Distal anterior cerebral artery aneurysms

Objective: Distal anterior cerebral artery (DACA) aneurysms represent about 6% of all intracranial aneurysms. So far, only small series on treatment of these aneurysms have been published. Our aim is to evaluate the anatomic features, microneurosurgical techniques, treatment results, and long-term outcome in patients treated for DACA aneurysms. Patients and methods: We analyzed the clinical and radiological data on 517 consecutive patients diagnosed with DACA aneurysm at two neurosurgical centers serving solely the Southern (Helsinki) and Eastern (Kuopio) Finland in 1936–2007, and used a defined subgroup of the whole study population in each part of the study. Detailed anatomic analysis was performed in 101 consecutive patients from 1998 to 2007. Treatment results were analyzed in 427 patients treated between 1980 to 2005, the era of CT imaging and microneurosurgery. Long-term treatment outcome of ruptured DACA aneurysm(s) was evaluated in 280 patients with a median follow-up of 10 years; no patients were lost to follow-up. Results: DACA aneurysms, found most often (83%) at the A3 segment of the anterior cerebral artery (ACA), were smaller (median 6 mm vs. 8 mm), more frequently associated with multiple aneurysms (35% vs. 18%), and presented more often with intracerebral hematomas (ICHs) (53% vs. 26%) than ruptured aneurysms in general. They were associated with anomalies of the ACA in 23% of the patients. Microsurgical treatment showed similar complication rates (treatment morbidity 15%, treatment mortality 0.4%) as for other ruptured aneurysms. At one year after subarachnoid hemorrhage (SAH), DACA aneurysms had equally favorable outcome (GOS≥4) as other ruptured aneurysms (74% vs. 69%) but their mortality was lower (13% vs. 24%). Factors predicting unfavorable outcome for ruptured DACA aneurysms were advanced age, Hunt&Hess≥3, rebleeding before treatment, ICH, intraventricular hemorrhage, and severe preoperative hydrocephalus. The cumulative relative survival ratio showed 16% excess mortality in patients with ruptured DACA aneurysm during the first three years after SAH compared to the matched general population. From the fourth year onwards, there was no excess mortality during the follow-up. There were four episodes of recurrent SAH, only one due to treated DACA aneurysm, with a 10-year cumulative risk of 1.4%. Conclusions: The special neurovascular features and frequent association with anterior cerebral artery anomalies must be taken into account when planning occlusive treatment of DACA aneurysms. Clipping of DACA aneurysms provides a long-lasting result, with very small rates of rebleeding. After surviving three years from rupture of DACA aneurysm, the long-term survival of these patients becomes similar to that of the matched general population.

Bone health and vitamin D status in children with motor disability and adults with intellectual disability

Osteoporosis is not only a disease of the elderly, but is increasingly diagnosed in chronically ill children. Children with severe motor disabilities, such as cerebral palsy (CP), have many risk factors for osteoporosis. Adults with intellectual disability (ID) are also prone to low bone mineral density (BMD) and increased fractures. This study was carried out to identify risk factors for low BMD and osteoporosis in children with severe motor disability and in adults with ID. In this study 59 children with severe motor disability, ranging in age from 5 to 16 years were evaluated. Lumbar spine BMD was measured with dual-energy x-ray absorptiometry. BMD values were corrected for bone size by calculating bone mineral apparent density (BMAD), and for bone age. The values were transformed into Z-scores by comparison with normative data. Spinal radiographs were assessed for vertebral morphology. Blood samples were obtained for biochemical parameters. Parents were requested to keep a food diary for three days. The median daily energy and nutrient intakes were calculated. Fractures were common; 17% of the children had sustained peripheral fractures and 25% had compression fractures. BMD was low in children; the median spinal BMAD Z-score was -1.0 (range -5.0 – +2.0) and the BMAD Z-score <-2.0 in 20% of the children. Low BMAD Z-score and hypercalciuria were significant risk factors for fractures. In children with motor disability, calcium intakes were sufficient, while total energy and vitamin D intakes were not. In the vitamin D intervention studies, 44 children and adolescents with severe motor disability and 138 adults with ID were studied. After baseline blood samples, the children were divided into two groups; those in the treatment group received 1000 IU peroral vitamin D3 five days a week for 10 weeks, and subjects in the control group continued with their normal diet. Adults with ID were allocated to receive either 800 IU peroral vitamin D3 daily for six months or a single intramuscular injection of 150 000 IU D3. Blood samples were obtained at baseline and after treatment. Serum concentrations of 25-OH-vitamin D (S-25-OHD) were low in all subgroups before vitamin D intervention: in almost 60% of children and in 77% of adults the S-25-OHD concentration was below 50 nmol/L, indicating vitamin D insufficiency. After vitamin D intervention, 19% of children and 42% adults who received vitamin D perorally and 12% of adults who received vitamin D intramuscularly had optimal S-25-OHD (>80 nmol/L). This study demonstrated that low BMD and peripheral and spinal fractures are common in children with severe motor disabilities. Vitamin D status was suboptimal in the majority of children with motor disability and adults with ID. Vitamin D insufficiency can be corrected with vitamin D supplements; the peroral dose should be at least 800 IU per day.

