Iäkkäiden lääkehoitoihin liittyvien riskien kartoittaminen – Arviointityökalun kehittäminen Delfoi-menetelmällä

Tutkimuksen taustalla on väestön ikääntyminen ja iäkkäiden lisääntynyt lääkkeiden käyttö. Ikääntyminen aiheuttaa elimistössä useita muutoksia, jotka voivat muuttaa lääkevastetta ja altistaa potilaan haittavaikutuksille. Iäkkäillä riski joutua sairaalaan lääkkeen haittavaikutuksen vuoksi on arvioitu olevan neljä kertaa suurempi kuin nuoremmilla. Monet lääkkeiden yhteis- ja haittavaikutukset olisivat ehkäistävissä välttämällä iäkkäillä tiettyjä lääkeaineita. Iäkkäiden lääkehoitojen seurantaa ja arviointia varten on kehitetty erilaisia suosituksia sekä Suomessa että kansainvälisesti. Tutkimuksen tavoitteena oli luoda Suomen oloihin soveltuva, hoitajien koulutettuina käytettävissä oleva, avohoidon yli 65-vuotiaiden iäkkäiden lääkitykseen liittyviä riskejä arvioiva työkalu. Työkalun avulla voitaisiin löytää ne potilaat, joiden lääkitykseen liittyy paljon riskejä. Tutkimuksen aineistona olivat laaja kansainvälinen kirjallisuuskatsaus iäkkäiden lääkehoitoihin liittyvistä tekijöistä sekä asiantuntijakommentoinnit, joiden perusteella luotiin alustava arviointityökalu. Alustava arviointityökalu validoitiin kolmikierroksisella Delfoi-menetelmällä. Delfoi-menetelmä on laadullinen konsensusmenetelmä, joka perustuu asiantuntijoiden arvioihin tutkittavasta asiasta. Kaksi ensimmäistä Delfoi-kierrosta mittasivat alustavan arviointityökalun kohtien soveltuvuutta ja kolmas kierros kohtien tärkeyttä arvioitaessa iäkkään lääkityksiin liittyviä riskejä. Tutkimuksen Delfoi-kierroksien vastaajiksi pyydettiin 33 geriatrian asiantuntijaa, joista vastaajiksi lupautui 11 lääkäriä, 3 proviisoria ja 4 sairaanhoitajaa. Delfoi-kierrosten tuloksia analysoitiin sekä kvantitatiivisesti että kvalitatiivisesti. Tutkimuksen tuloksena saatu arviointityökalu käsittää 19 iäkkäiden lääkehoitoa arvioivaa kohtaa. Asiantuntijapaneelin mukaan kaikki arviointityökalun lääkitykseen liittyviä riskejä mittaavat kohdat ovat tärkeitä tai jokseenkin tärkeitä, joten työkalun voidaan olettaa olevan validi mitattaessa lääkitykseen liittyviä riskejä. Jatkotutkimuksissa työkalun käytettävyyttä sekä riskien mittaamiskykyä tulee testata sekä arviointityökalun käyttäjien että potilaiden keskuudessa. Kehitettyä työkalua voidaan jatkossa hyödyntää esimerkiksi koulutustarkoituksissa sen varsinaisen käyttötarkoituksen lisäksi. Työkalun avulla iäkkäiden lääkehoitoa voidaan tulevaisuudessa toteuttaa entistä turvallisemmin ja tarkoituksenmukaisemmin.

Kestävästi vaihtuva muoti : Kestävän muodin mahdollisuudet ja haasteet vaatesuunnittelijan näkökulmasta

