The Art of Sympathy : Forms of Moral and Emotional Persuasion in Fiction

"The Art of Sympathy: Forms of Moral and Emotional Persuasion" in Fiction is an interdisciplinary study that looks closely at the ways that stories evoke sympathy, and the significance of this emotion for the development of moral attitudes and awareness. By linking readers' emotional responses to fiction with the potential impact of such responses on "the moral imagination," the study builds on empirical research conducted by literary scholars and psychologists into the emotional effects of reading fiction, as well as social psychological research into the connections between empathy/sympathy and moral development. I first investigate the dynamics of readers beliefs regarding characters in fictional narratives, and the nature of the emotions that they may experience as a result of those beliefs. The analysis demonstrates that there are important similarities between real emotions and emotions generated by fiction. Recognizing these similarities, I claim, can help us to conceptualize the nature of sympathetic responses to fictional characters. Building on these assertions, I then draw on research from social psychology and philosophy to develop a comprehensive definition of sympathy and to clarify the ways in which sympathy operates, both in people s daily lives and in readers sympathetic responses to fictional characters. Having established this definition and delineated its practical implications, I then examine how particular stories, through a variety of narrative techniques, persuade readers to feel sympathy for characters who are unsympathetic in certain ways. In order to verify my claims about the impact of these stories on readers emotions, I also review the results of tests that I conducted with nearly 200 adolescent readers. Through these tests, which were constructed and scored according to methods prevalent in social psychological research, it was determined that a majority of readers felt sympathy for the protagonists in two of the stories included in the study. These results were combined with data from an additional test, a standard measure of empathy and sympathy in the field of social psychology. The cross-tabulation of these results suggests that there was not a strong connection between readers responses and their general tendencies to feel sympathy for others. This finding would appear to support my hypotheses regarding the sympathetic persuasiveness of the stories in question. In light of these results, finally, I consider the potential contribution that fiction can make to adolescent emotional and moral development and the implications of that potential for future language arts curricula in the schools. In particular, I suggest the pedagogical importance of providing adolescents with opportunities to engage with the lives of fictional characters, and especially to experience feelings of sympathy for individuals towards whom they ordinarily might feel aversion.

Englanniksiko maailmanmaineeseen? : Suomalaisen proosakaunokirjallisuuden kääntäminen englanniksi Isossa-Britanniassa vuosina 1945 2003

This doctoral thesis focuses on the translation of Finnish prose literature into English in the United Kingdom between 1945 and 2003. The subject is approached using translation archaeology, interviews, archival material, detailed text analysis and reception material. The main theoretical framework is Descriptive Translation Studies, and certain sociological theories (Bourdieu s field theory, actor-network theory) are also used. After charting the published translations, two periods of time are selected for closer analysis: an earlier period from 1955 to 1959, involving eight translations, and a later one from 1990 to 2003, with a total of six translations. While these translation numbers may appear low, they are actually rather high in proportion to the total number of 28 one-author literary prose translations published in the UK over the approximately 60 years being studied. The two periods of time, the 1950s and 1990s, are compared in terms of the sociological context of translation activity, the reception of translations and their textual features. The comparisons show that the main changes in translation practice between these two periods are increased completeness (translations in the 1950s group often being shortened by hundreds of pages) and lesser use of indirect translation via an intermediary language (about half of the 1950s translations having been translated via Swedish). Otherwise, translation practices have not changed much: except for large omissions, which are far more frequent in the 1950s, variation within each group is larger than between groups. As to the sociological context, the main changes are an increase in long-term institution-level contacts and an increase in the promotion of foreign translation rights by Finnish publishing houses. This is in contrast to the 1950s when translation rights were mainly sold through personal contacts by individual authors and translators. The reception of translations is difficult to study because of scarce material. However, the 1950s translations were aggressively marketed and therefore obtained far more reviews and reprints than the 1990s translations. Several of the 1950s books, mostly historical novels by Mika Waltari, were mainstream bestsellers at the time, while current translations are frequently made for niche markets. The thesis introduces ample new material on the translation of Finnish prose literature into English in the UK. The results are also relevant to translation from a minority literature into a majority one. As to translation theory, they lead us to question the social nature of translation norms and the assumption of a static target culture. The translations analysed here are located in a very fragmented interculture and gain a stronger position in the Finnish culture than in the British one.

