Doctoral dissertations

Recent Submissions

  • Tornberg, Sara (Helsingin yliopisto, 2020)
    Background Kidney cancer is the 12th most common malignancy worldwide, accounting for over 400,000 new cases in 2018 (1). As renal cell carcinoma (RCC) incidence and mortality, as well as treatment patterns, vary widely in Europe, to plan strategies for the future, we need to comprehend the current situation in Finland. Accurate prognostic tools are essential for detecting cancers amongst the tumours noted in imaging studies and choosing optimal treatment for cancer patients. The Tumor, Node, Metastasis (TNM) staging system and International Society of Urologic Pathology (ISUP)/Fuhrman grading system are the most commonly used prognostic parameters for RCC. Currently, risk stratification relies on prognostic nomograms or risk stratification tools combining clinical, anatomical and histopathological data. However, these models have well-known limitations. Treatment for RCC is changing. Over the last decades, more incidental RCCs were found, and more minor lesions were operated on using less invasive techniques. At the opposite end of the disease spectrum, selected metastatic RCC patients receive a combined treatment consisting of nephrectomy, metastasectomy and oncologic therapies. Surgery for locally advanced and metastasised tumours must be justified by the prospect of an improved outcome or quality of life. Decisions to operate on metastatic RCCs are currently based on expert opinions and nomograms designed for targeted therapy survival estimations only. Thus, better prognostic markers and diagnostic tools are needed. Aims The aims of this PhD study were to evaluate the current changes in the clinical picture, treatment and outcomes of RCC in Helsinki University Hospital district. Further analysis was done to determine the clinical outcomes of surgically treated RCC with tumour thrombus and metastasised RCC (mRCC). The authors aimed to externally validate the performance of the Leuven-Udine (LU) prognostic group model for mRCC and to evaluate the prognostic value of serum concentration of tumour-associated trypsin inhibitor (TATI). The performance of renal tumour diameter and parenchymal invasion depth was compared with more complex classifications to assess their accuracy in predicting the nephrectomy performed. Patients and methods All patients studied were either suspected to have RCC or had RCC, and the majority of patients underwent nephrectomy at the Helsinki University Hospital (HUH). There were 1,719 patients with tumours suspected of RCC evaluated in four periods from 2006 to 2016 for clinical characteristics and treatments offered. From 2006–2014, 142 RCC patients with tumour thrombus (TT) were operated on at HUH. In total, using computed tomography (CT) or magnetic resonance imaging (MRI) images of 915 patients, tumour maximum diameter, depth of invasion, Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score and Renal Tumour Invasion Index (RTII) were estimated. There were 97 patients with metastatic RCC undergoing surgery for metastases. Preoperative and postoperative serum levels of tumour associated trypsin inhibitor (S-TATI) of 132 RCC patients were determined by time-resolved immunofluorescence assay in 2006-2010. Main results and conclusions During the study period, the proportions of frail and co-morbid patients increased significantly as did the percentage of small (diameter ≤4 cm) and asymptomatic tumours. The use of surveillance as treatment increased significantly while the use of cytoreductive nephrectomies (CNs) decreased to 54%. However, CN combined with tyrosine kinase inhibitors remained the primary option in patients with metastatic RCC. However, the changing landscape of RCCs has already affected and will increasingly affect the treatments given. For RCC patients with TT, no statistically significant difference in survival was found amongst the different levels of the venous extension. The prognosis for operated RCC patients with TT was good in the absence of papillary histology of primary tumour, lymphoid or distant metastases. Surgery also remains a feasible option for selected patients in the era of modern oncologic therapy. In predicting the type of nephrectomy, partial or radical, the simple measurements of tumour diameter and parenchymal invasion, were superior to the more complex classification. Hence, all of them were significant predictors for nephrectomy type. Our results recommend that potential anatomical classifications should be tested against these user-friendly measurements, diameter and parenchymal invasion. Overall survival (OS) was more favourable for patients undergoing complete metastasectomy than patients with non-complete metastasectomy and time to systemic therapy was longer. Patients with skeletal metastases had shorter survival than patients with other metastatic sites whereas patients with lung metastases had the most favourable prognosis. In this study population, the performance of the LU prognostic group model could not be validated. Despite the abundant amount of inauspicious prognostic factors in our patient cohort, survival rates were reasonable. Significant associations with preoperative S-TATI and Chronic Kidney Disease Stage (CKD grade), tumour stage, lymph-node involvement, metastatic status and preoperative C-reactive protein (CRP) level were noted. S-TATI, as a continuous variable, however, significantly predicted OS and cancer-specific survival (CSS). Prognostic significance of S-TATI should be further studied in larger patient cohorts and prospective settings.
  • Mustajoki, Marianne (Helsingin yliopisto, 2020)
    Aims: To examine patient-reported aspects of communication by bilingual Swedish speaking patients using their second language, Finnish. The effects of discordant language communication were measured in four studies. Methods: In total, 411 Swedish speaking and 746 Finnish speaking patients participated in four studies. Study I was performed during 2004−2005 in a healthcare center with a structured questionnaire including partly standardized questions about Swedish speaking patients’ ability to express their health problems in their second language, Finnish. Furthermore, the occurrence of misunderstandings and effects on adherence to medical instructions caused by discordant language communication were explored. The effects of concordant and discordant language communication were compared between Swedish and Finnish speaking emergency patients during 2008−2009 using a researcher-designed pre-visit and post-visit questionnaire in study II and III. The pre-visit questionnaire included questions about the socioeconomic status and health conditions based on the FINRISK protocol. The patients’ proficiency in their second language was measured on a standardized 5 grade scale. Patients were also asked about the language they used with the physician and their language preference, their experiences of discordant language communication, annual visits to a physician and the reason for the emergency visit. In the fourth study, performed during 2013−2016, fifty-one Swedish speaking patients with diabetes aged 28−72 years completed the verbal sensory and affective pain vocabulary sfMPQ, twice, first in Finnish (test I) and after 30 minutes in Swedish (re-test II). A Finnish speaking control group (n=10) aged 40−65 years was also tested in order to reveal intrinsic repetition variations. Results: The first study revealed that 50.7 % of Swedish speaking patients in the healthcare center (n=221) considered communication in their native language very important. One third of the participants reported getting along with Finnish in the absence of a common native language with healthcare providers. Every tenth patient reported miscomprehensions, either often or always. Poor proficiency in Finnish and low education level increased the risk of misunderstandings. Due to deficient language communication 41 % of the patients reported revisits (n=32), talked with another expert (n=40) or discontinued relevant healthcare visits (n=10). In the second and third studies the effects of concordant and discordant language communication with the physician were compared between 139 bilingual Swedish speaking and 736 Finnish speaking emergency patients. No significant differences between the language groups in health condition and prevalence of self-reported chronic diseases were observed but the Finnish speakers (24.1 %) reported significantly more annual visits to a physician compared with Swedish speakers (10.7 %). Communication in Finnish significantly decreased Swedish speakers’ motivation to adhere to the physicians’ medical instructions compared to Finnish speakers communicating in their native language (p=0.001). In the fourth study the sensory and affective verbal description of pain was tested among Swedish speakers with sfMPQ in Swedish and Finnish. The study was performed during 2013-2016 in one healthcare center in South Ostrobothnia and one in the metropolitan area, as well as in the Finnish Diabetes Association. Fifty-one Swedish speaking bilingual patients with diabetes aged 28-72 years and 10 Finnish speaking patients aged 40-65 years with diabetes participated in the study. Swedish speakers with poor proficiency in Finnish scored significantly more differences in affective descriptions of pain compared with Finnish speaking respondents (p=0.001). Conclusions: Poor Finnish proficient bilingual Swedish speaking patients frequently had difficulties in expressing health problems in their second language, Finnish. Patient-reported deficient language communication tended to increase Swedish speakers’ revisits but patients also discontinued consultations. A common native language promoted clarification of the health problem and pain communication, enhanced the patient’s adherence to medical instructions and trust. Language difficulties could possibly explain why Swedish speakers visit physicians less frequently than Finnish speakers. The effects of discordant language communication on healthcare outcomes were not explored.
