82 resultados para Medicine administration at home
Resumo:
Kohonneiden kolesterolipitoisuuksien alentamisessa käytettävien statiinien hyödyt sydän- ja verisuonisairauksien estossa on vahvasti osoitettu ja niiden käyttö on niin Suomessa kuin muuallakin maailmassa kasvanut voimakkaasti – Suomessa statiininkäyttäjiä on noin 600 000. Statiinilääkitys on pitkäaikaisessakin käytössä melko hyvin siedetty, mutta yleisimpinä haittavaikutuksina voi ilmetä lihasheikkoutta, -kipua ja -kramppeja, jotka voivat edetä jopa henkeä uhkaavaksi lihasvaurioksi. Lihashaittariski suurenee suhteessa statiiniannokseen ja plasman statiinipitoisuuksiin. Statiinien plasmapitoisuuksissa, tehossa ja haittavaikutusten ilmenemisessä on suuria potilaskohtaisia eroja. SLCO1B1-geenin koodaama OATP1B1-kuljetusproteiini kuljettaa monia elimistön omia aineita ja lääkeaineita verenkierrosta solukalvon läpi maksasoluun, mm. statiineja, joiden kolesterolia alentava vaikutus ja poistuminen elimistöstä tapahtuvat pääosin maksassa. Erään SLCO1B1-geenin nukleotidimuutoksen (c.521T>C) tiedetään heikentävän OATP1B1:n kuljetustehoa. Tässä väitöskirjatyössä selvitettiin SLCO1B1-geenin perinnöllistä muuntelua suomalaisilla ja eri väestöissä maailmanlaajuisesti. Lisäksi selvitettiin SLCO1B1:n muunnosten vaikutusta eri statiinien pitoisuuksiin (farmakokinetiikka) ja vaikutuksiin (farmakodynamiikka) sekä kolesteroliaineenvaihduntaan. Näihin tutkimuksiin valittiin SLCO1B1-genotyypin perusteella terveitä vapaaehtoisia koehenkilöitä, joille annettiin eri päivinä kerta-annos kutakin tutkittavaa statiinia: fluvastatiinia, pravastatiinia, simvastatiinia, rosuvastatiinia ja atorvastatiinia. Verinäytteistä määritettiin plasman statiinien ja niiden aineenvaihduntatuotteiden sekä kolesterolin ja sen muodostumista ja imeytymistä kuvaavien merkkiaineiden pitoisuuksia. Toiminnallisesti merkittävien SLCO1B1-geenimuunnosten esiintyvyydessä todettiin suuria eroja eri väestöjen välillä. Suomalaisilla SLCO1B1 c.521TC-genotyypin (geenimuunnos toisessa vastinkromosomissa) esiintyvyys oli noin 32 % ja SLCO1B1 c.521CC-genotyypin (geenimuunnos molemmissa vastinkromosomeissa) esiintyvyys noin 4 %. Globaalisti geenimuunnosten esiintyvyys korreloi maapallon leveyspiirien kanssa siten, että matalaan transportteriaktiivisuuteen johtavat muunnokset olivat yleisimpiä pohjoisessa ja korkeaan aktiivisuuteen johtavat päiväntasaajan lähellä asuvilla väestöillä. SLCO1B1-genotyypillä oli merkittävä vaikutus statiinien plasmapitoisuksiin lukuun ottamatta fluvastatiinia. Simvastatiinihapon plasmapitoisuudet olivat keskimäärin 220 %, atorvastatiinin 140 %, pravastatiinin 90 % ja rosuvastatiinin 70 % suuremmat c.521CC-genotyypin omaavilla koehenkilöillä verrattuna normaalin c.521TT-genotyypin omaaviin. Genotyypillä ei ollut merkittävää vaikutusta minkään statiinin tehoon tässä kerta-annostutkimuksessa, mutta geenimuunnoksen kantajilla perustason kolesterolisynteesinopeus oli suurempi. Tulokset osoittavat, että SLCO1B1 c.521T>C geenimuunnos on varsin yleinen suomalaisilla ja muilla ei-afrikkalaisilla väestöillä. Tämä geenimuunnos voi altistaa erityisesti simvastatiinin, mutta myös atorvastatiinin, pravastatiinin ja rosuvastatiinin, aiheuttamille lihashaitoille suurentamalla niiden plasmapitoisuuksia. SLCO1B1:n geenimuunnoksen testaamista voidaan tulevaisuudessa käyttää apuna valittaessa sopivaa statiinilääkitystä ja -annosta potilaalle, ja näin parantaa sekä statiinihoidon turvallisuutta että tehoa.