Literaturnaja skazka A.M. Remizova (1900-1920-e gody)

Literary tale of A.M. Remizov (1900’s – 1920’s) The thesis is devoted to a detailed historical-literary description of a tale as a genre tradition in the creative work of Alexei Mikhailovich Remizov (1877-1957), one of the major Russian prose writers of the 20’s century. This very approach allows to specify the place and functional meaning of this genre in literary practice of the writer and to appeal to one of the key problems of the 20-21 century literature history – a specific of modernistic literature composition principle and a role of montage techniques in its formation. Remizov was working on tales during his whole life, though the most productive years of folklore studies fell to 1900’s – 1910’s. During this period he intensively studied folklore materials, narrated several hundreds of folk tales and in 1900’s – 1920’s published eight tale collections which played a significant role in the formation of stylistic and compositional principles of his prose of the 1910’s – 1920’s, especially montage techniques, which in its turn influenced the development of the narrative forms in the Russian post-revolutionary literature. At the same time a tale has specified not only poetics but also problematics of Remizov’s creative work, as when choosing folklore sources the writer always alluded to modern themes and relevant intellectual trends. The current research work, based on various archive materials and a wide spectrum of modern historical-literary data, complies four chapters with a consistent description of creation history, publication and critics’ reviews of Remizov’s tale collections and single tales contributing to his creative evolution characteristic. Furthermore, the work refers to composition and subject of the particular collections. On the whole it enables to follow up genre dynamics. The first chapter of the work is devoted to Posolon’ (Sunwise), the earliest tale collection of Remizov. The main feature of the collection is that its composition is oriented on the agrarian calendar and the subject – on the system of mythological views reflected in the Russian folklore. This very collection to a large extent corresponds to the writer’s views on the myth represented in Pis’mo v redaktsiyu (Letter to the Editor). The history of this manifesto appearing is analyzed in the second chapter. The incident which caused its forthcoming contributed to ‘legitimization’ of Remizov’s narrations as a relevant genre of modern literature and to upgrading the writer in professional hierarchy. The third chapter analyzes Remizov’s collections of 1900’s – early 1920’s, a result of Remizov’s scrupulous work with a specific tale material. He is acting here as a tale repertory researcher and in some cases as a collector as well. The means of such collections’ topical organization is not the myth but the hero of the tale. According to this principle single pieces are grouped into cycles, which then form complicated montage constructs. Texts themselves can be viewed as a sort of hyper-quotations, as they in fact entirely coincide with their original sources. Besides, collections usually have their own ideal patterns. In the fourth chapter a connection of Remizov’s creative work with folk fun culture and a tradition of the folklore noel story is being demonstrated on Zavetnyie skazy (Secret Tales) material. A consistent collections’ history creation analysis convinces us that the tale was a sort of laboratory in which main writer’s prose methods were being worked out.

Strike Hard, Strike Sure - Operation Musketeer : British Military Planning during the Suez Crisis, 1956

