Vapaaehtoiset vuodeosastolla : Etnografinen tutkimus vanhusten ja vapaaehtoisten kohtaamisesta

This ethnographic study investigates encounters between volunteers and older people at the Kerava Municipal Health Centre inpatient ward for chronic care. Volunteer activities have been under development, in cooperation with the Voluntary Work Center (Talkoorengas), since the start of the 1990s. When my research began in 2003, nine of the volunteers came to the ward on set days per week or visited the ward according to their own timetables. The volunteers ranged in age from 54 to 78 years. With one exception, all of them were on pension. Nearly all of them had been volunteers for more than ten years. My study is research on ageing, the focal point being older people, whether volunteers or those receiving assistance. The research questions are: How is volunteer work implemented in daily routines at the ward? How is interaction created in encounters between the older people and the volunteers? What meanings does volunteer work create for the older people and the volunteers? The core material of my research is observation material, which is supplemented by interviews, documentation and photographs. The materials have been analysed by using theme analysis and ethnomethodological discussion analysis. In the presentation of the research findings, I have structured the materials into three main chapters: space and time; hands and touch; and words and tones. The chapter on space and time examines time and space paths, privacy and publicness, and celebrations as part of daily life. The volunteers open and create social arenas for the older people through chatting and singing together, celebrations in the dayroom or poetry readings at the bedside. The supporting theme of the chapter on hands and touch is bodily closeness in care and the associated concrete physical presence. The chapter highlights the importance of everyday routines, such as meals and rituals, as elements that bring security. Stimuli in daily life, such as handicrafts in groups, pass time but also give older people the experience of meaningful activity and bring back positive memories of their own life. The chapter on words and tones focuses on the social interaction and identity. The volunteers’ identity is built up into the identity of a helper and caregiver. The older people’s identity is built up into a care recipient’s identity, which in different situations is shaped into, among others, the identity of one who listens, remembers, does not remember, defends, composes poetry or is dying. The cornerstones of voluntary social care are participation, activity, trust and presence. Successful volunteer work calls for mutual trust between the older people, volunteers and the health care personnel, and for clear agreements on questions of responsibility, the status of volunteers and their role alongside professional personnel. This study indicates that volunteer work is a meaningful resource in work with older people.

Aspiraatiobiopsianäytteen herkkyys kohdunrungonsyövän diagnostiikassa

Tutkimukseni tarkoituksena oli tutkia aspiraatiobiopsianäytteen herkkyyttä kohdunrungonsyövän diagnostiikassa suomalaisessa potilasaineistossa. Tutkimusaineistoni koostui potilaista, joilla on todettu kohdunrungonsyöpä hysterektomiassa 5.4.2006- 16.12.2008 välisenä aikana ja otettu aspiraatiobiopsianäyte vuoden sisällä ennen kohdunpoistoa. Potilastiedot hain Patologian laitoksen Q-Pati tietokannasta. Biopsian diagnoosin perusteella jaoin potilasaineiston kolmeen ryhmään: karsinooma, kompleksi atyyppinen hyperplasia ja karsinooman suhteen negatiivinen vastaus. Näissä ryhmissä tarkastelin edelleen, oliko biopsianäyte johtanut leikkaushoitoon tai jatkotutkimuksiin. Tutkimukseni mukaan biopsianäytteiden vastauksena oli 61% tapauksista karsinooma. Suoraan hysterektomiaan biopsianäytteen perusteella johtaneita tapauksia oli 82%, eli tapaukset joiden PAD-vastauksena oli karsinooma sekä kompleksit atyyppiset hyperplasiatapaukset, joissa epäiltiin karsinoomaa. Lopullinen herkkyys oli kuitenkin 97% sillä perusteella, että näissä tapauksissa biopsian vastaus johti hysterektomiaan joko suoraan tai jatkotutkimusten jälkeen kohtuullisen ajan (2kk) sisällä. Tutkimukseni mukaan aspiraatiobiopsia on luotettava testi epäiltäessä kohdunrungonsyöpää. Tulosten perusteella jatkotutkimukset ovat tarpeen, mikäli biopsian vastauksena on niukka näyte tai pyometra.