The concept of sustainable fashion covers not only the ecological and ethical matters in fashion and textile industries but also the cultural and social affairs, which are equally intertwined in this complex network. Sustainable fashion does not have one explicit or well-established definition; however, many researchers have discussed it from different perspectives. This study provides an overview of the principals, practices, possibilities, and challenges concerning sustainable fashion. It focuses particularly on the practical questions a designer faces. The aim of this study was to answer the following questions: What kind of outlooks and practices are included in sustainable fashion? How could the principles of sustainable fashion be integrated into designing and making clothes? The qualitative study was carried out by using the Grounded Theory method. Data consisted mainly of academic literature and communication with designers who practice sustainable fashion. In addition to these, several websites and journalistic articles were used. The data was analyzed by identifying and categorizing relevant concepts using the constant comparative method, i.e. examining the internal consistency of each category. The study established a core category, around which all other categories are integrated. The emerged concepts were organized into a model that pieces together different ideas about sustainable fashion, namely, when the principles of sustainable development are applied to fashion practices. The category named Considered Take and Return is the core of the model. It consists of various design philosophies that form the basis of design practice, and thus it relates to all other categories. It is framed by the category of Attachment and Appreciation, which reflects the importance of sentiment in design practice, for example the significance of aesthetics. The categories especially linked to fashion are Materials, Treatments of Fabrics and Production Methods. The categories closely connected with sustainable development are Saving Resources, Societal Implications, and Information Transparency. While the model depicts separate categories, the different segments are in close interaction. The objective of sustainable fashion is holistic and requires all of its sections to be taken into account.

Tavallisuudesta tyylikkyyteen? : Sukupuoli ja maku kodinmuutosohjelmissa

The study focuses on the Finnish home makeover shows Inno (2004 , Nelonen) and Kodin kääntöpiiri (2001 2005; YLE TV2) and their episodes broadcast in spring 2004. The research material also includes the websites of both shows and messages concerning Inno from an online discussion forum. As people decorate their homes and reflect on them, they engage in negotiations of taste and in the construction of the ideal self. The main question of the study is: how are representations of the gendered self produced in home makeover shows? The broader theoretical and methodological context of the study is based on intersectionality, or simultaneous study of different identity categories. In this study, the main focus is on the intersections of gender, class and sexuality. Hence, the secondary research question is: how do ways of doing gender intersect with producing the ideas of class and sexuality in the representations of home makeover shows? The theoretical framework of the study combines Judith Butler s theory of gender performativity and Pierre Bourdieu s theory of taste. The analysis is founded upon a close reading focusing on the details and ambiguous meanings contained in the televisual representation. Home makeover shows are explored as a part of contemporary television culture, which is characterised by a significant increase in the number of both television channels and global television formats, as well as the hybridisation of programme types. Researchers on lifestyle television have paid attention to male designers and their ability to reconstruct meanings related to domesticity and home decoration as feminine spheres. The dissertation contributes to this discussion by analysing the representations of the male interior decorator in Inno and the four female interior decorators in Kodin kääntöpiiri. The focus is on the professional self and how it is both gendered and defined as an arbiter of taste. The programme concepts produce the impression that the makeover homes and their occupants are ordinary . The manufactured sense of ordinariness often conceals differences between the participants. One argument of the study is that the ordinariness of participants on lifestyle television should not be taken for granted without further reflection on the implications of labeling something as ordinary. Updating of interior decoration in home makeover shows can be interpreted as an area of doing gender that requires deliberation, effort, expert knowledge and a sufficient budget. The ideal lay decorator is portrayed as culturally omnivorous, brave and receptive to new ideas. The ability to reflect on ways of representing masculinity and femininity through decoration is also implied. In home makeover shows, greater self-awareness regarding the ways in which gender is produced does not lead to repeating gender differently. The idea of normative heterosexuality is in a hegemonic position in the representations of the participants. In Inno and Kodin kääntöpiiri questions of class are not made explicit. However, the idea of class is produced indirectly e.g. by describing the apartments and houses of the participants, by discussing their hobbies or interest in cultural products. In Inno, home decoration is primarily depicted as an individualistic consumer choice, while in Kodin kääntöpiiri it is often defined as a way to strengthen the ties of nuclear families. In Kodin kääntöpiiri, the ethos of familism is combined with pleasures gained from consumption and DIY activities. As a whole, the multidisciplinary study indicates a great number of differences between the two shows.