  • Marttinen, Eeva (Helsingin yliopisto, 2020)
    Knowledge of the defense responses of mosses against pathogens has gained less attention than has our knowledge of the pathogens of vascular plants. Recently, the use of mosses has gained attention because mosses are used for greenhouse production as well as landscaping. In particular, the landscaping and greening of buildings have become popular because these initiatives offer one solution for mitigating urban problems such as heat islands and flooding. Mosses are an easy and lightweight solution for greening purposes as they can survive the harsh rooftop environment and have great stormwater retention. However, the health of plants is fundamental to achieving the benefits of greening. Like vascular plants, mosses also are susceptible to plant diseases. Many fungi damage mosses by causing brown patches of greenish moss. Brown patches on mosses are a characteristic sign of fungal infection. However, plants have various defense mechanisms, the first of which consists of preexisting structural and chemical defenses. Second, the plant immune system uses specific receptors with which to recognize the molecular structures of microbes that are not present on the surface of the plant's own cells. Receptor-mediated sensing of these structures can trigger early defense responses of plant, which can make the plant resistant to the attacking microbe. The model moss Physcomitrella patens, like the vascular plants, senses the molecular structures of microbes. For example, exposure of P. patens to chitosan—a component of the fungal cell wall—significantly increases peroxidase activity and oxygen radical formation. Oxygen radicals in turn affect many biological events; they can directly damage the pathogen or stimulate the plant's defenses. Currently, little is known about the peroxidase-based defense as well as chitosan-induced signaling pathways of P. patens. The aim of the research presented in this thesis was to study the pathogens of green roof mosses and establishes the host range of the isolated pathogens; the study also utilized a Physcomitrella mutant collection to identify genes involved in chitosan-induced signaling pathway. Fungal species that naturally inhabit mosses at a moss farm in Japan and on green roof environments in southern Finland were isolated and the ability of these fungi to infect and cause disease symptoms on the model moss P. patens was tested. In addition, the pathogenicity of fungus species towards vascular plants was also assessed. To elucidate the genes involved in chitosan-induced peroxidase activity, part of the Physcomitrella mutant collection was screened using the oxidation of 2,2´-azino-bis(3-ethylbenzothiazoine-6-sulfonic acid) as an indicator of peroxidase activity. Genome walking analyses were used to identify which genes were mutated within each moss line of interest. The work described in this thesis demonstrates that mosses used for greening are colonized by many different fungal isolates. These studies reveal that several fungal genera such as Fusarium, Trichoderma, Phoma and Alternaria cause severe symptoms in P. patens. Moreover, our results demonstrate that mosses and vascular plants have common pathogens. The fungal isolates Fusarium avenaceum and Cladosporium oxysporum obtained from moss panels caused disease symptoms on barley and carrots, respectively, and also on two different moss species. The results also demonstrate that the Physcomitrella mutant collection is a valuable source for identifying genes involved in the chitosan-induced signaling pathway. Screening of part of the mutant collection and further analyses revealed that Rossmann fold protein is a significant part of the signaling chain leading to upregulated peroxidase activity induced by chitosan. In addition, this Rossmann fold protein is an important factor for normal lipoxygenase (LOX) expression and might contribute to defense against fungal pathogens. The results from this doctoral thesis provide new insights into the pathogens of green roofs, the host range of the pathogens and the molecular mechanisms involved in disease control and defense responses in moss. The knowledge gained concerning the pathogenicity of Trichoderma isolates and the host range of pathogenic fungi should be considered when planting moss farms and cultivating crops in close proximity to each other or when applying biological control agents containing Trichoderma species to green roofs. Furthermore, these results may encourage the use of the Physcomitrella mutant collection to identify candidate genes for signaling pathways to elucidate the molecular mechanisms underlying the defense responses of mosses.
  • Wallenius, Tommi (Helsingin yliopisto, 2020)
    In this dissertation I scrutinised the Finnish comprehensive school quality assurance and evaluation (QAE) policy with a special focus on the policy of publicising school performance indicators. The research originated from a simple notion: while no school performance indicators are publicised at the school level in Finland, in the other Nordic countries various comparable and commensurable school-specific performance indicators are publicised in the government’s official web portals. Thus, by contrasting the institutionalisation of the Finnish publicising policy with the other Nordic countries, the aim of this research was to clarify how and why Finland has been able to resist the pressures of the ‘global testing culture’ and the idea of publicising school-specific performance results. The following research questions were examined: 1) How are opposite publicising policies (being) justified in Finland and Sweden? (Article I); 2) How are the current publicising policies explained through historically institutionalised path-dependent elements? (Article II); and 3) How are the two core concepts that typically promote a school-specific publicising policy, accountability and transparency, manifested in the policy discourses in Finland, Sweden, Denmark and Norway? (Article III) The research utilised the theories and concepts of various neo-institutional policy research approaches, above all, the writings on discursive institutionalism by Vivien A. Schmidt. Methodologically, all three research articles represented comparative policy research in education. In Article I, seven interviews with key policy actors in Finland collected within the Fabricating Quality in Education (FabQ) research project in 2007-08 were contrasted with the official policy justifications in Sweden. In Article II, the historical institutionalisation of the publicising policy in Finland and Sweden was examined through an analytical literature review. In Article III, 58 interviews with key policy actors in Finland, Sweden, Denmark and Norway collected within the Dynamics in Basic Education Politics in the Nordic Countries (DYNO) research project collected in 2015-17 were analysed. Together, the three research articles showed how the deep-seated rationalities institutionalised in the policies, practices and policy discourses, strengthened further by Finland’s initial PISA success, have provided a suitable platform for the Finnish policy actors to control the coordinative policy discourse on the comprehensive school QAE policy and to resist effectively the pressures to publicise school-specific performance indicators. The decline in the Finnish PISA scores since 2009 in my data did not show up as a ‘critical juncture’ at which new ideas started to challenge the legitimacy of the prevailing policy. In Finland, the main policy discourse, which I have described as the depoliticisive discourse of school performance, has continued to be effective in setting the limits for the ‘appropriate’ QAE policy and behaviour by controlling the concepts of accountability and transparency. It is noteworthy that in this discourse, the citizens have been guided to trust the Finnish comprehensive school system and ‘prevented’ from seeing themselves as eligible users of school-specific performance data. The current comprehensive school QAE policy in Finland, for example the sample-based national level pupil testing that prevents the opportunity to draw up school rankings, has been established as taken for granted. Indisputably, the detrimental effects attached to school rankings, such as increased social segregation by naming and shaming of pupils, teachers and schools, should continue to be taken seriously. However, comparative research in the Nordic countries showed that the policy of publicising school performance indicators is more complex than the main discourse in Finland suggests. Demands concerning either governance transparency or families’ equal rights to access official data may challenge the current publicising policy in future. ________________________________________ Keywords: quality assurance and evaluation policy, school performance indicators, governance publicity, accountability, transparency, comparative policy research in education
  • Salmi, Leo (Helsingin yliopisto, 2020)
    Inorganic–organic hybrids represent a class of materials consisting of inorganic and organic components mixed at the molecular level. This offers not only the possibility to combine material properties of the constituents, but also to discover completely new characteristics. Because of this, hybrid materials have become an important part of materials research. Atomic layer deposition (ALD) is a gas phase thin film deposition method with the ability to deposit conformal films with good control over film thickness and composition. Furthermore, ALD offers large-area uniformity and perfect step-coverage. Molecular layer deposition (MLD), used for depositing organic polymers, is a method derived directly from ALD. The combination of ALD and MLD offers a convenient way of depositing inorganic–organic hybrid material thin films for applications, such as electronics and optics, where ultimate precision is needed. In this thesis, ALD/MLD was used to deposit hybrid nanolaminates, metal–organic frameworks, and zinc glutarate. Nanolaminates of Ta2O5 and polyimide were deposited using tantalum ethoxide, water, pyromellitic dianhydride, and diaminohexane as the precursors. The leakage currents could be greatly reduced compared to the bare Ta2O5 and polyimide by layering of the materials. It was also shown that the mechanical properties could be improved by introduction of the organic layers. MOF-5 and IRMOF-8 thin films were deposited using zinc acetate, 1,4-benzenedicarboxylic acid, and 2,6-naphthalenedicarboxylic acid as the precursors. The deposition process included ALD/MLD combined with a two-step post-deposition crystallization in moist air and in an autoclave with dimethylformamide. Despite the need for a liquid-phase crystallization, the conformality and continuity of the films could be preserved. ALD/MLD of zinc glutarate thin films was shown for the first time ever using zinc acetate and glutaric acid as the precursors. The films were crystalline as-deposited with a structure matching to zinc glutarate. Catalytic activity of the films was demonstrated by polymerizing propylene oxide and CO2 in the presence of zinc glutarate coated glass wool and steel mesh.
