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  • Häikiö, Kaarina (Helsingin yliopisto, 2015)
    The purpose of this study is to shed light on the status of the patient in health policies implemented in order to secure patients access to care and to improve the quality of the care. The study focuses on patients and the treatment guarantee from the viewpoints of government and nongovernmental organisations in 2004-2010. The treatment guarantee is the only segment of legislation that gives patients concrete assurance of access to treatment and quality care. The experiences of patients and organisations in combination with inconsistencies in official follow-up data reinforce the need for this study. The three-level theoretical framework of the study based on the discourse-historical approach in Ruth Wodak s linguistic model. It builds on the impressive background of period pieces and modern-day diagnostics (zeitdiagnose), special phenomena such as the notion of patients as actors in the health policy debate, and language management. The task of the study is to describe the status of patients in the context of the treatment guarantee, as well as to outlines the relationship of public health organisations and government authorities to the reform in national health policy over the period 2004-2010. The study addresses questions about the status of patients and questions about the viewpoints of government and public health organisations concerning the treatment guarantee. The research material comprises documents from government and organisations, data from interviews with experts, and articles from the Helsingin Sanomat daily newspaper. Content analysis occasionally shifts to discourse analysis in the course of the study. The government authorities expected the treatment guarantee as a major health care reform, but according to the experts' interviews it did no turn out that way partly due to the weak implementation. National government authorities and public health organisations differ in use of the concept of a treatment guarantee. The public health organisations were not concerned about a usage threshold for use the concept of a treatment guarantee. Government authorities had different practices in use the concept. At the beginning of the research period, the Ministry of Social Affairs and Health , unlike other government authorities, shunned the concept. When the matter was dealt with in Parliament, however, the opposition referred to the concept of a treatment guarantee. Perceptions about the content of the treatment guarantee varied among the actors, and its application changed during the research period. Narrowly speaking it meant that access to treatment was only provided within a certain time frame. The treatment guarantee was usually written without mentioning the patient. If the patient was mentioned in the documents from the government and public health organisations he or she was usually referred to as an object. There were signs of imminent change in the preparatory documents of the Health Care Act in 2010. The documents still described the patient as an object, but they were also described as an actor. In documents from public health organisations, the patient was perceived as an active player in a generally positive way. In documents from the government, the patient was positively perceived as an object. In parliament, when the legislative process for the treatment guarantee drew to a close, members of parliament began speaking more about the economy and less about the patients, nor were the patient viewed as a potential voter. Public health organisations discussed the empowerment of patients just before the reform, but the trend quickly diminished after the legal reforms were initiated in March 2005.These organisations wrote about the treatment guarantee as a patient right as late as 2006. According to the data from experts interviews the treatment guarantee did not give protection to patient.
  • Lämsä, Riikka (Helsingin yliopisto, 2013)
    Riikka Lämsä Patient story. An ethnographic study of patienthood in the practices of a hospital ward Health care services are changing towards more client orientation, where the patient is identified as a lay-expert, consumer and participant. The purpose of this study is to examine what kinds of patienthood are constructed by the practices of a hospital ward. In accordance with ethnomethodology, the concept of patient is not determined beforehand or imposed from above; instead, patient is seen as an agent that arises through the daily practices of a hospital ward. The patient is multiple and, through the insight of science and technology studies, non-human agents, such as devices, can also enact patienthood. I study the concept of patienthood arising out of time, sound, and technology in a hospital ward as well as how it arises through interactions during ward rounds and through patient discharge negotiations. The study is ethnographic, and I collected the data in three internal medicine wards by observing events, by conversing with patients and staff, and by collecting written data. Qualitative content analysis was chosen as the method of analysis. Patienthood in a hospital ward will be described through five different kinds of dimensions. Stability describes the temporal stability of patienthood, i.e., the frequency of changes in practices. The telemetry method, which is an example of the constant development of technology in hospital wards, is changing the patterns of interaction between the patient and the staff. In contrast, the practice of ward rounds has remained relatively unchanged. As a result, in rooms shared by several patients, patients overhear information about other patients and adapt to the situation by behaving as if indifferent during the rounds. Focus describes the scale of patienthood. At times, the patient is identified with the microbe he or she has caught or with electrical impulses of the heart, while at times the focus is on the patient s life situation. Integration of these "different-scaled" forms of patient requires a lot of negotiating in the ward. The self-directed agency of a patient is constructed as "active passivity" when the doctor talks with other patients during ward rounds or as "minor agency" directed towards daily activities during the patient's free time. The patient's self-directed agency is very different from the patient's more passive agency as part of the hospital ward practices. Separateness describes the patient either as an individual or as a collective agent. Ward rounds in shared rooms construct a group of patients and, at the same time, violate the informational privacy of individual patients. The status of the patient as an inpatient or a patient to be discharged is the subject to continuous negotiation. The grounds for discharging a patient are often to do with the patient's functional capacity or life situation as well as with medical or administrative reasons. Discharge negotiations are fairly volatile because the purpose is also to decide in what kind of condition the patient can be discharged. The study provides a new kind of theoretical model on patienthood in hospital wards as well as proposals for the development of practices in hospital wards. In the future, the concealment of verbal patient information should be assured by improving the practice of ward rounds. The best way to improve the activity of the patient is to promote the patient's existing agency, i.e. the agency directed towards daily activities. Discharge negotiations can be improved by developing a set of transparent discharge criteria. Keywords: Hospital, patient, practices, ethnography