Essays on Market Microstructure: Price Discovery and Informed Trading

Market microstructure is “the study of the trading mechanisms used for financial securities” (Hasbrouck (2007)). It seeks to understand the sources of value and reasons for trade, in a setting with different types of traders, and different private and public information sets. The actual mechanisms of trade are a continually changing object of study. These include continuous markets, auctions, limit order books, dealer markets, or combinations of these operating as a hybrid market. Microstructure also has to allow for the possibility of multiple prices. At any given time an investor may be faced with a multitude of different prices, depending on whether he or she is buying or selling, the quantity he or she wishes to trade, and the required speed for the trade. The price may also depend on the relationship that the trader has with potential counterparties. In this research, I touch upon all of the above issues. I do this by studying three specific areas, all of which have both practical and policy implications. First, I study the role of information in trading and pricing securities in markets with a heterogeneous population of traders, some of whom are informed and some not, and who trade for different private or public reasons. Second, I study the price discovery of stocks in a setting where they are simultaneously traded in more than one market. Third, I make a contribution to the ongoing discussion about market design, i.e. the question of which trading systems and ways of organizing trading are most efficient. A common characteristic throughout my thesis is the use of high frequency datasets, i.e. tick data. These datasets include all trades and quotes in a given security, rather than just the daily closing prices, as in traditional asset pricing literature. This thesis consists of four separate essays. In the first essay I study price discovery for European companies cross-listed in the United States. I also study explanatory variables for differences in price discovery. In my second essay I contribute to earlier research on two issues of broad interest in market microstructure: market transparency and informed trading. I examine the effects of a change to an anonymous market at the OMX Helsinki Stock Exchange. I broaden my focus slightly in the third essay, to include releases of macroeconomic data in the United States. I analyze the effect of these releases on European cross-listed stocks. The fourth and last essay examines the uses of standard methodologies of price discovery analysis in a novel way. Specifically, I study price discovery within one market, between local and foreign traders.

The Innocent Pleasure : A Study on Luther's theology of music

The aim of the study is to examine Luther s theology of music from the standpoint of pleasure. The theological assessment of musical pleasure is related to two further questions: the role of emotions in Christianity and the apprehension of beauty. The medieval discussion of these themes is portrayed in the background chapter. Significant traits were: the suspicion felt towards sensuous gratification in music, music as a mathematical discipline, the medieval theory of emotions informed by Stoic apatheia and Platonic-Aristotelian metriopatheia, the notion of beauty as an attribute of God, medieval aesthetics as the aesthetic of proportion and the aesthetic of light and the emergence of the Aristotelian view of science that is based on experience rather than speculation. The treatment of Luther s theology of music is initiated with the notion of gift. Luther says that music is the excellent (or even the best) gift of God. This has sometimes been understood as a mere music-lover s enthusiasm. Luther is, however, not likely to use the word gift loosely. His theology can be depicted as a theology of gift. The Triune God is categorically giving. The notion of gift also includes reciprocity. When we receive the gifts of God, it evokes praise in us. Praising God is predominantly a musical phenomenon. The particular benefit of music in Luther s thought is that it can move human emotions. This emphasis is connected to the overall affectivity of Luther s theology. In contrast to the medieval discussion, Luther ascribes to saints not just emotions but particularly warm and tender affections. The power of music is related to the auditory and vocal character of the Word. Faith comes through hearing the Word that is at once musical and affective perception. Faith is not a mere opinion but the affective trust of the heart. Music can touch the human heart and persuade with its sweetness, like the good news of the Gospel. Music allows us to perceive Luther s theology as a theology of joy and pleasure. Joy is for Luther a gift of the Holy Spirit that fills the heart and bursts out in voice and gestures. Pleasure appears to be a central aspect to Luther s theology. The problem of the Bondage of the Will is precisely the human inability to feel pleasure in God s will. To be pleased in the visible and tangible creation is not something a Christian should avoid. On the contrary, if one is not pleased with the world that God has created, it is a sign of unbelief and ingratitude. The pleasure of music is aesthetic perception. This in turn necessitates the investigation of Luther s aesthetics. Aesthetic evaluation is not just a part of Luther s thought. Eventually his theology as a whole could be portrayed in aesthetic terms. Luther s extremely positive appreciation of music illutrates his theology as an affective acknowledgement of the goodness of the Creation and faith as an aesthetic contentment.