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The aim of the study was to examine the influence of school smoking policy and school smoking prevention programs on the smoking behaviour of students in high schools in Prince Edward Island using the School Health Action Planning Evaluation System (SHAPES). A total sample included 13,131 observations of students in grades 10-12 in ten high schools in Prince Edward Island over three waves of data collection (1999, 2000, and 2001). Changes in prevalence of smoking and factors influencing smoking behaviour were analyzed using descriptive statistics and Chi-Square tests. Multi-level logistic regression analyses were used to examine how both school and student characteristics were associated with smoking behaviour (I, II, III, IV). Since students were located within schools, a basic 2-level nested structure was used in which individual students (level 1) were nested within schools (level 2). For grade 12 students, the combination of both school policies and programs was not associated with the risk of smoking and the presence of the new policy was not associated with decreased risk of smoking, unless there were clear rules in place (I). For the grade 10 study, (II) schools with both policies and programs were not associated with decreased risk of smoking. However, the smoking behaviour of older students (grade 12) at a school was associated with younger students’ (grade 10) smoking behaviour. Students first enrolled in a high school in grade 9, rather than grade 10, were at increased risk of occasional smoking. For students who transitioned from grade 10 to 12 (III), close friends smoking had a substantial influence on smoking behaviour for both males and females (III). Having one or more close friends who smoke (Odds Ratio (OR) = 37.46; 95% CI = 19.39 to 72.36), one or more smokers in the home (OR = 2.35; 95% CI = 1.67 to 3.30) and seeing teachers and staff smoking on or near school property (OR=1.78; 95% CI = 1.13 to 2.80), were strongly associated with increased risk of smoking for grade 12 students. Smoking behaviour increased for both junior (Group 1) and senior (Group 2) students (IV). Group 1 students indicated a greater decrease in smoking behaviour and factors influencing smoking behaviour compared to those of Group 2. Students overestimating the percentage of youth their age who smoke was strongly associated with increased likelihood of smoking. Smoking rates showed a decreasing trend (1999, 2000, and 2001). However, policies and programs alone were not successful in influencing smoking behaviour of youth. Rather, factors within the students and schools contextual environment influenced smoking behaviour. Comprehensive approaches are required for school-based tobacco prevention interventions. Keywords: schools, policy, programs, smoking prevention, adolescents Subject Terms: school-based programming, public health, health promotion
Resumo:
The aim of the study was to clarify the occurrence, and etiological and prognostic factors of primary fallopian tube carcinoma (PFTC). We studied the sociodemographic determinants of the incidence of PFTC in Finland and the role of chlamydial infections and human papillomavirus infections as risk factors for PFTC. Serum tumor markers were studied as prognostic factors for PFTC. We also evaluated selected reproductive factors (parity, sterilization and hysterectomy) as risk or protective factors of PFTC. The risks of second primary cancers after PFTC were also studied. The age-adjusted incidence of PFTC in Finland increased to 5.4 / 1,000,000 in 1993 97. The incidence rate was higher in the cities, but the relative rise was higher in rural areas. Women in the two highest social classes showed a 1.8 fold incidence compared with those in the lowest. Women in agriculture and those not working outside the home showed only half the PFTC incidence of those in higher socioeconomic occupations. Pretreatment serum concentrations of hCGβ, CA125 and TATI were evaluated as prognostic markers for PFTC. Elevated hCGβ values (above the 75th percentile, 3.5 pmol/L; OR 2.49, 95% CI 1.22 5.09), stage and histology were strong independent prognostic factors for PFTC. The effects of parity, sterilization and hysterectomy on the risk of PFTC were studied in a case control-study with 573 PFTC cases from the Finnish Cancer Registry. In multivariate analysis parity was the only significant protective factor as regards PFTC, with increasing protection associated with increasing number of deliveries. In univariate analysis sterilization gave borderline protection against PFTC and the protective effect increased with time since the operation. In multivariate analysis the protection did not reach statistical significance. Chlamydial and human papillomavirus (HPV) infections were studied in two separate seroepidemiological case-control studies with 78 PFTC patients. The incidence of women with positive HPV or chlamydial serology was the same in PFTC patients and in the control group and was not found to be a risk factor for PFTC. Finally, the possible risk of a second primary cancer after diagnosis and treatment of PFTC in a cohort of 2084 cases from 13 cancer registries followed for second primary cancers within the period 1943 2000 was studied. In PFTC patients, second primary cancers were 36% more common than expected (SIR 1.36, 95% CI 1.13 1.63). In conclusion, the incidence of PFTC has increased in Finland, especially in higher social classes and among those in certain occupations. Elevated serum hCGβ reflect a worsened prognosis. Parity is a clear protective factor, as is previous sterilization. After PFTC there is a risk of second primary cancers, especially colorectal, breast, lung and bladder cancers and non-lymphoid leukemia. The excess of colorectal and breast cancers after PFTC may indicate common effects of earlier treatments, or they could reflect common effects of lifestyle or genetic, immunological or environmental background.