  • Penttinen, Anni (Helsingfors universitet, 2008)
    Poor farmers have been blamed for environmental degradation in developing countries. Struggling to survive, they have been claimed to overexploit their natural resource base; but empirical testing has provided confusing evidence. To clarify the discourse, Thomas Reardon and Steven Vosti proposed the concept of investment poverty. It identifies the potentially large group of households that are not poor by traditional welfare poverty measures, but that are too poor in that their surplus above the welfare poverty line is too small to allow them to make investments for the conservation of their natural resource base. They also emphasize the role of assets in generating welfare for rural households, thus affecting production and investment decisions. This research pursues two questions: How can investment poverty be conceptualised and measured? And, which are the welfare-enhancing effects of household assets? Empirical data is collected in the province of Herrera of the Republic of Panama. 402 farmer households are interviewed with a structured questionnaire, using a non-probabilistic quota sampling frame. Household welfare is measured with household consumption and income aggregates, and traditional welfare poverty lines are calculated. This allows to divide the studied households by their per capita consumption aggregates into extremely poor (15,4% of households), moderately poor (33,6%) and non-poor (51,0 %). Comparisons reveal that welfare poverty groups differ significantly not only in asset endowments, income and investment strategies, but also in household structure and in their access to infrastructure and extension services. Although clearly defined in theory, the empirical measurement of investment poverty is challenging. In Herrera, pure conservation investments are not found and welfare is not associated with the sustainability of land use. Hence, the investment poverty line is studied as a level of welfare below which household welfare ceases to be linearly associated with investments that have both productive and conservation aims. Such an investment poverty line, located roughly at twice the annual price of a minimum nutrition, is surpassed by 42,3% of studied households. Investment non-poor households are characterized by both spouses working, high level of social involvement, high farm productivity, growing input-intensive crops, and naturally by having accumulated more land, cattle, vehicles, education, and better housing than the investment poor households. The contribution of assets to household welfare is explored by hypothesizing mechanisms through which land, livestock, education and labour force could enhance welfare, and under which conditions. Results of multinomial logistic regressions using the elaboration method reveal that among extremely and moderately poor households, education is the only studied asset contributing to higher welfare levels. Among the moderately and non-poor households, on the other hand, education, land and labour force contribute to higher welfare through several mechanisms, but depending on conditioning variables, such as input use. There is no automation by which assets generate welfare flows towards households. And, asset accumulation strategies change as welfare increases; the mechanisms are different among the poorest from among the richest households. The relationship between poverty and the environment remains problematic. Overcoming the investment poverty line can be seen as the necessary price of overcoming poverty and accumulating assets in the long run, but under current circumstances it is way out of reach for the poorest Herreran households. Even beyond the investment poverty line environmental sustainability is not necessarily achieved, if cattle herds increase and pastures spread.
  • Svärd, Saana (Helsingin yliopisto, 2012)
    In this dissertation, I analyze theories of power in order to study the Neo-Assyrian (934-610 BC) women of the palaces. This study subscribes to that sociological understanding of power which stipulates that power exists in all relationships between people. This is why the main research question of this dissertation is not whether women had power or not, but instead, the question is: What kind of power did women have in Neo-Assyrian palaces? Neo-Assyrian women have not been much discussed in earlier research. In addition to presenting the textual evidence relating to them, this dissertation hopes to offer new theoretical perspectives for Assyriology and the study of ancient Near East. The aim of this study is not to present a mere catalogue of powerful women, listing occupations and texts. Instead, the aim is to go further than that and show that by using theories of power, one can get new viewpoints additional to those procured by the traditional philological methodology. The structure of the dissertation is dictated by the research questions. After the introduction in Chapter 1, the second Chapter evaluates sociological discussions regarding the concept of power from the viewpoint of women s studies and Assyriology. However, to discuss women s power in the Neo-Assyrian palaces, it is necessary to consider what power meant for the Assyrians themselves. Although not an easy question to tackle, Chapter 3 discusses this problem from a semantic and lexicographical perspective. I discuss those words which imply power in the texts relating to the women of the palace. At the end of Chapter 3, these lexicographical results are compared with the sociological concepts of power presented in Chapter 2. The theoretical framework built on these two chapters understands power as a hierarchical phenomenon. What positions did women have in the palace hierarchy? What did they do in the palaces, and what kind of authority did they possess? This is the topic of Chapter 4, where the textual evidence relating to the palace women is presented. Power in general and women s power especially has been understood mostly in a hierarchical way in earlier research concerning Mesopotamian women. Hierarchical power structures were important in Mesopotamia, but other theoretical approaches can help one gain new perspectives into the ancient material. One of these approaches consists of concentrating on heterarchical, negotiable and lateral power relations in which the women were engaged. In Chapter 5, the concept of heterarchical power is introduced and the text material is approached from a heterarchical perspective. Heterarchical power relations include hierarchical power relations, but also incorporate other kinds of power relations, such as reciprocal power, resistance and persuasion. Although earlier research has certainly been aware of women s influence in the palaces, this dissertation makes explicit the power concepts employed in previous research and expands them further using the concept of heterarchy. By utilizing the concept of power as a theoretical tool, my approach opened up new avenues for interpreting the texts.
