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  • Wikstén, Eeva Johanna (Helsingin yliopisto, 2016)
    Peritonsillar abscess (PTA) is the most common otorhinolaryngological infection that requires special health care management. Its treatment varies greatly due to a lack of common clinical guidelines. Tonsillectomy (TE) is performed on a portion of PTA patients, yet it remains controversial as to which PTA patients would benefit from TE. Traditional bacterial culture is ineffective at defining the causative bacteria for PTA. Rapid microarray methods have been tested, for example on serum and joint fluid samples, but not yet on pus. Most of the bacteria found in PTA are susceptible to penicillin, but, to avoid complications, antibiotics, with unnecessary broad spectrum, are frequently used instead. The aim of the first study in this thesis was to explore the microbiology of adults with PTA using a modern identification method and to find cofactors among patients with different pathogens. Using a modern DNA-based microarray method, we examined the microbial findings in the pus aspirated from 180 PTA patients. Fusobacterium necrophorum proved to be the most prevalent bacteria, occurring more frequently in younger patients; group A Streptococcus was the second most common. The microarray method seemed to work well for identifying bacteria directly from pus. In the second study, the aim was to compare the treatment modalities for PTA in countries closely related to Finland. We sent an electronic questionnaire regarding PTA treatment to all central and university hospitals in Finland, Sweden, Norway and Denmark. The study revealed diversity among treatment modalities between the four countries. To identify factors predicting a doctor ́s decision for TE among PTA patients, in the third study, we retrieved data on 819 PTA patients from a national database, which included information on whether a TE was performed within five years after a PTA diagnosis and why. The study showed that young age and previous tonsillar infections increased the probability of having a TE performed. In the fourth study, the aim was to investigate whether combining metronidazole with penicillin enhances the recovery from PTA and whether metronidazole helps prevent PTA recurrences. A total of 200 prospectively collected patients were randomised to receive either penicillin and placebo or penicillin and metronidazole. The patients filled in an electronic diary daily for the first two weeks and then weekly for the following six weeks. Most patients (90 in each group) healed well without recurrence of PTA. Thus, metronidazole neither enhanced the recovery nor prevented recurrences; furthermore, it caused unwanted adverse effects (diarrhoea and nausea). These four explorations into PTA provided valuable insight. These results make a difference not just for one patient, but for the whole health care system; the treatment is evidence-based and can be offered to those whom it serves best.
  • Marjamaa, Kaisa (Helsingin yliopisto, 2007)
    Lignin is a complex plant polymer synthesized through co-operation of multiple intracellular and extracellular enzymes. It is deposited to plant cell walls in cells where additional strength or stiffness are needed, such as in tracheary elements (TEs) in xylem, supporting sclerenchymal tissues and at the sites of wounding. Class III peroxidases (POXs) are secreted plant oxidoreductases with implications in many physiological processes such as the polymerization of lignin and suberin and auxin catabolism. POXs are able to oxidize various substrates in the presence of hydrogen peroxide, including lignin monomers, monolignols, thus enabling the monolignol polymerization to lignin by radical coupling. Trees produce large amounts of lignin in secondary xylem of stems, branches and roots. In this study, POXs of gymnosperm and angiosperm trees were studied in order to find POXs which are able to participate in lignin polymerization in developing secondary xylem i.e. are located at the site of lignin synthesis in tree stems and have the ability to oxidize monolignol substrates. Both in the gymnosperm species, Norway spruce and Scots pine, and in the angiosperm species silver birch the monolignol oxidizing POX activities originating from multiple POX isoforms were present in lignifying secondary xylem in stems during the period of annual growth. Most of the partially purified POXs from Norway spruce and silver birch xylem had highest oxidation rate with coniferyl alcohol, the main monomer in guaiacyl-lignin in conifers. The only exception was the most anionic POX fraction from silver birch, which clearly preferred sinapyl alcohol, the lignin monomer needed in the synthesis of syringyl-guaiacyl lignin in angiosperm trees. Three full-length pox cDNAs px1, px2 and px3 were cloned from the developing xylem of Norway spruce. It was shown that px1 and px2 are expressed in developing tracheids in spruce seedlings, whereas px3 transcripts were not detected suggesting low transcription level in young trees. The amino acid sequences of PX1, PX2 and PX3 were less than 60% identical to each other but showed up to 84% identity to other known POXs. They all begin with predicted N-terminal secretion signal (SS) peptides. PX2 and PX3 contained additional putative vacuolar localization determinants (VSDs) at C-terminus. Transient expression of EGFP-fusions of the SS- and VSD-peptides in tobacco protoplasts showed SS-peptides directed EGFP to secretion in tobacco cells, whereas only the PX2 C-terminal peptide seems to be a functional VSD. According to heterologous expression of px1 in Catharanthus roseus hairy roots, PX1 is a guaicol-oxidizing POX with isoelectric point (pI) approximately 10, similar to monolignol oxidizing POXs in protein extracts from Norway spruce lignifying xylem. Hence, PX1 has characteristics for participation to monolignol dehydrogenation in lignin synthesis, whereas the other two spruce POXs seem to have some other functions. Interesting topics in future include functional characterization of syringyl compound oxidizing POXs and components of POX activity regulation in trees.