  • Saarilahti, Marja (Helsingin yliopisto, 2020)
    Mastering daily life has been the topic of research in different academic disciplines over the years. This dissertation study approaches the topic from the point of view of home economics. Home economics deals with - and studies - the management of households and their dynamic interaction with surrounding communities. The background of this dissertation is a project in the field of family work. It aimed for helping with mastering everyday life for so-called “drifting families”, i.e., families, with children, that have enduring and considerable problems, especially in coping with their daily duties and timetables. Due to this background, the present study extends beyond home economics and connects it with approaches used in social and educational sciences. The project under study was designed for experimenting with a new family work practice, which used a special method called “sequence map”. The map is intended to function as a tool for supporting to carry out the basic routines of families by organizing and timing daily practices of the family. The project worked together with, and gathered data from, 31 families. The data comprise audio-recordings of family workers’ discussions in project group meetings. The latter data set was investigated in this study. The discussions in these meetings were looked at from the perspective of local knowledge creation of family workers while jointly reflecting their experiences, ideas and questions concerning the use of the sequence map during their family visits. Theoretically, drawing upon cultural-historical activity theory, the sequence map was considered as an artefact, which combines the semiotic and functional meanings of the tool. In the analysis of discursive data on an artefact, the study used three different levels, i.e. primary, secondary and tertiary level of artefact functioning (Wartofsky, 1979), for organizing the data into categories to be further analysed thematically. The analysis aimed to reveal the meanings and functions which the sequence map reaches at each level. The following research questions were addressed: 1. How the sequence map can be placed on the artefact levels and what kind of representations it gets on these levels?; 2. What are the meanings of sequence map as a personal tool of family workers?; and 3. What is the potential new knowledge produced in team meetings and how to further conceptualize the sequence map? The main finding of the research is the multifunctionality of the sequence map which extends its use in practice beyond the designed narrower use of making timetables and fixing a daily structure for helping the families in question to cope with their daily duties. The study shows added meanings and functions, such as a collaborative "pact" between family members, a tool for strengthening the authority of the parent(s), a tool for activating parents, and a tool to bring flexibility to daily life. On the tertiary level the sequence map, mediated by discussions with family workers, revealed new resources of modelling family life, e.g. towards responsible parenthood. For the family workers, the sequence map functioned as an essential tool to communicate sensitively with clients, make plans, and evaluate. The other area of the findings concerns the reflective discussions of family workers seeing these as a way of articulating potential knowledge that is normally hidden or, epistemically, verbalized in an incomplete manner. Keywords: Sequence map, artefact, family work, everyday life, reflective orientation to work, concept formation, mastery of life
  • Välipakka, Salla (Helsingin yliopisto, 2020)
    Neuromuscular disorders (NMD) are highly heterogenic with around 1000 reported different subtypes. Most are genetic in origin, and some 500 genes are currently identified to cause NMDs. Massively parallel sequencing (MPS) approaches have been widely used to increase the cost-effectiveness and diagnostic yield in the work-up of the genetic molecular diagnosis and to speed up the process. Copy number variants (CNVs), deletions and duplications larger than 50 base pairs, explain approximately 10% of the Mendelian disorders. No best practices pipelines have been developed yet for CNV analysis from MPS data. Therefore, the detection and verification of CNV findings has often involved complementary methods, such as array comparative genomic hybridization (array CGH), multiplex ligation-dependent probe amplification (MLPA) and quantitative PCR approaches. Recently, various CNV detection programs have been developed, but for widely different types of designated research settings, which complicates choosing the correct approach for NMDs. These individual programs have generally exhibited less than ideal sensitivity and specificity for CNV detection. Our aim was to develop a comprehensive pipeline for the detection and annotation of CNVs with high accuracy from targeted gene panel sequencing and whole exome sequencing (WES) data of patients with NMDs. Four different CNV analysis programs were chosen for this study: CoNIFER, XHMM, ExomeDepth and CODEX. The targeted gene panel MYOcap includes 349 genes for myopathic disorders and MNDcap 302 genes for neurogenic disorders in their current panel versions. 2359 samples were sequenced with MYOcap, 942 samples with MNDcap and 262 samples with WES. This included for the targeted gene panels 24 positive control samples with previously characterized CNVs and 31 negative control samples with certain genes verified to not have CNVs. A detection sensitivity of 100% and specificity of 100% were reached for these control samples. Previously undetected CNVs from MYOcap or MNDcap sequenced samples were verified as true positive detections in 36 cases with MLPA, PCR or array CGH, and eight CNVs were verified as false positive detections. These and the positive control samples were utilized in validation of a predictive logistic regression model. In silico CNV generation into MYOcap sequenced samples provided 18,677 specific and 3892 unspecific CNV detections to initially train the model. The model was trained to differentiate true positive detections from false positive detections in order to increase the specificity of the CNV detection pipeline. The advantage of using four different CNV detection programs compared to using them individually, or with any other combination, was demonstrated by CNV detection sensitivity from the set of in silico CNVs. The predictive model with variables from all four programs provided the highest sensitivity (96.6%) and specificity (87.5%) for predicting CNV detections correctly, indicating an accuracy of 95.5% (95% CI 87.3–99.1%). The CNV detection pipeline together with the predictive model was validated for WES samples with control samples with 235 previously characterized CNVs. For CNVs spanning at least three exons, the detection sensitivity was 97.3% and the sensitivity of the predicative model was 99.3% after adjusting the model threshold for WES data. The CNV annotation platform cnvScan was expanded to contain the most recent CNV population databases as well as in-house CNV databases for all the sequenced sample sets. CNV detection results were filtered by < 1% frequency with reciprocal overlap of 90% in the common CNV population databases, with both it and < 5% frequency with 50% reciprocal overlap in the in-house CNV database, and by the true positive prediction with the model. These procedures significantly decreased the workload (with 3–13% of the original CNV detections preserved) in evaluating the CNVs further regarding clinical significance. The added value, i.e. the additional diagnostic yield from CNVs for both the targeted gene panel sequenced samples and WES samples was estimated to be 1.9%. Altogether 39 final genetic diagnoses were solved with these CNV findings. In addition, 18 patient cases had a likely pathogenic finding, and five had a heterozygous CNV likely pathogenic for a recessive disease without association to the patient’s phenotype. The clarified cases included six different DMD deletions or duplications causing dystrophinopathies. In three sequenced familial cases, the detected CNVs in CACNA1A, SGCD and TTN genes co-segregated with the disease. One case had two separate genetic diseases, tibial muscular dystrophy (TMD) and BMD, caused by the founder mutation FINmaj in the gene TTN and a deletion in DMD. Some of the solved cases had novel findings: the second ever reported large intragenic deletion in NEB causing dominant disease, and the first CNV, an intragenic deletion, in TIA1 in a patient diagnosed with Welander distal myopathy (WDM). Some of the genes associated with NMDs are challenging to analyze from short-read sequencing data due to homology or repetitive regions. An additional script was thus written to differentiate copy numbers of the highly homologous genes, SMN1 and SMN2. Two SMN1/SMN2 copy number 0/3 control cases were successfully recognized, and five cases were identified with a possible exon 7 conversion in SMN1 and a compatible spinal muscular atrophy phenotype. The latter findings were considered likely pathogenic and are awaiting further validation on the genomic level. Comparison of CNV detections within the in-house CNV database revealed divergences in the CNV detections within the triplicate repetitive region of NEB with potentially clinically significant changes. One array CGH validated change correlated well with the nemaline rod pathology observed in the patient. CNV analysis utilizing MPS data from targeted gene panels and WES samples provided increased diagnostic yield as reported also in other studies on NMDs. Our multi-algorithm and -platform approach decreased the workload in variant analysis and provided more insight into the many difficult to analyze genomic regions involved in NMDs. In the future, whole genome sequencing and long-read sequencing will likely provide higher resolution for CNV detections and reveal an even wider spectrum of structural genomic variants, together with other emerging comprehensive methods, such as optical mapping.