Microvascular reconstruction in extremity soft tissue sarcoma surgery

Soft tissue sarcomas (STS) are rare tumors of soft tissue occurring most frequently in the extremities. Modern treatment of extremity STS is based on limb-sparing surgery combined with radiotherapy. To prevent local recurrence, a healthy tissue margin of 2.5 cm around the resected tumor is required. This results in large defects of soft tissue and bone, necessitating the use of reconstructive surgery to achieve wound closure. When local or pedicled soft tissue flaps are unavailable, reconstruction with free flaps is used. Free flaps are elevated at a distant site, and have their blood flow restored at the recipient site through microvascular anastomosis. When limb-sparing surgery is made impossible, amputation is the only option. Proximal amputation such as forequarter amputation (FQA) causes considerable morbidity, but is nevertheless warranted for carefully selected patients for cure or palliation. 116 patients treated in 1985 - 2006 were included in the study. Of these, 93 patients treated with limb-sparing surgery and microvascular reconstructive surgery after resection of extremity STS. 25 patients who underwent FQA were also included. Patients were identified and their medical records retrospectively reviewed. In all, 105 free flap procedures were performed for 103 patients. A total of 95 curatively treated STS patients were included in survival analysis. The latissimus dorsi, used in 56% of cases, was the most frequently used free flap. Free flap success rate was 96%. There were 9% microvascular anastomosis complications and 15% wound complications. For curatively treated STS patients, local recurrence-free survival at 5 years was 73.1%, metastasis-free survival 58.3%, and overall disease-specific survival 68.9%. Functional results were good, with 75% of patients regaining normal or near-normal function after lower extremity, and 55% after upper extremity STS resection. Among curatively treated forequarter amputees, 5-year disease-free survival was 44%. In the palliatively treated group median time until disease death was 14 months. Microvascular reconstruction after extremity soft tissue sarcoma resection is safe and reliable, and produces well-healing wounds allowing early oncological treatment. Oncological outcome after these procedures is comparable to that of other extremity sarcoma patients. Functional results are generally good. Forequarter amputation is a useful treatment option for soft tissue tumors of the shoulder girdle and proximal upper extremity. When free flap coverage of extended forequarter amputation is required, the preferable flap is a fillet flap from the amputated extremity. Acceptable oncological outcome is achieved for curatively treated FQA patients. In the palliatively treated patient considerable periods of increased quality of life can be achieved.

Iodine Brachytherapy for Large Uveal Melanomas

Uveal melanoma is the most common primary intraocular malignancy in adults. Vision in the affected eye is threatened by both the tumor and side-effects from the treatments currently available. Poor prognosis for saving vision increases with tumor size and, consequently, enucleation has been the treatment of choice for large uveal melanomas in most centers. However, increasing evidence suggests that no survival benefit is gained (nor lost) by enucleation as compared to eye-conserving methods. The Helsinki University Eye Hospital has since 1990 offered episcleral iodine-125 plaque brachytherapy (IBT) for all patients unwilling to undergo enucleation for a large uveal melanoma. The primary aim of this study was to assess survival, local tumor recurrence and preservation of the eye and vision after IBT in a population-based series of 97 patients with uveal melanomas classified as large by the Collaborative Ocular Melanoma Study (COMS) criteria. Further aims included reporting the incidence of side-effects and assessing the role of intraocular dose distribution and clinical risk factors in their development. Finally, means to improve the current treatment were investigated by using computer models to compare existing plaques with collimating ones and by comparing the outcome of a subgroup of 54 IBT patients with very thick tumors with 33 patients with similarly-sized tumors managed with transscleral local resection (TSR) in Liverpool, United Kingdom. Kaplan-Meier estimates of all-cause and melanoma-specific survival at 5 years after IBT were 62% and 65%, respectively, and visually comparable with the survival experience of patients reported after enucleation by the COMS. Local recurrence developed in 6% of eyes and 84% of eyes were conserved at 5 years. Visual prognosis was guarded with 11% avoiding loss of 20/70 vision and 26% avoiding loss of 20/400 vision in the tumor eye at 2 years. Large tumor height and short distance from the posterior pole were independently associated with loss of vision. Using cumulative incidence analysis to account for competing risks, such as enucleation and metastatic death, the 5-year incidence of cataract after IBT was 79%, glaucoma 60%, optic neuropathy 46%, maculopathy 52%, persistent or recurring retinal detachment (RD) 25%, and vitreous hemorrhage 36%. In multivariate competing risks regression models, increasing tumor height was associated with cataract, iris neovascularization and RD. Maculopathy and optic neuropathy were associated with distance from the tumor to the respective structure. Median doses to the tumor apex, macula and optic disc were 81 Gy (range, 40-158), 79 Gy (range, 12-632), and 83 Gy (range, 10-377), respectively. Dose to the optic disc was independently associated with optic neuropathy, and both dose to the optic disc and dose to the macula predicted vision loss after IBT. Simulated treatment using collimating plaques resulted in clinically meaningful reduction in both optic disc (median reduction, 30 Gy) and macular (median reduction, 36 Gy) doses as compared to the actual treatment with standard plaques. In the subgroup of patients with uveal melanomas classified as large because of tumor height, cumulative incidence analysis revealed that while long-term preservation of 20/70 vision was rare after both IBT and TSR, preservation of 20/400 vision was better after TSR (32% vs. 5% at 5 years). In multivariate logistic regression models, TSR was independently associated with better preservation of 20/400 vision (OR 0.03 at 2 years, P=0.005) No cases of secondary glaucoma were observed after TSR and optic neuropathy was rare. However, local tumor recurrence was more common after TSR than it was after IBT (Cumulative incidence 41% vs. 7% at 5 years, respectively). In terms of survival, IBT seems to be a safe alternative to enucleation in managing large uveal melanomas. Local tumor control is no worse than with medium-sized tumors and the chances of avoiding secondary enucleation are good. Unfortunately, side-effects from radiotherapy are frequent, especially in thick tumors, and long-term prognosis of saving vision is consequently guarded. Some complications can be limited by using collimating plaques and by managing uveal melanomas that are large because of tumor height with TSR instead of IBT. However, the patient must be willing to accept a substantial risk of local tumor recurrence after TSR and it is best suited for cases in which the preservation of vision in the tumor eye is critical.

