Intergenerational Transfer of Sabbath Observance : How is Religious Tradition Transferred to Children among Finnish Seventh-day Adventists?

This study examined religious home education in educational, psychological, and sociological context. Growing up within a religious denomination is a process of learning the rules, norms, opinions, and attitudes, which serve to make the individual an active member of the group. It is a process of transferring the cultural inheritance between generations. Sabbathkeeping can be regarded as a strong indicator of the Seventh-day Adventist value system, which is also why I have concentrated on this specific issue in my study. The purpose of the study was to find out, how the Sabbath is transferred from parents to children among Finnish Adventists. It was also examined how parents could make the day of rest positively exceptional for children, and how the parental authoritativeness affects the process of transference. According to Bull & Lockhart s (1989) theory, the amount of Adventist generations in family history influences the transfer of religious tradition. This study aimed to find out whether or not this theory would apply to the present-day Finland. The nature of religious development among Adventist young people was also one of the interests of the research. The methods used in the study were in-depth interviews (n = 10) and a survey (n = 106). The majority of the interviewees was young adults (age 15-30) grown up in Adventist families. The interviews were taped and transcribed for the study, and survey answers were analysed with SPSS-data analysis program. The amount of survey questionnaires evaluated was 106, whole population of 15-30 year-old Finnish Adventists being about one thousand. Democratic relationship between parents and children, parents' example, encouragement to own thinking, and positive experiences of Sabbath and the whole religion, including the social dimension of the Adventism, seem to be some of the most significant factors in transference of religious tradition. Both too severe and too permissive education were considered to lead to similar results: unsuccessful transfer of values, or even rebellion and adopting a totally opposite way of life than that of the parents. In this study the amount of Adventist generations in family history does not correlate significantly with the end results of value transference. Keywords: Sabbath, intergenerational, value transference, religious home education Avainsanat: sapatti, arvojen siirtyminen vanhemmilta lapsille, uskonnollinen kotikasvatus

Noise sensitivity medical, psychological and genetic aspects

Noise can be defined as unwanted sound. It may adversely affect the health and well-being of individuals. Noise sensitivity is a personality trait covering attitudes towards noise in general and a predictor of noise annoyance. Noise sensitive individuals are more affected by noise than less sensitive individuals. The determinants and characteristics related to noise sensitivity are rather poorly known. The risk of health effects caused by noise can be hypothesized to be higher for noise sensitive individuals compared to those who are not noise sensitive. A cardiovascular disease may be an example of outcomes. The general aim of the present study was to investigate the association of noise sensitivity with specific somatic and psychological factors, including the genetic component of noise sensitivity, and the association of noise sensitivity with mortality. The study was based on the Finnish Twin Cohort of same-sex twin pairs born before 1958. In 1988 a questionnaire was sent to twin pairs discordant for hypertension. 1495 individuals (688 men, 807 women) aged 31 88 years replied, including 573 twin pairs. 218 of the subjects lived in the Helsinki Metropolitan Area. Self-reported noise sensitivity, lifetime noise exposure and hypertension were obtained from the questionnaire study in 1988 and other somatic and psychological factors from the questionnaire study in 1981 for the same individuals. In addition, noise map information (1988 1992) from the Helsinki Metropolitan Area and mortality follow-up 1989 2003 were used. To evaluate the stability and validity of noise sensitivity, a new questionnaire was sent in 2002 to a sample of the subjects who had replied to the 1988 questionnaire. Of all subjects who had answered the question on noise sensitivity, 38 % were noise sensitive. Noise sensitivity was independent of noise exposure levels indicated in noise maps. Subjects with high noise sensitivity reported more transportation noise exposure than subjects with low noise sensitivity. Noise sensitive subjects reported transportation noise exposure outside the environmental noise map areas almost twice as often as non-sensitive subjects. Noise sensitivity was associated with hypertension, emphysema, use of psychotropic drugs, smoking, stress and hostility, even when lifetime noise exposure was adjusted for. Monozygotic twin pairs were more similar with regards noise sensitivity than dizygotic twin pairs, and quantitative genetic modelling indicated significant familiality. The best fitting genetic model provided an estimate of heritability of 36 %. Follow-up of subjects in the case-control study showed that cardiovascular mortality was significantly increased among noise sensitive women, but not among men. For coronary heart mortality the interaction of noise sensitivity and lifetime noise exposure was statistically significant in women. In conclusion, noise sensitivity has both somatic and psychological components. It does aggregate in families and probably has a genetic component. Noise sensitivity may be a risk factor for cardiovascular mortality in women.