  • Anyan, James (Helsingin yliopisto, 2016)
    This study explores how opportunities for higher education (HE) are distributed in Ghana's public universities to students; and particularly, how those from the disadvantaged sections of the Ghanaian society fare in that regard. It was approached as a multi-level (integrating elements of micro, meso and macro) and multi-perspective dual transformative case study. Drawing mainly upon data collected from semi-structured interviews with students, graduates, university officials and policy-makers, as well as secondary data archived by the relevant institutions; it examines the processes and patterns in the distribution of admission slots to students. It engages with the tensions and dilemmas confronting the universities in such allocations, and debates same, in the context of procedural justice and meritocracy on the one hand, and distributive justice and affirmative action on the other. The interactions and intersections of socio-economic and other significant variables parental education, family income, geographical location, gender and disability are discussed, principally, in the framework of effectively maintained inequality (EMI), to understand the factors influencing the patterns of distribution observed. The data were thematically analysed using both sensitising concepts from the literature review, the conceptual frameworks as well as the indigenous concepts that emerged from the data. The findings indicate that the distribution of HE seats in the two public universities selected for the study is highly inequitable with students who graduated from the few urban-based and elite upper secondary schools overrepresented while graduates from the majority rural-based and resource-poor schools are underrepresented. Although there was unanimity among the different groups of participants about the existence and persistence of the problem, their approaches to dealing with the problem proved dichotomous. While students from the rural schools, for instance, exposed their status frustration and assumed a reformist stance on the issue of remodelling the current grade-based admission system to one cognisant of the difficult circumstances under which rural students pursue their upper secondary education, their counterparts from the elite schools essentially defended the maintenance of the status quo. The majority of female participants, contrary to the views of policy-makers, strongly objected to affirmative action for the admission of females; arguing that the policy reinforces the notion that they are inferior to their male counterparts. The results further reveal a multi-layered social stratification in access to, and equity in HE in Ghana. Almost all the students and graduates who were admitted into the universities on affirmative action basis identified themselves as rural people from low-income families, with little or no parental education, and poor parental occupations. Such students, though in dire financial straits, were contrary to expectations, found to be very resilient and highly motivated to complete their studies; posting excellent academic performance. Students with disabilities were also found to be internally excluded, facing life and academic threatening challenges, whereas female students reported entrenched socio-cultural norms impeding the education and aspirations of women in the Ghanaian society. Against these backdrops, the study calls for a rethink of the current overly meritocratic admission procedures in Ghana's public universities that do harm to access and equity for the majority rural students. It further recommends financial support from government to support the affirmative action initiatives of the public universities; an improvement in the conditions of students with disability, and multi-sectoral interventions to ameliorate the barriers impeding the education of females. The successful completion of HE holding all things constant by these disadvantaged groups, with its attendant better educated citizenry, enhanced civic consciousness, empowerment and participation, in addition to other socio-economic benefits, make such investments worthwhile. Keywords: distributive justice, procedural justice, affirmative action, gender, disability, stratification.
  • Lundén, Janne (Helsingin yliopisto, 2004)
  • Törnroos, Maria (Helsingin yliopisto, 2015)
    The role of individual differences in perceptions of stress has long been recognized. Despite this, the models that are used to measure stress at the workplace the job strain model and the effort-reward imbalance model were developed to assess strenuous work characteristics and their health effects, regardless of the individual. Because work characteristics are usually measured using self-reports the measures cannot be completely objective. The present study examined the susceptibility of the job strain model and the effort-reward imbalance model to Five-Factor personality traits and cynicism. In addition, this study tested the longitudinal measurement invariance of the effort-reward imbalance scales. This study was part of the ongoing prospective, population-based Young Finns study. The measurements for the present study were carried out in 2001, 2007, and 2012. Five-Factor personality traits were assessed with a questionnaire on the Five-Factor model, and cynicism was assessed with a scale derived from the Minnesota Multiphasic Personality Inventory. Work characteristics were measured with questionnaires on the job strain model and the effort-reward imbalance model. The results showed that high neuroticism was associated with higher job strain and higher effort-reward imbalance and that high agreeableness was associated with lower job strain and lower effort-reward imbalance. High extraversion, high openness, and high conscientiousness were associated with lower job strain. Furthermore, high conscientiousness was related to lower effort-reward imbalance only in men. High job strain prospectively predicted higher cynicism six years later. The effort-reward imbalance scales achieved strict longitudinal measurement invariance and showed adequate criterion validity. Although developed to measure the structural work environment, the job strain model and the effort-reward imbalance model seem to be susceptible to Five-Factor personality traits especially to neuroticism and agreeableness. In addition, high job strain seems to have far reaching consequences on cynical attitudes. Furthermore, the results show that scores on effort-reward imbalance from different time points can reliably be compared with each other. This study shows that organizations and occupational health services should apply a more person-oriented approach to increasing wellbeing at work.