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Memory Meanders is an ethnographic analysis of a postcolonial migrant community, white former Rhodesians, who have emigrated from Zimbabwe to South Africa after Zimbabwe s independence in 1980. An estimated 100 000 whites left the country during the first years of independence. Majority of these emigrants settled in South Africa. In recent years President Mugabe s land redistribution program has inflicted forced expulsions and violence against white farmers and black farm workers, and instigated a new wave of emigration. Concerning the study of Southern Africa, my research is therefore very topical. In recent years there has been a growing concern to study postcolonialism as it unfolds in the lived realities of actual postcolonies. A rising interest has also been cast on colonial cultures and white colonials within complex power relationships. My research offers insight to these discussions by investigating the ways in which the colonial past affects and effects in the present activities and ideas of former colonials. The study also takes part in discussing fundamental questions concerning how diaspora communities socially construct their place in the world in relation to the place left behind, to their current places of dwelling and to the community in dispersal. In spite of Rhodesia s incontestable ending, it is held close by social practices; by thoughts and talks, by material displays, and by webs of meaningful relationships. Such social memory practices, I suggest, are fundamental to how the community understands itself. The vantage points from which I examine how the ex-Rhodesians reminisce about Rhodesia concern ideas and practices related to place, home and commemoration. I first focus on the processes of symbolic investment that go into understanding place and landscape in Rhodesia and ask how the once dwelled-in places, iconic landscapes and experiences within places are reminisced about in diaspora. Secondly, I examine how home both as a mundanely organized sphere of everyday lives and as an idea of belonging is culturally configured, and analyze how and if homes travel in diaspora. In the final ethnographic section I focus on commemorative practices. I first analyze how food and culturally specific festive occasions of commensality are connected to social and sensual memory, considering the unique ways in which food acts as a mnemonic trigger in a diaspora community. The second example concerns the celebration of a centenary of Rhodesia in 1990. Through this case I describe how the mnemonic power of commemoration rests on the fact that culturally meaningful experiences are bodily re-enacted. I show how habitual memory connected to performance is one example of how memory gets passed-on in non-textual ways.
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This study Someone to Welcome you home: Infertility, medicines and the Sukuma-Nyamwezi , looks into the change in the cosmological ideology of the Sukuma-Nyamwezi of Tanzania and into the consequences of this change as expressed through cultural practices connected to female infertility. This analysis is based on 15 months of fieldwork in Isaka, in the Shinyanga area. In this area the birth rate is high and at the same time infertility is a problem for individual women. The attitudes connected to fertility and the attempts to control fertility provide a window onto social and cultural changes in the area. Even though the practices connected to fertility seem to be individualized the problem of individual women - the discourse surrounding fertility is concerned with higher cosmological levels. The traditional cosmology emphasized the centrality of the chief as the source of well-being. He was responsible for rain and the fertility of the land and, thus, for the well-being of the whole society. The holistic cosmology was hierarchical and the ritual practices connected to chiefship which dealt with the whole of the society were recursively applied at the lower levels of hierarchy, in the relationships between individuals. As on consequence of changes in the political system, the chiefship was legally abolished in the early years of Independence. However, the holistic ideology, which was the basis of the chiefship, did not disappear and instead acquired new forms. It is argued that in African societies the common efflorence of diviner-healers and witchcraft can be a consequence of the change in the relationship between the social reality and the cosmological ideology. In the Africanist research the increase in the numbers of diviner-healers and witchcraft is usually seen as a consequence of individualism and modernization. In this research, however, it is seen as an altered form of holism, as a consequence of which the hierarchical relations between women and men have changed. Because of this, the present-day practices connected to reproduction pay special attention to the control of women s sexuality.