Cow's milk allergy and the development of tolerance

Aims: To gain insight on the immunological processes behind cow’s milk allergy (CMA) and the development of oral tolerance. To furthermore investigate the associations of HLA II and filaggrin genotypes with humoral responses to early oral antigens. Methods: The study population was from a cohort of 6209 healthy, full-term infants who in a double-blind randomized trial received supplementary feeding at maternity hospitals (mean duration 4 days): cow’s milk (CM) formula, extensively hydrolyzed whey formula or donor breast milk. Infants who developed CM associated symptoms that subsided during elimination diet (n=223) underwent an open oral CM challenge (at mean age 7 months). The challenge was negative in 112, and in 111 it confirmed CMA, which was IgE-mediated in 83. Patients with CMA were followed until recovery, and 94 of them participated in a follow-up study at age 8-9 years. We investigated serum samples at diagnosis (mean age 7 months, n=111), one year later (19 months, n=101) and at follow-up (8.6 years, n=85). At follow-up, also 76 children randomly selected from the original cohort and without CM associated symptoms were included. We measured CM specific IgE levels with UniCAP (Phadia, Uppsala, Sweden), and β-lactoglobulin, α-casein and ovalbumin specific IgA, IgG1, IgG4 and IgG levels with enzyme-linked immunosorbent assay in sera. We applied a microarray based immunoassay to measure the binding of IgE, IgG4 and IgA serum antibodies to sequential epitopes derived from five major CM proteins at the three time points in 11 patients with active IgE-mediated CMA at age 8-9 years and in 12 patients who had recovered from IgE-mediated CMA by age 3 years. We used bioinformatic methods to analyze the microarray data. We studied T cell expression profile in peripheral blood mononuclear cell (PBMC) samples from 57 children aged 5-12 years (median 8.3): 16 with active CMA, 20 who had recovered from CMA by age 3 years, 21 non-atopic control subjects. Following in vitro β-lactoglobulin stimulation, we measured the mRNA expression in PBMCs of 12 T-cell markers (T-bet, GATA-3, IFN-γ, CTLA4, IL-10, IL-16, TGF-β, FOXP3, Nfat-C2, TIM3, TIM4, STIM-1) with quantitative real time polymerase chain reaction, and the protein expression of CD4, CD25, CD127, FoxP3 with flow cytometry. To optimally distinguish the three study groups, we performed artificial neural networks with exhaustive search for all marker combinations. For genetic associations with specific humoral responses, we analyzed 14 HLA class II haplotypes, the PTPN22 1858 SNP (R620W allele) and 5 known filaggrin null mutations from blood samples of 87 patients with CMA and 76 control subjects (age 8.0-9.3 years). Results: High IgG and IgG4 levels to β-lactoglobulin and α-casein were associated with the HLA (DR15)-DQB1*0602 haplotype in patients with CMA, but not in control subjects. Conversely, (DR1/10)-DQB1*0501 was associated with lower IgG and IgG4 levels to these CM antigens, and to ovalbumin, most significantly among control subjects. Infants with IgE-mediated CMA had lower β -lactoglobulin and α-casein specific IgG1, IgG4 and IgG levels (p<0.05) at diagnosis than infants with non-IgE-mediated CMA or control subjects. When CMA persisted beyond age 8 years, CM specific IgE levels were higher at all three time points investigated and IgE epitope binding pattern remained stable (p<0.001) compared with recovery from CMA by age 3 years. Patients with persisting CMA at 8-9 years had lower serum IgA levels to β-lactoglobulin at diagnosis (p=0.01), and lower IgG4 levels to β-lactoglobulin (p=0.04) and α-casein (p=0.05) at follow-up compared with patients who recovered by age 3 years. In early recovery, signal of IgG4 epitope binding increased while that of IgE decreased over time, and binding patterns of IgE and IgG4 overlapped. In T cell expression profile in response to β –lactoglobulin, the combination of markers FoxP3, Nfat-C2, IL-16, GATA-3 distinguished patients with persisting CMA most accurately from patients who had become tolerant and from non-atopic subjects. FoxP3 expression at both RNA and protein level was higher in children with CMA compared with non-atopic children. Conclusions: Genetic factors (the HLA II genotype) are associated with humoral responses to early food allergens. High CM specific IgE levels predict persistence of CMA. Development of tolerance is associated with higher specific IgA and IgG4 levels and lower specific IgE levels, with decreased CM epitope binding by IgE and concurrent increase in corresponding epitope binding by IgG4. Both Th2 and Treg pathways are activated upon CM antigen stimulation in patients with CMA. In the clinical management of CMA, HLA II or filaggrin genotyping are not applicable, whereas the measurement of CM specific antibodies may assist in estimating the prognosis.

