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  • Stewart, Timo (Helsingin yliopisto, 2015)
    This study analyses Finnish Christian Zionism from the end of the 19th century to the 1960s using the methodology of the history of ideas. It evaluates previous interpretations and investigates how Finns and in particular Finnish Christians related to Zionism and the State of Israel and why many Finnish Christians gave Zionism and the State of Israel a religious significance. The study points to three significant sources of growing Finnish Christian interest in Palestine, Jews and prophecy before Israeli independence. The first was through early visits to Palestine and the travel accounts that ensued. Pastors and theologians were particularly active in seeking out the lands of the Bible and the Fifth Gospel that they saw in it. The second was missionary work, which created a small but influential group of Finnish experts on Palestine. Of the people they encountered in Palestine, the missionaries clearly identified most with the Zionists and conveyed their worldview to their Finnish audiences. The third source was the increasingly prevalent prophecy literature that more frequently and confidently linked Zionism with the fulfilment of Biblical prophecies. This was most common amongst Pentecostals, but soon Lutheran missionaries and Evangelical revivalist followed suit. With the creation of the State of Israel even broadly read Lutheran papers made use of the same interpretive traditions. Interpretations varied in detail, but general allusions to an unspecified connection between Bible prophecy and the State of Israel founded in 1948 become common to the point of not requiring explanations. Even bolder forms of Christian Zionism were never challenged. These interpretations were facilitated until the middle of the 1960s by very favourable popular impressions of Zionism and Israel, in which the national experiences of Finland and Israel were seen to have much in common. In contrast, the voice of the Palestinians was not heard at all. Many Finnish Christians saw the State of Israel as a sign of the times and a miracle from year to year. Zionism and the State of Israel seemed to offer an answer to the question of God s continuing involvement with the world and the significance of the Bible. They were constantly relevant signs, but also seen as proof that settled the question of whether the Bible could be trusted. In the eyes of many Finnish Christians this gave the State of Israel a very special significance indeed.
  • Koskela, Elina (2015)
    Intracranial aneurysms (IAs) affect 2-3% of the population. In Finland, their rupture rate has been exceptionally high. This study aims to evaluate the prevalence and risk factors affecting neuro-ophthalmic findings in patients undergoing treatment for IAs. We also investigate the utility of conventional head computed tomography (CT) in the diagnosis of Terson´s syndrome (TS, vitreous hemorrhage in association with aneurysmal subarachnoid hemorrhage (aSAH)). Patients treated endovascularly or microsurgically for their IAs at the Department of Neurosurgery, Helsinki University Central Hospital, in 2011 prospectively underwent a neuro-ophthalmic examination preoperatively and at 3 days, 14 days, 2 to 4 months, and 6 months postoperatively. Findings suggestive of TS, as independently reviewed by two radiologists, on conventional CT head scans were compared with dilated fundoscopic findings. Participants comprised 121 patients with a ruptured aneurysm and 142 patients with an unruptured intracranial aneurysm (UIA). TS was present on fundoscopy in 13 patients (11%); the overall observed agreement between the two radiologists was 96% (116/121), with a substantial κ of 0.69 (95% CI 0.56-0.82). On average, CT demonstrated sensitivity of 42% and specificity of 97%. Factors independently predicting TS were female gender (OR 5.34, 95% CI 1.05-27.17) and World Federation of Neurosurgical Societies (WFNS) grade (OR 15.05 for grades IV-V vs. I-III, 95% CI 3.07-73.89). For patients with aSAH, the frequencies of a third, fourth, or sixth nerve palsy were 11 (9%; preoperatively), 16 (13%; immediately postoperatively), and 3 (3%; at the last follow-up), compared with corresponding frequencies of 6 (4%), 15 (11%), and 7 (5%) for patients with UIAs. Significant risk factors for postoperative eye movement disorders (EMDs) among patients with UIAs were aneurysm location in the posterior circulation (OR 142.02, 95% CI 20.13-1002.22) and aneurysm size (OR 1.28, for each 1-mm increase in diameter, 95% CI 1.12-1.47). After a follow-up time of 6 months, patients with aSAH presenting with visual field defects (VFDs) for aneurysm- or operation-related reasons numbered 20 (19%); homonymous VFDs were the most prevalent finding, and in logistic regression analysis, they were significantly associated with the Hunt and Hess (H and H) grade (OR 4.45 for grades IV-V vs. I-III, 95% CI 1.21-16.39) and presence of intracranial hemorrhage (OR 8.93, 95% CI 2.14-37.28). By contrast, seven patients (5%) treated for a UIA had VFDs. Poor-grade aSAH (H and H or WFNS grade IV-V) appears to be a strong predictive factor for TS and VFDs. With a high specificity value, conventional head CT scan might prove a useful tool in the diagnosis of TS. Although a common finding in the acute postoperative stage of ruptured and unruptured IAs, EMDs show marked improvement during follow-up.
  • Turunen, Harri (Helsingin yliopisto, 2015)
    I study the importance of variation in the higher moments of macroeconomic and financial quantities. The first essay considers the effects of uncertainty on the fiscal multiplier when the economy has hit the zero lower bound (ZLB) on the nominal rate in a relatively standard New Keynesian Dynamic Stochastic General Equilibrium (DSGE) model. As the ZLB is a very strong form of nonlinearity, the model is solved using a numerical method. Uncertainty in government spending and productivity are modeled as stochastic volatility. Confirming previous research (e.g. Christiano, Eichenbaum and Rebelo, 2011), the multiplier is found to be higher when at the bound, and the effects of volatility shocks are found to be noticeable (e.g. Basu and Bundick, 2015). Uncertainty is found to have an impact on the multiplier: when future spending is uncertain, the multiplier is high, but when future productivity is uncertain, the multiplier is low. The second essay studies whether or not DSGEs are able to generate simulated realizations with realistic third and fourth moments. Many time series in macroeconomics and finance exhibit either excess kurtosis or skewness or both. However, as was shown by Ascari et al (2013), standard DSGEs such as the neoclassical growth model or the model of Smets and Wouters (2007) are unable to produce realizations with reasonable moments, regardless of shock distribution or the order of the Taylor approximation applied. My results however indicate that this is mostly due to lack of nonlinearity in the models, since especially a model with a very strong form of nonlinearity, such as the ZLB, is able to generate non-Gaussian realizations. The third essay considers the pricing of macroeconomic risk. The theory of Merton (1973) implies that there can be other sources of priced risk than the risk associated with the return on the market portfolio and that an appropriate measure for sensitivity of a stock to this risk is the covariance of the return of that stock with the source of that risk. I apply the multivariate volatility model of Engle (2002) to estimate time-varying covariances of US stock portfolios with a variety of US macro time series. The finding is that inflation and unemployment are priced in the market and earn a negative premium, while the growth rate of industrial production and the Case-Shiller house price index are not priced.