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Background: The national resuscitation guidelines were published in Finland in 2002 and are based on international guidelines published in 2000. The main goal of the national guidelines, available on the Internet free of charge, is early defibrillation by nurses in an institutional setting. Aim: To study possible changes in cardiopulmonary resuscitation (CPR) practices, especially concerning early defibrillation, nurses and students attitudes of guideline implementation and nurses and students ability to implement the guideline recommendations in clinical practices after publication of the Current Care (CC) guidelines for CPR 2002. Material and methods: CPR practices in Finnish health centres; especially concerning rapid defibrillation programmes, as well as the implementation of CC guidelines for CPR was studied in a mail survey to chief physicians of every health centre in Finland (Study I). The CPR skills using an automated external defibrillator (AED) were compared in a study including Objective stuctured clinical examination (OSCE) of resuscitation skills of nurses and nursing students in Finnish and Swedish hospital and institution (Studies II, III). Attitudes towards CPR-D and CPR guidelines among medical and nursing students and secondary hospital nurses were studied in surveys (Studies IV, V). The nurses receiving different CPR training were compared in a randomized trial including OSCE of CPR skills of nurses in Finnish Hospital (Study VI). Results: Two years after the publication, 40.7% of Finnish health centres used national resuscitation guidelines. The proportion of health centres having at least one AED (66%) and principle of nurse-performed defibrillation without the presence of a physician (42%) had increased. The CPR-D training was estimated to be insufficient regarding basic life support and advanced life support in the majority of health centres (Study I). CPR-D skills of nurses and nursing students in two specific Swedish and Finnish hospitals and institutions (Study II and III) were generally inadequate. The nurses performed better than the students and the Swedish nurses surpassed the Finnish ones. Geriatric nurses receiving traditional CPR-D training performed better than those receiving an Internet-based course but both groups failed to defibrillate within 60 s. Thus, the performance was not satisfactory even two weeks after traditional training (Study VI). Unlike the medical students, the nursing students did not feel competent to perform procedures recommended in the cardiopulmonary resuscitation guidelines including the defibrillation. However, the majority of nursing students felt confident about their ability to perform basic life support. The perceived ability to defibrillate correlated significantly with a positive attitude towards nurse-performed defibrillation and negatively with fear of damaging the patient s heart by defibrillation (Study IV). After the educational intervention, the nurses found their level of CPR-D capability more sufficient than before and felt more confident about their ability to perform defibrillation themselves. A negative attitude toward defibrillation correlated with perceived negative organisational attitudes toward cardiopulmonary resuscitation guidelines. After CPR-D education in the hospital, the majority (64%) of nurses hesitated to perform defibrillation because of anxiety and 27 % hesitated because of fear of injuring the patient. Also a negative personal attitude towards guidelines increased markedly after education (Study V). Conclusions: Although a significant change had occurred in resuscitation practices in primary health care after publication of national cardiopulmonary resuscitation guidelines the participants CPR-D skills were not adequate according to the CPR guidelines. The current way of teaching is unlikely to result in participants being able to perform adequate and rapid CPR-D. More information and more frequent training are needed to diminish anxiety concerning defibrillation. Negative beliefs and attitudes toward defibrillation affect the nursing students and nurses attitudes toward cardiopulmonary resuscitation guidelines. CPR-D education increased the participants self-confidence concerning CPR-D skills but it did not reduce their anxiety. AEDs have replaced the manual defibrillators in most institutions, but in spite of the modern devices the anxiety still exists. Basic education does not provide nursing students with adequate CPR-D skills. Thus, frequent training in the workplace has vital importance. This multi-professional program supported by the administration might provide better CPR-D skills. Distance learning alone cannot substitute for traditional small-group learning, tutored hands-on training is needed to learn practical CPR-D skills. Standardized testing would probably help controlling the quality of learning. Training of group-working skills might improve CPR performance.
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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.