  • Lindfors, Olavi (Terveyden ja hyvinvoinnin laitos, 2014)
    Personality functioning and psychotherapy outcome Personality dysfunction is manifested in interpersonal interactions and self-concept. It generates vulnerability to psychopathology and increases the risk of recurring symptoms and impaired work ability. Change in personality functioning is considered a major goal of psychotherapy, but published studies comparing different psychotherapeutic treatments on the subject are scarce. Likewise, the suitability of short-term and long-term therapy has been suggested to be partly determined by the patient s personality functioning but only limited research evidence on the issue is available. Accordingly, assessment of these personality factors with reliable and valid instruments and knowledge on their prediction on outcome are needed for selecting the most optimal treatment for patients. The aims of this study were to study the effectiveness of short-term and long-term psychotherapy on personality functioning for patients with anxiety or mood disorder, and to study the respective prediction of personality functioning on outcomes, during a 3-year follow-up. The subjects consisted of 326 outpatients with anxiety or mood disorder, randomized to short-term or long-term psychotherapy in the Helsinki Psychotherapy Study (HPS). Altogether 97 patients were randomly assigned to solution-focused therapy (SFT), 101 patients to short-term psychodynamic psychotherapy (SPP) and 128 patients to long-term psychodynamic psychotherapy (LPP). The patients psychological status was monitored by questionnaires and interviews before randomization and at 3, 7, 9, 12, 18, 24 and 36 months after the baseline during the 3-year follow-up. Key personality factors in the study were the quality of object relations and self-concept, measured by the Quality of Object Relations Scale (QORS), assessed at baseline with interview, and the Structural Analysis of Social Behavior self-concept questionnaire (SASB). The QORS was used as a predictor variable and as an effect modifying factor. The SASB was used both as a predictor and an outcome variable, the main dimensions measured being affiliation (AF) and autonomy (AU), as well as the secondary sub-scores: self-free, self-affirm, self-love, self-protect, self-control, self-blame, self-attack, and self-neglect. Outcomes in psychiatric symptoms were assessed by the Global Severity Index and the Anxiety Scale of the self-report Symptom Check List 90 (SCL-90-GSI, SCL-90-ANX), and by the Beck Depression Inventory (BDI). Outcomes in work ability were assessed by three self-report questionnaires, the Work Ability Index (WAI), the work subscale of the Social Adjustment Scale (SAS-work), and with the Perceived Psychological Functioning (PPF) scale. In study I, a methodological cross-sectional study, the concurrent validity of the QORS was examined in a subgroup of 263 patients, and found to be adequate, showing discontinuity and devaluation in relationship to be its main determinants, in line with the theoretical scale constituents. Study II was a randomized clinical trial which compared the effectiveness of the two short-term psychotherapies (SFT and SPP) and LPP on self-concept during the 3-year follow-up. Self-concept improved faster during the first year of follow-up in the short-term therapies than in LPP in most of the self-concept scores, whereas at the 3-year follow-up LPP was more effective than SFT in AF, self-affirm, self-blame and self-neglect. No difference between the short-term and long-term psychodynamic therapies was noted at any measurement point. Long duration and psychodynamic orientation of therapy may thus benefit self-concept improvement in comparison to a short-term, supportive therapy like SFT. Support for the relevance of personality functioning also in the selection of treatment was received from Study III, which was based on the previous study and evaluated the effect modification of the quality of object relations on changes in self-concept, in the two short-term therapies and in LPP. The effectiveness of SFT, but not SPP, was significantly poorer in AF, AU, self-attack, self-love and self-free, for patients with less mature relational patterns (low QORS) than for patients with high QORS, mostly in several follow-up points. Contrary, low QORS predicted better outcome in LPP, albeit to a lesser degree, during the first follow-up year in AF, self-attack and self-love. Finally, in Study IV, the prediction of the QORS and the SASB self-concept scores (AF, AU) on psychiatric symptoms and work ability in short-term and long-term therapy was studied in a cohort study design. As no differences were found between the short-term therapies, a short-term therapy group was formed by combining SFT and SPP, to increase statistical power in the analyses. Negative self-concept (low AF) strongly and overly controlling self-concept (low AU) modestly predicted greater early gains in psychiatric symptoms and work ability in short-term therapy than in LPP. However, at the 3-year follow-up low AF predicted better outcomes in LPP, by a greater reduction in psychiatric symptoms. More limited long-term benefits in LPP vs. short-term therapy were found in symptoms and work ability among the patients with low AU and low QORS. Patients with relatively good personality functioning (high AF, high AU, high QORS) experienced consistently more extensive benefits in work ability and mostly also in psychiatric symptoms, after LPP than after short-term therapy. In conclusion, patients with anxiety or mood disorders, with mild to moderate personality pathology, benefited more in terms of psychiatric symptoms from LPP than from short-term psychotherapy in the long run. This was most evident in the reduction of depressive symptoms among the LPP patients with negative self-concept. Further, the findings showed that favorable aspects of self-concept improved and unfavorable aspects decreased to a greater extent after LPP than after SFT during the 3-year follow-up. The fact that higher QORS was associated with more extensive benefits