Turbulent vertical fluxes and air quality measured in urban air in Helsinki

There is a growing need to understand the exchange processes of momentum, heat and mass between an urban surface and the atmosphere as they affect our quality of life. Understanding the source/sink strengths as well as the mixing mechanisms of air pollutants is particularly important due to their effects on human health and climate. This work aims to improve our understanding of these surface-atmosphere interactions based on the analysis of measurements carried out in Helsinki, Finland. The vertical exchange of momentum, heat, carbon dioxide (CO2) and aerosol particle number was measured with the eddy covariance technique at the urban measurement station SMEAR III, where the concentrations of ultrafine, accumulation mode and coarse particle numbers, nitrogen oxides (NOx), carbon monoxide (CO), ozone (O3) and sulphur dioxide (SO2) were also measured. These measurements were carried out over varying measurement periods between 2004 and 2008. In addition, black carbon mass concentration was measured at the Helsinki Metropolitan Area Council site during three campaigns in 1996-2005. Thus, the analyzed dataset covered far, the most comprehensive long-term measurements of turbulent fluxes reported in the literature from urban areas. Moreover, simultaneously measured urban air pollution concentrations and turbulent fluxes were examined for the first time. The complex measurement surrounding enabled us to study the effect of different urban covers on the exchange processes from a single point of measurement. The sensible and latent heat fluxes closely followed the intensity of solar radiation, and the sensible heat flux always exceeded the latent heat flux due to anthropogenic heat emissions and the conversion of solar radiation to direct heat in urban structures. This urban heat island effect was most evident during winter nights. The effect of land use cover was seen as increased sensible heat fluxes in more built-up areas than in areas with high vegetation cover. Both aerosol particle and CO2 exchanges were largely affected by road traffic, and the highest diurnal fluxes reached 109 m-2 s-1 and 20 µmol m-2 s-1, respectively, in the direction of the road. Local road traffic had the greatest effect on ultrafine particle concentrations, whereas meteorological variables were more important for accumulation mode and coarse particle concentrations. The measurement surroundings of the SMEAR III station served as a source for both particles and CO2, except in summer, when the vegetation uptake of CO2 exceeded the anthropogenic sources in the vegetation sector in daytime, and we observed a downward median flux of 8 µmol m-2 s-1. This work improved our understanding of the interactions between an urban surface and the atmosphere in a city located at high latitudes in a semi-continental climate. The results can be utilised in urban planning, as the fraction of vegetation cover and vehicular activity were found to be the major environmental drivers affecting most of the exchange processes. However, in order to understand these exchange and mixing processes on a city scale, more measurements above various urban surfaces accompanied by numerical modelling are required.

The Media and the Academic Globalization Debate : Theoretical Analysis and Critique

