4 resultados para 177-1092D

em Helda - Digital Repository of University of Helsinki


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Ennen Suomen EU-jäsenyyttä kansallisen maatalouspolitiikan yksi päätavoitteista oli elintarvikeomavaraisuus. Tavoitteen saavuttamiseksi Suomessa oli maatalouspolitiikan osalta käytössä hintatukijärjestelmä, jossa yksi pääasiallisista tuotannon ohjauskeinoista oli tavoitehinnat, joilla valtiovalta pyrki vaikuttamaan tuottajahintoihin. Tavoitehintojen avulla tuottajat pystyivät ennakoimaan tulevan hintatason ja näin siirtämään tuotantoaan taloudellisesti kannattavimpaan suuntaan. Tästä oli kuitenkin seurauksena kotimaisen elintarvikeomavaraisuuden ylittyminen varsinkin eläinkunnan tuotteiden osalta. Vuonna 1994 lihatuotteiden yhteenlaskettu omavaisuus oli 110 prosenttia. Sianlihan osalta omavaisuus oli hieman tätä suurempi, 114 prosenttia. Suomen liityttyä EU:n jäsenmaaksi vuonna 1995 tavoitehinnoista luovuttiin ja samalla tuottajahinnat putosivat. Korvaukseksi tuottajahintojen pudotuksesta tuottajille alettiin maksaa suoria tulotukia. Tutkimuksen tarkoituksena oli selvittää mitkä tekijät vaikuttivat sianlihan tuotantopäätöksiin maatalouden muuttuneessa toimintaympäristössä ja miten yhteisen maatalouspolitiikan uudistukset vaikuttivat sianlihan tarjontaan. Tutkimuksen tarkasteluaikavälinä olivat vuodet 1995 2006. Tutkimuksen tavoitteena oli myös tuotantoon vaikuttavien tekijöiden pohjalta ennustaa sianlihan tuotantoa vuoteen 2013. Tuotantopäätöksiin vaikuttavia tekijöitä tarkasteltiin regressio-analyysin avulla, jotta saataisiin selville sianlihan tuotantoa parhaiten selittävät tekijät. Tutkimuksen aikasarja-aineisto poimittiin maa- ja metsätalousministeriön tietopalvelukeskuksen (Tike:n) ja tilastokeskuksen julkaisemista ja ylläpitämistä tilastoista. Sianlihan tuotantoon vaikuttavien tekijöiden ennusteisiin tutkimuksessa käytettiin sekä kansainvälisten että kotimaisten taloustutkimuslaitosten ja organisaatioiden ennusteita. Tutkimuksen teoreettinen viitekehys muodostui yrityksen teoriasta, tarjontateoriasta ja aikavälin merkityksestä tarjontaan. Tuotantomallin estimoinnin tuloksena sianlihan tuotantoon vaikuttivat vuosien 1996 2006 aikana sianlihan tuotannon tuottavuuden kasvua kuvaava teknologiamuuttuja, neljällä neljänneksellä viivästetty sianlihan tuottajahinta ja tuotantotuet yhteenlaskettuna, kolmella neljänneksellä viivästetty vehnän tuottajahinta, kahdeksalla neljänneksellä viivästetty sianlihan tuotanto, kahdella neljänneksellä viivästetty porsaan välityshinta ja kuudella neljänneksellä viivästetty investointituet. Sianlihan tuotantomallin selitysasteeksi saatiin 0,91. Estimoidulla tuotantomallilla ennustettiin sianlihan tuotannon kehitystä vuosina 2007 2013. Perusskenaariossa tuotannon ennustettiin muuttuvan vuodesta 2007 eteenpäin samalla tavalla kuin vuosina 1995 2006 keskimäärin. Perusskenaarion lisäksi tuotantomallilla simuloitiin tuotantotukien ja investointitukien dekoplauksen vaikutusta sianlihan tuotantoon. Tuotantotukien dekoplauksen myötä sianlihan tuotanto laskisi 177 milj. kiloon vuonna 2009, mutta nousisi 193 milj. kiloon vuonna 2013. Investointitukien dekoplauksen myötä tuotanto laskisi 176 milj. kiloon vuonna 2009 ja nousisi vuoteen 2013 mennessä 191 milj. kiloon. Suurimman pudotuksen aiheutti kuitenkin vehnän tuottajahinnan nousu vuosien 2006 ja 2007 aikana, jonka seurauksena sianlihan tuotanto laskisi jo vuonna 2008 180 milj. kiloon.