in self-concept in SFT, suggests that SFT is applicable especially for patients with relatively good personality functioning. Instead, patients with low QORS experienced additional benefits in some areas of self-concept, during the first year in LPP. This indicates that LPP gave them a beneficial start for continuing to work out their problems in self-concept. Thus negative self-concept and low QORS may indicate the need for a more intensive or lengthier psychotherapeutic treatment. Another important issue concerns the finding that short-term therapy generally gave faster benefits in symptoms, work ability and self-concept than LPP, but was more frequently insufficient in providing sustained benefits. Accordingly, careful pre-treatment evaluation is needed to screen those patients for whom short-term therapy or LPP should be considered. The finding that patients with relatively good personality functioning also experienced more extensive benefits after LPP in symptoms and work ability, suggests that patients capacities and motivation for LPP, along with their dysfunction, need to be acknowledged when considering treatment options. More research is needed to confirm the findings and to help in the development of more effective psychotherapies and therapist training. Further research on the relative importance of different personality functioning dimensions on the outcome of short-term and long-term psychotherapies, in comparison with other patient-related factors, will deepen understanding on the most essential predictors of outcome. Further effectiveness research during a longer follow-up is also needed to explore differences in sustained benefits of the therapies, by a more extensive battery of personality functioning factors and in comparison to other outcome dimensions. Keywords: anxiety disorder, mood disorder, object relations, outcome, prediction, psychodynamic, psychotherapy, self-concept, solution-focused
  • Kluen, Edward (Helsingin yliopisto, 2012)
    In order to adapt their behaviour optimally and to be able to increase fitness, individuals are assumed to respond flexibly to environmental variation they encounter. Contrasting with this classical behavioural ecological point of view is the concept of animal personality. The latter focuses on understanding the mechanisms underlying and evolutionary processes maintaining variation in the expression of a behavioural trait over time and across situations or contexts. Originating in human psychology, personality studies have recently been integrated into the fields of ecology and evolution. Studies on consistent variation in behaviour within and between individuals (personality) have resulted in numerous insights and these are still expanding. In the first chapter of this thesis I research underlying factors and possible consequences of the response (delayed hatching) of blue tits (Cyanistes caeruleus) to encountered climatic variation. I find that hatching delay (i.e. number of days hatching was delayed) is associated with early laying dates and low mean temperatures during the egg-laying phase. In addition hatching delay is negatively associated with clutch hatchability and female body condition. Using a reciprocal cross-fostering protocol on a large number of broods, I find that hatching delay may also negatively affect developmental parameters in offspring, in particular body mass of nestlings at fledging. Results from this study demonstrate that environmental conditions during egg laying can have effects lasting throughout the breeding and nestling period. In chapters II to V I investigate variation in behaviour among individuals. The focus in these four chapters is on personality traits in blue tits. I first design an experimental setup, using a bird cage, in which several behavioural traits can be measured in a quick and non-invasive manner and which can be applied in both winter and breeding season. In addition several behavioural traits are measured during handling of both adult and nestling birds. All these behavioural measures are then used to test several aspects of behaviour in a personality context in the blue tit. The behavioural traits derived from the bird cage are repeatable over time and qualify as personality traits in this species. In addition I find an association between one of the measured personality traits in the cage and a single nucleotide polymorphism in the 3rd exon of the dopamine receptor (D4) gene (DRD4), similar to what has been found in recent research on great tits (Parus major). This suggests that there is a genetic basis underlying this personality trait and that this genomic region might be involved in animal personality. I apply a reaction norm framework to assess context specificity of the traits measured in the bird cage, using measures from (partly) the same birds measured in two distinct contexts (winter and breeding season). I show that one needs to carefully consider the context under which individuals are assayed and that a recorded behaviour may or may not be repeatable in another context. Furthermore I use data from a cross-foster protocol on nestling blue tits in combination with quantitative genetics. I assess the heritability of three behavioural traits and show that these traits form a behavioural syndrome at both the phenotypic and genetic level. In addition, from the applied animal model analysis I can conclude that environmental factors, encountered by nestlings during the rearing period, may have a considerable impact on a nestling s personality. Thus, taken into account findings from the first chapter in this thesis, the development of both physical and behavioural traits in an individual seems to find its origin already in the earliest phases of life. Finally I test whether three personality traits and two immunological traits in the blue tit covary and form a syndrome which includes behavioural and immunological traits. I find that there are intrinsic correlations between behavioural and immunological traits; however there is no strong evidence for the existence of a syndrome of these traits in the blue tit.