This study offers a reconstruction and critical evaluation of globalization theory, a perspective that has been central for sociology and cultural studies in recent decades, from the viewpoint of media and communications. As the study shows, sociological and cultural globalization theorists rely heavily on arguments concerning media and communications, especially the so-called new information and communication technologies, in the construction of their frameworks. Together with deepening the understanding of globalization theory, the study gives new critical knowledge of the problematic consequences that follow from such strong investment in media and communications in contemporary theory. The book is divided into four parts. The first part presents the research problem, the approach and the theoretical contexts of the study. Followed by the introduction in Chapter 1, I identify the core elements of globalization theory in Chapter 2. At the heart of globalization theory is the claim that recent decades have witnessed massive changes in the spatio-temporal constitution of society, caused by new media and communications in particular, and that these changes necessitate the rethinking of the foundations of social theory as a whole. Chapter 3 introduces three paradigms of media research the political economy of media, cultural studies and medium theory the discussion of which will make it easier to understand the key issues and controversies that emerge in academic globalization theorists treatment of media and communications. The next two parts offer a close reading of four theorists whose works I use as entry points into academic debates on globalization. I argue that we can make sense of mainstream positions on globalization by dividing them into two paradigms: on the one hand, media-technological explanations of globalization and, on the other, cultural globalization theory. As examples of the former, I discuss the works of Manuel Castells (Chapter 4) and Scott Lash (Chapter 5). I maintain that their analyses of globalization processes are overtly media-centric and result in an unhistorical and uncritical understanding of social power in an era of capitalist globalization. A related evaluation of the second paradigm (cultural globalization theory), as exemplified by Arjun Appadurai and John Tomlinson, is presented in Chapter 6. I argue that due to their rejection of the importance of nation states and the notion of cultural imperialism for cultural analysis, and their replacement with a framework of media-generated deterritorializations and flows, these theorists underplay the importance of the neoliberalization of cultures throughout the world. The fourth part (Chapter 7) presents a central research finding of this study, namely that the media-centrism of globalization theory can be understood in the context of the emergence of neoliberalism. I find it problematic that at the same time when capitalist dynamics have been strengthened in social and cultural life, advocates of globalization theory have directed attention to media-technological changes and their sweeping socio-cultural consequences, instead of analyzing the powerful material forces that shape the society and the culture. I further argue that this shift serves not only analytical but also utopian functions, that is, the longing for a better world in times when such longing is otherwise considered impracticable.

Verkkomedian käyttö ja tutkiminen : Iltalehti Online 1995-2001

Marja Heinonen s dissertation Verkkomedian käyttö ja tutkiminen. Iltalehti Online 1995-2001 describes the usage of new internet based news service Iltalehti Online during its first years of existence, 1995-2001. The study focuses on the content of the service and users attitudes towards the new media and its contents. Heinonen has also analyzed and described the research methods that can be used in the research of any new media phenomenon when there is no historical perspective to do the research. Heinonen has created a process model for the research of net medium, which is based on a multidimensional approach. She has chosen an iterative research method inspired by Sudweeks and Simoff s CEDA-methodology in which qualitative and quantitative methods take turns both creating results and new research questions. The dissertation discusses and describes the possibilities of combining several research methods in the study of online news media. On general level it discusses the methodological possibilities of researching a completely new media form when there is no historical perspective. The result of these discussions is in favour for the multidimensional methods. The empiric research was built around three cases of Iltalehti Online among its users: log analysis 1996-1999, interviews 1999 and clustering 2000-2001. Even though the results of different cases were somewhat conflicting here are the central results from the analysis of Iltalehti Online 1995-2001: - Reading was strongly determined by the gender. - The structure of Iltalehti Online guided the reading strongly. - People did not make a clear distinction in content between news and entertainment. - Users created new habits in their everyday life during the first years of using Iltalehti Online. These habits were categorized as follows: - break between everyday routines - established habit - new practice within the rhythm of the day - In the clustering of the users sports, culture and celebrities were the most distinguishing contents. Users did not move across these borders as much as within them. The dissertation gives contribution to the development of multidimensional research methods in the field of emerging phenomena in media field. It is also a unique description of a phase of development in media history through an unique research material. There is no such information (logs + demographics) available of any other Finnish online news media. Either from the first years or today.

A Success Story or a Failure? : Representing the European Integration in the Curricula and Textbooks of Five Countries

The economic, political and social face of Europe has been changing rapidly in the past decades. These changes are unique in the history of Europe, but not without challenges for the nation states. The support for the European integration varies among the countries. In order to understand why certain developments or changes are perceived as threatening or as desired by different member countries, we must consider the social representations of the European integration on the national level: how the EU is represented to its citizens in media and in educational systems, particularly in the curricula and textbooks. The current study is concerned with the social representations of the European integration in the curricula and school textbooks in five European countries: France, Britain, Germany, Finland and Sweden. Besides that, the first volume of the common Franco-German history textbook was analyzed, since it has been seen as a model for a common European history textbook. As the collective representations, values and identities are dominantly mediated and imposed through media and educational systems, the national curricula and textbooks make an interesting starting point for the study of the European integration and of national and European identities. The social representations theory provides a comprehensive framework for the study of the European integration. By analyzing the curricula and history and civics textbooks of major educational publishers, the study aimed to demonstrate what is written on the European integration and how it is portrayed how the European integration is understood, made familiar and concretized in the educational context in the five European countries. To grasp the phenomenon of the European integration in the textbooks in its entirety, it was investigated from various perspectives. The two analysis methods of content analysis, the automatic analysis with ALCESTE and a more qualitative theory-driven content analysis, were carried out to give a more vivid and multifaceted picture of the object of the research. The analysis of the text was complemented with the analysis of visual material. Drawing on quantitative and qualitative methods, the contents, processes, visual images, transformations and structures of the social representations of European integration, as well as the communicative styles of the textbooks were examined. This study showed the divergent social representations of the European integration, anchored in the nation states, in the five member countries of the European Union. The social representations were constructed around different central core elements: French Europe in the French textbooks, Ambivalent Europe in the British textbooks, Influential and Unifying EU in the German textbooks, Enabling and Threatening EU in the Finnish textbooks, Sceptical EU in the Swedish textbooks and EU as a World Model in the Franco-German textbook. Some elements of the representations were shared by all countries such as peace and economic aspects of the European cooperation, whereas other elements of representations were found more frequently in some countries than in others, such as ideological, threatening or social components of the phenomenon European integration. The study also demonstrated the linkage between social representations of the EU and national and European identities. The findings of this study are applicable to the study of the European integration, to the study of education, as well as to the social representation theory.