This study analyses British military planning and actions during the Suez Crisis in 1956. It seeks to find military reasons for the change of concepts during the planning and compares these reasons with the tactical doctrines of the time. The thesis takes extensive advantage of military documents preserved in the National Archives, London. In order to expand the understanding of the exchange of views during the planning process, the private papers of high ranking military officials have also been consulted. French military documents preserved in the Service Historique de la Defence, Paris, have provided an important point of comparison. The Suez Crisis caught the British armed forces in the middle of a transition phase. The main objective of the armed forces was to establish a credible deterrence against the Soviet Union. However, due to overseas commitments the Middle East playing a paramount role because of its economic importance the armed forces were compelled to also prepare for Limited War and the Cold War. The armed forces were not fully prepared to meet this demand. The Middle Eastern garrison was being re-organised after the withdrawal from the Canal Base and the concept for a strategic reserve was unimplemented. The tactical doctrines of the time were based on experiences from the Second World War. As a result, the British view of amphibious operations and the subsequent campaigns emphasised careful planning, mastery of the sea and the air, sufficient superiority in numbers and firepower, centralised command and extensive administrative preparations. The British military had realized that Nasser could nationalise the Suez Canal and prepared an outline plan to meet this contingency. Although the plan was nothing more than a concept, it was accepted as a basis for further planning when the Canal was nationalised at the end of July. This plan was short-lived. The nominated Task Force Commanders shifted the landing site from Port Said to Alexandria because it enabled faster expansion of the bridgehead. In addition, further operations towards Cairo the hub of Nasser s power would be easier to conduct. The operational concept can be described as being traditional and was in accordance with the amphibious warfare doctrine. This plan was completely changed at the beginning of September. Apparently, General Charles Keightley, the Commander-in-Chief, and the Chairman of the Chiefs of Staff Committee developed the idea of prolonged aerial operations. The essence of the concept was to break the Egyptian will to resist by attacking the oil facilities, the transportation system and the armed forces. This victory through air concept would be supported by carefully planned psychological operations. This concept was in accordance with the Royal Air Force doctrine, which promoted a bomber offensive against selected target categories. General Keightley s plan was accepted despite suspicions at every planning level. The Joint Planning Staff and the Task Force Commanders opposed the concept from the beginning to the end because of its unpredictability. There was no information that suggested the bombing would persuade the Egyptians to submit. This problem was worsened by the fact that British intelligence was unable to provide reliable strategic information. The Task Force Commanders, who were responsible for the tactical plans, were not able to change Keightley s mind, but the concept was expanded to include a traditional amphibious assault on Port Said due to their resistance. The bombing campaign was never tested as the Royal Air Force was denied authorisation to destroy the transportation and oil targets. The Chiefs of Staff and General Keightley were too slow to realise that the execution of the plan depended on the determination of the Prime Minister. However, poor health, a lack of American and domestic support and the indecisiveness of the military had ruined Eden s resolve. In the end, a very traditional amphibious assault, which was bound to succeed at the tactical level but fail at the strategic level, was launched against Port Said.

On the Origin of Ideas : An Abductivist Approach to Discovery

The purpose of this study is to analyze and develop various forms of abduction as a means of conceptualizing processes of discovery. Abduction was originally presented by Charles S. Peirce (1839-1914) as a "weak", third main mode of inference -- besides deduction and induction -- one which, he proposed, is closely related to many kinds of cognitive processes, such as instincts, perception, practices and mediated activity in general. Both abduction and discovery are controversial issues in philosophy of science. It is often claimed that discovery cannot be a proper subject area for conceptual analysis and, accordingly, abduction cannot serve as a "logic of discovery". I argue, however, that abduction gives essential means for understanding processes of discovery although it cannot give rise to a manual or algorithm for making discoveries. In the first part of the study, I briefly present how the main trend in philosophy of science has, for a long time, been critical towards a systematic account of discovery. Various models have, however, been suggested. I outline a short history of abduction; first Peirce's evolving forms of his theory, and then later developments. Although abduction has not been a major area of research until quite recently, I review some critiques of it and look at the ways it has been analyzed, developed and used in various fields of research. Peirce's own writings and later developments, I argue, leave room for various subsequent interpretations of abduction. The second part of the study consists of six research articles. First I treat "classical" arguments against abduction as a logic of discovery. I show that by developing strategic aspects of abductive inference these arguments can be countered. Nowadays the term 'abduction' is often used as a synonym for the Inference to the Best Explanation (IBE) model. I argue, however, that it is useful to distinguish between IBE ("Harmanian abduction") and "Hansonian abduction"; the latter concentrating on analyzing processes of discovery. The distinctions between loveliness and likeliness, and between potential and actual explanations are more fruitful within Hansonian abduction. I clarify the nature of abduction by using Peirce's distinction between three areas of "semeiotic": grammar, critic, and methodeutic. Grammar (emphasizing "Firstnesses" and iconicity) and methodeutic (i.e., a processual approach) especially, give new means for understanding abduction. Peirce himself held a controversial view that new abductive ideas are products of an instinct and an inference at the same time. I maintain that it is beneficial to make a clear distinction between abductive inference and abductive instinct, on the basis of which both can be developed further. Besides these, I analyze abduction as a part of distributed cognition which emphasizes a long-term interaction with the material, social and cultural environment as a source for abductive ideas. This approach suggests a "trialogical" model in which inquirers are fundamentally connected both to other inquirers and to the objects of inquiry. As for the classical Meno paradox about discovery, I show that abduction provides more than one answer. As my main example of abductive methodology, I analyze the process of Ignaz Semmelweis' research on childbed fever. A central basis for abduction is the claim that discovery is not a sequence of events governed only by processes of chance. Abduction treats those processes which both constrain and instigate the search for new ideas; starting from the use of clues as a starting point for discovery, but continuing in considerations like elegance and 'loveliness'. The study then continues a Peircean-Hansonian research programme by developing abduction as a way of analyzing processes of discovery.