  • Lindqvist, Ann-Marie (Helsingin yliopisto, 2014)
    The thesis describes how adults with learning disabilities are experiencing, creating and exercising their social citizenship. It concerns lived citizenship, understood as the meaning citizenship actually has in the persons lives and the ways in which the social and cultural background and material circumstances affect their lives as citizens. It is based on Ruth Lister's understanding of citizenship. The study approaches the following questions: How do people with learning disabilities experience their participation and how are obstacles and possibilities for their participation manifested in everyday life? What factors are important when people with learning disabilities are creating and exercising their citizenship in a housing context? The thesis posits itself within an ethnographic tradition and represents disability research where the users' and the professionals perspectives are highlighted. The thesis follows a tradition of research in social work that studies the living conditions for people in vulnerable positions and draws attention to their agency. Critical realism based on Roy Bhaskar and Berth Danermark gives the methodological guidelines for the thesis. To understand disability, critical realism and the International Classification of Functioning, Disability and Health (ICF) provide the theoretical understanding with a focus on interaction between the individual and the environment. Knowledge production has been made in collaboration with a group of people with learning disabilities. The two empirical studies in the thesis are based on interviews with people with learning disabilities and professionals, participant observation and documents. The persons in the study exercise and create their citizenship in areas where they are dependent on how professionals view their work and their role. The study gives some evidence of the fact that both the professionals and the service users are trying to find new roles and new positions. The forums to exercise control over their everyday life are individual plans, formal face to face discussions and everyday informal discussions with staff. However, as service users the persons are unsure of their rights and obligations. Furthermore the persons are not always included in the discussions relating to them. Formulation of wishes and a positive self-relation can be seen as prerequisites when people create their citizenship. The size of the service units is relevant to the amount of control the service users can have over their lives, but what matters most is the professionals approach to work and spatial practice that takes into account opportunities for social interaction and privacy. In collective service units the professionals find it problematic to take into account all the service users´ individual needs while balancing between the rights and individual differences. Citizenship as status gives the rights and opportunities to get one s voice heard as an actor. But rights themselves are not sufficient. While the persons in the study have a will to control their lives they are on different levels, dependent on various degrees of support from the environment, in order to take an active role in the process of creating and exercising their citizenship. Negotiations on belonging and participation take place in interaction with the environment. The persons in the study benefit from supported decision making. It means being provided with information in a way that they understand and having professionals, who are familiar with alternative methods of communicating so as to reach a common understanding. The professionals reflective approach and the persons opportunity to receive support from professionals they have confidence in, make it possible to build up a joint reflection regarding processes where they actively create their citizenship. Key words: lived citizenship, people with learning disability, critical realism, everyday life experiences, ICF, participatory research.
  • Siivonen, Jonita (Helsingin yliopisto, 2007)
    The thesis The portrait interview as a newspaper genre. A qualitative close reading focussing on topical motifs, conventions of narration, and gender defines the portrait interview as a newspaper genre and analyses how the personalities in the portraits are constructed textually. The main body of material consists of 107 portrait interviews in two morning newspapers, Dagens Nyheter (published in Stockholm, Sweden) and Hufvudstadsbladet (published in Swedish in Helsinki, Finland), during two one-week periods (week 46/1999 and week 38/2002). There is also complementary material of 59 portraits from four magazines. The study is carried out within the research traditions of journalistic genre studies, gender and journalism, and critical text analysis. It is comprised of a qualitative close reading focussing on content (topical motifs or themes), conventions of narration, and gender. The methods used to carry out the study are qualitative close reading and quantitative content analysis. The analysis identifies the stylistic elements that differentiate the portrait genre from other journalistic genres, as well as from the autobiographical genre, and explores what opportunities and limitations these elements present for the inclusion of even more women protagonists in the portrait genre. The portrait interview is an exception from the critical mission of journalism in general, with its position as a genre of politeness. Since a typical characteristic of the portrait interview genre is that it pays tribute to the protagonist, the genre reveals the kind of personalities and lives that are seen as admirable in society. Four levels of portrait interview are defined: the prototype portrait, the pure portrait, the hybrid portrait and the marginal portrait. The prototype is a raw version of a portrait that fulfils the criteria but may be lacking in content and stylistics. The pure portrait does not lack these qualities and resembles an ideal portrait. The hybrid is a borderline case which relates to another genre or is a mixture between the portrait and some other genre, most commonly the news genre. The marginal portrait does not fulfil the criteria, and can therefore be seen as an inadequate portrait. For example, obituaries and caricatures are excluded if the protagonist s voice is never quoted. The analysis resulted in three factors that in part help to explain why the portrait interview genre has somewhat more female protagonists than journalistic news texts do in general. The four main reasons why women are presented somewhat more in the portrait genre than in other journalistic genres are: (i) women are shown as exceptions to the female norm when, for example, taking a typical male job or managing in positions where there are few women; (ii) women are shown as representing female themes ; (iii) use of the double bind as a story-generating factor; and (iv) the intimisation of journalism. The double bind usually builds up the narration on female ambiguity in the contradiction between private and public life, for example family and career, personal desire and work. The intimisation of journalism and the double bind give women protagonists somewhat more publicity also because of the tendency of portrait interviews to create conflicts within the protagonist, as an exception to journalism in general where conflicts are created or seen as existing between, for example, persons, groupings or parties. Women protagonists and their lives create an optimal narration of inner conflicts originating in the double bind as men are usually not seen as suffering from these conflicts. The analysis also resulted in gendered portrait norms: The feminine portrait norm and the masculine portrait norm or more concretely, professional life and family life as expectation and exception. Women are expected to be responsible parents and mediocre professionals, while men are expected to be professionals and in their free time engaging fathers. Key words: journalism, genre, portrait interview, gender, interview, newspaper, women s magazine.