Lapset, media ja symbolinen vuorovaikutus : Suomalaisten, englantilaisten ja saksalaisten lasten mediasuhteen tarkastelua

Tämän hetken mediaympäristölle on ominaista intensiivisyys ja jatkuva läsnäolo. Medialla on merkittävä rooli myös pienten lasten jokapäiväisessä elämässä, sillä he aloittavat median säännöllisen seuraamisen keskimäärin kolmen vuoden iässä. Mediasisällöt, mediavälineet ja mediaan liittyvät sosiaaliset suhteet muodostavatkin lapsille mediaympäristön, jossa lapset rakentavat identiteettejään, oppivat sosiaalista kanssakäymistä ja kehittävät näkemyksiään yhteiskunnasta ja kulttuurista. Tutkimuksessa on selvitetty 4-6-vuotiaitten suomalaisten, englantilaisten ja saksalaisten lasten audiovisuaalisen median tulkintaa ja median roolia heidän elämässään. Tutkimuksen tavoitteena on ollut syventää tutkimuksellista tietoa median sosiaalisesta ja kulttuurisesta merkityksestä pienten lasten elämässä ja sitä, miten he tulkitsevat mediasisältöä. Tutkimuksessa lasten mediasuhdetta on tarkasteltu välineellisenä, sosiaalisena, symbolisena ja kulttuurisena tulkintaympäristönä. Edellisten lisäksi tutkimuksessa on arvioitu harvemmin viestinnän tutkimuksessa käytetyn symbolisen interaktionismin teorian tarjoamia mahdollisuuksia lasten mediasuhteen tarkasteluun. Suomessa, Englannissa ja Saksassa kootun kansainvälisen aineiston pohjalta on tarkasteltu myös vertailuryhmien välillä olevia mediaan liittyviä kulttuurisia eroja. Eri vertailumaiden melko samankaltaisesta mediaympäristöstä huolimatta tutkimus antaa viitteitä mediatulkinnoissa olevista kulttuurisista eroista. Media mahdollistaa lapsen erilaistan taitojensa kehittymistä ja voi siten muodostaa heille sosiaalisia, symbolisia ja kulttuurisia resursseja, joilla on merkitystä lapsen kehittymisen kannalta. Lapsen ja median suhde on kaksisuuntainen vuorovaikutussuhde ja mediainformaation tulkinnassa ovat mukana lapsen aiemmat tiedolliset ja sosiaaliset kokemukset. Aktiivisessa mediatulkintasuhteessaan lapsi kehittää sanavarastoaan, havainnointiaan, ajatteluaan ja tunne-elämäänsä. Median käyttö sosiaalisena tapahtumana kehittää osaltaan lapsen sosiaalisia valmiuksia. Siten esimerkiksi perheen median käyttöön liittyvät säännöt ja ohjeet ohjaavat perheen sisäistä toimintaa ja määrittävät lapsen asemaa perheessä. Median sisällöt ja niihin liittyvät erilaiset oheistuotteet toimivat osaltaan lapsen kulttuuristen koodistojen ja luokittelujen muodostajana. Tutkimus osoittaa myös symbolisen interaktionismin teorian tarjoavan varsin poikkitieteellisen tutkimuksellisen viitekehyksen lapsia ja mediaa koskevalle tutkimukselle ja mahdollistaa lasten mediasuhteen tutkimisen ja ymmärtämisen useiden, erilaisten tekijöiden suhteena.