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Many residential and small business users connect to the Internet via home gateways, such as DSL and cable modems. The characteristics of these devices heavily influence the quality and performance of the Internet service that these users receive. Anecdotal evidence suggests that an extremely diverse set of behaviors exists in the deployed base, forcing application developers to design for the lowest common denominator. This paper experimentally analyzes some characteristics of a substantial number of different home gateways: binding timeouts, queuing delays, throughput, protocol support and others.
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Prostate cancer is the most common cancer in males. Although many patients with localized disease can be cured with surgery and radiotherapy, advanced disease and especially castration resistant metastatic disease remains incurable, with a median life expectancy of less than 18 months. Oncolytic adenoviruses (Ads) are a new promising treatment against cancer due to their innate capacity to kill cancer cells. Viral replication in tumor cells leads to oncolysis and production of a multiplicity of new virions that are capable of further destroying cancerous tissue. Oncolytic Ads can be modified for tumor targeted infection and replication and be armed with therapeutic transgenes to maximize the oncolytic effect. Worldwide, clinical trials with oncolytic Ads have demonstrated good safety while the antitumor efficacy remains to be improved. Importantly, the best responses have been reported when oncolytic adenoviruses have been combined with standard cancer treatments, such as chemotherapy and radiation. Further, a challenge in many virotherapy approaches has been the monitoring of virus replication in vivo. Reporter genes have been extensively used as transgenes to evaluate the biodistribution of the virus and activity of specific promoters. However, these techniques are often limited to preclinical evaluation and not amenable to human use. The aim of the thesis was to find and develop new oncolytic Ads with maximum efficacy against metastatic, castration resistant prostate cancer and study them in vitro and in vivo combined to different forms of radiation therapy. Using combination therapy, we were aiming for better antitumor efficacy with reduced side effects. Capsid modified Ads for enhanced transduction were studied. Serotype 3 targeted chimera, Ad5/3, was found to have enhanced infectivity for prostate cancer and was used for developing new viruses for the study. Correlation between Ad-encoded marker peptide secretion and simultaneous viral replication was evaluated and the effects of radiotherapy on viral replication were studied in detail. We found that the repair of double strand breaks caused by ionizing radiation was inhibited by adenoviral proteins and led to autophagic cell death. Both subcutaneous models and intrapulmonary tumor models mimicking metastatic, aggressive disease were used in vivo. Virus efficacy was evaluated by intratumoral injections. Also, intravenous administration was evaluated to study the effectiveness in metastatic disease. Oncolytic adenovirus treatment led to significant tumor growth control and increased the survival rate of the mice. These results were further improved when oncolytic Ads were combined with radiation therapy. Oncolytic Ads expressing human sodium/iodide transporter (hNIS) as a transgene were evaluated for their oncolytic potency and for the functionality of hNIS in vitro and in vivo. Monitoring of viral replication was also assessed using different imaging modalities relative to clinical use. SPECT imaging of tumor-bearing mice was evaluated and combined with simultaneous CT-scanning to obtain important anatomical information on biodistribution, also in a three-dimensional form. It was shown that hNIS-expressing adenoviruses could harbour a bi-functional transgene allowing for localization and imaging of viral replication. Targeted radiotherapy was applied by systemic radioiodide administration and resulted in iodide accumulation into Ad-infected tumor. The combination treatment showed significantly enhanced antitumor efficacy in mice bearing prostate cancer tumors. In summary, the results presented above aim to provide new treatment modalities for castration resistant prostate cancer. Molecular insights were provided for better understanding of the benefits of combined radiation therapy and oncolytic adenoviruses, which will hopefully facilitate the translation of the approach into clinical use for humans.