  • Koskela, Elina (2015)
    Intracranial aneurysms (IAs) affect 2-3% of the population. In Finland, their rupture rate has been exceptionally high. This study aims to evaluate the prevalence and risk factors affecting neuro-ophthalmic findings in patients undergoing treatment for IAs. We also investigate the utility of conventional head computed tomography (CT) in the diagnosis of Terson´s syndrome (TS, vitreous hemorrhage in association with aneurysmal subarachnoid hemorrhage (aSAH)). Patients treated endovascularly or microsurgically for their IAs at the Department of Neurosurgery, Helsinki University Central Hospital, in 2011 prospectively underwent a neuro-ophthalmic examination preoperatively and at 3 days, 14 days, 2 to 4 months, and 6 months postoperatively. Findings suggestive of TS, as independently reviewed by two radiologists, on conventional CT head scans were compared with dilated fundoscopic findings. Participants comprised 121 patients with a ruptured aneurysm and 142 patients with an unruptured intracranial aneurysm (UIA). TS was present on fundoscopy in 13 patients (11%); the overall observed agreement between the two radiologists was 96% (116/121), with a substantial κ of 0.69 (95% CI 0.56-0.82). On average, CT demonstrated sensitivity of 42% and specificity of 97%. Factors independently predicting TS were female gender (OR 5.34, 95% CI 1.05-27.17) and World Federation of Neurosurgical Societies (WFNS) grade (OR 15.05 for grades IV-V vs. I-III, 95% CI 3.07-73.89). For patients with aSAH, the frequencies of a third, fourth, or sixth nerve palsy were 11 (9%; preoperatively), 16 (13%; immediately postoperatively), and 3 (3%; at the last follow-up), compared with corresponding frequencies of 6 (4%), 15 (11%), and 7 (5%) for patients with UIAs. Significant risk factors for postoperative eye movement disorders (EMDs) among patients with UIAs were aneurysm location in the posterior circulation (OR 142.02, 95% CI 20.13-1002.22) and aneurysm size (OR 1.28, for each 1-mm increase in diameter, 95% CI 1.12-1.47). After a follow-up time of 6 months, patients with aSAH presenting with visual field defects (VFDs) for aneurysm- or operation-related reasons numbered 20 (19%); homonymous VFDs were the most prevalent finding, and in logistic regression analysis, they were significantly associated with the Hunt and Hess (H and H) grade (OR 4.45 for grades IV-V vs. I-III, 95% CI 1.21-16.39) and presence of intracranial hemorrhage (OR 8.93, 95% CI 2.14-37.28). By contrast, seven patients (5%) treated for a UIA had VFDs. Poor-grade aSAH (H and H or WFNS grade IV-V) appears to be a strong predictive factor for TS and VFDs. With a high specificity value, conventional head CT scan might prove a useful tool in the diagnosis of TS. Although a common finding in the acute postoperative stage of ruptured and unruptured IAs, EMDs show marked improvement during follow-up.
  • Fields, Marek (Helsingin yliopisto, 2015)
    The study examines British and American propaganda and cultural diplomacy in Finland during the first decades of the Cold War. As the Cold War intensified in the late 1940s, both Britain and the United States sharpened their informational and cultural activities throughout the world. The general goal of these operations was not only the promotion of culture and the Western way of life , but also the containment of communism. For the distribution of anti-communist propaganda and the projection of culture, the British used printed material prepared by a special Foreign Office unit, BBC broadcasts and operations executed by the British Council, while the Americans relied on material produced by the United States Information Agency (USIA), including Voice of America (VOA) broadcasts. The United States also emphasised the importance of the exchange of people through, for example, the Fulbright Programme. The two Western powers operations were also conducted in exceptional environments such as Finland, in which the country s complex relationship with the Soviet Union meant that the distribution of anti-communist propaganda, for example, through Finnish newspapers was always going to be a sensitive affair. Although the British and Americans knew that the majority of Finns resented communism, they were constantly worried about finding the appropriate methods to promote their message to the broader masses. In addition to informational and cultural activities, Britain, and in particular the United States, through the CIA, also supported the anti-communist work of some Finnish organisations. The general objective of this study is to discover the nature of British and American propaganda and cultural diplomacy operations in Finland. The focus lies on their breadth, closer traits and the channels used in their execution. Furthermore, the aim is to discuss how certain characteristics of Finnish society, such as the widely accepted practice of self-censorship, affected the Western powers operational methods. Some emphasis is also placed on examining the effects of these activities and comparing the two campaigns with each other. The study is predominantly based on archived documents of the British Foreign Office, the British Council, the BBC, the US State Department and the USIA. Furthermore, records filed at numerous Finnish archives provide valuable information about the Western operations' distribution processes, while certain Finnish newspapers and magazines make up essential sources for the examination of propaganda content. This study comes to the conclusion that both Britain and the United States carried out reasonably extensive propaganda and cultural diplomacy operations in Finland in the first Cold War decades, and as a consequence supported the country's independence and attachment to the West to a greater extent than has been previously recognised. The placement of British anti-communist articles in Finnish newspapers was especially successful in the early 1950s. The BBC Finnish Service broadcasts, which included anti-communist output, were also rather warmly welcomed by the Finns as were the operations of the British Council, despite its fairly slim resources. In addition to press operations, the Americans were able to influence a considerable number of Finns especially through USIA films, television programmes, the exchange of people and other cultural operations. The Finnish political crises of the late 1950s and early 1960s restricted Western activities and forced the countries to find new methods of operation. Despite this, the impact British and American informational and cultural activities had on Finnish society can be regarded as substantial.