  • Grandell, Jens (Helsingin yliopisto, 2020)
    From the mid-nineteenth century onwards, the political culture in Finland started to shift towards a more modern path. This turn was widely influenced by western liberal and republican languages. Although the history of liberalism in Finland has been broadly discussed in previous historical research, the discussion has often lacked a clear understanding of the concept of liberalism. This has in turn lead to a deficit in the understanding of republicanism as part of the Finish political landscape. This thesis addresses these questions by studying how a liberal and republican language was formulated and disseminated in Finland around the middle of the nineteenth century. The underlying notion of the theses is to nuance and broaden the understanding of the ideological turn that took place in Finland during the second half of the nineteenth century. The three main research questions that I pose are: 1) In what kind of spatial, social and historical context did August Schauman's liberal and republican language take form? 2) Which ideological elements were included in Schauman's worldview, and what does this say about the Finnish ideoscape around the mid-nineteenth century? 3) What strategies did Schauman use for the dissemination of ideas and what does the relationship between public and private thinking look like in a nineteenth-century context? The methodological framework is built around a biographical understanding of history. The individual perspective in connection with a source close reading reveals a nuanced thought landscape, which is something that has been overlooked in previous research. By regarding the individual, in this case the journalist August Schauman, as a representative of his times and as a prism in which the times are reflected, it is possible to highlight elements of history that would otherwise be challenging to capture. Studying one of the key public voices in ninteeenth-century Finland, August Schauman, this thesis shows how ideas are formulated on a personal level, processed within different collectives and in interaction with the surrounding society. Using newspapers, letters, and published memoires, I show the dynamics that describe the movement of ideas during the nineteenth century and how republicanism alongside with liberalism was part of the Finnish spectrum of ideas. In Finland, it was not until the 1860s that the term liberal was applied to domestic conditions. In the intellectual discussion that had taken place before this, one can, as I show in this thesis, find traces of republican thought, which, on the other hand, is not surprising given that republicanism lent central features to early liberalism. August Schauman's republicanism is brought to the fore by studying him in relation to time and space and by making him part of the public discussion of Finland's future.
  • Lehikoinen, Petteri (Helsingin yliopisto, 2020)
    Human induced climate change will affect global biodiversity considerably. One of the most studied consequences is climate driven redistributions of species. Simultaneously, increasing land development resulting in habitat loss will add difficulties for species to adapt and redistribute under changing climate. Failing to move or adapt, species face a risk of extinction. The high latitude and high altitude species are facing increased risk of extinction because these species have limited possibilities to retreat and the warming has been faster in northern high latitudes than other regions Protected areas are likely to aid species in adapting to the changing climate by preserving high quality natural habitats where species can thrive. However, due to extensive land use and habitat degradation protection cannot always cover a sufficient amount of high quality habitat. In this case, habitat restoration can be the solution to improve habitat quality and availability, which can have positive effects on the ability of species to move and persist under climate change. The aim of this thesis is to shed light on how protected areas have been able to mitigate the negative effects of the current climate change. In addition, it studies the role of habitat quality in the processes of redistribution events. Lastly, the thesis evaluates how habitat enhancement by restoration affects the abundances of species threatened by wide-scale habitat loss and degradation. The focal species of the thesis are birds, owing to the extensive, long-term Finnish monitoring data which are unique even in a global perspective. In the first chapter, I study changes in abundance of the past five decades on the trailing range edge of northern and leading range edge of southern bird species. This study shows that protected areas help northern bird species maintain their abundances on the southern boundary of their current area of distribution, while aiding certain southern bird species spread to new territories on the northern boundary of their distribution area. This suggests that protected areas are able to slow down the northbound retreat of species, but also facilitate northward range expansions of southern species. The second chapter studies if the effect of conservation in mitigating climate driven changes observed in the first chapter increases with increasing coverage of the protected area network. The results show that in northern and central Finland the increasing protected area coverage in the landscape is indeed associated with communities that are more stable and less affected by climate driven changes. However, such effect was not found in southern Finland, where the protected area coverage was very low, and in fact could be too low to support detectable levels of community resilience against climate change. Populations and communities are shown to be more resilient to environmental changes when higher proportions of suitable high-quality habitat is available. Thus habitat quality could certainly explain the results gained in chapters I & II. The chapter III studies the effect of habitat quality on the occurrence of the white-backed woodpecker. Woodpeckers occupied more frequently the high-quality habitat patches than lower quality patches suggesting that colonization events are more and local extinctions less frequent on these sites. Thus, high-quality habitats seem to enhance the ability of species to move and persist and therefore, protection of these sites should be a priority under the redistributing outcome of climate change. Chapter IV shows that habitat quality can be further improved through restoration. Counteracting the overgrowth of wetlands rapidly increased the number of staging and breeding birds. Many waterbird species are threatened and declining due to eutrophication and overgrowth and the results show that wetland management can mitigate these negative developments. The thesis concludes that protecting high-quality habitats can mitigate climate change driven range and community changes. However, current trajectories of conservation seem to be inadequate to preserve the current biodiversity. Therefore, to meet the aims to prevent further biodiversity loss, extensive and rapid efforts to increase protected area coverage and connectivity are direly needed. The main conclusion of this thesis support these acts and the benefits this will have for preserving biodiversity in the future.
  • Pesonen, Maiju (Natural Resources Institute Finland (Luke), 2020)
    The decrease in the dairy cattle population observed in recent years threatens to reduce the level of beef production. Although the number of beef cows has increased by 20% over the last 10 years, there is a clear discrepancy between the demand for and supply of domestic beef. Consequently, slaughterhouse pricing favours heavy carcasses and the average carcass weights of slaughtered animals have increased in recent years. There is a paucity of information on the effects of the breed on the performance, carcass characteristics and meat quality of beef breed bulls raised to heavy carcass weights. The first aim of this thesis was to evaluate the growth performance, carcass traits and meat quality of different beef breeds in the Finnish beef cattle population. The second aim was to evaluate the potential for improvement of carcass and meat quality traits through crossbreeding compared to purebred animals. The third objective was to evaluate carcass fat scores in relation to carcass weights in different breed groups. In addition, the effects of the proportion of concentrates and rapeseed meal (RSM) supplementation on animal performance, carcass characteristics and meat quality parameters were determined for Hereford (Hf) and Charolais (Ch) bulls. To achieve these aims five experiments were carried out. The objectives of the first experiment in which Hf and Ch bulls were offered grass silage-based diets, were to determine the effects on the performance, carcass traits and meat quality of the proportion of concentrate in the diet, and the inclusion of RSM in a barley-based concentrate. The objective of the second and third experiments were to study performance and meat quality of purebred Hf, Ch bulls and Hf × Ch crossbred bulls and Angus (Ab) and Limousin (Li) bulls and Ab × Li crossbred bulls which were offered grass silage-grain-based rations and raised to heavy carcass weights. The objective of the fourth experiment was to determine the growth and carcass traits of beef breed bulls and heifers. The data collected from Finnish slaughterhouses. The objective of the fifth experiment was to study the potential for improvement in the gain and carcass traits through Ab × beef breed crossbreeding compared to purebred Ab bulls and through Hereford Hf × beef breed crossbreeding compared to purebred Hf bulls. Continental breeds tended to have carcass traits that suit the Finnish beef production system well under the current Finnish feeding management approach. British breeds produced more intramuscular fat in the meat and have a higher sensory quality compared to Continental breeds. The carcass traits of British breeds can be enhanced for the current market demand by crossbreeding British breed dams with Continental breeds. The grass silage-grain-based diet suited beef breeds well for growing and finishing diets. The concentrate level can be reduced for British breeds. Continental breeds will benefit from increased concentrate levels in the diet. Protein supplementation does not add any substantial advantages to the diet. Using protein supplements will increase the environmental impacts of beef production.