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ABSTRACT Sense of coherence (SOC) is a core concept within Antonovsky s salutogenic theory and is argued to be a psychological determinant of health. The present social-epidemiological study explores the associations between a wide range of generalized resistance resources of SOC among Finnish- and Swedish-speaking women and men with a view to gaining deeper insight into its developmental circumstances and determinants. Secondly, a five-year follow-up study was conducted in order to assess the stability of SOC in difficult life events. Finally the role and effect of SOC in the intentions to retire early was investigated in a prospective study. The above studies were based on two data sets: the Finnish 'Survey on Living Conditions' (ELO-94) conducted in 1994 by means of personal face-to-face interviews (N=6506), and a prospective postal survey of the 15-year Health and Social Support (HeSSup) study for which the baseline data was collected in 1998 (N=25 898) and the follow-up in 2003. The present study reveals that the level of SOC in adulthood is strongly dependent on close and successful social relationships during both childhood and adulthood, and that there is a strong association with qualitative work features. Not having a partner as well as being unable to use one s skills at work proved to threaten men s SOC in particular, whereas a lack of social support did the same for women. Otherwise, the association with generalized resistance resources turned out to be quite similar in both genders. Swedish-speaking Finns appear to have a slightly stronger SOC due to the better psycho-emotional circumstances in the childhood home and work circumstances in adulthood, in other words higher levels of generalized resistance resources compared to Finnish speakers. These language group differences did not concern any social-life factors included in the present study. The results of the five-year follow-up study suggest that SOC is not stable, and that the level clearly decreases after a negative life event. Even a strong SOC decreased during the follow-up period and, furthermore, was no more stable than a mediocre or weak SOC. There seems to be a clear and independent association with the intentions to retire early among both men and women following full adjustment. Swedish speakers appear to be less inclined to retire early than Finnish speakers. In the light of the present study, it seems that SOC is determined not only by socio-economic factors but also by close and successful social relationships during both childhood and adulthood. This applied to both genders and language groups. Interventions aimed at promoting the health of the disadvantaged should therefore focus on families with children, and extend later also to other than socio-economic spheres of life. SOC theory could also be applied in efforts to inhibit early retirement: management practices aimed at providing employees with a work environment and tasks that are comprehensible, manageable and meaningful could potentially decrease the intentions to retire early.
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Despite the acknowledged importance of strategic planning in business and other organizations, there are few studies focusing on strategy texts and the related processes of their production and consumption. In this paper, we attempt to partially fill this research gap by examining the institutionalized aspects of strategy discourse: what strategy is as genre. Combining textual analysis and analysis of conversation, the article focuses on the official strategy of the City of Lahti in Finland. Our analysis shows how specific communicative purposes and lexico-grammatical features characterize the genre of strategy and how the actual negotiations over strategy text involve particular kinds of intersubjectivity and intertextuality.
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Investors significantly overweight domestic assets in their portfolios. This behavior which is commonly called “home bias” contradicts the prescriptions of portfolio theory. This thesis explores potential reasons for the “home bias” by examining the characteristics of the investing and the target countries and features of the interaction between them. A common theme of the four essays is a focus on the importance of information about foreign markets in explaining the share of these markets in investors’ portfolios. The results indicate that the size of the equity ownership in another country strongly relates to the distance to the financial capital of that country, and to trade in goods with and direct investments (FDI) to that country. The first essay empirically investigates the relationship between trade in real goods and portfolio investments. Overall, the evidence indicates a substantial role for trade in reducing the information cost relating to portfolio investments. The second essay examines the implications of the launch of the European Monetary Union (EMU) on international portfolio investments. The evidence on the allocation of Finnish international portfolio investments is more consistent with an information-based than a diversification motive explanation. The third essay employs new data for a large number of countries and further explores the role of trade on international portfolio investments. The results indicate that trade provides important information especially on firms in countries in which the corporate governance structure and the information environment of firms generate less reliable information. The fourth essay examines the relationship between direct investments (FDI) and portfolio investments. In contrast to the predications of portfolio theory, it provides evidence that FDI is a complement rather than a substitute for portfolio investments.
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Parliaments are political institutions, but they are also places where people work; the MPs and the people who are employed there work, albeit in rather different ways. In this research the focus is on those in a Parliament who work there as employees and managers, and thereby, in some senses, run the organisation. Accordingly, this involves seeing the Parliament as a working environment, for MPs and employees, for men and women. The institution of Parliament is thus here examined by looking at it from a different and new angle. Instead of the usual focus on politicians the focus is on the administration of this institution. The aim is, amongst other things, to increase knowledge and offer different perspectives on democracy and democratic institutions. Unpacking the nearly mythical institution into smaller, more digestible, graspable realities should at the very least help to remind the wider society that although nations, to a certain extent, do need national institutions they should not become mystified or seen as larger than life. Institutions should work on behalf of people and thus be accountable to these same people. The main contribution of this work is to explore and problematise how managing and working is done inside an institution that both largely fulfils the characteristics of a bureaucracy and yet also has added special features that seem to be rather far removed from clear bureaucratic structures. This research offers a new kind of information on working life inside this elite institution. The joys and the struggles of working and managing in this particular public sector organisation are illustrated here and offer a view, a glimpse, into the experiences of managing and working in this House.