Rethinking Media Pluralism : A Critique of Theories and Policy Discourses

This study examines different ways in which the concept of media pluralism has been theorized and used in contemporary media policy debates. Access to a broad range of different political views and cultural expressions is often regarded as a self-evident value in both theoretical and political debates on media and democracy. Opinions on the meaning and nature of media pluralism as a theoretical, political or empirical concept, however, are many, and it can easily be adjusted to different political purposes. The study aims to analyse the ambiguities surrounding the concept of media pluralism in two ways: by deconstructing its normative roots from the perspective of democratic theory, and by examining its different uses, definitions and underlying rationalities in current European media policy debates. The first part of the study examines the values and assumptions behind the notion of media pluralism in the context of different theories of democracy and the public sphere. The second part then analyses and assesses the deployment of the concept in contemporary European policy debates on media ownership and public service media. Finally, the study critically evaluates various attempts to create empirical indicators for measuring media pluralism and discusses their normative implications and underlying rationalities. The analysis of contemporary policy debates indicates that the notion of media pluralism has been too readily reduced to an empty catchphrase or conflated with consumer choice and market competition. In this narrow technocratic logic, pluralism is often unreflectively associated with quantitative data in a way that leaves unexamined key questions about social and political values, democracy, and citizenship. The basic argument advanced in the study is that media pluralism needs to be rescued from its depoliticized uses and re-imagined more broadly as a normative value that refers to the distribution of communicative power in the public sphere. Instead of something that could simply be measured through the number of media outlets available, the study argues that media pluralism should be understood in terms of its ability to challenge inequalities in communicative power and create a more democratic public sphere.

Parisuhde ja ero : Sosiologinen analyysi terapeuttisesta ymmärryksestä

This study takes as its premise the prominent social and cultural role that the couple relationship has acquired in modern society. Marriage as a social institution and romantic love as a cultural script have not lost their significance but during the last few decades the concept of relationship has taken prominence in our understanding of the love relationship. This change has taken place in a society governed by the therapeutic ethos. This study uses material ranging from in-depth interviews to various mass media texts to investigate the therapeutic logic that determines our understanding of the couple relationship. The central concept in this study is therapeutic relationship which does not refer to any particular type of relationship. In contemporary usage the relationship is, by definition, therapeutic. The therapeutic relationship is seen as an endless source of conflict and a highly complex dynamic unit in constant need of attention and treatment. Notwithstanding this emphasis on therapy and relationship work the therapeutic relationship lacks any morally or socially defined direction. Here lies the cultural power and according to critics the dubious aspect of the therapeutic ethos. For the therapeutic logic any reason for divorce is possible and plausible. Prosaically speaking the question is not whether to divorce or not, but when to divorce. In the end divorce only attests to the complexity of the relationship. The therapeutic understanding of the relationship gives the illusion that relationships with their tensions and conflicting emotions can be fully transferred to the sphere of transparency and therapeutic processing. This illusion created by relationship talk that emphasizes individual control is called omnipotence of the individual. However, the study shows that the individual omnipotence is inevitably limited and hence cracks appear in it. The cracks in the omnipotence show that while the therapeutic relationship based on the ideal of communication gives an individual a mode of speaking that stresses autonomy, equality and emotional gratification, it offers little help in expressing our fundamental dependence on other people. The study shows how strong an attraction the therapeutic ethos has with its grasp on the complexities of the relationship in a society where divorce is so common and the risk of divorce is collectively experienced.

Species-specific and Indication-based Use of Antimicrobials in Dogs, Cats, Cattle and Horses in Finland : Data collected using three different methods

Increasing antimicrobial resistance in bacteria has led to the need for better understanding of antimicrobial usage patterns. In 1999, the World Organisation for Animal Health (OIE) recommended that an international ad hoc group should be established to address human and animal health risks related to antimicrobial resistance and the contribution of antimicrobial usage in veterinary medicine. In European countries the need for continuous recording of the usage of veterinary antimicrobials as well as for animal species-specific and indication-based data on usage has been acknowledged. Finland has been among the first countries to develop prudent use guidelines in veterinary medicine, as the Ministry of Agriculture and Forestry issued the first animal species-specific indication-based recommendations for antimicrobial use in animals in 1996. These guidelines have been revised in 2003 and 2009. However, surveillance on the species-specific use of antimicrobials in animals has not been performed in Finland. This thesis provides animal species-specific information on indication-based antimicrobial usage. Different methods for data collection have been utilized. Information on antimicrobial usage in animals has been gathered in four studies (studies A-D). Material from studies A, B and C have been used in an overlapping manner in the original publications I-IV. Study A (original publications I & IV) presents a retrospective cross-sectional survey on prescriptions for small animals at the Veterinary Teaching Hospital of the University of Helsinki. Prescriptions for antimicrobial agents (n = 2281) were collected and usage patterns, such as the indication and length of treatment, were reviewed. Most of the prescriptions were for dogs (78%), and primarily for the treatment of skin and ear infections most of which were treated with cephalexin for a median period of 14 days. Prescriptions for cats (18%) were most often for the treatment of urinary tract infections with amoxicillin for a median length of 10 days. Study B (original publication II) was a retrospective cross-sectional survey where prescriptions for animals were collected from 17 University Pharmacies nationwide. Antimicrobial prescriptions (n = 1038) for mainly dogs (65%) and cats (19%) were investigated. In this study, cephalexin and amoxicillin were also the most frequently used drugs for dogs and cats, respectively. In study C (original publications III & IV), the indication-based usage of antimicrobials of practicing veterinarians was analyzed by using a prospective questionnaire. Randomly selected practicing veterinarians in Finland (n = 262) recorded all their antimicrobial usage during a 7-day study period. Cattle (46%) with mastitis were the most common patients receiving antimicrobial treatment, generally intramuscular penicillin G or intramammary treatment with ampicillin and cloxacillin. The median length of treatment was four days, regardless of the route of administration. Antimicrobial use in horses was evaluated in study D, the results of which are previously unpublished. Firstly, data collected with the prospective questionnaire from the practicing veterinarians showed that horses (n = 89) were frequently treated for skin or wound infections by using penicillin G or trimethoprim-sulfadiazine. The mean duration of treatment was five to seven days. Secondly, according to retrospective data collected from patient records, horses (n = 74) that underwent colic surgery at the Veterinary Teaching Hospital of the University of Helsinki were generally treated according to national and hospital recommendations; penicillin G and gentamicin was administered preoperatively and treatment was continued for a median of three days postoperatively. In conclusion, Finnish veterinarians followed well the national prudent use guidelines. Narrow-spectrum antimicrobials were preferred and, for instance, fluoroquinolones were used sparingly. Prescription studies seemed to give good information on antimicrobials usage, especially when combined with complementary information from patient records. A prospective questionnaire study provided a fair amount of valuable data on several animal species. Electronic surveys are worthwhile exploiting in the future.