  • Juvonen, Tarja (Nuorisotutkimusverkosto/Nuorisotutkimusseura, 2015)
    This doctoral dissertation examines the construction of agency among young people on the threshold of adulthood who are, or risk being, socially excluded. Adolescence involves many choices and decisions that impact later life, such as leaving the parental home and transitioning to independent living, establishing financial independence, making decisions about education and careers, and starting a family. An essential part of adolescence is the pursuit of autonomy and finding one s place in the adult world and its social order. Adolescents who cannot attain these goals are easily rejected as non-adults who fail to meet social expectations for different age groups and life stages. This rejection has the effect of excluding them from full citizenship. Emerging adulthood is particularly challenging for adolescents living in vulnerable circumstances who feel they are not yet ready or able to make decisions about their life. The choices they must make may also involve options that adolescents find dissatisfactory or difficult to handle. This dissertation explores young people s agency from a relational perspective, emphasising the social and contextual basis of agency rather than its individualist foundation. The relational perspective relates to autonomous agency primarily because the construction of autonomy can require the context of human relationships and mutual dependency. In contrast, an emphasis on agency that stresses individuality and independence may engender feelings of loneliness and insecurity as well as of going through the motions of a life with no true sense of meaning. People who work with and support adolescents should also bear in mind that wellbeing depends substantially on the ability of individuals to connect with others. A lack of relationships and a feeling of loneliness characterise the lives of many socially excluded and disadvantaged people. The relational perspective is particularly obvious among those without relationships. This dissertation employs a constructionist philosophy and a relational viewpoint. It focuses on outreach work and, more broadly, the service network that strives to help young people. The research data comprise documents from 2001 on street-based youth work, recordings from the development seminar of a working group, interviews with young people encountered during outreach work in 2010 and 2011, the working group s focus group discussions and recorded client visits. The four scientific articles included in the dissertation use content analysis and the voice-centred relational method to consider the themes of control, the construction of autonomous agency and the concept of having-to as it pertains to young people. The first of the articles discusses elements of control in outreach work. The three other articles explore the theme of agency and the associated relational perspective. The second and third articles examine the construction of young people s autonomous agency, first in tense meetings with outreach workers and the authorities, and then from the perspective of the challenges of independent living. The fourth article analyses the construction of adolescents agency from the viewpoint of cultural expectations, particularly the concept of having-to. The results of the articles inform the concluding section, which addresses the two research questions: How is the autonomous agency of young people constructed in the tense relationship of social control, professional support and having-to, and how is the relational approach connected to the construction of young people s autonomous agency? The results demonstrate that various social structures and service systems provide a framework for the construction of agency, particularly among young people who are or risk being socially excluded. Even the most autonomous individual must deal with certain have-to s and is the subject of control through both societal and social relationships. Both control and culturally defined having-to are factors that define the limits of agency based on freedom and choices. As clients of outreach work, adolescents who are or risk being socially excluded must negotiate with various societal representatives about the limits of their autonomy and range of choices and must respond to the expectation of stronger agency. Young people s experience of their agency and place in the world depends partly on social ties, relationships and the various resources available to them. Strengthening the agency of young people encountered through outreach work requires long-term partnership and support to help them succeed in the challenging transition to adulthood, which is limited by having-to. Interaction in outreach work, the parties meetings or failures to meet each other, plays an important role. Those involved in such work have the power to profoundly affect young people s lives as well as their ideas of themselves and their significance. External compulsion or decisions made without the adolescents contribution do not improve their self-understanding or autonomous agency, which are important to any definition of a good life.
  • Pierides, Georgios (Helsingin yliopisto, 2015)
    Repair of Inguinal hernia ranks among the most common surgical procedures worldwide. Large patient numbers necessitate efficacy and sophistication in the procedure. A novel self-attaching composite mesh (Parietene ProGrip , Covidien, Dublin, Ireland) and a sutured light-weight mesh (Parietene Light , Covidien) were compared double-blinded in 394 randomized patients. Outcomes were collected with a symptom diary and telephone contact during immediate convalescence and by clinical assessment one year after the operation. Outcomes up to 5 years after application of either a sutureless bilayer mesh (Prolene® Hernia System, Ethicon Endo-Surgery, Somerville, MA, USA) or standard tension-free repair (Surgipro , AutoSuture, Norwalk, CT, USA) were collected with a postal questionnaire, telephone contact, and clinical assessment in 300 patients. Health-related quality of life before and after open inguinal hernia repair was measured by RAND 36-Item Health Survey 1.0 (RAND Corporation, Santa Monica, CA, USA) in altogether 159 patients aged at least 65 years and 373 patients aged under 65 years. The results were compared within and between age groups as well as with the values from the general population. A database of 932 open mesh-based hernia repairs was subjected to regression analyses for factors predicting the presence of chronic posthernioplasty pain or more intensive postoperative inguinal pain. Outcomes between the self-attaching mesh and sutured light-weight mesh were equivalent. Applying the self-fixating mesh was faster (34 min vs. 42 min, p less than 0.001). Median sick leave was 2 weeks. At one year, 4.7% of patients perceived pain while resting, 2.0% had pain interfering with every-day life, 25.4% experienced discomfort, and 9.5% had losses in sensation in the operated groin. One recurrence (0.3%) was encountered. Sensory dysfunction of groin skin was rarer 5 years after the operation with the bilayer device than after tension-free repair (5.0% vs. 13.9%, p = 0.022). Other long-term outcomes did not differ. Occurrence of chronic pain diminished from 6.8% at 2 years to 1.3% at 5 years. Cumulative recurrence rate was 1.3%. Discomfort was present in 25.2% of patients, but 92.7% of patients were satisfied with the operation. RAND-36 showed similar improvement in both the elderly and younger patients after open inguinal hernia repair. Complication rates between the age groups did not differ. Higher preoperative VAS score (p less than 0.006), mid-weight mesh (p = 0.012), complications (p = 0.002), recurrence (p = 0.005), and younger age (p = 0.027) predicted chronic pain after open inguinal hernia repair. Higher VAS scores for inguinal pain were predicted by higher preoperative VAS scores (p less than 0.001), heavyweight meshes (p = 0.046), complications (p = 0.016) and recurrence (p = 0.001).