Esteettinen kokemus kulttuurisiltana : Soile Yli-Mäyryn taide kiinalaisen, japanilaisen ja suomalaisen yleisön kokemana

AESTHETIC EXPERIENCE AS A BRIDGE ACROSS CULTURES Soile Yli-Mäyry s art as experienced by Chinese, Japanese and Finnish audiences This study focuses on surveying and analysing experiences of Soile Yli-Mäyry s art in eleven different countries. Questionnaires were translated into nine different languages. In addition, interviews were conducted on the experiences of Chinese, Japanese and Finnish art audiences concerning a painting called Sun Wind . The study was mainly inspired by John Dewey s ideas of art as an interactive communication where the artist, the piece and those who experience it make up an interactive process. In this process experience is a meeting point with both individual and communal characteristics. The data was collected in conjunction with exhibitions in 1997−2005. The survey was carried out in eleven countries (Finland, United States, Brazil, China, Taiwan, Japan, India, Israel, Argentina, Germany and Switzerland). The survey data was made up of 2,563 returned questionnaires. The interviews in China, Japan and Finland were about the same painting Sun Wind , which was transported from Finland to Japan (Tokyo) and China. A total of 89 people were interviewed in Shanghai Art Museum, 30 people in Port-Ginza Gallery, Tokyo and 45 people in Soile Yli-Mäyry s Gallery in Finland. Three hypotheses that were turned into research questions directed the study: 1. Are there differences/ similarities between culturally different communities in the meanings attributed to experiences, e.g. according to emotional dimensions, or do experiences focus more on reflecting on one s own life or meanings attributed to the world around us? What kinds of experiential dimensions are there in different countries? Do similar, analogous experiences that transcend cultural barriers emerge in culturally different countries such as China, Japan and Finland? 2. Does the data display different types of experiencing subjects which are typical to a subject s own country or are they experiences that can be compared to those generated by an ideal landscape , where the art touches the subconscious and collective selfhood, being thus transnational and timeless? Closer analysis focuses on audience experiences in China, Japan and Finland (interviews, textual survey data). 3. Are the experiences and interpretations of experts similar/different to those of larger audiences? The survey data has been analysed with the help of cross-tabulation. After content analysis of the interviews and textual survey data, different ways of experiencing subjects were sketched by country (China, Japan, Finland). The types were both similar and dissimilar. The most important types were social/ecological (China), therapeutic/reserved (Japan) and narrative/projecting (Finland). There were differences in how experiences were emphasised: the Chinese public approached their experiences from the viewpoint of pragmatism and utility, where they could obtain new ideas for their own work or experiencing the exhibition gave courage to approach their own lives from a new perspective. In turn, the Japanese public experienced the art from a therapeutic angle and from a very reserved perspective, which Dylan Evans (2001, 13−17) has described as typical to Japanese culture. The experiences of the Finnish audience were strongly therapeutic and narrative. The people projected their emotions onto the piece and in a concrete manner forged them into a story. The partly similar results of this study in China, Japan and Finland demonstrate that the art displayed in the exhibitions contain images of the beginning or elements connected to the beginning of life, which touch the subconscious in the way an ideal landscape would. Experiencing the meaningfulness of one s own life through art is a common thread and a bridge across cultures that unites the experiences of the audiences of this study, be they Taoists, Confucians, Buddhists or Maoists in China, Shinto followers, Zen Buddhists in Japan or Evangelist-Lutherans in Finland. Keywords: experience, reception, bridge across cultures, types of experiencing subjects, experiential process, ideal landscape, elementality

Mid-urethral slings for treatment of stress urinary incontinence : long- and mid-term follow-up