The Europeanisation of occupational health services: A study of the impact of EU policies

This study concerns Framework Directive 89/391/EEC on health and safety at work, which encouraged improvements in occupational health services (OHS) for workers in EU member states. Framework Directive 89/391/EEC originally aimed at bringing the same level of occupational health and safety to employees in both the public and private sectors in EU member states. However, the implementation of the framework directive and OHS varies widely among EU member states. Occupational health services have generally been considered an important work-related welfare benefit in EU member states. The purpose of this study was to analyse OHS within the EU context and then analyse the impact of EU policies on OHS implementation as part of the welfare state benefit. The focus is on social, health, and industrial policies within welfare state regimes as well as EU policy-making processes affecting these policies in EU member states. The research tasks were divided into four groups related to the policy, functions, targets,and actors of OHS. The questions related to policy tried to discover the role of OHS in other policies, such as health, social, and labour market policies within the EU. The questions about functions sought to describe the changes, as well as the path dependence, of OHS in EU member states after the framework directive. The questions about targets were based on the general aims of WHO and the ILO in relation to equity, solidarity, universality, and access to OHS. The questions on actors were designed to understand the variety of stakeholders interested in OHS. The actors were supranational (EU, ILO, and WHO), national (ministries, institutes, and professional organisations), and social partners (trade unions and employers organisations). The study data were collected by interviewing 92 people in 15 EU member states, including representatives of ministries, institutions, research,trade unions, employers organisations, and occupational health organisations. Other documents were collected from the Internet,databases, libraries, and conference materials for a systematic review of the policies, strategies, organisation, financing, and monitoring of OHS in EU member states. Different analytical methods were used in the data analysis. The main findings of the study can be summarised as follows. First, occupational health services is a context-dependent phenomenon, which therefore varies according to the development of the welfare state in general, and depends on each country s culture, history, economy, and politics. The views of different stakeholders in EU member states concerning the impact and possibilities of OHS to improve health vary from evidence-based opinions to the sporadic impact of OHS on occupational health. OHS as a concept is vaguely defined by the EU, whereas the ILO defines OHS content. The tasks of OHS began as preventive and protective services for workers. However, they have moved towards multidisciplinary and organisational development as well as the workplace health promotion sphere.Since 1989 OHS has developed differently in different EU member states depending on the starting position of those states, but planning and implementation are crucial phases in the process toward better OHS coverage, equity, and access. Nevertheless, the data used for the planning and legitimisation of OHS activities are mainly based on occupational health data rather than on OHS data. This makes decisions on political or policy grounds inaccurate. OHS is still an evolving concept and benefit for workers, but the Europeanisation of OHS reflects contextual changes, such as the impact of the internal market, competition, and commercialisation on OHS. Stronger cooperation and integration with health, social, and employment services would be an asset for workers, because of new epidemics, an epidemiological shift towards new risks, an ageing labour market, and changes in the labour market. Different methods and approaches are needed in order to study the results of integrated services. In the future, more detailed information will be needed about the actual impact of EU policies on OHS and decision-making processes in order to get OHS into different policies in the EU and its member states. Further results and effects of OHS processes on occupational health need to be analysed more carefully. The adoption of a variety of research strategies and a multidisciplinary approach to understand the influence of different policies on OHS in the EU and its member states would highlight the options and opportunities to improve workers occupational health. Key subject headings: Occupational health services, EU policy, policymaking,framework directive 89/391/EEC

Ecological restoration of forests in Fennoscandia : Defining reference stand structures and immediate effects of restoration.