  • Ahlqvist, Kati (Helsingin yliopisto, 2015)
    Somatic stem cell (SSC) dysfunction is a common feature of mouse models of premature ageing, most of which are created by disturbing nuclear DNA repair, damage recognition or ROS defence. The SSC dysfunction leads to decline in SSCs ability to maintain tissue homeostasis resulting in degeneration and ageing. The role of mitochondria or mitochondrial DNA (mtDNA) integrity in SSC homeostasis is unknown. Mutator mice, which harbour proof-reading deficient mitochondrial DNA polymerase gamma, accumulate mtDNA point mutations and develop a premature ageing phenotype, whereas Deletor mice, a model for adult-onset mitochondrial myopathy, accumulate mtDNA deletions and have a normal lifespan. Accumulation of mtDNA mutations and respiratory chain (RC) defect are thought to contribute to ageing process, and the Mutator mouse was the first experimental evidence supporting this theory. The aim of this thesis work was to elucidate somatic stem cell function in both Mutator and Deletor models, to investigate whether SSC dysfunction might explain the premature ageing phenotype. Our results show that the Mutator mouse accumulates mtDNA point mutations in SSC compartments, leading to changes in SSC function already during embryonal development. Deletors do not accumulate mtDNA deletions in SSCs and have normal SSC function. This suggests that premature ageing of Mutators is due to disrupted SSC homeostasis. Hematopoietic progenitors are especially sensitive to mtDNA mutagenesis, which may partly explain the high prevalence of anemia without iron deficiency seen in elderly humans. In this thesis, a novel mechanism for mitochondrial anemias is presented. MtDNA mutagenesis in hematopoietic precursors modifies signaling which causes aberrant iron loading and delayed mitochondrial clearance from maturing erythrocytes. In consequence, Mutator mice have abnormal circulating erythrocytes carrying mitochondria, which are prematurely captured and destructed by splenic macrophages, leading to iron accumulation in spleen. Enhanced destruction of newly-born erythrocytes and concurrently depleted iron stores in the bone marrow make compensatory reticulocytosis inefficient. Delayed mitochondrial clearance was also detected in a human patient with Pearson s syndrome, a rare disorder caused by a sporadic single large mtDNA deletion and causing life-threatening anemia. Treatment with N-acetyl-L-cysteine (NAC), a glutathione precursor and a ROS scavenger, was able to rescue the SSC phenotype during embryogenesis and to normalize iron loading in vitro, suggesting that mtDNA mutagenesis affects ROS signaling. However, NAC could not prevent anemia in vivo, nor rescue delayed mitochondrial clearance in vitro. This indicates that signaling in the SSC compartment is different during embryogenesis than in adulthood. This thesis shows that mtDNA integrity is essential for SSC function. Further, a new and essential role is proposed for mitochondria in regulating their own removal from maturing reticulocytes.
  • Rahkila, Riitta (Helsingin yliopisto, 2015)
    Ks. RahkilaAbstract.docx
  • Tuppurainen, Eeva (Helsingin yliopisto, 2015)
    Lumpy skin disease (LSD) is an economically important pox disease of cattle and Asian water buffalo caused by a lumpy skin disease virus (LSDV), a member of the genus Capripoxvirus. The disease occurs in Africa and the Near East, causing substantial economic losses for the whole cattle industry in affected countries. The disease is characterized by skin nodules, high fever, lymphadenopathy and loss of production of infected animals. Transmission of LSDV is known to occur mechanically by a variety of blood-feeding insects and to a lesser extent through contaminated feed and water, semen or via direct contact. The disease is classified as notifiable by the World Animal Health Organization (OIE). Currently, Finland is free of LSD. The general aim of the study was to investigate the vector capacity of common sub-Saharan tick species, Rhipicephalus appendiculatus, Amblyomma hebraeum and Rhipicephalus decoloratus for LSDV in cattle via mechanical, intra/transstadial or vertical routes. The specific aim was to investigate if mechanical transmission occurs by R. appendiculatus males and transovarial by R. decoloratus females. As many of the infected animals become viraemic without showing skin lesions, it was investigated if feeding on healthy looking skin of viraemic animals was sufficient for successful mechanical transmission. The final objective was to investigate if the virus was able to grow in vitro in Rhipicephalus spp. tick cell lines. In addition, the presence of the virus or viral DNA in ticks collected from naturally infected animals was investigated. Two animal experiments, using naïve cattle and laboratory-reared ticks were conducted at the Department of Veterinary Tropical Diseases, University of Pretoria, South Africa and samples were tested at the Pirbright Institute, United Kingdom. For the first time, transmission of LSDV (or any pox virus) by hard ticks was demonstrated to occur mechanically/intrastadially by R. appendiculatus males and vertically by R. decoloratus females. Feeding directly on skin lesions was not necessary for transmission of the virus between infected and naïve cattle. No evidence of viral replication in Rhipicephalus tick cell lines was obtained. The presence of the viral DNA was detected in Rhipicaphalus, Amblyomma and Hyalomma ticks collected during natural LSDV outbreaks in South Africa and Egypt. In 2013 - 2015 LSDV is spreading in the Near East at a scale never seen before, posing a threat to the European Union, Caucasus region, Afghanistan and Pakistan. In order to control and eradicate the disease, it is fundamental to understand the role of different arthropod vectors and their importance in the field. The presence of infected tick eggs or different instars in the environment underlines the importance of effective prophylactic tools and sufficient vaccination coverage. In addition, this study contributes to the recommendations set for the international trade of live cattle from affected countries.