Constructions and situations : a constructivist reading of Hegel's System

The object of this work is Hegel's Logic, which comprises the first third of his philosophical System that also includes the Philosophy of Nature and the Philosophy of Spirit. The work is divided into two parts, where the first part investigates Hegel s Logic in itself or without an explicit reference to rest of Hegel's System. It is argued in the first part that Hegel's Logic contains a methodology for constructing examples of basic ontological categories. The starting point on which this construction is based is a structure Hegel calls Nothing, which I argue to be identical with an empty situation, that is, a situation with no objects in it. Examples of further categories are constructed, firstly, by making previous structures objects of new situations. This rule makes it possible for Hegel to introduce examples of ontological structures that contain objects as constituents. Secondly, Hegel takes also the very constructions he uses as constituents of further structures: thus, he is able to exemplify ontological categories involving causal relations. The final result of Hegel's Logic should then be a model of Hegel s Logic itself, or at least of its basic methods. The second part of the work focuses on the relation of Hegel's Logic to the other parts of Hegel's System. My interpretation tries to avoid, firstly, the extreme of taking Hegel's System as a grand metaphysical attempt to deduce what exists through abstract thinking, and secondly, the extreme of seeing Hegel's System as mere diluted Kantianism or a second-order investigation of theories concerning objects instead of actual objects. I suggest a third manner of reading Hegel's System, based on extending the constructivism of Hegel's Logic to the whole of his philosophical System. According to this interpretation, transitions between parts of Hegel's System should not be understood as proofs of any sort, but as constructions of one structure or its model from another structure. Hence, these transitions involve at least, and especially within the Philosophy of Nature, modelling of one type of object or phenomenon through characteristics of an object or phenomenon of another type, and in the best case, and especially within the Philosophy of Spirit, transformations of an object or phenomenon of one type into an object or phenomenon of another type. Thus, the transitions and descriptions within Hegel's System concern actual objects and not mere theories, but they still involve no fallacious deductions.

Finlandssvenska åsikter om och attityder till modern språkpåverkan

The study describes and analyzes Finland Swedes attitudes to modern-day linguistic influence, the relationship between informants explicitly reported views and the implicit attitudes they express towards language influence. The methods are primarily sociolinguistic. For the analysis of opinions and attitudes I have further developed and tested a new tool in attitude research. With statistical correlation analysis of data collected through a quantitative survey I describe the views that Swedish-language Finns (N=500) report on the influence of English, on imports, and on domain loss. With experimental matchedguise techniques, I study Finland-Swedes (N=600) subconscious reactions to English imports in spoken text. My results show that the subconscious reactions in some respects differ markedly from the views informants explicitly report that they have: informants respond that they would like English words that come into Swedish to be replaced by Swedish replacement words, but in a matched-guise test on their subconscious attitudes, the informants consider English words in a Swedish context to have a positive effect. The topic is further dealt with in interviews where I examine 36 informants implicit attitudes through interactional sociolinguistic analyses. This study comes close to pragmatic discourse analysis in its focus on pragmatic particles and modality. The study makes a rather strict distinction between explicitly expressed opinions and implicit, subconscious attitudes. The quantitative analyses suggest that the opinions we express can be tied to the explicit in language. The outcome of the matched-guise test shows that it is furthermore possible to find subconscious, implicit attitudes that people in actual situations rely on when they make decisions. The discourse analysis finds many subconscious signals, but it also shows that the signals arise in interaction with one s interlocutor, the situation, and the norms in the society. To account for this I have introduced the concept of socioconscious attitude. Socioconscious attitudes reflect not only the traditions and values the utterer grew up with, but also the speaker s relation to the social situation (s)he takes part in.

Una gramática descriptiva del chabacano de Ternate

This dissertation is a descriptive grammar of Ternate Chabacano, a Spanish-lexifier Creole spoken by 3.000 people in the town of Ternate, Philippines. The dissertation offers an analysis of the phonological, morphological, and syntactic system of the language. It includes an overview of the historical background, the current situation of the speech community and a collection of annotated texts. Ternate Chabacano shares many characteristics with its main adstrate language Tagalog as well as the dialectal varieties of Spanish. At present, English also exerts an influence, nevertheless mainly affecting its lexicon. The description offered is based on fieldwork conducted in Ternate. Spoken language collected through thematic interviews forms the main type of the material analysed. Information regarding the informants and text types is included in the examples. Ternate Chabacano has a five-vowel system and 17 consonant phonemes. The morphology of the language is largely isolating. Clitics are used extensively for expressing adverbial relations. The verbal system is based on the preverbal markers that express the category of tense, modality and aspect, among which aspect is the main dimension. Complex predicates and verbal chains are used in order to further distinguish aspect and modality, as well as changes of voice and valency. Intransitive verbs express motion, states, and reflexive actions, even though the majority of verbs can occur in both intransitive and transitive clauses. Ternate Chabacano is a nominative-accusative type language but the typological configuration of the Philippine languages influences the marking of its constituents. A case in point is constituted by the nominal determination system. The basic constituent order in a clause is VSO. Equative and attibutive clauses are formed by juxtaposition while the locative clauses feature a copula. Indefinite terms are expressed through existential constructions. The negation of existential clauses differs from standard negation but both are intensified in the same way. In spoken discourse, tag-questions are common. Pragmatic elements and social formulas reflect largely the corresponding Tagalog expressions. Coordination and subordination occur typically without overt markers but a variety of markers exists for expressing different relations, especially those made explicit by adverbial clauses. Verbal chains form a continuum from serial verbs to complementation and ultimately to coordination.