The first aim of this thesis was to explore the structural characteristics of near-natural forests and to quantify how human utilization has changed them. For this, we examined the stand characteristics in Norway spruce Picea abies (L.) Karst-dominated old-growth stands in northwestern Russia and in old Scots pine Pinus sylvestris L.-dominated stands in three regions from southern Finland to northwestern Russia. In the second study, we also compared stands with different degrees of human impact, from near-natural stands and stands selectively cut in the past to managed stands. Secondly, we used an experimental approach to study the short-term effects of different restorative treatments on forest structure and regeneration in managed Picea abies stands in southern Finland. Restorative treatments consisted of a partial cut combined with three levels of coarse woody debris retention, and a fire/no-fire treatment. In addition, we examined burned and unburned reference stands without cutting treatments. Results from near-natural Picea abies forests emphasize the dynamic character of old-growth forests, the variety of late-successional forest structures, and the fact that extended time periods are needed to attain certain late-successional stages with specific structural and habitat attributes, such as large-diameter deciduous trees and a variety of deadwood. The results from old Pinus sylvestris-dominated forests showed that human impact in the form of forest utilization and fire exclusion has strongly modified and reduced the structural complexity of stands. Consequently, small protected forest fragments in Finland may not serve as valid natural reference areas for forest restoration. However, results from the restoration experiment showed that early-successional natural stand characteristics can be restored to structurally impoverished managed Picea abies stands, despite a significant portion of wood volume being harvested. A variety of restoration methods is needed, due to differences in the condition of the forest when restoration is initiated and the variety of successional stages of forest structures after anthropogenic and natural disturbances. Keywords: dead wood, disturbance dynamic, fire, near-natural stand, rehabilitation, succession

Population structure of Pyrenophora teres, the causal agent of net blotch of barley

Spring barley is the most important crop in Finland based on cultivated land area. Net blotch, a disease caused by Pyrenophora teres Drech., is the most damaging disease of barley in Finland. The pressure to improve the economics and efficiency of agriculture has increased the need for more efficient plant protection methods. Development of durable host-plant resistance to net blotch is a promising possibility. However, deployment of disease resistant crops could initiate selection pressure on the pathogen (P. teres) population. The aim of this study was to understand the population biology of P. teres and to estimate the evolutionary potential of P. teres under selective pressure following deployment of resistance genes and application of fungicides. The study included mainly Finnish P. teres isolates. Population samples from Russia and Australia were also included. Using AFLP markers substantial genotypic variation in P. teres populations was identified. Differences among isolates were least within Finnish fields and significantly higher in Krasnodar, Russia. Genetic differentiation was identified among populations from northern Europe and from Australia, and between the two forms P. teres f. teres (PTT, net form of net blotch) and P. teres f. maculata (PTM, spot form of net blotch) in Australia. Differentiation among populations was also identified based on virulence between Finnish and Russian populations, and based on prochloraz (fungicide) tolerance in the Häme region in Finland. Surprisingly only PTT was recovered from Finland and Russia although both forms were earlier equally common in Finland. The reason for the shift in occurrence of forms in Finland remained uncertain. Both forms were found within several fields in Australia. Sexual reproduction of P. teres was supported by recover of both mating types in equal ratio in those areas although the prevalence of sexual mating seems to be less in Finland than in Australia. Population from Krasnodar was an exception since only one mating type was found in there. Based on the substantial high genotypic variation in Krasnodar it was suggested go represent an old P. teres population, whereas the Australian samples were suggested to represent newer populations. In conclusion, P. teres populations are differentiated at several levels. Human assistance in dispersal of P. teres on infected barley seed is obvious and decreases the differentiation among populations. This can increase the plant protection problems caused by this pathogen. P. teres is capable of sexual reproduction in several areas but the prevalence varies. Based on these findings it is apparent that P. teres has the potential to pose more serious problems in barley cultivation if plant protection is neglected. Therefore, good agricultural practices, including crop rotation and the use of healthy seed, are recommended.

Lumi ilmaston osana - Lumen vesiarvon ja pinnan albedon mallintaminen Pohjois-Euraasian alueella