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Juvenile idiopathic arthritis (JIA) is associated with growth disturbances, especially leg length discrepancy (LLD) and knee valgus deformity (KVD). Studies have demonstrated growth plate stimulation with chronic arthritis. In the context of surgical treatment of LLD or KVD of a growing knee, the less invasive procedures, which allow immediate mobilisation, are preferred. Establishment of the skeletal age and the correction potential in the knees of rheumatic children is difficult due to rheumatic changes. In this present work, an analysis of the efficacy, safety and long-term results of temporary epiphyseal arrests performed in Rheumatism Foundation Hospital (Heinola, Finland). The distribution of diagnoses among children (n=71) with JIA and LLD (68 knees) was consistent with the normal oligoarthritis-predominated population of children with JIA. A higher male:female ratio (1:1.7 vs. 1:2.4 in population-based studies (PBS)) and earlier mean onset age (4 vs. 7 years in PBSs) were, however, distinct features in the study population. In most cases the correction was reliable and temporary arrest produced a mean correction of 1mm per month. The time of arrest required, however, varied significantly, probably due to the effect of underlying diseases and medication, and the age of the child. All complications encountered (10%) were minor. The correction achieved persisted in long-term follow-up. KVD (n=112, 177 knees) was associated with a high proportion of polyarthritic disease subtype (45% vs. 12-31% in PBSs), and the male:female distribution was grossly female-dominated (1:4.9 vs. 1:2.4 in PBSs). The early mean onset age (3 vs. 7 years in PBSs) was also notable in this cohort. Successful correction was achieved in 2/3 cases and the mean angular correction was 0.7 degrees per month. The required time of arrest, however, varied considerably. In 13% of knees the paucity of follow-up visits resulted in over-correction to varus. The complication rate (3%) in the knees operated for KVD was considerably lower compared to ten per cent in the management of LLD. Most of the complications related to epiphyseal stapling were reversible. However, the risk of premature closure of growth plates does exist. The number of over-corrections was notably high, with 13% knees turning to varus. The correction achieved persisted in long-term follow-up.