  • Ruusila, Anna (Helsingin yliopisto, 2014)
    This work integrates the research of phraseology, lexicography, and translation. The study is primarily concerned with a specific type of phraseologisms called pragmatic phraseologisms that are first and foremost pragmatically fixed. Pragmatic phraseologisms can be divided into two groups: routine formulae and conversational formulae. Both of them have numerous functions in different communication situations and are frequently used in both written and spoken languages. Pragmatic phraseologisms and their use are in many cases language and cultural bound, which is only one of the reasons why their translation can be difficult. When translators bump into translation problems, they often resort to dictionaries in hopes of finding suitable translation equivalents and information about the use on the expression that has to be translated. This leads to the question this study aims to provide an answer for: How pragmatic phraseologisms should be described in a dictionary so that the translators could get the best possible help with regard to different kinds of translation problems? This study attempts to a) investigate how the pragmatic phraseologisms are described in various dictionaries, both printed and electronic, and b) sketch two concepts of dictionary entries, one for routine formulae, one for conversational formulae. The sketched dictionary entries are designed for an electronic dictionary, whose primary target group is translators. The corpus of the study consists of 15 German, Finnish and French dictionaries. Some of them are mono- and some bilingual; some are general and some phraseological. As a basis for the collection of the corpus data, a German dictionary for language learners (Wörterbuch Deutsch als Fremdsprache 2000) was used since it is this only dictionary in which the pragmatic phraseologisms are explicitly marked as such. With the help of a list of all pragmatic phraseologisms in this dictionary the corresponding pragmatic phraseologisms were collected from the other German dictionaries. In case of the Finnish and French dictionaries all expressions that could be defined as pragmatic phraseologisms were collected. It is especially important to look into the description of pragmatic phraseologisms in the Finnish and French dictionaries as this has not been studied before. According to the results, the dictionary entries often consist of meaning, pragmatic information, lexicographic examples, and equivalents (in the bilingual dictionaries). The meaning of the pragmatic phraseologism is given as a free formulated sentence, as a pragmatic remark or as a combination of the two. The pragmatic description of these expressions in the existing dictionaries is, however, often scarce since their functions in the communication are rarely mentioned, and even if they are mentioned it often happens without a recognizable logic. This is a severe shortcoming in the description of pragmatic phraseologisms since their real meaning and use cannot be described properly without this information. Furthermore, the specifications and restrictions of their use were not always described. In addition, the pragmatic phraseologisms were in some cases situated illogically within the dictionary. In the electronic dictionaries, various types of search mechanisms were rarely used even if they could be easily built in them. In the sketched models for the dictionary entries, the main focus lies on their pragmatic description and on their equivalents. For every pragmatic phraseologism, one or more pragmatic or metacommunicative functions are given. Thanks to the electronic form of the dictionary, an onomasiological approach is also possible when searching for a suitable expression. (One can, for example, search for all routine formulae that are used to express surprise, or for all conversational formulae that are used to interrupt the partner.) Moreover, the description of the use of pragmatic phraseologisms follows a certain pattern so that a logical and reliable way of their description is secured. The order of the lexicographic information depends on the specific question the translator is trying to find a answer for (e. g. if the problem is that the translator does not know what the expression of the source language means or does not know how to translate it). Pragmatic phraseologisms of the source language are not always translated with a pragmatic phraseologism of the target language, but very variable translation solutions can be found ranging from other types of phraseologisms to completely freely formed paraphrases and one-word expressions. Therefore a wide array of possible equivalents is provided and the differences between the expressions of the source and target language are explicitly explained in order to facilitate the work of the translator.
  • Yijälä, Anu (Helsingin yliopisto, 2012)
    This dissertation research focused on the pre-migration stage of the migration process and, specifically, the action period, which starts from making a decision to move abroad and lasts until the actual move. The research further developed the concept of pre-acculturation, that is, the active process that voluntary migrants in particular go through during the preparatory stage of migration process. As studies on pre-acculturation are still rather scarce, the theoretical background of the research was formulated by applying both previous (mostly post-migration) acculturation and expatriate literature, and completing them with social psychological theories of intergroup relations, and organizational psychology. The present research concentrated on the pre-acculturation of two groups of skilled voluntary migrants preparing to move to Finland: ethnic (re)migrants and their family members from Russia and self-initiated foreign employees (SFEs) recruited to the European Chemicals Agency. The results of the research indicate that immigrant acculturation is a complex process that begins already at the pre-migration stage and involves at least four different dimensions of pre-migration adaptation among voluntary migrants. First, the research showed that integration was the most preferred pre-migration acculturation orientation among ethnic migrants. The following factors were associated with the formation of acculturation orientations: participants general well-being, degree of Russian identification, support for multicultural ideology, and perceptions of the acculturation expectations of future hosts. Second, it was shown that ethnic migrants pre-acculturative stress largely depended on their expectations of post-migration adaptation. These expectations were developed through direct and indirect pre-migration contact with, as well as knowledge about, the society of immigration. Third, it was shown that ethnic migrants anticipated socio-cultural adaptation was related to their familiarity with the country of immigration, the openness to change value, and perceived value congruence between migrants personal values and the perceived values of typical hosts. Finally, previous international work experience, perceived organizational prestige and support, as well as the quality of contact with Finns during recruitment simultaneously predicted various dimensions of SFEs pre-migration adaptation (psychological, socio-psychological and work adaptation). These connections were mediated by European identification, self-esteem and relocation stress. Altogether, the results point to the crucial role of early contact experiences of potential migrants with future home country nationals. According to the results, it is essential to identify the expectations and beliefs related to potential migrants pre-acculturation orientations and pre-migration adaptation, including stress reactions prior to migration. Moreover, the results speak to the importance of psychological resources and preparedness for a successful pre-acculturation. This dissertation research emphasizes that the pre-migration stage in general and pre-acculturation of voluntary migrants in particular should be given more attention in both acculturation and expatriate literature. A proper understanding of pre-acculturation is seen as a means of promoting the most adaptive acculturation profiles at the earliest stage of migration.