Työssä tarkasteltiin ilmakehän yleisen kiertoliikkeen mallin, ECHAM5:n, ja Euroopan keskipitkien sääennusteiden keskuksen uudelleenanalyysijärjestelmän, ERA-40:n, lumen vesiarvon ja lumisten alueiden pinnan albedon mallintamista. Tarkoituksena oli selvittää näiden välisiä eroja sekä sitä, kuinka hyvin ECHAM5 kuvaa nykyilmaston lumioloja. Esimerkinomaisesti tarkasteltiin myös Rossby-keskuksen alueellisen ilmastomallin, RCA3:n, lumen mallintamistapaa. ECHAM5-simulaatioissa käytetty pakote oli havaintojen mukainen meriveden pintalämpötilan ja merijään jakauma. ECHAM5:n ja ERA-40:n aineistoja vertailtiin jaksolla 1986-1990 Pohjois-Euraasian alueella. ERA-40:n lumen vesiarvoja verrattiin lisäksi INTAS-SCCONE-hankkeen havaintoaineistoon. Saatujen tulosten mukaan ECHAM5:n lumen vesiarvo oli monilla alueilla ERA-40:n lumen vesiarvoa pienempi. Suurimmillaan erot olivat vesiarvon maksimialueilla Euraasian keskiosissa. ECHAM5:ssä myös eri vuosien välinen vaihtelu oli pienempää kuin ERA-40:ssä. Varsinkin tarkastelujakson viimeisinä vuosina, 1989 ja 1990, lumen vesiarvo sai Pohjois-Euroopan alueella ERA-40:n mukaan hyvin matalia arvoja, jotka selittyvät NAO-indeksin korkeilla arvoilla. NAO-ilmiön voimakkuus 1980-luvun lopulla ei kuitenkaan erotu ECHAM5:n lumen vesiarvossa. ERA-40:n lumianalyysissä on mukana lumensyvyyshavaintoja, mikä on suurin tuloksiin eroa aiheuttava tekijä. Lienee myös mahdollista, että ECHAM5-simulaatioissa käytetty pakote ei ole riittävän voimakas tuottamaan kaikilta osin realistista lumen vesiarvon jakaumaa. ERA-40:n ja INTAS-SCCONE-aineiston välillä ei ollut kovin suuria eroja. Lumisten alueiden pinnan albedon osana käytetty lumialbedo on ERA-40:ssä ennustettava muuttuja, ECHAM5:ssä se parametrisoidaan. Saatujen tulosten mukaan pinnan albedon arvot ovat ECHAM5:ssä laajalti suurempia kuin ERA-40:ssä. Erot aiheutuvat albedojen erilaisesta laskentatavasta sekä mallien erilaisista kasvillisuusjakaumista. ECHAM5 aliarvioi kasvillisuuden albedoa pienentävän vaikutuksen varsinkin pohjoisen havumetsävyöhykkeen alueella. ERA-40:n pinnan albedo lieneekin realistisempi kuin ECHAM5:n.

Komplexa tal - vad är det?

Komplexa tal har traditionellt undervisats i de finländska gymnasierna som en valbar kurs. Denna situation har för��ndrats i och med de nya läroplanerna som tagits i bruk senast hösten 2005. Den nya, striktare läroplanen ger inte lika stora valmöjligheter för skolorna att bestämma undervisningsstoffet, inte ens för de valbara kurserna, och därför har många gymnasier varit tvungna att sluta undervisa om komplexa tal. För att fortsättningsvis ge en möjlighet för gymnasieelever att studera komplexa tal finns detta kompendium. Kompendiet fyller två syften. I de gymnasier där komplexa tal fortfarande finns med i läroplanen kan kompendiet användas som läromedel på ifr��gavarande kurs. Kompendiet torde vara önskat eftersom det inte existerar något modernt, finlandssvenskt läromedel där de komplexa talen tas upp. Kompendiets andra, huvudsakliga syfte är att finnas till att ge en möjlighet för de elever, som inte går ett gymnasium där komplexa tal undervisas, att på egen hand lära sig grunder om komplexa tal. Kunskap om utvidgandet av talomr��det fr��n reella talen till komplexa hör till matematisk allmänbildning, och är till stor nytta om man är intresserad av att fortsätta studera matematik eller naturvetenskaper efter gymnasiet. Kompendiet kommer att läggas ut på nätet för att få det lättillgängligt. I det första kapitlet behandlas matematikens uppkomst. Det andra kapitlet är en introduktion till varför man behöver komplexa tal, där gås tal- och mängdlära igenom samtidigt som de i kompendiet använda beteckningarna introduceras. I det tredje kapitlet behandlas de komplexa talen; grundläggande r��kneregler, absolutbelopp och argument, komplexa tal i polär form och lösning till högregradsekvationer är centrala begrepp. de Moivers formel är ett av de viktigare målen, även Eulers formel behandlas kort. Problematik med negativa kvadratr��tter tas också upp. Det fjärde kapitlet handlar om de komplexa talens intressanta historia. I kompendiet finns rikligt med exempel och övningsuppgifter. Kapitel fem innehåller extra övningsuppgifter och i kapitel sex finns lösningarna till samtliga uppgifter. Trots att kompendiets omfång avsevärt ökas i och med dessa lösningar är det av värde att de finns med för att kompendiets huvudsakliga syfte skall uppfyllas: att eleverna på egen hand skall kunna lära sig stoffet.