  • Salonen, Hilma (Helsingin yliopisto, 2020)
    The Russian Arctic is known of its vastness of space, unrelenting weather and natural resources. Renewable energy, however, is rarely linked with developing the country’s Arctic regions. This dissertation explores what kind of importance could de-centralized energy sources have in a setting dominated by fossil fuel revenues Initiatives launched by private actors are mainly absent in the Russian Arctic, butthis does not mean that the local level does not have agency of its own, nor does it rule out interesting side trajectories developed in the regions. This study examines these issues with the help of three case studies, which explore (i) the key priorities of national renewable energy policies, (ii) the enabling and restricting factors behind the use of biomass for energy in Arkhangelsk, and (iii) the relation between existing power structures and new energy projects in the Republic of Sakha. In addition to increasing knowledge on renewable energy use in the Russian Arctic regions, this study contributes to the theoretical discussions on public justification sociotechnical (energy) transitions and the multi-level perspective approach, and carbon lock-ins. With the help of these theoretical concepts, it is possible to analyze Russian energy politics not only as a special case but as a part of a bigger continuum of sociotechnical transitions. Since literature on energy transitions has mainly discussed transition cases in market-led, energy-importing countries, evaluating its key notions in the context of the Russian Arctic offers new viewpoints on their adaptability. The results of this dissertation state that the Russian official discourse promoting renewable energy use favors concrete, technical objectives at the expense of a more ambitious long-term vision. Various lock-ins restrict the possibility of alternative energy forms to develop, and while new actors work alone, existing lock-ins reinforce each other. However, even the current situation holds many possibilities for alternative practices to find niches and develop. Energy policy-making and regional development are neither top-down nor bottom-up affairs, but instead happen in a dynamic interaction between local, regional, and national actors — despite the highly centralized character of the current political system. These realities offer possibilities for renewable energy projects to take root in the Russian Arctic, albeit as a part of the great power politics related to fossil fuel exports.
  • Silvennoinen, Kirsi (Helsingin yliopisto, 2020)
    The significance of food waste (FW) arises from its large environmental, economic and social impacts. Furthermore, it affects food security and is a matter of resource efficiency for sustainable food production. In a situation where the world population is growing and climate change is affecting food production, FW should be minimized, to ensure the future food supply and natural habitats. The aim of this thesis was to study FW in the Finnish food supply chain, in households, food services, the food industry and the retail sector. Even though FW is generated throughout the supply chain, the impacts are most significant at the end of the chain. That is why reducing FW in households and food services is especially important. In this thesis, FW amounts and types were studied in the food chain in addition to methods for measuring FW and means for reducing FW in households and food services. Diary studies were used for studying the FW in households and food services and in the retail and food industry sector surveys and interviews were used. Together 380 of households from different areas in Finland finished the two weeks study period. The amount, type and origin of avoidable food waste were investigated in 51 food service outlets, including schools, day-care centres, workplace canteens, cafes and petrol stations, restaurants and diners. The average annual FW was about 23 kg per person and 4–5% of the purchased food amount. The main discarded foodstuffs were vegetables (19%), home cooked food (18%) and milk products (15%). The main reasons for disposing of foodstuffs were spoilage, expiry of the best-before or use-by date and plate leftovers. Almost half of the food waste (40%) was still unspoiled at the time of discarding it. In food services the amount of FW varied depending on the outlet type and was about one-fifth of all food handled and prepared in the outlets. During the study period the most FW were generated in day-care centres (28%) and workplace and student canteens (25%). The findings also suggest that the significant origin of FW was serving waste because of food overproduction for buffet lines. Suitable and appropriate measurement methods for monitoring FW are necessary for reducing FW amounts and following trends in FW. The most suitable method varies depending the sector and the data requirements. Besides FW data, also data about the food purchased or produced is needed for analyses and discussion.
  • Jamshidi, Maral (Helsingin yliopisto, 2020)
    Despite advances in the early detection and treatment of breast cancer, identifying germline markers and tumor molecular profiles which objectively predict prognosis and treatment response remains a challenge. The aim of this thesis was to identify such markers in breast cancer by investigating cancer-related networks as well as candidate genes of regulatory networks in invasive breast cancer cases. Taking both a network analysis approach as well as a candidate gene study, clinicopathological and survival analyses were performed to study the breast cancer survival and therapy association of (I) germline variations in TP53 network genes; (II) two-SNP interaction of NF-κB signaling network; (III) NQO1 protein expression and NF-κB activation; and (IV) miR-30 family members. In Study I, the variations were initially analyzed in a set of DNA samples from 925 invasive breast cancer cases from Helsinki Breast Cancer Study (HEBCS) included in Breast Cancer Association Consortium (BCAC), and were further analyzed in pooled data of 4,701 cases from four independent studies in BCAC. In Study II, the germline variations were studied in 30,431 cases from 24 independent studies of BCAC. In Studies III and IV, the tumor samples for immunohistochemical and miRNA in situ hybridization of 1,240 cases were from two series of 884 unselected Finnish invasive breast cancer patients and an additional 542 familial cases. Gene expression analysis used RNA from 187 fresh frozen primary breast cancer tumors. Drug sensitivity screening tested the influence of miR-30 family members on the response of human breast cancer cell lines to doxorubicin and lapatinib. In Study I, an interaction effect was found between germline variations in TP53-related genes, PRKAG2 (rs4726050) and MDM2 SNP309: rs4726050 rare G allele showing a dose-dependent impact for superior breast cancer survival only among the MDM2 SNP309 rare G allele carriers. PPP2R2B (rs10477313) rare A allele predicted increased survival after hormonal therapy. In Study II, the SNP-SNP interaction test in the NF-κB activating pathway found two interacting SNP pairs, rs5996080-rs7973914 and rs17243893-rs57890595, which associated with patients’ survival under recessive and dominant models of inheritance, respectively. The haplotype block of the SNP pairs contained BAFFR and TNFR1/3 (for recessive model) and TRAF2 and TRAIL-R4 (for dominant model). The observe association may be a result of interplay between these gene pairs and their influence on the dynamic of non-canonical NF-κB pathways. In Study III, the immunohistochemical analysis of NQO1 expression and NF-κB nuclear localization did not find significant association with patients’ survival. An inverse correlation between NQO1 expression and NF-κB activity was observed in breast cancer tumors underlined by ER-negativity status. In Study IV, high expression of miR-30d associated with longer metastasis-free survival, particularly in subgroups of patients with high proliferative tumors, ER negativity, HER2 positivity, and among those who received chemotherapy. But, the high expression of miR-30 also correlated with the characteristics of aggressive tumors. In a drug sensitivity screening test, miR-30a–e sensitized the human breast cancer cell lines to doxorubicin and lapatinib. In the pathway enrichment analysis of METABRIC dataset, high levels of miR-30 occurred simultaneously with low expressions of genes involved in cell movements, consistent with the observed association with longer metastasis-free survival.