  • Cinar, Ayse Basak (2008)
    The present study aimed to investigate how non-biologic determinants of oral health (behavior, cognition, and affect, maternal and societal influences) are interrelated with each other and with oral health among preadolescents in two different oral health care and cultural settings, Turkey and Finland. In addition, the association of their general well-being with their oral health was assessed. The cross-sectional study of Turkish (n=611) and Finnish (n=223) school preadolescents in Istanbul and Helsinki, from the fourth, fifth, and sixth grades, aged 10 to 12, was based on self-administered and pre-tested health behavior questionnaires for them and their mothers as well as the youth’s oral health records. Both questionnaires assessed self-reported dental health and oral health behaviors along with cognitive-affective factors (self-efficacy and dental anxiety). In addition, health behavior questionnaires for preadolescents (PHBQ) included questions of self-esteem and self-reported gingival health, whereas those for mothers (MHBQ) surveyed societal factors, dietary habits and body-weight of preadolescents. PHBQ were completed in classes, whereas MHBQ were carried to and from home. Dental examinations in Turkey based on World Health Organisation (WHO) criteria (1997) were carried out in the classrooms 2 weeks after the questionnaire survey by two calibrated pediatric dentists. Finns´ oral health data came with permission from records at the Helsinki City Health Department. Among the Turks, response rate for PHBQ was 97% (n=591) and 87% for the MHBQ (n=533). The corresponding Finnish rates were 65% (n=223) and 53% (n=182). Participation in oral health examinations was 95% for the Turkish (n=584) and 65% for the Finnish (n=223). Clinically assessed dental status (DMFT) and self-reported oral health of Turkish preadolescents was significantly poorer than the Finns`. A similar association occurred for well-being measures (height and weight, self-esteem), but not for school performance. Turkish preadolescents were more dentally anxious and reported lower mean values of toothbrushing self-efficacy (TBSE) and dietary self-efficacy (DSE) than did Finns. The Turks less frequently reported recommended oral health behaviors (twice daily or more toothbrushing, sweet consumption on 2 days or less/week, decreased between-meal sweet consumption) than did the Finns. In both groups, those with high TBSE were more likely to practice the recommended toothbrushing. Similarly, all with high DSE were more likely to report recommended toothbrushing and sweet consumption. High levels of TBSE and DSE contributed to low dental anxiety in various patterns in both groups. Turkish mothers less frequently reported dental health as being above average and recommended oral health behaviors as well as regular dental visits (once within 12 months). Their mean values for dental anxiety were higher and self-efficacy on implementation of twice-daily toothbrushing were lower than for the Finnish mothers. All preadolescents were likely to imitate toothbrushing and sweet consumption behaviors of their mothers. In both groups, those who reported high TBSE were more likely to have mothers who practiced recommended toothbrushing. Among Finns, high maternal self-efficacy and low dental anxiety contributed positively to preadolescent’s recommended toothbrushing and high TBSE. Among the Turks, high maternal dental anxiety contributed to that of their children. Among Turks, the mothers of public school preadolescents reported a poorer societal profile and oral health behaviors than did mothers of private school preadolescents. Public school preadolescents were more likely to imitate non-recommended toothbrushing and sweet-consumption behaviors of their mothers, whereas their counterparts in private school followed a similar trend for recommended maternal toothbrushing behavior. Self-esteem and school performance were positively correlated with TBSE and DSE in both groups. Clustering between high self-esteem and low preadolescent- and maternal dental anxiety occurred in various patterns for Turks and Finns. Societal factors contributed to self-esteem among the Turks. Among all preadolescents, good school performance was a common predictor for recommended toothbrushing. Oral health and well-being of preadolescents were interrelated. In both groups, DMFT was negatively correlated with better school performance. Body height and the societal factors were the common explanatory variables accounting for DMFT s. TBSE and school performance contributed positively to self-reported dental health, in common, among all preadolescents. High self-esteem and less frequent maternal sweet consumption among Finns, decreased number of children in the family, and recommended preadolescent toothbrushing among Turks were the other contributors to self-reported good dental health. In the present study, non-biologic determinants of oral health were interrelated and related to well-being measures in various patterns, and these all contributed to the oral health of preadolescents. Based on these findings, a need exists for improvement in Turkish preadolescents’ and their mothers’ oral health behaviors, cognition, and affect. The paired associations separately studied in the literature; self-efficacy─behavior, child─mother health behavior, general well-being─oral health, self-esteem─school performance, were all found in a holistic theoretical framework, regardless of different cultural, socio-economic, and health-care systems in the two countries, Turkey and Finland. This may indicate that the respective associations are turning out to be part of the global health culture, and therefore a need exists for similar further research including the complex interaction pathways between these associations in countries with different developmental, cultural, and health-care characteristics. Clarifying these complex relations by psychosocial holistic approaches in different cultural settings and socio-economic contexts may provide a multidimensional understanding of preadolescents’ oral health behavior that will provide enhancement of their well-being and oral health.