Mies, talli ja moottoripyör�� : Etnografinen tutkimus Misfit MC:stä ja bikerkulttuurin eetoksesta

Tutkimuksen punaisena lankana kulkee kysymys siitä, millainen on bikerkulttuurin eetos? Miten se on syntynyt, miten sitä ylläpidetään ja miten Misfit MC:n jäsenet sitä tulkitsevat ja toteuttavat omassa elämässään? Tarkastelen eetosta kahdenlaisen aineiston valossa. i) Kenttätyöllä (vuosina 1995-1998 ja 2000-2001) ker��tyn aineiston valossa tarkastelen yhtä pääkaupunkiseudulla toimivaa HD-moottoripyör��kerhoa, vuonna 1989 toimintansa aloittanutta Misfit MC:tä. Jäsenet kutsuvat kerhoaan useimmiten talliksi, joskus pajaksi, kerhoksi tai klubiksi. Puhuessaan tallista, miehet voivat viitata kerhorakennukseen ("tuut sä tallille?") mutta myös ryhmään ("meidän talli") ja sen olemassaoloon ajallisesti ja paikallisesti. Aloittaessani kenttätyön vuonna 1995 Misfit MC:n kuului kymmenen 25-30-vuotiasta miestä. ii) Kenttätyöllä ker��tyn aineiston lisäksi käytän materiaalia, joka koostuu Harley-Davidson-moottoripyör��n ympärille rakentuneen bikerkulttuurin historiasta ja kulttuurituotteista, kuten kertomuksista, elokuvista, musiikista, kuvataiteesta ja moottoripyör��lehdistä. Aineiston avulla valotan bikerkulttuurin eetoksen syntyä, alkuvaiheita, leviämistä ja keskeisiä elementtejä. Lähdeaineiston monimuotoisuus ja runsaus palautuu kenttätyöhöni jolloin vakuutuin siitä, että tutkimusmatka bikerkulttuurin historiaan, perinteisiin ja median välittämiin (mieli)kuviin on välttämätöntä, sillä menneisyys ja Harrikkaan ajan kuluessa varastoituneet merkitykset vaikuttavat ja ovat vahvasti läsnä Misfit MC:n toiminnassa ja talliin kuuluvien miesten elämäntyylissä. Tutkimus etenee seuraavanlaisesti. Luku I on Johdanto. Luvussa II Etnografia käsittelen etnografisen tiedon luonnetta niin tutkimusasenteena kuin kenttätyön valossa. Pohdin kenttätyötä ja sen suhdetta etnografian kirjoittamiseen eli miten kenttätyöllä ker��tty aineisto muuntuu etnografiseksi monografiaksi. Käsittelen myös kenttätyöni reunaehtoja, kuten tyttöystävyyden ja sukupuolen merkitystä, ja tarkastelen tutussa kulttuurissa tehdyn kenttätyön ominaispiirteitä. Reunaehtojen kuvailu toimii myös johdatuksena bikerkulttuuriin sellaisena kuin se ilmenee Misfit MC:n tallielämässä ja käytänteissä. Lopuksi pohdin "tiheän kuvauksen" mahdollisuuksia ja vaateita aineistoni puitteissa. Luvussa III Bikerkulttuurin eetosta kartoittamassa, kuvailen Harley-Davidson-moottoripyör��n ympärille rakentuneen elämäntavan syntyä, levittäytymistä ja keskeisiä elementtejä. Tarkastelen media- ja populaarikulttuurisia tekstejä (elokuvien kertomat tarinat, musiikkikappaleiden sanoitukset ja HD- ja bikerlehtien artikkelit) ja kuvia (elokuvien audiovisuaaliset aspektit, kuvataide ja HD- ja bikerlehtien kuvitus), jotka ovat vaikuttaneet bikerkulttuurin eetokseen. Luvun keskeisiä - aineistosta nousevia ja miessukupuoleen vahvasti sidoksissa olevia - käsitteitä ovat biker, outlaw ja chopper, jotka ovat bikerkulttuurissa säilyneet alkuper��isessä muodossa maantieteellisestä tai kielialueesta riippumatta. Luvussa IV Misfit MC ja bikerkulttuurin eetos temaattinen painopiste siirtyy Suomeen ja Misfit MC:hen. Aluksi käyn läpi suomalaisen bikerkulttuurin muotoutumista ja ominaispiirteitä. Alkukappaleiden jälkeen keskityn Misfit MC:n jäsenten elämäntyylin sävyihin ja heidän käsityksiinsä bikerkulttuurin eetoksesta. Analyysin kiintopisteitä ovat Misfit MC:n jäsenten näkemys bikeriydestä ja tallitoiminnasta, miesten elämäntyylin moraaliset ja esteettiset sävyt, tallirakennus miesyhteisöllisyyttä ja bikerkulttuurin eetosta luovana ja ylläpitävänä sosiaalisena tilana ja Misfit MC miesten yhteisönä. Luvussa V Eetoksen ytimessä: mies ja Harley-Davidson keskityn bikerkulttuurin ytimeen: miehen ja Harley-Davidson-moottoripyör��n väliseen suhteeseen. Luvun alussa esittelen ruotsalaisen yhteiskuntatieteilijä Lars Lagergrenin moottoripyör��än soveltamaa työkalu - leikkikalu - toteemi - välittäjä -typologiaa ja tarkastelen moottoripyör��n olemusta sukupuolittavana ja sukupuolittuvana artefaktina. Johdanto-osion jälkeen siirryn kuvailemaan Misfit MC:n jäsenten suhdetta Harley-Davidson-moottoripyör��än. Lähestyn miesten ja moottoripyörien suhdetta kahden toiminnan - moottoripyör��n kunnostamisen ja rakentamisen sekä moottoripyör��llä ajamisen - kautta. Avainsanat: aineellinen kulttuuri, arvot, biker, bikerkulttuuri, chopper, eetos, elämäntapa, etnografia, Harley-Davidson-moottoripyör��, Harley-Davidson-moottoripyör��kerho, kenttätyö, maskuliinisuus, mieskulttuuri, mieskuva, moottoripyör��ily, osakulttuurit, outlaw, populaarikulttuuri, sukupuoliroolit, yhteisöt