  • Anttila, Erkko (Helsingin yliopisto, 2015)
    Suburban century: Local community in the working-class suburbs of Helsinki in the twentieth century. The study discusses working-class suburbs that sprang up outside Helsinki in the early twentieth century and their change into affluent middle-class suburbs in the second half of the century. The focus of the study is on local community life and its change in the studied suburbs. Moreover, the study discusses how the suburbanites' ways of life and their relationship to their social and physical surroundings changed due to modernization in the latter half of the century. The research data consist of historical documents and personal reminiscences of residents that deal with topics such as neighbourhood life, practices of everyday life and local clubs and associations. In the first half of the twentieth century the working-class suburbs under study (e.g. Malmi, Pakila, Tapanila and Leppävaara) were fairly rural communities, which were characterized by their close-knit community life, widely practiced subsistence gardening and animal husbandry and numerous local small businesses. Another important characteristic of these suburbs was the central role played by local formal and informal organizations in solving problems of everyday life and in organizing leisure activities for local residents. This manifested itself, for example, in the form of local road maintenance associations, voluntary fire brigades and community festivals. Such practices indicated that the residents of these suburbs were in many ways functionally dependent on their local suburban community. Soon after the Second World War the way of life in the suburbs under study began to change towards a more privatized way of life. Behind this change was the growing prosperity of the post-war era, technological progress and the strengthening of extra-local networks and organizations. These factors diminished the suburban residents' dependence on local community networks and widened their horizons beyond narrow local circles. The suburbanites actively contributed to this change by lobbying state and municipal authorities to hasten the modernization of local infrastructure and public services. By the late twentieth century the working-class suburbs under study had changed into modern middle-class suburbs which were characterized by a high standard of living, a privatized way of life and the residents' dependence on extra-local networks and organizations. The local social and economic practices that were typical of the first half of the century had by now mostly disappeared. Instead, local community action now focused on maintaining the peace and quiet of the residential area. There were also aspirations to revive some aspects of the old community life. However, unlike in the local community networks of the early twentieth century, participation in these new forms of community building was entirely voluntary.
  • Maanavilja, Liisa (Finnish Society of Forest Science, Natural Resources Institute Finland, Faculty of Agriculture and Forestry of the University of Helsinki, School of Forest Sciences of the University of Eastern Finland, 2015)
    Drainage to increase timber production has drastically decreased the area of undrained spruce swamp forests in northern Europe. In restoration by rewetting, drainage ditches are blocked to restore the original hydrology and, ultimately, the structure, function and ecosystem services of undrained boreal spruce swamp forests. This study quantifies the restoration success of rewetting regarding plant community composition, moss community carbon assimilation potential, Sphagnum biomass production and surface peat biogeochemistry, and aims to determine the main controls of success. The study sites comprised 18 rewetted, nine undrained and nine drained spruce swamp forests in southern Finland, complemented by sites in the umava Mountains, Czech Republic. Drainage had taken place decades prior; the rewetted sites varied in their rewetting age from 1 to 15 years. The results show that rewetting has to raise the water table above a threshold to initiate any changes in the drained ecosystem. If the threshold is crossed, the changes that occur will be rapid. Two strands of development emerged throughout the different components of the ecosystem: development towards the undrained reference state and development towards a new direction, different from both the undrained and the drained state. Rewetting created favourable conditions for Sphagnum photosynthesis. Sphagnum mosses recovered in cover and biomass production rapidly. The new growth started the accumulation of the porous surface organic matter layer characteristic of mires, which increased microbial decomposition activity in the surface organic layer towards undrained levels. Meanwhile, rewetting applied on the compacted, physicochemically altered peat created wet, unstable hydrological conditions, which increased the cover of opportunistic plant species in the understory and caused high NH4 mobilization and CH4 production in the surface organic layer. Demanding spruce swamp forest species were lacking at the rewetted sites, but rewetting was successful in restoring the common species and directing the ecosystem towards mire-like functioning.
  • Luostarinen, Tapio (Helsingin yliopisto, 2015)
    Cervical cancer is the 4th most common cancer in women. In its carcinogenesis human papillomavirus (HPV) 16/18 are most important. HPV6/11 cause benign lesions. A small proportion of HPV infection(s) develop into cancer. Therefore, joint effects between HPVs and putative co-factors, Chlamydia trachomatis and smoking, are of interest but largely open. The aims of this work were to understand joint effects of infections with 1) HPV types, 2) HPVs and C. trachomatis, and 3) order of these infections in the carcinogenesis. For the 1st two aims, two case-control studies were nested within cohorts of Nordic biobanks. 1st linkage to cancer registers identified 182 cases of invasive cervical cancer (ICC, 148 squamous cell carcinomas, SCC) with prediagnostic sera until 1994. 2nd linkage with a longer follow-up until 2002 comprised 604 new ICC cases. Incidence density sampled controls were individually matched for age at serum sampling, sample storage time and region. For the 3rd aim, a case-control study in a serial setting was nested within a cohort of Swedish women participating in a cervical cancer screening programme in 1969 1995, and 118 ICCs with age and sampling-time-matched controls were identified. Finally, a case-cohort study in the Finnish Maternity Cohort was based on women with two pregnancies within 5 years. The women were followed on average for 4.8 years, from the 2nd pregnancy sample until the end of 2004. During follow-up, 490 women were diagnosed with cervical high-grade precancer. A comparison subcohort of 2796 women was randomly sampled from age and calendar time strata. IgG antibodies to HPV 6/11/16/18/31/33/45 capsids, and C. trachomatis were determined by ELISA. Serum cotinine, a marker for recent smoking, was measured by immunoassays. HPV and C. trachomatis DNA in smears and biopsy specimen were examined by PCR. HPV DNA-positive specimens were typed. Rate ratios were estimated by conditional logistic or proportional hazards regression. Misclassification of HPV serology was corrected for. In the 1st study, we found no excess risk of cervical carcinoma among women seropositive for both HPV16 and HPV6/11. In the 2nd study, the excess risk was 2.4-fold, but the joint effect was again significantly smaller than the expected joint effects. Finally, if infection with HPV6 preceded infection with high-risk HPV31, there was no material excess risk of in situ cervical carcinoma. The smaller than expected joint effect between HPV types was probably due to a cell-mediated immune response to past, natural HPV6/11 infection, of which the serum antibodies were a surrogate. The risk of ICC was highly increased not only among women whose 1st smear was HPV DNA-positive but also among C. trachomatis DNA-positive women. The risk was even higher among HPV or C. trachomatis DNA positives both at the start and end of follow-up. The risk of in situ cervical carcinoma was highly increased among women whose HPV18/45 and C. trachomatis infections were virtually concomitant. The risk of SCC was increased related to C. trachomatis, after adjusting/stratifying for HPV. These results support early HPV vaccination in cervical cancer prevention. C. trachomatis should not be ignored in the preventive efforts against cervical cancer.