  • Ala-Honkola, Outi (Helsingin yliopisto, 2009)
    It has been only recently realized that sexual selection does not end at copulation but that post-copulatory processes are often important in determining the fitness of individuals. In this thesis, I experimentally studied both pre- and post-copulatory sexual selection in the least killifish, Heterandria formosa. I found that this species suffers from severe inbreeding depression in male reproductive behaviour, offspring viability and offspring maturation times. Neither sex showed pre-copulatory inbreeding avoidance but when females mated with their brothers, less sperm were retrieved from their reproductive system compared to the situation when females mated with unrelated males. Whether the difference in sperm numbers is due to female or male effect could not be resolved. Based on theory, females should be more eager to avoid inbreeding than males in this species, because females invest more in their offspring than males do. Inbreeding seems to be an important part of this species biology and the severe inbreeding depression has most likely selected for the evolution of the post-copulatory inbreeding avoidance mechanism that I found. In addition, I studied the effects of polyandry on female reproductive success. When females mated with more than one male, they were more likely to get pregnant. However, I also found a cost of polyandry. The offspring of females mated to four males took longer to reach sexual maturity compared to the offspring of monandrous females. This cost may be explained by parent-offspring conflict over maternal resource allocation. In another experiment, in which within-brood relatedness was manipulated, offspring sizes decreased over time when within-brood relatedness was low. This result is partly in accordance with the kinship theory of genomic imprinting. When relatedness decreases, offspring are expected to be less co-operative and demand fewer resources from their mother, which leads to impaired development. In the last chapter of my thesis, I show that H. formosa males do not prefer large females as in other Poeciliidae species. I suggest that males view smaller females as more profitable mates because those are more likely virgin. In conclusion, I found both pre- and post-copulatory sexual selection to be important factors in determining reproductive success in H. formosa.
  • Suojala, Terhi (Helsingin yliopisto, 2000)
  • Leppo, Anna (Helsingin yliopisto, 2012)
    Since the 1970s alcohol and drug use by pregnant women has become a target of political, professional and personal concern. The present study focuses on prenatal substance use and the regulation of risks by examining different kinds of societal responses to prenatal alcohol and drug use. The study analyses face-to-face encounters between professionals and service users at a specialised maternity clinic for pregnant women with substance abuse problems, medical and political discourses on the compulsory treatment of pregnant women as a means of FAS prevention and official recommendations on alcohol intake during pregnancy. Moreover, the study addresses the women s perspective by asking how women who have used illicit drugs during pregnancy perceive and rank the dangers linked to drug use. The study consists of five empirical sub-studies and a summary article. Sub-study I was written in collaboration with Dorte Hecksher and Sub-study IV with Riikka Perälä. Theoretically the study builds on the one hand, on the socio-cultural approach to the selection and perception of risks and on the other on governmentality studies which focus on the use of power in contemporary Western societies. The study is based on an ethnographic approach and makes use of the principles of multi-sited ethnography. The empirical sub-studies are based on three different types of qualitative data: ethnographic field notes from a maternity clinic from a period of 7 months, documentary material (medical journals, political documents, health education materials, government reports) and 3) interviews from maternity clinics with clients and members of staff. The study demonstrates that the logic of the regulation of prenatal alcohol use in Finland is characterised by the rise of the foetus , a process in which the urgency of protecting the foetus has gradually gained a more prominent role in the discourses on alcohol-related foetal damage. An increasing unwillingness to accept any kinds of risks when foetal health is at stake is manifested in the public debate on the compulsory treatment of pregnant women with alcohol problems and in the health authorities decision to advise pregnant women to refrain from alcohol use during pregnancy (Sub-studies I and II). Secondly, the study suggests that maternity care professionals have an ambivalent role in their mundane encounters with their pregnant clients: on the one hand professionals focus on the well-being of the foetus, but on the other, they need to take into account the women s needs and agency. The professionals daily encounters with their clients are thus characterised by hybridisation: the simultaneous use of technologies of domination and technologies of agency (Sub-studies III and IV). Finally, the study draws attention to the women s understanding of the risks of illicit drug during pregnancy, and shows that the women s understanding of risk differs from the bio-medical view. The study suggests that when drug-using pregnant women seek professional help they can feel that their moral worth is threatened by professionals negative attitudes which can make service-use challenging.
  • Isomaa, Marleena (Helsingin yliopisto, 2015)
    The purpose of this thesis was to increase knowledge of heavily harvested cod stock dynamics and attain information for more suitable and sustainable management strategies. Achieving sustainable management strategies requires sufficient knowledge about the population dynamics. One tool for research this is to introduce stochastic variation models in investigated species stock dynamics. As a model species we use eastern Baltic Sea cod (Gadus morhua callarias), where the population dynamics are strongly influenced by environmental factors and fishing. We consider the stock dynamics and recovery potential under three different harvest strategies (proportional, threshold) and environmental noise scenarios. We developed age-structured discrete-time population models that include interactions with the environmental factors, e.g. salinity, fishing and natural mortality. Our results show that under current environmental conditions and threshold harvest methods cod fishing is at a sustainable level. Precautionary management ensures the best economical incomes and sustainable stocks in the long run, despite environmental fluctuations or moratoria. Results also reveal how the unpredictability of stock size, catch, and recovery increase with increasing environmental autocorrelation. Initial age structure has a strong impact on population recovery capacity in the short run, especially in over-harvested populations and under strongly fluctuating environmental conditions. Protection of younger age groups will substantially increase the recovery potential and will increase the maximum sustainable yield considerably. As a whole, precautionary harvesting strategies will increase the stock resilience against adverse environmental conditions and harvesting, guaranteeing sustainable yields in the future.