Eru Ilúvatar : Jumala J.R.R. Tolkienin legendariumissa

The purpose of my research is to inquire into the essence and activity of God in the legendarium of the English philologist and writer J.R.R. Tolkien (1892-1973). The legendarium, composed of Tolkien’s writings related to Middle-earth, was begun when he created two Elvish languages, Quenya based on Finnish, Sindarin based on Welsh. Tolkien developed his mythology inspired by Germanic myths and The Kalevala. It is a fictional ancient history set in our world. The legendarium is monotheistic: God is called Eru ‘The One’ and Ilúvatar ‘Father of All’. Eru is the same as the Christian God, for Tolkien wanted to keep his tales consistent with his faith. He said his works were Christian by nature, with the religious element absorbed into the story and the symbolism. In The Silmarillion, set in the primeval ages of Middle-earth, the theological aspects are more conspicuous, while in The Lord of the Rings, which brings the stories to an end, they are mostly limited to symbolic references. The legendarium is unified by its realistic outlook on creaturely abilities and hope expressing itself as humbly defiant resistance. ”The possibility of complexity or of distinctions in the nature of Eru” is a part of the legendarium. Eru Ilúvatar is Trinitarian, as per Tolkien’s faith. Without contextual qualifiers, Eru seems to refer to God the Father, like God in the Bible. Being the creator who dwells outside the world is attributed to Him. The Holy Spirit is the only Person of the Trinity bestown with names: the Flame Imperishable and the Secret Fire. When Eru creates the material world with His word, He sends the Flame Imperishable to burn at the heart of the world. The Secret Fire signifies the Creative Power that belongs to God alone, and is a part of Him. The Son, the Word, is not directly mentioned, but according to one writing Eru must step inside the world in order to save it from corruption, yet remain outside it at the same time. The inner structure of the legendarium refers to the need for a future salvation. The creative word of Eru, “Eä! Let these things Be!”, probably has a connection with the Logos in Christianity. Thus we can find three “distinctions” in Eru: a Creator who dwells outside the world, a Sustainer who dwells inside it and a Redeemer who shall step inside it. Some studies of Tolkien have claimed that Eru is distant and remote. This seems to hold water only partially. Ilúvatar, the Father of All, has a special relation with the Eruhíni, His Children, the immortal Elves and the mortal Men. He communicates with them directly only through the Valar, who resemble archangels. Nevertheless, only the Children of Eru can fight against evil, because their tragic fortunes turn evil into good. Even though religious activities are scarce among them, the fundamental faith and ultimate hope of the “Free Peoples” is directed towards Eru. He is present in the drama of history as the “Author of the Story”, who at times also interferes with its course through catastrophes and eucatastrophes, ‘good catastrophes’. Eru brings about a catastrophe when evil would otherwise bring good to an end, and He brings about a eucatasrophe when creaturely strength is not sufficent for victory. Victory over corruption is especially connected with mortal Men, of whom the most (or least) insignificant people are the Hobbits. However, because of the “primeval disaster��� (that is, fall) of Mankind, ultimate salvation can only remain open, a hope for the far future.