  • Toivonen, Kaisu Maria (Helsingin yliopisto, 2014)
    This doctoral thesis focuses on the interpretation of children s ethical growth and education in the Finnish education system through the lens of a specific philosophical approach. The hermeneutic frame of reference is a systematic-holistic model based on Lauri Rauhala s view of the human being and the situational regulation system. It has been widened in this thesis partly concerning socialization and the education system using Urie Bronfenbrenner´s ecological socialization theory. As the level of pre-understanding, Kohlberg´s cognitive-structural theory of moral development is applied. In this research the concepts of human being, personality, value and education have been applied in accordance with existential and phenomenological philosophy. The concepts of good, value mastering and the ethics of virtue are the guiding principles of value and ethical education.The research problem is as follows: what kind of knowledge will emerge as being applicable to ethical education in a postmodern Finnish education system? It was found that ethical growth begins at birth. This is contrary to the previous belief, according to which ethical awareness would emerge as late as at the age of six. Early interaction is also an important part of ethical growth. Personality development is by nature open, dynamic and holistic. It consists of a physical dimension, consciousness and situational components. The subjective world view is built on holistic experience and meaning. It is influenced by concrete situational and ideological factors. In this way children are immediately brought into relation with situational values, moral ideas, norms and rules. This way children create different meanings when building their own world view. During interaction between growth and education the child´s capacity for empathy, feelings, self-control and thinking will become integral parts of their moral action. As a result, ethical growth and social competence will develop. Cognition and the appreciation of values are but one way of looking at ethical growth and moral action. At the micro level, interaction between growth and education takes place between children, parents, friends, homes and schools. It also means that actions transpire at the meso-, exo- and macro levels as well. In the postmodern age, children´s growth and living experiences are strongly affected by media, which creates universal feelings, knowledge and values. In addition, professional educators are affected by laws and other official documents. The aim of dialogical education is the good life and ideals of becoming oneself. Freedom and responsibility are the cornerstones of modern ethics and morality. The educational tradition is no longer enough. In this rapidly changing world with its flood of information, the capacity to make ethically lasting choices is needed. In supporting holistic personal growth, and with the help of value-competence and virtue ethics, individual ethical growth can be developed. This should be taken into account more directly than previously in the Finnish educational context and specially in its official documents. Keywords: dialogical education, ecological socialization theory, ethical education, ethics, existential and phenomenological concept of human being, hermeneutic analysis, moral development, morality, person, systemic- holistic model, values.
  • Immonen, Sirpa (Helsingin yliopisto, 2012)
    Alcohol use plays a part in the life of older adults, and can be assumed to be increasingly prominent in the future as the baby boomers age. Understanding alcohol consumption patterns and factors associated with risky drinking in the general population of older adults aids in detecting older adults who may suffer from the hazardous use of alcohol or alcohol use disorders. The present study assessed some issues in alcohol consumption among older adults: the prevalence of consumption and associated factors, older adults own reasoning for their alcohol consumption, the drinking of alcohol for medicinal purposes, and potentially inappropriate drug alcohol interactions. The data were gathered using a postal questionnaire sent to a stratified random sample of older adults aged ≥65 years in the City of Espoo. The number of respondents was 1 395 (71.6%). The mean age was 78 years and 62.7% were women. The guidelines of the American Geriatrics Society were used to define the at-risk drinking limits. The prevalence of alcohol consumption was 71.5% and at-risk drinking was estimated to be 10.8%; 20.6% among older men and 4.2% among women. At-risk alcohol consumption was more common in the youngest age groups and among men; 25.4% of men and 7.7% of women aged 65 70 years exceeded the at-risk drinking limit. Although the frequency and quantity of alcohol use declined with age, 18.9% of males aged 71 80 years and 11.3% aged 81 90 years exceeded the at-risk drinking limit. The corresponding figures among females were 2.5% and 1.4%. The respondents most common reasons for drinking were for having fun, celebration (58.7%), and for social reasons (54.2%). Of the respondents, the younger age groups reported more often than the older age groups that they used alcohol for having fun, celebration, and for social reasons . The proportion reporting drinking alcohol for medicinal purposes increased with age. Alcohol was consumed with meals in all age groups, although this was more common in younger age groups. A larger proportion of the at-risk users than the moderate users indicated that they were using alcohol because of meaningless life, in relieving anxiety, relieving loneliness, and relieving depression , as a pastime and because everybody uses it . The medicinal consumption of alcohol was more common in the oldest age group. Both genders used this self-medication equally. The most common conditions for which alcohol was used as a medicine were cardiovascular diseases, sleep disturbances, a common cold and indigestion. The concomitant use of drugs that have potential interactions with alcohol was common. Of the drug users, 62.2% also used alcohol. Among the at-risk users and moderate users , 42.2% and 34.9% were on drugs potentially causing significant interactions with alcohol.