  • Helmiö, Päivi (Helsingin yliopisto, 2015)
    TOWARDS BETTER PATIENT SAFETY: The WHO Surgical Checklist in Otorhinolaryngology More than one-half of adverse events in health care are related to surgery. Surgical patient injuries account for about 80% of patient injuries in otorhinolaryngology (ORL). The World Health Organisation (WHO) has developed a Surgical Safety Checklist to prevent errors in the operating theatre. Its use has been shown to reduce complications and mortality. The aims of the present study were to identify errors that may underlie those patient injuries that occur in operative ORL, to assess the effects of the WHO checklist on working processes in the operating theatre, including compliance, and to evaluate how it would fit into the specialty. Data of the patient injuries that were sustained during treatment by the ORL specialty between the years 2001 and 2011 were obtained from a search of the Finnish Patient Insurance Centre registry. The causes of the injuries were analysed, and whether the WHO checklist could have prevented the error was evaluated. The checklist was implemented in four Finnish hospitals as a pilot in 2009. A prospective before-versus-after-intervention study was conducted with a questionnaire for OT personnel in these four hospitals to evaluate the checklist. The checklist was subsequently implemented for regular use in the operative unit of the Department of Otorhinolaryngology of Helsinki University Central Hospital. After one-year of use, compliance and user attitudes were analysed by using data obtained from the operations database and a survey of operative ORL personnel. In the 10-year study period, 188 patient injuries were associated with operative ORL. A total of 142 (75.5%) of these injuries occurred due to errors that were made in the operating theatre, and in 125 cases (66.5%) a manual error in performing the surgery was the primary cause of the injury. Six injuries (3.2%) were caused by wrong site surgery. An error had some degree correspondence with a WHO checklist item for 18 injuries (9.6%) and it was determined that 9 of these injuries (4.8%) could have been prevented had the checklist been correctly used. The implementation of the checklist enhanced the communication between the surgical team members, improved verification of the patient s identity and of the correct operation site. Checklist compliance was 62.3% during first year of use. It was considered easy to use and the Safety Attitude Scores of the personnel were found to be on a high level. All check items on the list were considered important for ORL. However, a more compact checklist for outpatient surgery was requested. Patient injuries in ORL were strongly related to surgery. The WHO Surgical Safety Checklist seems to be a beneficial tool for preventing errors ORL and is highly relevant for the specialty.
  • Lehtinen, Miia (Helsingin yliopisto, 2015)
    Background: Worldwide, the leading cause of morbidity and mortality is heart failure. It is most often caused by coronary artery disease (CAD) and myocardial infarction (MI), which causes death of myocardial tissue. Although coronary interventions such as coronary bypass graft surgery (CABG) can restore blood flow to ischemic areas, and established pharmacotherapy for heart failure exists, no treatment available in the clinics can regenerate the dead cardiomyocytes. For surgical treatment, patients with heart failure represent a challenge, as they are prone to surgical complications, and suitable preoperative imaging modalities to assess possible benefit from surgery are few. Aims: Cell therapies have recently emerged as a possible alternative for treating heart failure. We wanted to explore the capacity of autologous bone marrow mononuclear cells to regenerate myocardial tissue as an adjunct to CABG. The aim was to assess the therapy s safety and detect the cells possible effects on cardiac function and viability. In addition, we investigated whether it would be possible to predict benefit from CABG in these heart-failure patients with 3-vessel CAD with the aid of combined nuclear imaging data. For this, we used 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to measure cardiac viability, and 99m-technetium-tetrofosmin single-photon emission computed tomography (99mTc-SPECT) to measure cardiac perfusion. Methods: Between 2006 and 2010, we enrolled 104 patients scheduled for CABG who suffered from CAD and ischemic heart failure. Preoperatively, pharmacotherapy was optimized, after which 39 patients still had left ventricular ejection fraction (LVEF) ≤45%. These patients received injections of bone marrow mononuclear cells (BMMCs) (N=20) or vehicle (N=19) intraoperatively into the myocardial infarction border area in a randomized and double-blind manner. During surgery and at the intensive care unit (ICU), the patients hemodynamics, arterial blood gases, systemic venous oxygen level, blood glucose, acid-base balance, lactate, hemoglobin, body temperature, and diuresis as well as medications needed were monitored and recorded every four hours throughout the first postoperative 24 hours. BMMC effects on the heart were evaluated by use of pre- and 1-year postoperative cardiac magnetic resonance imaging (MRI), FDG-PET, and 99mTc-SPECT and by measuring pro-B-type amino-terminal natriuretic peptide (proBNP) levels. As we later decided to extend the follow-up, these same variables, except for nuclear imaging data, as well as current quality of life were measured at a late follow-up visit in 2013. For this, we could contact 36 of the 39 patients recruited for the original study, of which 30 participated in the extended follow-up. Preoperatively, we also analyzed FDG-PET and 99mTc-SPECT data by using three quantitative techniques with a software tool to measure defects with hypoperfused but viable and non-viable myocardium in 15 control patients. One method used solely PET, two others combined PET and SPECT at different thresholds. As a reference, we used change in LV function and volume by MRI. Results: During the first-year follow-up, improvement was similar in both groups in LVEF, the predefined primary end-point measure (P=0.59), and similar improvement also occurred in local wall thickening (WT) (P=0.68) in the injected segments. Neither changes in viability by PET and SPECT and levels of proBNP differed between these groups. Myocardial scar size by MRI in injected segments rose by a median of 5.1% in the control group (interquartile range, IQR -3.3 to 10.8) but fell by 13.1% in the BMMC group (IQR -21.4 to -6.5) (P=0.0002). During surgery and ICU stay, hemodynamics, arterial blood gases, systemic venous oxygen level, blood glucose, acid-base balance, lactate, hemoglobin, body temperature, and diuresis and levels of medications administered were similar between the study groups. For the extended follow-up, the median period was 60.7 months (IQR 45.1 to 72.6). No statistically significant difference was observable in change in proBNP values or in quality of life between groups. LVEF in both groups remained similarly improved (P=0.647), as also did WT (P=0.434). For controls, scar size in injected segments increased with a median of 2% (IQR -7 to 19); for BMMC patients it remained reduced with a median change of -17% (IQR -30 to -6) (P=0.011). When assessing the benefit-predictive capacity of the two techniques combining FDG-PET and 99mTc-SPECT with different thresholds and one technique using FDG-PET data only, no correlation appeared with preoperative PET- or PET-SPECT-derived viable or non-viable tissue, when compared with global functional outcome (change in LVEF) or local change in WT. Conclusions: In patients with 3-vessel disease and heart failure, the three techniques using SPECT perfusion and PET viability imaging data failed to predict the functional benefit received from CABG. Thus, these imaging modalities may provide no additional advantage to preoperative patient selection, which should be considered when planning treatment for this patient group in the clinics. In the treatment of chronic ischemic heart failure, during surgery and perioperatively in the ICU, both intramyocardial BMMC and placebo injections appear safe. Although failing to affect cardiac function, combining intramyocardial BMMC therapy with CABG can sustainably reduce scar size.