  • Salmenlinna, Inkeri (Helsingin yliopisto, 2020)
    This conversation analytic (CA) study examined other-initiation of repair in speech-language therapy sessions and in free play situations by 5–8-year-old children with mixed receptive-expressive language disorder, also known as Specific Language Impairment, SLI, or Developmental Language Disorder, DLD. Other-initiations of repair are practices by which the recipient of the talk points out that there is a problem in hearing, understanding or inferencing previous talk in conversation. Other-initiations are frequently used for maintaining intersubjective understanding between the interlocutors in everyday interaction. The data consist of children’s video-recorded language assessment sessions, speech-language therapy sessions and two kinds of non-institutional play sessions: parent-child and peer play. All the repair sequences in which the children used other-initiations of repair were identified, transcribed and analysed following CA conventions. The transcriptions focused on speech and relevant embodied actions and included the conversational context preceding and succeeding repair sequences. The database consists of 112 other-initiations of repair by the children. In the analysis, the children's other-initiations of repair were examined for 1) the repair-initiation practices, 2) problems that they dealt with and 3) conversational context in which they emerged. Qualitative analysis of the children’s other-initiations of repair indicated that the children used similar repair-initiation practices that have been earlier described in adults' everyday conversations. Children’s repair-initiations could be classified as 1) open repair initiations 2) restricted repair initiations (question words, combination of question word and partial repeats of the trouble turn, partial repeats of the trouble turn and clausal repair initiations) and 3) candidate understandings. Some of the restricted repair initiations and candidate understandings included both speech and embodied actions. Quantitative analysis of the children’s other-initiation practices revealed differences between the younger children with severe language disorder and the older children with mild language disorder. These differences were not explicable by the traditional developmental hypothesis of increasing specificity and complexity. Contrary to this hypothesis, the younger children with severe language disorder used mainly specific candidate understandings, and the older children with mild language disorder used more often non-specific open repair initiations than the younger children with severe language disorder. The most common problems (in 94 % of the repair sequences) that the children were dealing with by other-initiation of repair were: 1) problems of hearing or understanding the previous turn generally 2) problems of unclear or uncertain reference 3) problems of an unfamiliar word or uncertain understanding of a word or concept 4) problems of inferencing the meaning or the implications of the previous turn(s). There were also differences between the younger children with severe language disorder and the older children with mild language disorder in the problems they faced and dealt with. At the same time, connections were found between the use of other-initiation practices and the trouble they were used to resolve. The older children with mild language disorder often used open repair initiations and candidate understandings and dealt with troubles that are commonly resolved with these practices: with open repair-initiations they treated the previous turn as generally problematic and with candidate understandings they mostly dealt with problems of uncertain references and inferencing the meaning or the implications of the previous turn(s). Meanwhile, the younger children with severe language disorder mostly used candidate understandings to deal with an uncertain meaning of a word or concept. Overall, younger children with severe language disorder used less other-initiations of repair than older children with mild language disorder. However, there were also differences between speech-language therapy sessions and the play sessions: The younger children with severe language disorder used other-initiations of repair mainly in language assessment sessions and in speech and language therapy sessions, whereas the use of other-initiations of repair by the older children with mild language disorder was more evenly divided between the different sessions. Thus, the difference in the quantity of other-initiations of repair between the children varied between the sessions. This finding shows that the selected data and the nature of the interaction studied can have a significant effect on the results and how they can be generalized. This observation is meaningful particularly for the designing and interpretation of comparative studies of children’s other-initiations of repair. The analysis of the conversational context showed that the troubles dealt with and thereby the uses of practices of other-initiation of repair were distributed differently between the different activities in conversation. Problems of unfamiliar word or uncertain understanding of a word or concept were mostly dealt with in speech-language therapy during task sequences. Problems of inferencing the meaning or the implications of the previous turn(s) were mostly dealt with during planning actions. Open initiations of repair were mostly used during task sequences in speech-language therapy and during free play in play sessions. The sequential local contexts during different kinds of actions were also analyzed. The way that the local contexts took shape can explain, together with the difficulties that the children had in receptive language, some of the differences in the problems faced and dealt with, and the use of different kinds of repair practices. The older children with mild language disorder often used non-specific open repair initiations. At the same time there were also several features in the local conversational contexts, which for their part seem to explain the need to use open repair initiations. According to CA, every turn by every interlocutor shapes the local context of conversation. The children’s own actions in the interaction seemed to have affected the way that the local context took shape preceding the open repair initiations. The younger children with severe language disorder in turn often used specific candidate understandings. This can be partly explained by the fact that they had considerably more lexical difficulties and often faced problems of uncertain understanding of a word or concept during task sequences in speech-language therapy. At the same time, the task setting sequence and the task materials at hand seemed to support the use of candidate understandings. The findings of this study show that in conversation, besides the age and language skills, several contextual factors and the troubles faced and dealt with can significantly affect children’s use of other-initiations of repair. These findings support the view that children’s developmental phase and language skills can affect the way that interactional situations are mutually shaped, the problems that the children are facing and dealing with in conversation and thereby children’s other-initiations of repair. By expanding research from principally studying children’s other-initiation practices to cover also the systematic analysis of contextual matters and the problems that the children are facing and dealing with, we could reach a more comprehensive and reliable understanding of children’s other-initiations of repair and their skills in dealing with problems of hearing, understanding and inferencing speech in conversation. Key words: interaction, conversation, Developmental Language Disorder, Specific Language Impairment, receptive-expressive language disorder, other-initiation of repair, speech and language therapy, play interaction, intersubjectivity, problems of hearing, understanding and inferencing speech, conversation analysis
  • Lai, Tin-Yu (Helsingin yliopisto, 2020)
    Ecosystem-based management is necessary for management of marine ecosystems because they are affected by multiple impacts, and some synergistic effects or conflicts may exist among these impacts and the possible solutions. This thesis applies three different approaches to contribute to ecosystem-based management. First, this research develops a multispecies bio-economic model that is able to consider food web interactions, different types of fisheries, and the various economic benefits provided by multiple ecosystem services. The developed model focuses on a food web consisting of migratory fish (salmon; Salmo salar), mammalian predators (grey seals; Halichoerus grypus), and schooling fish (herring; Clupea harengus) in the Baltic Sea. Additionally, the included ecosystem services include both provisioning and non-market cultural services, such as ecosystem services for fisheries, recreation and the existence of the species. By applying optimization approaches, the developed model is used to examine fisheries management. Second, structural equation modelling is applied to explore the causal relationship among climate and environmental factors, fisheries, prey availability and competitors to the salmon population. The last applied approach was ecosystem accounting, which is able to reveal the economic implications of ecosystem changes and the use of ecosystem services by different economic sectors. A framework integrating the ecosystem services and accounting system is proposed with a marine case study. Furthermore, the developed multispecies bio-economic model is applied with different valuation approaches to value the marine ecosystem for ecosystem accounting. By applying different approaches, this thesis provides insight and recommendations for ecosystem-based management from various perspectives.