  • Muukkonen-van der Meer, Hanni (Helsingin yliopisto, 2011)
    Higher education is faced with the challenge of strengthening students competencies for the constantly evolving technology-mediated practices of knowledge work. The knowledge creation approach to learning (Paavola et al., 2004; Hakkarainen et al., 2004) provides a theoretical tool to address learning and teaching organized around complex problems and the development of shared knowledge objects, such as reports, products, and new practices. As in professional work practices, it appears necessary to design sufficient open-endedness and complexity for students teamwork in order to generate unpredictable and both practically and epistemologically challenging situations. The studies of the thesis examine what kinds of practices are observed when student teams engage in knowledge creating inquiry processes, how the students themselves perceive the process, and how to facilitate inquiry with technology-mediation, tutoring, and pedagogical models. Overall, 20 student teams collaboration processes and productions were investigated in detail. This collaboration took place in teams or small groups of 3-6 students from multiple domain backgrounds. Two pedagogical models were employed to provide heuristic guidance for the inquiry processes: the progressive inquiry model and the distributed project model. Design-based research methodology was employed in combination with case study as the research design. Database materials from the courses virtual learning environment constituted the main body of data, with additional data from students self-reflections and student and teacher interviews. Study I examined the role of technology mediation and tutoring in directing students knowledge production in a progressive inquiry process. The research investigated how the scale of scaffolding related to the nature of knowledge produced and the deepening of the question explanation process. In Study II, the metaskills of knowledge-creating inquiry were explored as a challenge for higher education: metaskills refers to the individual, collective, and object-centered aspects of monitoring collaborative inquiry. Study III examined the design of two courses and how the elaboration of shared objects unfolded based on the two pedagogical models. Study IV examined how the arranged concept-development project for external customers promoted practices of distributed, partially virtual, project work, and how the students coped with the knowledge creation challenge. Overall, important indicators of knowledge creating inquiry were the following: new versions of knowledge objects and artifacts demonstrated a deepening inquiry process; and the various productions were co-created through iterations of negotiations, drafting, and versioning by the team members. Students faced challenges of establishing a collective commitment, devising practices to co-author and advance their reports, dealing with confusion, and managing culturally diverse teams. The progressive inquiry model, together with tutoring and technology, facilitated asking questions, generating explanations, and refocusing lines of inquiry. The involvement of the customers was observed to provide a strong motivation for the teams. On the evidence, providing team-specific guidance, exposing students to models of scientific argumentation and expert work practices, and furnishing templates for the intended products appear to be fruitful ways to enhance inquiry processes. At the institutional level, educators do well to explore ways of developing collaboration with external customers, public organizations or companies, and between educational units in order to enhance educational practices of knowledge creating inquiry.
  • Berg, Patricia (Helsingin yliopisto, 2014)
    Throughout history, people have moved between places. One approach of studying the relationship between people and the environment they live within is called a phenomenology of landscape. According to this approach, all landscapes are embedded in the social and individual times of memory and there is a right way to move around in the familiar landscape. In this dissertation I present textual references to mobility and travelling in ancient Egyptian non-literary texts from Deir el-Medina. In other words, I examine in what ways the inhabitants of Deir el-Medina wrote about functionally-bound forms of individual movement. The purpose of this study is primarily to examine mobility as expressed in the written media, rather than the practical aspects of travelling. Deir el-Medina is situated on the West Bank of Thebes (modern Luxor). It was built to house the workmen that were employed by the state to build the royal tombs during the New Kingdom (ca. 1550 1069 BCE), and their families and servants. Due to the nature of the work at least some of the villagers were literate. They thus communicated to some extent in writing, and by doing this, produced a vast textual material of which a part has been preserved until today. Of the large number of non-literary texts originating from Deir el-Medina and its surroundings ca. 4,500 non-literary texts have been made available to scholars through publications. Among these, ca 320 texts include references to mobility and travelling and were incorporated in the corpus of this study. This dissertation is the first comprehensive study of mobility among the inhabitants of Deir el-Medina. Within the corpus, references to mobility and travelling are found in a large variety of text types dating from throughout the New Kingdom. A considerable number of various expressions were used when referring to mobility. However, especially in administrative texts, standardized expressions were also used. One might thus argue that the villagers not only moved in the right way within the familiar landscape, but also wrote about moving within their close environment in a standardized manner. Additionally, in administrative texts references to mobility were in general recorded at the beginning of the text. This would indicate that events related to mobility had a high importance ranking in the documentation system of the necropolis administration.