  • Kivilaakso, Katri (Helsingin yliopisto, 2015)
    This study explores Pirkko Saisio s novel, Kainin tytär (Cain s Daughter, 1984) published under her own name, and her later novels that were published under different pseudonyms. Kiusaaja (Tornmenter, 1986), Viettelijä (Seducer, 1987) and Kantaja (Bearer, 1991) were published under the male pseudonym Jukka Larsson, and Puolimaailman nainen (A Demimonde, 1990) and Kulkue (Procession, 1992) were published under the female pseudonym, Eva Wein. My research investigates the poetics of gender difference constructed by these works, when considered in particular from the three perspectives of authorship, intertextuality and narrative structure. The novels are contextualized within Finnish feminist-oriented research and discourse on women s literature of the 1980s. During the spring of 1985, author Pirkko Saisio took part in a seminar on research in women s literature held at the University of Turku. This seminar addressed issues of research from feminist perspectives that were typical of the period, such as the different receptions of work by male and female writers, and the possible differences between literature written by men and women respectively. Pirkko Saisio was aware of feminist literary discourse of the 1980s and, as demonstrated in the present study, she also contributed to the discourse by writing under both male and female pseudonyms. The theoretical underpinning of the present study is feminist literary research. I interpret Saisio's switching from one pseudonym to another as the author commenting on the gender debates from outside the binary logic of male and female. From her borderline position, she worked not as a female or male author, but as a bit of both, or neither. The author's struggle to create a perspective beyond women's literature is precisely what makes Pirkko Saisio a lesbian feminist writer. The novels' intertextual references need to be contextualized within the literary discourse at the time of publication, defining the relationship of Saisio s Kainin tytär and her pseudonym novels with the literary tradition. The different relationships of male and female writers to this tradition were among the key issues of feminist literary discussion in the 1980s. Saisio s novels under different pseudonyms share a number of intertexts that are important for interpreting all of them and assemble the six novels into a whole. The main intertexts addressed in this study contain explicit or implicit statements on gender difference or the meaning of gender. Therefore analyzing the intertextual references open up the thematization of the problematic of gender in the novels. The novels of Saisio, Larsson and Wein also shared certain thematically central structural elements repeated from one work to another, such as a cyclical chronological structure, embedded narratives and recurring motifs. Pirkko Saisio s, Jukka Larsson s and Eva Wein s novels did not respond to the discussion on women s literature of the 1980s in any unequivocal way. Writing as Wein and Larsson, Saisio created a unique literary output that responded polemically to the literary debate of its time of publication, testing the boundaries and definitions of not only authorship and reception but also of literary production and the literary work . Keywords: author, authorship, gender, poetics, intertextuality, feminist narratology, feminist literary research, lesbian author, lesbian
  • Itkonen, Juha (Bank of Finland, 2015)
    Climate change is one of the greatest market failures of our time. This thesis consists of three essays in which we study the economics of climate change using networks as a theoretical framework. In the first essay, we discover flaws in the foundations of a recent strand of literature estimating the carbon Kuznets curve (CKC). The CKC hypothesizes that carbon dioxide emissions initially increase with economic growth but that the relationship is eventually reversed. The recent literature attempts to estimate the CKC by adding energy consumption as a control variable. Due to model misspecifications related to the econometric methodology and database definitions, the results are biased to support the existence of a CKC. Consequently, the literature underestimates the need for climate policies. In the second essay, we study how social networks might help to explain why differences of opinion about climate change persist across segments of the lay public despite the scientific consensus. To do this, we programmed a Facebook application that collected survey data on concerns about climate change and network data on friendships. We found that respondents tend to have friends with similar concerns as their own, the unconcerned respondents have fewer friends, and any two respondents who disagreed about the seriousness of global warming were less than half as likely to be friends. The results indicate that the structure of the social network may hinder changes in opinions, explaining why opinions persist despite the scientific consensus. The results suggest that the communication of climate science could be improved by strategies that aim to overcome these network effects. In the third essay, we study permit markets which are connected by a network of links. A link allows participants of one emissions trading system to use permits of other systems. In a linked network of markets, foreign regulators can influence domestic policy outcomes even without a direct link. We apply graph theory to study these dependencies between markets to determine who exactly can affect domestic emissions and prices. We characterize the equilibrium's dependency structure assuming perfect competition and an exogenous trading network. The results help to avoid unexpected foreign interference with domestic policy outcomes and to secure the effectiveness of climate change policies.