Cohésion modale et subordination : Le conditionnel et le jussif finnois au miroir de la valeur sémantique et discursive du subjonctif français

Modal cohesion and subordination. The Finnish conditional and jussive moods in comparison to the French subjunctive This study examines verb moods in subordinate clauses in French and Finnish. The first part of the analysis deals with the syntax and semantics of the French subjunctive, mood occurring mostly in subordinate positions. The second part investigates Finnish verb moods. Although subordinate positions in Finnish grammar have no special finite verb form, certain uses of Finnish verb moods have been compared to those of subjunctives and conjunctives in other languages. The present study focuses on the subordinate uses of the Finnish conditional and jussive (i.e. the third person singular and plural of the imperative mood). The third part of the analysis discusses the functions of subordinate moods in contexts beyond complex sentences. The data used for the analysis include 1834 complex sentences gathered from newspapers, online discussion groups and blog texts, as well as audio-recorded interviews and conversations. The data thus consist of both written and oral texts as well as standard and non-standard variants. The analysis shows that the French subjunctive codes theoretical modality. The subjunctive does not determine the temporal and modal meaning of the event, but displays the event as virtual. In a complex sentence, the main clause determines the temporal and modal space within which the event coded by the subjunctive clause is interpreted. The subjunctive explicitly indicates that the space constructed in the main clause extends its scope over the subordinate clause. The subjunctive can therefore serve as a means for creating modal cohesion in the discourse. The Finnish conditional shares the function of making explicit the modal link between the components of a complex construction with the French subjunctive, but the two moods differ in their semantics. The conditional codes future time and can therefore occur only in non-factual or counterfactual contexts, whereas the event expressed by French subjunctive clauses can also be interpreted as realized. Such is the case when, for instance, generic and habitual meaning is involved. The Finnish jussive mood is used in a relatively limited number of subordinate clause types, but in these contexts its modal meaning is strikingly close to that of the French subjunctive. The permissive meaning, typical of the jussive in main clause positions, is modified in complex sentences so that it entails inter-clausal relation, namely concession. Like the French subjunctive, the jussive codes theoretical modal meaning with no implication of the truth value of the proposition. Finally, the analysis shows that verb moods mark modal cohesion, not only on the syntagmatic level (namely in complexe sentences), but also on the paradigmatic axis of discourse in order to create semantic links over entire segments of talk. In this study, the subjunctive thus appears, not as an empty category without function, as it is sometimes described, but as an open form that conveys the temporal and modal meanings emerging from the context.

Compression of Weighted Graphs

We propose to compress weighted graphs (networks), motivated by the observation that large networks of social, biological, or other relations can be complex to handle and visualize. In the process also known as graph simplication, nodes and (unweighted) edges are grouped to supernodes and superedges, respectively, to obtain a smaller graph. We propose models and algorithms for weighted graphs. The interpretation (i.e. decompression) of a compressed, weighted graph is that a pair of original nodes is connected by an edge if their supernodes are connected by one, and that the weight of an edge is approximated to be the weight of the superedge. The compression problem now consists of choosing supernodes, superedges, and superedge weights so that the approximation error is minimized while the amount of compression is maximized. In this paper, we formulate this task as the 'simple weighted graph compression problem'. We then propose a much wider class of tasks under the name of 'generalized weighted graph compression problem'. The generalized task extends the optimization to preserve longer-range connectivities between nodes, not just individual edge weights. We study the properties of these problems and propose a range of algorithms to solve them, with dierent balances between complexity and quality of the result. We evaluate the problems and algorithms experimentally on real networks. The results indicate that weighted graphs can be compressed efficiently with relatively little compression error.