  • Svahnbäck, Lasse (Helsingin yliopisto, 2007)
    Precipitation-induced runoff and leaching from milled peat mining mires by peat types: a comparative method for estimating the loading of water bodies during peat production. This research project in environmental geology has arisen out of an observed need to be able to predict more accurately the loading of watercourses with detrimental organic substances and nutrients from already existing and planned peat production areas, since the authorities capacity for insisting on such predictions covering the whole duration of peat production in connection with evaluations of environmental impact is at present highly limited. National and international decisions regarding monitoring of the condition of watercourses and their improvement and restoration require more sophisticated evaluation methods in order to be able to forecast watercourse loading and its environmental impacts at the stage of land-use planning and preparations for peat production.The present project thus set out from the premise that it would be possible on the basis of existing mire and peat data properties to construct estimates for the typical loading from production mires over the whole duration of their exploitation. Finland has some 10 million hectares of peatland, accounting for almost a third of its total area. Macroclimatic conditions have varied in the course of the Holocene growth and development of this peatland, and with them the habitats of the peat-forming plants. Temperatures and moisture conditions have played a significant role in determining the dominant species of mire plants growing there at any particular time, the resulting mire types and the accumulation and deposition of plant remains to form the peat. The above climatic, environmental and mire development factors, together with ditching, have contributed, and continue to contribute, to the existence of peat horizons that differ in their physical and chemical properties, leading to differences in material transport between peatlands in a natural state and mires that have been ditched or prepared for forestry and peat production. Watercourse loading from the ditching of mires or their use for peat production can have detrimental effects on river and lake environments and their recreational use, especially where oxygen-consuming organic solids and soluble organic substances and nutrients are concerned. It has not previously been possible, however, to estimate in advance the watercourse loading likely to arise from ditching and peat production on the basis of the characteristics of the peat in a mire, although earlier observations have indicated that watercourse loading from peat production can vary greatly and it has been suggested that differences in peat properties may be of significance in this. Sprinkling is used here in combination with simulations of conditions in a milled peat production area to determine the influence of the physical and chemical properties of milled peats in production mires on surface runoff into the drainage ditches and the concentrations of material in the runoff water. Sprinkling and extraction experiments were carried out on 25 samples of milled Carex (C) and Sphagnum (S) peat of humification grades H 2.5 8.5 with moisture content in the range 23.4 89% on commencement of the first sprinkling, which was followed by a second sprinkling 24 hours later. The water retention capacity of the peat was best, and surface runoff lowest, with Sphagnum and Carex peat samples of humification grades H 2.5 6 in the moisture content class 56 75%. On account of the hydrophobicity of dry peat, runoff increased in a fairly regular manner with drying of the sample from 55% to 24 30%. Runoff from the samples with an original moisture content over 55% increased by 63% in the second round of sprinkling relative to the first, as they had practically reached saturation point on the first occasion, while those with an original moisture content below 55% retained their high runoff in the second round, due to continued hydrophobicity. The well-humified samples (H 6.5 8.5) with a moisture content over 80% showed a low water retention capacity and high runoff in both rounds of sprinkling. Loading of the runoff water with suspended solids, total phosphorus and total nitrogen, and also the chemical oxygen demand (CODMn O2), varied greatly in the sprinkling experiment, depending on the peat type and degree of humification, but concentrations of the same substances in the two sprinklings were closely or moderately closely correlated and these correlations were significant. The concentrations of suspended solids in the runoff water observed in the simulations of a peat production area and the direct surface runoff from it into the drainage ditch system in response to rain (sprinkling intensity 1.27 mm/min) varied c. 60-fold between the degrees of humification in the case of the Carex peats and c. 150-fold for the Sphagnum peats, while chemical oxygen demand varied c. 30-fold and c. 50-fold, respectively, total phosphorus c. 60-fold and c. 66-fold, total nitrogen c. 65-fold and c. 195-fold and ammonium nitrogen c. 90-fold and c. 30-fold. The increases in concentrations in the runoff water were very closely correlated with increases in humification of the peat. The correlations of the concentrations measured in extraction experiments (48 h) with peat type and degree of humification corresponded to those observed in the sprinkler experiments. The resulting figures for the surface runoff from a peat production area into the drainage ditches simulated by means of sprinkling and material concentrations in the runoff water were combined with statistics on the mean extent of daily rainfall (0 67 mm) during the frost-free period of the year (May October) over an observation period of 30 years to yield typical annual loading figures (kg/ha) for suspended solids (SS), chemical oxygen demand of organic matter (CODmn O2), total phosphorus (tot. P) and total nitrogen (tot. N) entering the ditches with respect to milled Carex (C) and Sphagnum (S) peats of humification grades H 2.5 8.5. In order to calculate the loading of drainage ditches from a milled peat production mire with the aid of these annual comparative values (in kg/ha), information is required on the properties of the intended production mire and its peat. Once data are available on the area of the mire, its peat depth, peat types and their degrees of humification, dry matter content, calorific value and corresponding energy content, it is possible to produce mutually comparable estimates for individual mires with respect to the annual loading of the drainage ditch system and the surrounding watercourse for the whole service life of the production area, the duration of this service life, determinations of energy content and the amount of loading per unit of energy generated (kg/MWh). In the 8 mires in the Köyhäjoki basin, Central Ostrobothnia, taken as an example, the loading of suspended solids (SS) in the drainage ditch networks calculated on the basis of the typical values obtained here and existing mire and peat data and expressed per unit of energy generated varied between the mires and horizons in the range 0.9 16.5 kg/MWh. One of the aims of this work was to develop means of making better use of existing mire and peat data and the results of corings and other field investigations. In this respect combination of the typical loading values (kg/ha) obtained here for S, SC, CS and C peats and the various degrees of humification (H 2.5 8.5) with the above mire and peat data by means of a computer program for the acquisition and handling of such data would enable all the information currently available and that deposited in the system in the future to be used for defining watercourse loading estimates for mires and comparing them with the corresponding estimates of energy content. The intention behind this work has been to respond to the challenge facing the energy generation industry to find larger peat production areas that exert less loading on the environment and to that facing the environmental authorities to improve the means available for estimating watercourse loading from peat production and its environmental impacts in advance. The results conform well to the initial hypothesis and to the goals laid down for the research and should enable watercourse loading from existing and planned peat production to be evaluated better in the future and the resulting impacts to be taken into account when planning land use and energy generation. The advance loading information available in this way would be of value in the selection of individual peat production areas, the planning of their exploitation, the introduction of water protection measures and the planning of loading inspections, in order to achieve controlled peat production that pays due attention to environmental considerations.