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This thesis explores the relationship between humans and ICTs (information and communication technologies). As ICTs are increasingly penetrating all spheres of social life, their role as mediators – between people, between people and information, and even between people and the natural world – is expanding, and they are increasingly shaping social life. Yet, we still know little of how our life is affected by their growing role. Our understanding of the actors and forces driving the accelerating adoption of new ICTs in all areas of life is also fairly limited. This thesis addresses these problems by interpretively exploring the link between ICTs and the shaping of society at home, in the office, and in the community. The thesis builds on empirical material gathered in three research projects, presented in four separate essays. The first project explores computerized office work through a case study. The second is a regional development project aiming at increasing ICT knowledge and use in 50 small-town families. In the third, the second project is compared to three other longitudinal development projects funded by the European Union. Using theories that consider the human-ICT relationship as intertwined, the thesis provides a multifaceted description of life with ICTs in contemporary information society. By oscillating between empirical and theoretical investigations and balancing between determinist and constructivist conceptualisations of the human-ICT relationship, I construct a dialectical theoretical framework that can be used for studying socio-technical contexts in society. This framework helps us see how societal change stems from the complex social processes that surround routine everyday actions. For example, interacting with and through ICTs may change individuals’ perceptions of time and space, social roles, and the proper ways to communicate – changes which at some point in time result in societal change in terms of, for example, new ways of acting and knowing things.
Resumo:
Whilst previous research on Human Resource Management (HRM) in subsidiaries of multinational companies (MNCs) has focused extensively on the HRM practices that exist in foreign subsidiaries and the extent to which they resemble MNC home country and/or local host country practices, considerably less attention has been directed at the question of how these practices come to exist. Accordingly, this thesis aims to shed light on the processes that shape HRM practices and capabilities in MNC subsidiaries. The main contribution of the thesis is the focus on how; how HRM practices are integrated in MNC subsidiaries, and how subsidiary HRM capabilities are developed through involvement in social networks. Furthermore, this thesis includes a time aspect which, despite not being purely longitudinal, provides an indication of the ongoing changes in HRM in MNC subsidiaries in China. Data for this study were collected in 2005-2006 through structured face to face interviews with 153 general managers and HR managers in 87 subsidiaries of European MNCs located in China. Five of the six thesis papers build on this questionnaire data and one paper builds on qualitative data collected at the same time. Two papers build on dual data sets, meaning that they in addition to the abovementioned data include quantitative questionnaire data from 1996 and 1999 respectively. The thesis focuses on the following four sub-questions i) To what extent do subsidiary HRM practices resemble parent MNC and host country practices? How has this changed over time and why? ii) How are HRM practices integrated into MNC subsidiaries and why are certain integration mechanisms used? iii) How does involvement in internal and external social networks influence subsidiary HRM capabilities? iv) What factors influence the strategic role of the subsidiary HR department? Regarding the first sub-question the findings indicate that the HRM practices of MNC subsidiaries in China are converging with both local company practices and parent MNC practices. This is interesting in the sense that it suggests that the isomorphic pressures the subsidiary faces from the MNC and from its local host environment are not always in conflict with each other. Concerning the question of how HRM practices are integrated into MNC subsidiaries and why certain integration mechanisms are used, the thesis provides a fine-grained examination of four mechanisms that MNCs use to integrate HRM practices in subsidiaries. The findings suggest that MNCs use a variety of different integration mechanisms as complements rather than as substitutes for each other. Furthermore, it is apparent that different contextual factors in the subsidiary and the subsidiary-headquarters relationship influence why certain mechanisms are or are not used. The most interesting contribution of the thesis in regard to the third question is that it highlights the importance of network involvement for learning about HRM practices in the Chinese context. Networks with other MNCs in China clearly emerged as particularly important contributors to enhanced HRM capabilities. Finally, concerning the fourth sub-question the findings indicate that the role of the HR department in MNC subsidiaries in China had become more strategic between 1999 and 2006.