  • Kerola, Anne (Helsingin yliopisto, 2015)
    Rheumatoid arthritis (RA) is associated with a substantially increased risk for cardiovascular (CV) morbidity and mortality. Along with their CV burden, RA patients are at increased risk for other comorbidities such as hypothyroidism and depressive symptoms. The aim of this work was to evaluate the prevalence of CV comorbidities and hypothyroidism among RA patients in comparison to those of the general population at the time of RA diagnosis. We also aimed to determine, among patients with early RA, the contribution of psychiatric and CV comorbidities as causes of long-term work disability (WD). Lastly, we assessed CV mortality rates in early RA. Between 2000 and 2007, all patients diagnosed with RA in Finland were possible to identify from a Finnish nationwide register on special reimbursements for medicine expenses. The same register provided information on the presence of comorbidities antedating RA diagnosis. From the pension registers, we retrieved data on permanent or temporary disability pensions. Causes of death were obtainable until the end of 2008. We compared the main outcomes, that is, the prevalence of comorbidities at RA diagnosis, the incidence of comorbidity-related disability pensions, and CV mortality rates to those of the age- and sex-specific Finnish population, and calculated standardized rate, incidence and mortality ratios (SRRs, SIRs, and SMRs). In a population of 7,209 RA patients, the risk of having coronary heart disease (CHD) at RA diagnosis was slightly elevated, the SRR (95% CI) being 1.10 (1.01 1.20). The SRR for levothyroxine-treated hypothyroidism at RA diagnosis was 1.51 (1.35 to 1.67). SRR was highest, almost 2.5, among women with RA aged 20 to 49, the excess prevalence of hypothyroidism decreasing steadily and fading in older age groups. From 2000 to 2008, of 7,831 RA patients, 1,095 were granted a disability pension. The 9-year cumulative incidence of WD resulting from RA was 11.9%, from a psychiatric comorbidity 1.3%, and from a CV disease 0.5%. SIR of WD resulting from CV disease was 1.75 (1.23 to 2.51) and SIR of WD resulting from psychiatric disorders was 0.99 (0.80 to 1.23). By the end of 2008, of 14,878 RA patients, 1,157 had died, 501 (43%) from CV causes. The SMR in the entire RA cohort was 0.57 (0.52 0.62). To conclude, the risks for CHD and hypothyroidism were already higher among RA patients at RA diagnosis, highlighting the importance of CV risk detection and management and of vigilance for hypothyroidism. Psychiatric and CV comorbidities were the primary causes of long-term WD much less frequently than was RA itself; the risk for WD due to CV disease, however, was higher in RA than in the general population. During the era of modern treatment regimens for RA, the risk of CV death during the early years of RA was not elevated. All these findings together stress the importance of recognizing, preventing, and targeting comorbidities in RA, already in the early years of the disease.
  • Nylén, Tua (Helsingin yliopisto, 2015)
    General patterns and processes of the unique land uplift beaches are still insufficiently understood. Advanced modelling methods and large homogeneous datasets provide novel opportunities to analyse spatio-temporal environmental processes. This doctoral thesis aims at expanding on the knowledge of the beach and adjacent coastal dunes as an ecogeomorphic system. More specifically, the thesis aims at answering: (1) which abiotic, biotic and temporal factors are the main determinants of substrate and vegetation properties, (2) what are the effects of the main drivers on substrate and vegetation properties, (3) how temporal processes interact with main spatial drivers in determining species richness and (4) how these effects differ between functional groups representing different adaptive strategies? Two advanced statistical methods, boosted regression trees and generalised linear mixed models, are utilised to analyse the effects of multiple factors on substrate and vegetation. My results demonstrate that substrate properties vary stronger along regional than local environmental gradients. The main drivers of textural properties are parent material and shore exposure, while organic properties are also determined by the local disturbance regime. Vegetation is mainly controlled by time, disturbance, productivity and biotic interactions. Specialist species richness and distribution are also influenced by habitat patch size and connectivity. The study highlights three mechanisms in shaping the mosaic of vegetation patterns: biotic interactions (i.e. competition and facilitation), the interplay of spatial and temporal processes and functional group (or species-) specific responses to environmental drivers. The doctoral thesis contributes to understanding the components of the ecogeomorphic beach system by identifying the main drivers of substrate and vegetation. Particularly, I demonstrate the variety of ecologic responses and the importance of dominant species in shaping vegetation assemblages. Furthermore, the feasibility of extensive homogeneous datasets and advanced modelling methods are demonstrated in analysing beach processes. Thus, the thesis may serve as one step towards a more in-depth understanding of the complex beach system and provide new methodology for further research. This knowledge is vital to the conservation of beaches that are unique landscapes and considerably contribute to biodiversity but are subject to multiple land use pressures.
  • Paalanen, Tommi (Sexpo-säätiö, 2015)
    The topic of the dissertation is applying of liberal sexual ethics to sexological work with clients, sexual politics and jurisprudential problems. The work consists of an introduction and six articles that look into 1) ethical challenges and tools in therapeutic practice concerning sexuality, 2) the ethical basis of sexuality counselling and utilizing ethics in working with clients, 3) societal and ethical dimensions of women s sexual power, 4) the meaning of objectification to the ethics of pornography, 5) legislative problems and consequent ethical questions caused by child pornography, and 6) the ethical justification of criminalizing sadomasochistic sex and violent pornography. The introduction presents philosophical background for the articles: John Stuart Mill s ethical liberalism and the liberal tradition built on it, including the concepts of liberties and rights, which compose the most central ethos of modern sexual culture. The philosophical basis of liberal sexual ethics is built on egalitarian social philosophy, ethical neutrality of sexual acticity and rejection of paternalism and moralism as liberty-limiting principles. The articles are concerned with questions about supporting freedom and autonomy in helping professions and justifying limiting them in the society. Each article looks into the questions within their own context and thus expands into necessary theoretical backgrounds, arguments, questions and consequences in legal philosophy, criminalization theory, ethical basis of helping professions and sexual politics. The articles share a question about, how liberal sexual ethics support sexual wellbeing of individuals in different contexts. A shared result emerges: prevailing practices should be consistently liberalized in professional ethics and policies concerning equality, sexuality and criminal issues. All of these fields nurture practices that are illiberal, inconsistent and moralist due to their historical and cultural contexts, and thus impede the highest possible realization of sexual rights and well-being.