Urinary incontinence is a common problem, affecting one third of the women at least at some time during their lives. The prevalence of urinary incontinence increases with advancing age, and the everyday impact of incontinence on women and on health services is enormous. Urinary incontinence is usually divided into three different subtypes, of which stress urinary incontinence (SUI) is the most common. Surgical treatment is often needed to cure SUI, and modern mid-urethral sling procedures give the possibility to cure this condition with a low risk of adverse events, a problem often associated with the so-called traditional incontinence operations. Life expectancy among women in Western countries has grown beyond 80 years of age. Long-term efficacy of treatment options for urinary incontinence therefore becomes an important issue in a world with limited eco-nomic resources. The purpose of the present study was to prospectively evaluate the long-term efficacy and safety of the first minimally invasive mid-urethral tape procedure, the Tension-free Vaginal Tape (TVT) procedure. The long-term (5-year) follow-up results of the TVT procedure as a repeat operation af-ter an unsuccessful mid-urethral tape operation were studied and the reasons for failure of the first operation were analyzed. Another purpose was to compare the original TVT procedure with a newer modification, the Tension-free Vaginal Tape Obturator (TVT-O) procedure within a multi-centre, randomized context in order to find out possible differences between these procedures re-garding efficacy and complications and the effects on symptoms of urgency. The first study of the present thesis is a prospective, Nordic, three-centre follow-up study of 90 women suffering from SUI, who were treated by means of the TVT procedure. The mean follow-up time was more than eleven years, and the study is the first to be published in connection with more than ten years of follow-up. The second study is a retrospective analysis of 26 women who were treated with a repeat TVT procedure after an unsuccessful primary mid-urethral tape procedure. The third and fourth studies concern 273 women in seven centres in Finland who were ran-domly assigned to the TVT and TVT-O procedures, the 3-year follow-up results of which are pre-sented in this thesis. After eleven years of follow-up, 90% of the women had a negative cough stress test result and a negative 24-h pad test result. The subjective cure rate measured as the women s global impression of cure was 77%, the rate of improvement 20%, and only 3% thought that the treatment had failed. No late-onset adverse effects were found. The repeat TVT procedure was successful in 75% of the cases when women who were cured and women who were significantly improved were included. The reasons for failure of the first operation could be separated into four different groups: tape material-related, operation technique-related, concomitant illness-related and a group with no identifiable reason. There were no intra-operative complications during the repeat operation. In the randomized trial comparing the TVT with the TVT-O procedure a cough stress test results were negative in 94.6% and 89.5% of the women in the two groups, respectively, after a 3-year follow-up period. There were no statistical differences in the cure rate or the rate of complications be-tween the two procedures. Symptoms of urgency were analyzed more closely and the main finding was that the prevalence of urgency symptoms decreased significantly after both mid-urethral sling procedures. The TVT operation was found to be an effective and safe procedure even after eleven years of follow-up. Long-term follow-up after a repeat TVT procedure revealed that the TVT procedure can well be considered after an unsuccessful mid-urethra tape procedure, because 75% of the patients showed significantly improvement of their incontinence. The TVT and TVT-O procedures showed no statistically significant differences in efficacy and rate of complications after three years of follow-up. In most cases these procedures alleviate preoperative symptoms of urgency and the risk of developing de novo urgency is low.

Divergencies of Perception : The Possibilities of Merleau-Pontian Phenomenology in Analyses of Contemporary Art

Maurice Merleau-Ponty (1908-1961) has been known as the philosopher of painting. His interest in the theory of perception intertwined with the questions concerning the artist s perception, the experience of an artwork and the possible interpretations of the artwork. For him, aesthetics was not a sub-field of philosophy, and art was not simply a subject matter for the aesthetic experience, but a form of thinking. This study proposes an opening for a dialogue between Merleau-Pontian phenomenology and contemporary art. The thesis examines his phenomenology through certain works of contemporary art and presents readings of these artworks through his phenomenology. The thesis both shows the potentiality of a method, but also engages in the critical task of finding the possible limitations of his approach. The first part lays out the methodological and conceptual points of departure of Merleau-Ponty s phenomenological approach to perception as well as the features that determined his discussion on encountering art. Merleau-Ponty referred to the experience of perceiving art using the notion of seeing with (voir selon). He stressed a correlative reciprocity described in Eye and Mind (1961) as the switching of the roles of the visible and the painter. The choice of artworks is motivated by certain restrictions in the phenomenological readings of visual arts. The examined works include paintings by Tiina Mielonen, a photographic work by Christian Mayer, a film by Douglas Gordon and Philippe Parreno, and an installation by Monika Sosnowska. These works resonate with, and challenge, his phenomenological approach. The chapters with case studies take up different themes that are central to Merleau-Ponty s phenomenology: space, movement, time, and touch. All of the themes are interlinked with the examined artworks. There are also topics that reappear in the thesis, such as the notion of écart and the question of encountering the other. As Merleau-Ponty argued, the sphere of art has a particular capability to address our being in the world. The thesis presents an interpretation that emphasises the notion of écart, which refers to an experience of divergence or dispossession. The sudden dissociation, surprise or rupture that is needed in order for a meeting between the spectator and the artwork, or between two persons, to be possible. Further, the thesis suggests that through artworks it is possible to take into consideration the écart, the divergence, that defines our subjectivity.