Nature of chemistry in the national frame curricula for upper secondary education in Finland, Norway and Sweden

The aim of this study was to discover how current chemistry syllabi in the frame curricula for up- per secondary education in three Nordic countries (Finland, Norway, and Sweden) take into account topics related to the nature of chemistry. By qualitative content analysis, the statements related to the nature of chemistry were divided into categories. Conclusions and implications for improving the frame curricula under study were made by comparing results with research into the nature of science. Chemistry syllabi from the Nordic frame curricula analyzed take into account the aims related to the nature of chemistry in a very similar manner. The ideas that should be made more explicit in all of the analyzed curricula are: i) the limits of the chemical models and theories, ii) the relationship between chemistry and other natural sciences, iii) the importance of creativity in chemical research, iv) the concepts of evidence in science texts, v) the social nature of chemical research, and vi) chemistry as a technological practice.

Sensitivity of wetland methane emissions to model assumptions: application and model testing against site observations

Abstract. Methane emissions from natural wetlands and rice paddies constitute a large proportion of atmospheric methane, but the magnitude and year-to-year variation of these methane sources is still unpredictable. Here we describe and evaluate the integration of a methane biogeochemical model (CLM4Me; Riley et al., 2011) into the Community Land Model 4.0 (CLM4CN) in order to better explain spatial and temporal variations in methane emissions. We test new functions for soil pH and redox potential that impact microbial methane production in soils. We also constrain aerenchyma in plants in always-inundated areas in order to better represent wetland vegetation. Satellite inundated fraction is explicitly prescribed in the model because there are large differences between simulated fractional inundation and satellite observations. A rice paddy module is also incorporated into the model, where the fraction of land used for rice production is explicitly prescribed. The model is evaluated at the site level with vegetation cover and water table prescribed from measurements. Explicit site level evaluations of simulated methane emissions are quite different than evaluating the grid cell averaged emissions against available measurements. Using a baseline set of parameter values, our model-estimated average global wetland emissions for the period 1993–2004 were 256 Tg CH4 yr−1, and rice paddy emissions in the year 2000 were 42 Tg CH4 yr−1. Tropical wetlands contributed 201 Tg CH4 yr−1, or 78 % of the global wetland flux. Northern latitude (>50 N) systems contributed 12 Tg CH4 yr−1. We expect this latter number may be an underestimate due to the low high-latitude inundated area captured by satellites and unrealistically low high-latitude productivity and soil carbon predicted by CLM4. Sensitivity analysis showed a large range (150–346 Tg CH4 yr−1) in predicted global methane emissions. The large range was sensitive to: (1) the amount of methane transported through aerenchyma, (2) soil pH (± 100 Tg CH4 yr−1), and (3) redox inhibition (± 45 Tg CH4 yr−1).

Shifting the perspective after the patient's response to an interpretation

Psychoanalytic interpretation is normally understood as a sequence of two utterances: the analyst gives an interpretation and the patient responds to it. This paper suggests that, in the interpretative sequence, there is also a third utterance where psychoanalytic work takes place. This third interpretative turn involves the analyst’s action after the patient’s response to the interpretation. Using conversation analysis as method in the examination of audio-recorded psychoanalytic sessions, the paper will explicate the psychoanalytic work that gets done in third interpretative turns. Through it, the analyst takes a stance towards the patient’s understandings of the interpretation, which are shown in the patient’s response to the interpretation. The third interpretative turns on one hand ratify and accept the patient’s understandings, but, in addition to that, they also introduce a shift of perspective relative to them. In most cases, the shift of perspective is implicit but sometimes it is made explicit. The shifts of perspective bring to the foreground aspects or implications of the interpretation that were not incorporated in the patient’s response. They recast the description of the patient’s experience by showing new layers or more emotional intensity in it. The results are discussed in the light of Faimberg’s concept of listening to listening and Schlesinger’s concept of follow-up interpretation.