  • Jusufovski, Dunja (Helsingin yliopisto, 2020)
    Overexploitation is still a leading problem of many commercially targeted fish species. In addition to the high harvest rates and increasing biomass removals, harvested marine ecosystems have become a stage for the dynamic interplay of evolutionary and ecological processes. Removal through size selective fishing gear can cause negative pervasive effects on individual as well as population level. Observations of the individual phenotypic traits show a general trend of decreasing size and age at maturity that can have further negative effects on fecundity and population productivity. As these phenotypic changes become heritable (i.e., fisheries-induced evolution or FIE), this can further diminish the fish available to fisheries and render future fishing yields unsustainable. Current management requires additional measures to include avoidance and detection of evolutionary changes. In order to understand which fishing objectives precede evolutionary change in individual traits, in my thesis I explored how different fishing strategies of the European hake (Merluccius merluccius) fishery reflect on ecological and evolutionary processes. While management focusing on the protection of juvenile fish can minimise the negative ecological impact of fishing, it increases the potential for evolutionary change in fish phenotypic traits. In contrary to this, fishing mortality targeting a wider range of age–size classes avoids evolutionary shifts in individual traits, however such fishing strategy demonstrates higher biomass removals. In the wild, fisheries continuously interact with other predators, such as marine mammals, which can prey upon the same fish species or stock. The impact of these direct and indirect biological interactions between the marine mammals and fisheries is harder to detect and quantify, especially in synergy with other natural or anthropogenic stressors. In the context of fisheries-induced evolution, changes observed on an individual and population level caused by fisheries will also affect the prey size selectivity and prey availability to natural predators. My synthesis of recent research and findings on marine mammal–fisheries biological interactions demonstrates the need for improvement on data regarding marine mammal dietary and energetic requirements as well as their representation in model-based approaches. Moreover, combining different sources of knowledge about marine mammal–fisheries competition can aid to better quantify fish mortality caused by predation. Subsequently, this information would improve the fish stock assessments and provide insight on a sustainable window of opportunity to catch fish for fisheries and natural predators. Thus far, attempts to quantify predation and fish availability for fisheries and natural predators exist through studies using mainly ecosystem and fisheries models. To explore how predation and fisheries shape and direct individual as well as population parameters, I have used an individual-based model to simulate hake growth trajectories with regards to its own biological characteristics. As an individual grows, its life history is formed by ecological and evolutionary processes which also take into account the reproductive cost of survival and sexual size dimorphism (SSD). With co-evolved interactions between hake and the bottlenose dolphin (Tursiops truncatus) as the predator, fishing is introduced through a limited time period in order to observe prey recovery and resilience on an individual and population level. Although different types of predation give insight to discrepancies in the intensity of predation mortality, mere presence or absence of predation determines the projected values reached by prey individual and population parameters. Moreover, the joint effect of predation and fishing reveal contra-intuitive trends in hake individual traits and population parameters. The combination of duration and intensity of both size-selective removals, predation type and SSD determine the potential for persistent phenotypic and demographic changes after a period of overexploitation. Additionally, not all individual traits are equally susceptible to fisheries-induced evolution where the accountability of SSD and predation type can play a critical role. While fisheries remain the most detrimental source of mortality and size-selective removal for the harvested species, the indirect effects of fishing intensity diminish predator survival, thus having direct implications for top predator conservation. In conclusion, increasing the biological realism of the targeted species and incorporating different predation types with respect to evolutionary processes provide a more holistic approach to fisheries management: as it helps to avoid potential FIE and an overestimation of fish available to fisheries that can prevent top predator collapse. This will, ultimately, lead to a more ecosystem-based management with sustainable harvest rates and optimised fishing effort as well as the minimal cascading effects of size-selective removals.
  • Laitinen, Kari (Helsingin yliopisto, 2020)
    This study examines military music activities in Finland during the last decades of Swedish rule (1770-1809), and the effect of these activities on Finland’s music life in general. The research topic is examined through military musicians of the six infantry regiments based on the allotment system. The research field thus covers the entire Finnish area of the Swedish realm. The research has two main research questions. The first question investigates the background and history of music activities at Finnish regiments: why did regiments begin to establish military bands during the Gustavian era, and how was this process carried out? The second question focuses on individual military musicians: who were they, how was their training organised, and what did their work consist of? In addition, the research examines military musicians’ activities in Finland’s mainstream music life, as well as providing an overview of the instruments they used and the repertoire they performed This research can be categorised as basic research in music history, with a strong source-based approach. The extensive archival materials and existing research literature were used to find answers to the questions posed in the research. The most important research materials include the army’s official document archives and correspondence, parish registers and research literature on individual and local history. Information on individual military musicians has been compiled into a military musician register (appendix). Research results indicate that the establishing of military bands in Finland was systematic and wide-ranging, and it was modelled on European examples. These activities, however, were not organised by the state but relied instead on the activeness of regiments and officers, who were also largely responsible for funding their military bands. The regiments covered in this study had approximately three hundred serving military musicians between 1770 and 1809, most of whom came from the local area. In addition, a number of European professional musicians, who had arrived in Finland via Stockholm, were employed to train military musicians. Likewise, the instruments and repertoire were largely imported from abroad. Even though the training of military musicians in the last decades of Swedish rule was modest and individual players’ skills remained intermediate, Finnish regiment players had a role in participating in their local music communities in a range of ways.
  • Kaartinen, Sara (Helsingin yliopisto, 2020)
    Diverse physical activity is globally recommended across all age groups but is sparsely studied. Previous literature has focused on the dose of physical activity that is required to achieve numerous health benefits, and links have been found between earlier and current physical activity, as well as physical activity and spinal pains. Simultaneously, evidence indicates that frequent participation in only a single sport increases the risk of overuse injuries, burnout, and even dropout from sports among young athletes. Frequent spinal pains are related to both low and high intensity of physical activity, as well as to specific risk sports among athletes. Similar population-based evidence is scarce. This thesis aimed to study the diversity of sport activities in adolescence and leisure-time physical activity in adulthood, as well as, associations between the diversity of sport activities and spinal pains, including low back pain and neck-shoulder region pain, in adulthood. This thesis includes three studies based on the FinnTwin16 study of Finnish twins born in 1975–79. The first survey wave took place in 1991-1995 when twins were 16 years of age and 4 follow-ups have occurred since. The second and fifth survey waves, conducted when twins were 17 and 34 years of age on average, provided information on participation in different leisure-time sport activities. Additionally, the fifth wave included more items on leisure-time physical activity behavior and several items on spinal pains including non-specific low back pain and neck-shoulder region pain, as well as, radiatiang and non-radiating low back pain lasting more than one day. Categorized variables were created for the quantity and quality of sport activities, leisure-time physical activity level, and spinal pains. Aiming to study the participation in a diversity of sport activities in comparison to single sport, the studied sample included only individuals who engaged in leisure-time physical activity at least once month and reported at least one sport activity at the wave of interest. The chosen sample was large and representative with 3734 individuals (57% females). The studies included cross-sectional, longitudinal, and within-pair analyses. Participation in five or more sport activities in adolescence was related to higher levels of leisure-time physical activity in adulthood, but only among females. Shared familial factors, however, seemed to confound the detected association. Neither participation in several sport activities in adolescence nor adulthood was associated with neck–shoulder region pain in adulthood. In contrast, participation in several sport activities in adulthood was related to less weekly low back pain among both sexes in cross-sectional but not in longitudinal design. Familial factors did not seem to confound the detected cross-sectional association. In further cross-sectional investigation, participation in endurance sports was related to less both radiating and non-radiating low back pain in adulthood. Overall the findings provide moderate support for additional health benefits related to participation in a diversity of sport activities compared to single sport activity. Promoting participation in several sport activities during adolescence may help to better maintain leisure-time physical activity levels through the transition from adolescence to adulthood, especially among females. In adulthood, participation in several sport activities, especially in endurance sports, may be related to a lower prevalence of weekly low back pain. Future studies should confirm and further investigate the direction of the detected associations in longitudinal study designs including objective measurement of leisure-time physical activity and standardized measures of low back and neck–shoulder region pain. Furthermore, the contribution of the shared familial factors on the observed associations remains unexplored.