  • Frias Beneyto, Rafael (Helsingin yliopisto, 2013)
    Intestinal permeability testing is the specific method to assess for a defective intestinal epithelial barrier. Intestinal permeability measurements are considered helpful and non-invasive means to evaluate intestinal mucosal damage for both scientific (particularly) and clinical purposes, and have been widely used in laboratory rodents and humans. Despite their many advantages, permeability tests have not gained widespread use as a testing option for the detection and management of canine intestinal disorders in veterinary clinical research. The main reasons for this may include the lack of an optimal biomarker for permeability testing, impracticalities involving current testing methodologies, and inconsistencies in test results that have been found by investigators using these tests. Chromium 51-labeled ethylenediamine tetra-acetic acid (51Cr-EDTA) is widely considered the most accurate intestinal permeability probe, but the use of radioactivity is a major drawback. Sugar biomarkers such as lactulose and rhamnose have been more commonly used in the recent years, but they have been associated with marked inconsistencies in the test results. Iohexol is a contrast medium commonly used in radiology for diagnostic purposes in human and veterinary patients, but this molecule has more recently been successfully used for the screening of gut mucosal damage in laboratory rats and humans. The main advantage of iohexol is that its use does not involve radioactivity, nor is it degraded in the intestinal lumen. Furthermore, it has the potential to be quantified by different analytical techniques. The main objective of this project was to improve the methodology of the intestinal permeability tests in dogs in order to make the testing simpler, more practical and accurate for veterinarians and researchers using this approach to investigate intestinal mucosal damage and disorders associated with a defective intestinal epithelial barrier. An additional objective was to preliminarily assess the use of iohexol as a novel intestinal permeability marker for use in dogs. The work consisted of preclinical comparisons of the most relevant intestinal permeability markers including 51Cr-EDTA, lactulose and rhamnose, and iohexol performed in both urine and blood tests using laboratory dog and rat models. In conclusion, studies on the percentage urinary recovery of 51Cr-EDTA, lactulose, and rhamnose, as well as D-xylose, 3-O-methyl-D-glucose, and sucrose after their oral simultaneous administration provided normative data for healthy adult male Beagle dogs. The analysis revealed a discrepancy in the percentage urinary recovery between 51Cr-EDTA and lactulose, suggesting that these two markers are not as equivalent as has so far been believed based on previous studies in humans and cats. It was also concluded that the use of a single marker provides comparable test results to the use of two markers, as evidenced by a comparison of recovery values from 51Cr-EDTA and lactulose versus their correspondent ratio against rhamnose. This supports the hypothesis that, in contrast to the dual sugar test, the use of one inert larger probe may be sufficient for permeability testing, and the testing procedure may consequently be considerably simplified. The studies also demonstrated that the 51Cr-EDTA permeability blood test based on the collection of at least two serum or plasma specimens gives comparable results to the 6-h cumulative urine test. The blood approach is much easier than the urine-based test, as it avoids the constraints associated with urine collection in dogs. Iohexol was shown to have a clear relationship with 51Cr-EDTA in serum levels when they were simultaneously administered to Beagle dogs. When it was used as an intestinal permeability probe in laboratory rats before and after the induction of a well-characterized experimental form of inflammatory bowel disease, it was also possible to clearly discriminate between healthy animals and rats with intestinal mucosal damage. The iohexol blood test can therefore be considered a promising tool for assessing canine intestinal permeability in veterinary clinical research. Nevertheless, further studies using iohexol as intestinal permeability blood marker, particularly in diseased dogs, are warranted before firm conclusions can be made on the validity of this test.
  • Saunaluoma, Sanna (Helsingin yliopisto, 2013)
    Amazonian earthworks have a variety of forms and sizes, and are found in different geographical and ecological locations, indicating separate time periods, distinct cultural affiliations, and diverse functions. Because research on pre-Columbian earthworks has only recently begun, a number of basic questions concerning the function and chronology of these structures, and the ethno-cultural and socio-political relationships of the societies who created them still remain unanswered. The main aim of this dissertation, consisting of four peer-reviewed articles and a synthesis paper, is to build new knowledge and expand on the existing, but still noticeably sparse data on the region's pre-Columbian earthworking cultures. It proposes a hypothesis of the existence of relatively early sedentary interfluvial populations with rather organized and peculiar societal and ideological systems in the southwestern Amazon. This suggestion challenges the conventional view of ancient Amazonian peoples being non-sedentary, with an egalitarian social organization and an inability to alter and manage the environment in which they lived. This dissertation presents and discusses the results of archaeological fieldwork undertaken at earthwork sites in two neighboring frontier regions in the southwestern Amazon: the region of Riberalta in Bolivia and the eastern state of Acre in Brasil. The Bolivian sites are interpreted as permanent settlements, while the Acrean earthworks were constructed principally for ceremonial purposes. The earthworks documented in the Riberalta region are structurally simpler than the ones studied in Acre and are found in slightly different locations, e.g., on high river bluffs or inland only a few kilometers from the main rivers. In Acre, the sites are located on high interfluvial plateaus near minor watercourses. The earthwork building practice prevailed in the Riberalta region from around 200 B.C. until the period of European contact, whereas the geometric earthwork tradition began earlier in Acre, around 1200 B.C., if not before. By the tenth century A.D., the regional confederation that created the geometric enclosures was already disintegrating. Even so, some sites apparently remained in use until the fourteenth century A.D. Chronologically and culturally, these earthworking peoples were formative-stage societies demonstrating emerging sedentism and evolving socio-organizational structures, and in Acre in particular, a society united by a highly developed ideological system materialized in the geometric enclosure architecture.