  • Hosia-Randell, Helka (Helsingin yliopisto, 2010)
    Prescribing for older patients is challenging. The prevalence of diseases increases with advancing age and causes extensive drug use. Impairments in cognitive, sensory, social and physical functioning, multimorbidity and comorbidities, as well as age-related changes in pharmacokinetics and pharmacodynamics all add to the complexity of prescribing. This study is a cross-sectional assessment of all long-term residents aged ≥ 65 years in all nursing homes in Helsinki, Finland. The residents’ health status was assessed and data on their demographic factors, health and medications were collected from their medical records in February 2003. This study assesses some essential issues in prescribing for older people: psychotropic drugs (Paper I), laxatives (Paper II), vitamin D and calcium supplements (Paper III), potentially inappropriate drugs for older adults (PIDs) and drug-drug interactions (DDIs)(Paper IV), as well as prescribing in public and private nursing homes. A resident was classified as a medication user if his or her medication record indicated a regular sequence for its dosage. Others were classified as non-users. Mini Nutritional Assessment (MNA) was used to assess residents’ nutritional status, Beers 2003 criteria to assess the use of PIDs, and the Swedish, Finnish, INteraction X-referencing database (SFINX) to evaluate their exposure to DDIs. Of all nursing home residents in Helsinki, 82% (n=1987) participated in studies I, II, and IV and 87% (n=2114) participated in the study III. The residents’ mean age was 84 years, 81% were female, and 70% were diagnosed with dementia. The mean number of drugs was 7.9 per resident; 40% of the residents used ≥ 9 drugs per day, and were thus exposed to polypharmacy. Eighty percent of the residents received psychotropics; 43% received antipsychotics, and 45% used antidepressants. Anxiolytics were prescribed to 26%, and hypnotics to 28% of the residents. Of those residents diagnosed with dementia, 11% received antidementia drugs. Fifty five percent of the residents used laxatives regularly. In multivariate analysis, those factors associated with regular laxative use were advanced age, immobility, poor nutritional status, chewing problems, Parkinson’s disease, and a high number of drugs. Eating snacks between meals was associated with lower risk for laxative use. Of all participants, 33% received vitamin D supplementation, 28% received calcium supplementation, and 20% received both vitamin D and calcium. The dosage of vitamin D was rather low: 21% received vitamin D 400 IU (10 µg) or more, and only 4% received 800 IU (20 µg) or more. In multivariate analysis, residents who received vitamin D supplementation enjoyed better nutritional status, ate snacks between meals, suffered no constipation, and received regular weight monitoring. Those residents receiving PIDs (34% of all residents) more often used psychotropic medication and were more often exposed to polypharmacy than residents receiving no PIDs. Residents receiving PIDs were less often diagnosed with dementia than were residents receiving no PIDs. The three most prevalent PIDs were short-acting benzodiazepine in greater dosages than recommended, hydroxyzine, and nitrofurantoin. These three drugs accounted for nearly 77% of all PID use. Of all residents, less than 5% were susceptible to a clinically significant DDI. The most common DDIs were related to the use of potassium-sparing diuretics, carbamazepine, and codeine. Residents exposed to potential DDIs were younger, had more often suffered a previous stroke, more often used psychotropics, and were more often exposed to PIDs and polypharmacy than were residents not exposed to DDIs. Residents in private nursing homes were less often exposed to polypharmacy than were residents in public nursing homes. Long-term residents in nursing homes in Helsinki use, on average, nearly eight drugs daily. The use of psychotropic drugs in our study was notably more common than in international studies. The prevalence of laxatives equaled other prior international studies. Regardless of the known benefit and recommendation of vitamin D supplementation for elderly residing mostly indoors, the proportion of nursing home residents receiving vitamin D and calcium was surprisingly low. The use of PIDs was common among nursing home residents. PIDs increased the likelihood of DDIs. However, DDIs did not seem a major concern among the nursing home population. Monitoring PIDs and potential drug interactions could improve the quality of prescribing.
  • Rautavirta, Kaija (Helsingin yliopisto, 2010)
    From bark bread to pizza - Food and exceptional circumstances: reactions of Finnish society to crises of food supply This study on the food supply under exceptional circumstances lies within the nutritional, historical and social sciences. The perspective and questions come under nutrition science, but are part of social decision-making. The study focuses on the first and second world wars as well as on contemporary society at the beginning of the 21st century. The main purpose of this study is to explore how Finnish society has responded to crises and what measures it has taken to sustain institutional food services and the food supply of households. The particular study interests include the school catering and food services in hospitals during the world wars. The situation in households is reflected in the counseling work carried out by state-run or civic organisations. Interest also focuses on the action of the scientific community. The decisions made in Finland are projected onto the solutions developed in some other European countries. The study is based primarily on the archive documents and annual reports prepared by food and health care authorities. Major source materials include scientific and professional publications. The evaluation of the situation in contemporary Finnish society is based on corresponding emergency plans and guidelines. The written material is supplemented by discussions with experts. Food rationing during the WWI and WWII differed in extent, details and unity. The food intake of some population groups was occasionally inadequate both in quantity, quality and safety. The counseling of the public focused on promoting self-sufficiency, improving cooking skills and widening food habits. One of the most vulnerable groups in regard to nutrition was long-term patients in institutions. As for future development, the world wars were never-theless important periods for public food services and counseling practices. WWII was also an important period for product development in the food industry. Significant work on food substitutes was carried out by Professor Carl Tigerstedt during WWI. The research of Professors A. I. Virtanen and Paavo Simola during WWII focused on vitamins. Crises threatening societies now differ from those faced a hundred years ago. Finland is bet-ter prepared, but in many ways more vulnerable to and dependent on other actors. Food rationing is a severe means of handling the scarcity of food, which is why contemporary society relies primarily on preparedness planning. Civic organisations played a key role during the world wars, and establishing an emergency food supply remains on their agenda. Although the objective of protecting the population remains the same for nutrition, food production, and food consumption, threat scenarios and the knowledge and skill levels of citizens are constantly changing. Continuous monitoring and evaluation is therefore needed.