  • Roitto, Hanna-Maria (Helsingin yliopisto, 2020)
    Background: Dementia is characterized not only by cognitive and functional decline, but also by neuropsychiatric symptoms (NPSs). These affect almost all people with dementia during the course of the disease. NPSs are associated with impaired health-related quality of life (HRQoL) and admission to long-term care. People with dementia have an elevated risk of falling. Fall risk has been associated with impaired mobility, some NPSs such as depression and anxiety, and the use of psychotropic drugs. In long-term-care settings the prevalence of use of any psychotropic drug has been reported to be very high. There is a scarcity of studies on the interplay between NPSs, psychotropics, falls, and HRQoL Objectives: This study, comprised of four sub-studies, was aimed at examining the relationships between NPSs, falls, psychotropic drug use and HRQoL among people with dementia. The relationship between NPSs and falls was explored in two different populations: home-dwelling older adults with Alzheimer’s disease (AD) (Study I), and institutionalized older adults with cognitive impairment (Study IV). Study I concerned how long-term exercise modifies the risk of falling in community-dwelling people with AD and NPSs. Study IV was carried out to explore whether or not psychotropic drug use modifies the relationship between NPSs and falls. Study III concerned the association between NPSs and HRQoL, and, further, how the severity of dementia modifies this relationship. In addition, Study II concerned temporal trends in the prevalence of use of psychotropics and opioids, and sedative load in long-term-care settings over a 14-year period in relation to the residents’ dementia status. Participants: Study I was a secondary analysis of a randomized controlled trial, FINALEX. All the participants from the original FINALEX trial whose spousal caregivers had completed the Neuropsychiatric Inventory (NPI) at baseline and who had had at least three months of follow-up were included in this study (n=179). Study II is based on Helsinki Nutrition and Medication studies conducted in 2003–2018. It comprised four cross-sectional studies in institutional settings in Helsinki. The participants were residents in nursing homes (NHs) in 2003 (n=1987), 2011 (n=1576), and 2017 (n=791) and in assisted-living facilities (ALFs) in 2007 (n=1377), 2011 (n=1586), and 2017 (n=1752). The participants of Studies III and IV were a random sample of long-term-care residents aged 65 years and older in Helsinki (n=532). Measures: NPSs were measured with the NPI. In Studies III and IV participants were placed in three groups: no significant NPSs (NPI points 0–3), low-NPS burden (4–12 points) and high-NPS burden (NPI >12 points). The severity of dementia was measured by using Clinical Dementia Rating (CDR). HRQoL was measured by using the 15D instrument. Falls were recorded in daily-falls diaries in Study I and collected from medical records in Study IV over a one-year period. Data on demographics, diagnoses and medication were collected from medical records. Types of medication were classified according to Anatomical Therapeutic Chemical (ATC) classification. Results: Mean ages ranged from 78 to 84 years in four large samples. The participants had a high number of comorbidities and were given a high number of drugs (mean range 6.9-8.6). The severity of cognitive impairment varied. Most of the participants in Study I had mild to moderate dementia (CDR 0.5–2), whereas almost all long-term-care residents had moderate to severe dementia (CDR 2–3) (Studies II–IV). In Studies I and IV falls had a clear relationship with NPSs measured by the total NPI score. In Study I the incidence of falls increased linearly with NPI score in the control group. The fall rate was 2.87 per person-years (95% Cl 2.43–3.35) in the control group, whereas the exercise intervention group showed no such relationship with NPI score and had a fall rate of 1.48 per person-years (95% Cl 1.26–1.73). In Study IV the NPI total score had a curvilinear association with the incidence rate of falls per person-years. Using the no-significant-NPSs group as a reference, the low-NPS-burden group had an IRR per SD for falls of 1.64 (95% Cl 1.27–2.12), whereas in the high-NPS-burden group the IRR per SD was 2.43 (95% Cl 1.91–3.08). Psychotropics did not modify the relationship between NPSs and falls. Psychosis and hyperactivity subsyndromes were associated with higher IRRs of falls, whereas apathy and affective symptoms were not. In Study III the severity of NPSs was significantly associated with better HRQoL (15D measures). This seemed to be related to better physical functioning and greater vitality. Residents with severe dementia (CDR 3) had worse HRQoL than residents with mild-to-moderate dementia (CDR <3). There was a significant interaction between NPI and CDR scores (p=0.037 for NPI, p<0.001 for CDR and p<0.001 for interaction). In Study II the prevalence of use of all psychotropics decreased significantly in NHs (from 81% to 61%), whereas in ALFs there was no such trend (from 65% to 64%). There was a significant increase in opioid use in both settings. Residents with dementia used fewer psychotropics and opioids than those without dementia in both settings and at all time points. Conclusions: Neuropsychiatric symptoms and their severity are associated with fall risk. Evaluation of NPSs, especially NPS severity and neuropsychiatric subsyndromes, should be part of comprehensive assessment when aiming to prevent falls in long-term-care residents with cognitive impairment. Exercise has the potential to reduce the risk of falls associated with NPSs. The severity of NPSs and dementia are both important factors determining HRQoL. NPSs have a distinct impact on HRQoL at different stages of dementia. The prevalence of psychotropic use has decreased over the last 14 years in NHs in Helsinki, but at the same time the rates of opioid use have increased in both NHs and ALFs, leading to a high overall sedative load among long-term-care residents.
  • Laurila-Pant, Mirka (Helsingin yliopisto, 2020)
    In environmental policy and management, the main objectives are to protect and enhance the environmental status so that we can preserve the services and benefits ecosystems provide for the society. To evaluate whether the management objectives are met, there is a need to measure the prevailing status of the system in focus, and to define the desirable versus the undesirable state. How these tasks are implemented will impact our judgement about whether the system needs restoration or not, or if ongoing or planned exploitation of natural resources can be seen as sustainable. Indicators thus provide means for the precise definition of the objectives by setting measurable target states to be achieved. However, it is not straightforward to judge, whether or not the objectives have been attained. The first question is, what we should measure, i.e. what is an appropriate indicator. The second question is, what the sufficiently good status of the indicator is, i.e. how to define the target level. Third, after we have decided what to measure and how to interpret the measurements, we have to think, how the different decision criteria are weighted in relation to each other. This thesis approaches the above-mentioned questions from the multidisciplinary and probabilistic perspective, providing novel ideas and tools. Maintaining biodiversity is one of the key objectives mentioned in the Marine Strategy Framework Directive (MSFD) and the Baltic Sea Action Plan (BSAP). Article I of the thesis reviews alternative metrics for measuring (i.e. indicating) biodiversity and discusses the ecological, economic and sociocultural perspectives to its valuation. The paper suggests integrating these three perspectives into a multi-objective framework. Furthermore, a formal guideline for decision support is proposed when quantitatively evaluating alternative management decisions against biodiversity. Article II elaborates the uncertainty related to the process of determining the prevailing status of an indicator as well as the boundary value used as the threshold between a desirable (Good Environmental Status “GES”) and a non-desirable state (“Sub-GES”). The current indicator-based management protocols such as the MSFD and the BSAP have not acknowledged the uncertainty of the GES boundary value, instead, the boundary value is given as a fixed value with no associated uncertainty. Article II presents an alternative way to define the target level and assess the prevailing status of one ecological indicator, the abundance of perch (Perca fluviatilis) - an indicator adopted by both BSAP and MSFD to represent the status of coastal fish communities in the central and northern Baltic Sea. A Bayesian model is developed to evaluate the prevailing relative abundance and the GES boundary for it while acknowledging the uncertainty related to these estimates. Multi-Criteria Decision Analysis (MCDA) is an approach used to frame and formally solve decision-making problems with multiple, often contradictory objectives. As society at large covers a variety of interests towards the services and benefits that ecosystems provide, the unavoidable trade-offs in environmental multi-objective decision-making processes easily lead to conflicts. In Article III, a Bayesian approach is developed to quantify the uncertainty about the stakeholder groups’ consensus concerning the valuation of ecological attributes. When integrated into a MCDA model, it is possible to visualise what we know about the level of disagreement or agreement and analyse the optimal decisions from the perspective of each group. The qualitative verbal management objectives (e.g. the “sustainable development” or “good environmental status”) are vague in their precise meaning and can thus complexify the societal discourse. Indicators can be thought to specify their definitions. By setting quantitative metrics for expressing the objectives and defining the rules for their weighing, they allow transparent discussion and judgement whether the objectives are actually met or not. However, the use of indicators does not remove the uncertainty nor the value judgements related to environmental decisions. The inherent uncertainty that arises from the limited knowledge of the system - both the ecological and social part of it - cannot be avoided. However, by adopting a multi-disciplinary perspective which utilises modern modelling methods and normative decision theory, this thesis demonstrate a probabilistic view on the issue and develops tools to tackle it.

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