Obstetric and gynaecological aspects of HIV infection

The purpose of the present study was to examine the outcome of pregnancies among HIV-infected women in Helsinki, use of the levonorgestrel-releasing intrauterine system (LNG-IUS) among HIV-infected women and the prevalence and risk factors of cytological and histologically proven cervical lesions in this population. Between 1993 and 2003 a total of 45 HIV-infected women delivered 52 singleton infants. HIV infection was diagnosed during pregnancy in 40% of the mothers. Seventeen of the mothers received antiretroviral (ARV) medication prior to pregnancy and in 34 cases, the medication was started during pregnancy. A good virological response (i.e. HIV RNA load <1000/mL during the last trimester) to ARV medication was achieved in 36/40 (90%) of the patients in whom HI viral load measurements were performed. Of the infants, 92% were born at term, and their mean (±SD) birth weight was 3350±395 g. The Caesarean section rate was low, 25%. All newborns received ARV medication and none of the infants born to mothers with pre-delivery diagnosis of maternal HIV infection were infected. The safety and advantages of the LNG-IUS were studied prospectively (n=12) and retrospectively (n=6). The LNG-IUS was well tolerated and no cases of PID or pregnancy were noted. Menstrual bleeding was reduced significantly during use of the LNG-IUS; this was associated with a slight increase in haemoglobin levels. Serum oestradiol concentrations remained in the follicular range in all subjects. The key finding was that genital shedding of HIV RNA did not change after the insertion of the LNG-IUS. The mean annual prevalence of low-grade squamous intraepithelial lesions (SIL) was 15% and that of high-grade SIL was 5% among 108 systematically followed HIV-infected women during 1989 2003. A reduced CD4 lymphocyte count was associated with an increased prevalence of SIL, whereas duration of HIV infection, use of ARV medication and HI viral load were not. The cumulative risk of any type of SIL was 17% after one year and 48% after five years among patients with initially normal Pap smears. The risk of developing SIL was associated with young age and a high initial HI viral load. During the follow-up 51 subjects (n=153) displayed cervical intraepithelial neoplasia (CIN), (16% CIN1 and 18% CIN 2-3). Only one case of cancer of the uterine cervix was detected. Pap smears were reliable in screening for CIN. Both nulliparity (p<0.01) and bacterial vaginosis (p<0.04) emerged as significant risk factors of CIN. In conclusion, a combination of universal antenatal screening and multidisciplinary management allows individualized treatment and prevents vertical transmission of HIV. Use of the LNG-IUS is safe among HIV-infected women and cervicovaginal shedding of HIV RNA is not affected by use of the LNG-IUS. The risk of cervical pre-malignant lesions is high among HIV-infected women despite systematic follow-up.

Total hip arthroplasty in young patients : with special references to patients under 55 years of age and to patients with developmental dysplasia of the hip