Slummiparakeista kyläkarnevaaleihin : Kumpulan ja Toukolan imagonmuutos sanomalehdissä 1963-1999

Having to do with residential areas, geographical image research in Finland has concentrated mainly on those areas with a relatively negative image, such as eastern parts of Helsinki. However, Kumpula and Toukola are former working class residential areas whose image nowadays is mainly positive. This research aims at understanding the process through which their image has gradually come to be that way. Theoretical background of the research relies on human geography and it s viewpoints on places, spaces and areas. Areas, in this research, are understood to be founded on discursive processes that form meanings in societies. This approach is useful because it provides a way to research newspapers and to see how they affect the society. In addition I lean on Sirpa Tani s research on place images to study image and it s formation process. Her point of view covers especially well the effect of media on images and their formation. Articles published in Helsingin Sanomat and Ilta-Sanomat between the years 1963 and 1999 form the data of the research. Methodologically I proceeded by using content analysis to see what kind of topics have been dominating the news feed from Kumpula and Toukola. Content analysis was followed by discourse analysis, which allowed me to focus on the ways of speaking about and representing Kumpula and Toukola. Discourse analysis also reveals whose viewpoint is being represented in media when it comes to publishing news from these parts of the city. It is clearly visible from the results of this research that the image of Kumpula and Toukola has gone through a significant change between 1963 and 1999. In the 1960s discussion in newspapers was dominated by the need for more effective city planning. This meant that Kumpula and Toukola were under a demolition threat in order for the city to built more effectively on those areas. At the same time there was discussion about wooden houses that were built in Kumpula and Toukola right after the second World War. Those houses were in a poor condition, it was even said in the newspapers that people were living in slum-like conditions in them. By the 1980s the image of Kumpula and Toukola gradually started to change. At this time gentrification process was affecting the areas and well-educated working force moved to Kumpula and Toukola. Already in the beginning of 1990s the image of the areas was highly positive. Throughout this decade newspapers published news on Kumpula and Toukola that commented favorably on the atmosphere and the feeling of togetherness among the residents. In addition Kumpula village carnivals, that were first held in 1991, brought a lot of positive publicity to the areas. This research has revelead that especially the active participationg of the residents to promote joint causes has positively affected the image of Kumpula and Toukola. Since the 1960s fighting for the preservation of the areas has provided a reason for a stronger feeling of communality and identifying in the community. This feeling of togetherness in a community has carried all the way to the 1990s, when the areas, having been affected by gentrification, could make good use of the positive image in order to promote joint causes. Keywords: Image, reputation, newspapers, discursive practices

Measurement of the Single Top Quark Production Cross Section at CDF

We report a measurement of the single top quark production cross section in 2.2 ~fb-1 of p-pbar collision data collected by the Collider Detector at Fermilab at sqrt{s}=1.96 TeV. Candidate events are classified as signal-like by three parallel analyses which use likelihood, matrix element, and neural network discriminants. These results are combined in order to improve the sensitivity. We observe a signal consistent with the standard model prediction, but inconsistent with the background-only model by 3.7 standard deviations with a median expected sensitivity of 4.9 standard deviations. We measure a cross section of 2.2 +0.7 -0.6(stat+sys) pb, extract the CKM matrix element value |V_{tb}|=0.88 +0.13 -0.12 (stat+sys) +- 0.07(theory), and set the limit |V_{tb}|>0.66 at the 95% C.L.