of leaf inclination angle was applied in field crops. This method was previously applied only to small and flat leaves of tree species. The error of LAI determination caused by the assumption of spherical LAD varied between 0 and 1.5 LAI units. The highest correlation between leaf mean tilt angle (MTA) and spectral reflectance was found at a wavelength of 748 nm. MTA was retrieved from imaging spectroscopy data using two algorithms. One method was to retrieve MTA from reflectance at 748 nm using a look-up table. The second method was to estimate MTA using the strong dependence of blue (479 nm) and red (663 nm) on MTA. The two approaches provide a new means to determine crop canopy structure from remote sensing data. LAI and MTA effects on Cab sensitive vegetation indices were examined. Three indices (REIP, TCARI/OSAVI and CTR6) showed strong correlations with Cab and similar performance in model-simulated and empirical datasets. However, only two (TCARI/OSAVI and CTR6) were independent from LAI and MTA. These two indices were considered as robust proxies of crop leaf Cab. Keywords: leaf angle; leaf area index; leaf chlorophyll; digital photograph; imaging spectroscopy; PROSAIL model; vegetation indices
  • Kalu, Emmanuel Okwara (Helsingin yliopisto, 2015)
    More than half of those newly infected with HIV/AIDS are between the ages of 15 and 24 (UNICEF, UNAIDS and WHO 2002). The disease s challenge is not limited to students already diagnosed with the disease, but also to students in limbo (students who do not know their status), because about 50% of those living with HIV do not know their status (UNAIDS 2012). However, voluntary HIV screening is unpopular, probably due to fear and gross misconceptions. Based on the presumption that besides its health and educational impacts, the disease also influences the productivity and future goals of students, this study investigated and compared the conceptions of HIV-positive university students in Finland and Nigeria in search of not only the negative, but also the positive meanings of living with the disease, with the aim of bettering HIV/AIDS understandings. The study is primarily approached through phenomenography. Seven individuals participated in the study (three Finns and four Nigerians) through in-depth and e-mail interviews. The outcomes are described and compared under 7 main categories, 26 sub-categories and 300 themes based on the similarities and qualitative differences in the participants conceptions. To further illustrate the outcomes, Concept Maps were used at the end of each main category to separately show the Finnish and Nigerian participants responses within each category. In addition, tables of comparison were used in Appendixes one to seven to compare the Finnish and Nigerian participants conceptions thematically and also in relation to the results of earlier studies. Subsequently, propositions in text format were used in Appendix eight to present the concept map outcomes in a different light. The findings reveal that although the negative effects are much more noticeable, the positive impacts are increasing. They add to refuting what we already know about living with the disease, especially in the 1980s and 1990s. In view of the many benefits of living with HIV, as illuminated by this study, the current situation is unlike the past, as today living with HIV does more good than harm especially in terms of motivating positive and healthful living. The comparison of the two groups reveals no wide gap between the Finnish and Nigerian participants conceptions; nevertheless, while the Finnish participants are slightly better informed about HIV/AIDS, their Nigerian counterparts are more open and positive about their conditions. Due to the nature of its findings, the implications of this study are many; the most outstanding of which is that it may positively and healthfully transform readers. By bringing into the spotlight the unpopular positive sides of living with HIV (not AIDS), PLWHA could further be strengthened to cope with the disease, and the fears of students in limbo due to misconceptions could be reduced, which may motivate them to voluntarily participate in HIV screening. Furthermore, the study may contribute to enabling HIV/AIDS organisations to better tailor their services towards meeting the needs of their subjects. School authorities could equally be motivated to make school environments more HIV/AIDS friendly. The Finnish Ministry of Social Affairs and Health and similar ministries in other countries may also find in these outcomes reasons to push for changes in HIV/AIDS policies. Keywords: HIV/AIDS, PLWHA, students, education, health, healthful living
  • Soininen, Leena (Helsingin yliopisto, 2015)
    THE HEALTH OF THE FINNISH SAMI IN THE LIGHT OF MORTALITY AND CANCER PATTERN The Sami are regarded as indigenous people of Scandinavia and northwest Russia. Their traditional dwelling zone consists of the most northern parts of those countries. In addition to the Arctic environmental circumstances, some radioactive and chemical pollution has been found in the environment of the Sami. In this study, the mortality and cancer incidence of the Finnish Sami groups (North-, Inari- and Skolt Sami) are studied and also compared to the Sami in Sweden and Norway. The survival of the Finnish Sami cancer patients was compared to that of the Finnish general population. A person representing at least 75 per cent of any ethnic subgroup of Sami was classified as Sami. The follow-up has been from 1979 to 2010. The disease mortality among the Northern and Inari Sami was statistically significantly lower, and that of the Skolt Sami higher than that of the general population of Finland. Standardized mortality ratio (SMR) among Northern Sami was 0.88 (95% Confidence Interval (CI) 0.78-0.99), among the Inari Sami 0.85 (0.73-0.96) and among the Skolt Sami 1.20 (1.00-1.41). The mortality from accidents and suicides was significantly increased among Sami men, SMR 1.88 (1.36-2.52) and 1.78 (1.14-2.65) correspondingly. The cancer incidences of the North- and Inari Sami were low. For the North Sami, the standardized incidence rate (SIR) was 0.68 (95% Confidence Interval 0.55-0.82) and for the Inari Sami 0.57 (0.43-0.74). The SIR of Skolt Sami was 0.96 (0.71-1.27) because of the high SIR of stomach cancer, SIR 3.40 (1.47-6.69). The common cancers among the Finnish main population, prostate-, breast- and skin cancers are especially rare among the Finnish Sami. The incidence and the mortality of cancers among the Finnish Sami are rather similar to those of the Swedish and Norwegian Sami, with the exception of the Swedish Sami women, whose incidence was the same as that of the Swedish general population. The survival of the Finnish Sami cancer patients was the same as that of the corresponding cancer patients in the general population. There were no signs of radioactive or chemical pollution in the mortality or cancer incidence results. The living habits and environment of the Sami have changed, and hence also the mortality and cancer morbidity is nowadays more like that of the majority of Finnish and other western populations. They have gone through an epidemiological transition, different subgroups in different times. The traditional Sami living has been a good example of a healthy way of living, except for the risk-taking of Sami men. When looking at the low figures of some cancers, the genetic features of the Sami as a cause for it cannot be excluded.