  • Augustin, Mona (Helsingin yliopisto, 2012)
    Myocardial infarction (MI) leading eventually to heart failure is a major cause of morbidity and mor-tality in Western countries. Current studies suggest that cell-based therapies can improve cardiac function after MI. Paracrine factors mediated by transplanted cells have been suggested to be the curative factors behind this effect. In the present work, we evaluated preconditioning methods of skeletal myoblasts (SM) and bone mar-row-derived mesenchymal stem cells (MSC) prior to transplantation in MI. We used epicardial trans-plantation of cell sheets in a rat model of MI which was induced by left anterior descending (LAD) coronary artery ligation. The preconditioning methods used were heat shock (HS) pre-treatment of SMs and gene modification of MSCs. Gene modification was performed by viral VEGF and Bcl-2 transductions. After preconditioning, cell sheets were transplanted onto MI and the therapeutic effect was evaluated. Furthermore, we studied the effect of HS pre-treatment on SM differentiation under hypoxic conditions and tested the hypothesis that HS preconditioning-treatment enhances the angio-genic properties of SM sheets. Metabolic activity of VEGF and Bcl-2 over-expressing cells was as-sessed under normal nutrient supply, serum starvation and staurosporine treatment. Our results demonstrate that HS preconditioning leads to increased expression of SM differentiation-associated troponin and to reduced caspase-3 activity from differentiation under hypoxic environment. HS-preconditioning protected SM sheets from hypoxia-associated apoptosis in vitro; however it reduced vascular endothelial growth factor (VEGF) expression of the sheet, leading to a lower therapeutic effect in heart failure. MSC sheets carrying VEGF showed enhanced efficacy of cell sheet transplantation therapy in an acute infarction model. These cell sheets attenuated left ventricular dysfunction and myocardial damage, and induced therapeutic angiogenesis. The metabolic activity of gene-over-expressing cells was significantly higher compared to wild type cells. Moreover, introducing VEGF expression in MSCs enhanced the metabolic activity of cells during serum starvation.
  • Keikkala, Elina (Helsingin yliopisto, 2014)
    Pre-eclampsia, defined as hypertension and proteinuria, causes significant maternal and perinatal complications. It affects about 2-8% of all pregnancies and there is no curative medication. If women at risk could be identified, prevention or, at least, reduction of the complications of pre-eclampsia might be possible. When serum biochemical markers and clinical characteristics have been combined, the prediction of pre-eclampsia has improved. We studied whether hyperglycosylated human chorionic gonadotropin (hCG-h) is useful for identifying women at risk of pre-eclampsia already in the first or second trimester of pregnancy. Concentrations of hCG, hCG-h, pregnancy-associated plasma protein-A (PAPP-A) and the free beta subunit of hCG (hCGβ) in the serum in the first trimester and of placental growth factor (PlGF), soluble vascular endothelial growth factor receptor 1 (sVEGFR-1) and of the angiogenetic factors, angiopoietin-1 (Ang-1), -2 (Ang-2) and their common soluble endothelial cell-specific tyrosine kinase receptor Tie-2 (sTie-2) in the second trimester were studied as predictors of pre-eclampsia. For first trimester screening, 158 women who subsequently developed preeclampsia, 41 with gestational hypertension, 81 with small-for-gestational age (SGA) infants and 427 controls were selected among 12,615 pregnant women who attended for first trimester screening for Down's syndrome. For second trimester screening we used serum samples from 55 women who subsequently developed pre-eclampsia, 21 with gestational hypertension, 30 who were normotensive and gave birth to SGA infants, and 83 controls. For analysis of Ang-1, -2 and sTie-2 at 12-15 and 16-20 weeks of pregnancy, 49 women who subsequently developed preeclampsia, 16 with intrauterine growth restriction (IUGR) and 59 healthy controls were recruited among 3240 pregnant women attending for first trimester screening for Down's syndrome. Another 20 healthy women were recruited at term pregnancy for examination of the concentrations of these markers in maternal and fetal circulation and urine and the amniotic fluid before and after delivery. The proportion of hCG-h out of total hCG(%hCG-h) was lower in the first but not in second trimester in women who subsequently developed pre-eclampsia as compared to controls. In the first trimester, %hCG-h was predictive of pre-eclampsia, especially of early-onset pre-eclampsia (diagnosed before 34 weeks of pregnancy). The predictive power improved when PAPP-A, the mean arterial blood pressure and parity were combined with %hCG-h. When these four variables were used together, 69% of the women who were to develop early-onset pre-eclampsia were identified with a specificity of 90%. The concentrations of circulating Ang-2 during the second trimester were higher and those of PlGF were lower in women who later developed pre-eclampsia. Ang-2 was only 20% sensitive and at 90% specific for predicting pre-eclampsia, but PlGF performed well and was 53% sensitive and 90% specific for predicting early-onset pre-eclampsia. %hCG-h did not provide independent prognostic value in the second trimester. In conclusion, hCG-h is a promising first trimester marker of early-onset preeclampsia. In line with the earlier observations, PlGF is a useful second trimester predictive marker of early-onset pre-eclampsia.