There is an ongoing controversy as to which methods in total hip arthroplasty (THA) could provide young patients with best long-term results. THA is an especially demanding operation in patients with severely dysplastic hips. The optimal surgical treatment for these patients also remains controversial. The aim of this study was to evaluate the long-term survival of THA in young patients (<55 years at the time of the primary operation) on a nation-wide level, and to analyze the long-term clinical and radio-graphical outcome of uncemented THA in patients with severely dysplastic joints. Survival of 4661 primary THAs performed for primary osteoarthritis (OA), 2557 primary THAs per-formed for rheumatoid arthritis (RA), and modern uncemented THA designs performed for primary OA in young patients, were analysed from the Finnish Arthroplasty Register. A total of 68 THAs were per-formed in 56 consecutive patients with high congenital hip dislocation between 1989-1994, and 68 THAs were performed in 59 consecutive patients with severely dysplastic hips and a previous Schanz osteotomy of the femur between 1988-1995 at the Orton Orthopaedic Hospital, Helsinki, Finland. These patients underwent a detailed physical and radiographical evaluation at a mean of 12.3 years and 13.0 years postoperatively, respectively. The risk of stem revision due to aseptic loosening in young patients with primary OA was higher for cemented stems than for proximally porous-coated or HA-coated uncemented stems implanted over the 1991-2001 period. There was no difference in the risk of revision between all-poly cemented-cups and press-fit porous-coated uncemented cups implanted during the same period, when the end point was defined as any revision (including exchange of liner). All uncemented stem designs studied in young patients with primary OA had >90% survival rates at 10 years. The Biomet Bi-Metric stem had a 95% (95% CI 93-97) survival rate even at 15 years. When the end point was defined as any revision, 10 year survival rates of all uncemented cup designs except the Harris-Galante II decreased to <80%. In young patients with RA, the risk of stem revision due to aseptic loosening was higher with cemented stems than with proximally porous-coated uncemented stems. In contrast, the risk of cup revision was higher for all uncemented cup concepts than for all-poly cemented cups with any type of cup revision as the end point. The Harris hip score increased significantly (p<0.001) both in patients with high con-genital hip dislocation and in patients with severely dysplastic hips and a previous Schanz osteotomy, treated with uncemented THA. There was a negative Trendelenburg sign in 92% and in 88% of hips, respectively. There were 12 (18%) and 15 (22%) perioperative complications. The rate of survival for the CDH femoral components, with revision due to aseptic loosening as the end point, was 98% (95% CI 97-100) at 10 years in patients with high hip dislocation and 92% (95% CI, 86-99) at 14 years in patients with a previous Schanz osteotomy. The rate of survival for press-fit, porous-coated acetabular components, with revision due to aseptic loosening as the end point, was 95% (95% CI 89-100) at 10 years in patients with high hip dislocation, and 98% (95% CI 89-100) in patients with a previous Schanz osteotomy. When revision of the cup for any reason was defined as the end point, 10 year sur-vival rates declined to 88% (95% CI 81-95) and to 69% (95% CI, 56-82), respectively. For young patients with primary OA, uncemented proximally circumferentially porous- and HA-coated stems are the implants of choice. However, survival rates of modern uncemented cups are no better than that of all-poly cemented cups. Uncemented proximally circumferentially porous-coated stems and cemented all-poly cups are currently the implants of choice for young patients with RA. Uncemented THA, with placement of the cup at the level of the true acetabulum, distal advancement of the greater trochanter and femoral shortening osteotomy provided patients with high congenital hip dislocation good long-term outcomes. Most of the patients with severely dysplastic hips and a previous Schanz osteotomy can be successfully treated with the same method. However, the subtrochanteric segmental shortening with angular correction gives better leg length correction for the patients with a previous low-seated unilateral Schanz osteotomy.

Complex trait of acute pancreatitis : Studies of candidate genes and adipokines

Acute pancreatitis (AP) is a common disease. Mild disease resolves spontaneously in a few days. Severe forms of the disease can lead to local complications, necrosis, and abscesses in and around the pancreas. Systemic inflammation in severe AP is associated with distant organ failures. The aim of this study is to identify genetically determined prognostic factors involved in the clinical features of AP. The study employs a candidate-gene approach, and the genes are involved in trysinogen activation in the initiation phase of the disease, as well as in the systemic inflammation as the disease proceeds. The last study examines adipokines, fat-derived hormones characterized with the capacity to modify inflammation. SPINK 1 is a gene coding trypsin activation inhibitor. Mutations N34S and P55N were determined by minisequencing methods in 371 AP patients and in 459 controls. The mutation N34S was more common in AP patients (7.8%) than in controls (2.6%). This suggests that SPINK 1 gene mutation N34S is a risk factor for AP. In the fourth study, in 12 matched pairs of patients with severe and mild AP, levels of adipokines, adiponectin, and leptin were evaluated. Plasma adipokine levels did not differ between patients with mild and severe AP. The results suggest that in AP, adipokine plasma levels are not factors predisposing to organ failures. This study identified the SPINK 1 mutation N34S to be a risk factor for AP in the general population. As AP is a multifactorial disease, and extensive genetic heterogeneity is likely, further identification of genetic factors in the disease requires larger future studies with more advanced genetic study models. Further identification of the patient characteristics associated with organ failures offers another direction of the study to achieve more detailed understanding of the severe form of AP.