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A total of 177 patients with primary dislocation of the patella (PDP) were admitted to two trauma centers in Helsinki, Finland during 1991 to 1992. The inclusion criteria were: 1. Acute (≤14 days old) first-time lateral dislocation of the patella. 2. No previous knee operations or major knee injuries. 3. No ligament injuries to be repaired. 4. No osteochondral fractures requiring fixation. 50 patients were excluded. 30 of these excluded patients would have met the inclusion criteria, 19 patients received treatment by consultants not involved in the study, 7 refused to participate and 4 had an erroneous randomization. 127 patients including, 82 females, were then randomized to have either tailor-made operative procedure (group O) or conservative treatment (group C). The aftercare was similar for both groups. The mean age of the patients was 20 (9-47) years. All patients were subjected to analysis of trauma history (starting position and knee movement during the dislocation), examination under anesthesia (EUA) and arthroscopy. 70 patients (52 females) were randomized by their odd year of birth to operative group O and 57 patients (30 females) by their even year of birth to conservative group C. The diagnosis of PDP was based on locked dislocation in 68 patients, on dislocatability in EUA in 47 patients, and on subluxation in EUA combined with typical intra-articular lesions in 12 patients. In group O, 63 patients had exploration of the injuries on the medial side of the knee and tailor made reconstruction added with lateral release in 54 cases. The medial injury was operated by suturing in 39 patients, by duplication in 18 patients and by additional augmentation of the medial patellofemoral ligament (MPFL) with adductor magnus tenodesis in 6 patients. 7 patients, without locking in trauma history and only subluxation in EUA had only lateral release for realignment. In adductor magnus tenodesis the proximal end of the distal tendinous part was rerouted to the upper medial border of the patella. In the conservative group C, the treatment was adjusted to the extent of patellar displacement in EUA. Patients with dislocation in EUA had 3 weeks’ immobilization with the knee in slight flexion. Mobilization was started with a soft patellar stabilizing orthosis (PSO) used for additional three weeks. The patients with subluxation in EUA wore an orthosis for six weeks. The aftercare was similar in group O. The outcome was similar in both groups. After an average of 25 (20-45) months´ follow-up, the subjective result was better in group C in respect of the mean Hughston VAS knee score (87 for group O and 90 for group C, p=0.04, visual analog scale), but similar in terms of the patient’s own overall opinion and the mean Lysholm II knee score. Recurrent instability episodes occurred in 18 patients in group O and in 20 patients in group C. After an average of 7 (6-9) years´ follow-up, the groups did not show statistical difference either in respect of the patient’s own overall opinion, or the mean Hughston VAS and Kujala knee scores. The proportions of stable patellae was 25/70 (36%) in group O and 17/57 (30%) in group O (p=0.5). In a multivariate risk analysis, there was a correlation between low Kujala score (<90) as dependent parameter and female gender (OR: 3.5; 95% CI: 1.4-9.0), and loose body on primary radiographs (OR: 4.1; 95% CI: 1.2-15). Recurrent instability correlated with young age at the time of PDP (OR: 0.9; 95% CI: 0.8-1.0/year). Girls with open tibial apophysis had the worst prognosis for instability (88%; 95% CI: 77-98). The most common mechanisms in trauma history of the patients were movement to flexion from a straight start (78%) and movement to extension from a well-bent start (8%). Spontaneous relocation of the patella had taken place in 13/39 of girls, in 11/21 of boys, in 26/42 of women and in 17/24 of men with skeletal maturity of the tibia. The dislocation in EUA was non-rotating in 96/126 patients followed by outward rotating dislocation in 14/126 patients. Operative treatment policy in PDP is not recommended. Locking tendency of the patella in PDP depended on the skeletal maturation. Recurrence rate after PDP was higher than expected.

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The study examines the origin and development of the Finnish activation policy since the mid-1990s by using the 2001 activation reform as a benchmark. The notion behind activation is to link work obligations to welfare benefits for the unemployed. The focus of the thesis is policy learning and the impact of ideas on the reform of the welfare state. The broader research interests of the thesis are summarized by two groups of questions. First, how was the Finnish activation policy developed and what specific form did it receive in the 2001 activation reform? Second, how does the Finnish activation policy compare to the welfare reforms in the EU and in the US? What kinds of ideas and instruments informed the Finnish policy? To what extent can we talk about a restructuring or transformation of the Nordic welfare policy? Theoretically, the thesis is embedded in the comparative welfare state research and the concepts used in the contemporary welfare state discourse. Activation policy is analysed against the backdrop of the theories about the welfare state, welfare state governance and citizenship. Activation policies are also analysed in the context of the overall modernization and individualization of lifestyles and its implications for the individual citizen. Further, the different perspectives of the policy analysis are applied to determine the role of implementation and street-level practice within the whole. Empirically, the policy design, its implementation and the experiences of the welfare staff and recipients in Finland are examined. The policy development, goals and instruments of the activation policies have followed astonishingly similar paths in the different welfare states and regimes over the last two decades. In Finland, the policy change has been manifested through several successive reforms that have been introduced since the mid-1990s. The 2001 activation reform the Act on Rehabilitative Work Experience illustrates the broader trend towards stricter work requirements and draws its inspiration from the ideas of new paternalism. The ideas, goals and instruments of the international activation trend are clearly visible in the reform. Similarly, the reform has implications for the traditional Nordic social policies, which incorporate institutionalised social rights and the provision of services.