Kohti lyyristä abstraktismia : Anitra Lucanderin 1950-luvun modernismi

Towards Lyrical Abstraction Anitra Lucander s Modernism in the 1950s Anitra Lucander (1918-2000) was one of the early pioneers of abstract art in Finland. During the Second World War Finnish art and cultural life was isolated and stagnated and figurative art was still dominant after the war. In the late 1940s and early 1950s, new international abstract art movements started to come to Finland. Anitra Lucander was one of the artists of the younger generation after the war who took an interest in the abstract movements in the early 1950s. At the beginning of the 1950s, abstract art came to Finland primarily in the form of Concretism, but simultaneously, a more delicate abstract movement emerged, and Anitra Lucander was among those cultivating such conceptions in her art. In this thesis, I observe and analyze through Anitra Lucander s art this central movement in Finnish modern art that has not yet been extensively studied. I examine how Anitra Lucander s art connects with the style change in Finnish art. I scrutinize the factors that affected Lucander and turned her towards abstract expression, and the effect her art had on emergence of abstract art in Finland. I will also consider the development of her art, the reception and critique of her art and the effect the critique had on her position in the 1950s art world. Because of a lack of earlier studies, I will undertake basic research, relying on empirical primary source material, where the starting point is to place the phenomenon under examination in the historical and cultural context. The most significant study materials are the artist s paintings and graphics from 1948 to 1960, newspaper and magazine articles from the same era, archive sources and interviews with Lucander s relatives, fellow artists and friends. An interesting aspect of the topic is the fact that Anitra Lucander was the only woman among the important pioneers of early Finnish abstract art. Through Lucander s art, I also examine the position of female artists in the tradition of Modernism as well as in the Finnish art world of the 1950s. This theoretical background is provided by the studies of feminist art historians, such as Marsha Meskimmon, Gill Perry, Griselda Pollock and Anne Middleton Wagner. Lucander s position in the male-dominated Finnish art scene of the 1950s, and how she achieved her position, emerges as one of the central themes of the study. I will also observe whether gender is evident in Lucander s art and expression, as well as her reception and critique compared to the reception of her male colleagues art. From a woman s point of view, I reveal the masculine rhetoric and gendered attitudes in the critique of the era. As a theoretical and methodological frame of reference, I use discourse analysis. Anitra Lucander encountered modernistic, international art movements during her journeys to Paris in the late 1940s and early 1950s. Her art evolved from the geometric Concretism of the early decade towards more delicate and painterly abstract expression. After the mid-1950s, she had developed her signature expression; through Cubism and a collage technique, she developed in her painting a delicate, coloristic imagery, which can be characterized as Lyrical Abstraction. Lucander did not consider abstract expression to be categorical, but saw the abstract and the nonfigurative as equals: the line between the abstract and the figurative is very often fleeting in her art. Already in her own time, Lucander achieved a position as one of the most talented young artists of her generation and her work was included in significant exhibitions. This success can definitely be attributed to the fact that she embraced Modernism in its extreme form, abstraction, already at the beginning of her career and networked with male painters who shared her outlook and modernistic expression. For her, this was either a conscious or an unconscious method of adapting to the male-dominated Finnish art field in the 1950s. In spite of acclaim and attention, Lucander had to encounter the gendered attitudes in the critique of the time, and her art was often perceived through stereotypical views as overly feminine and dependent. However, with her art, Lucander played an important role in the breakthrough for colorism and abstract art in Finland in the 1950s.

Diasporinen tietoisuus, arjen kokemukset ja kansanperinne : Tulkintoja suomessa asuvien kurdien perinnesuhteesta

Tutkielmani tavoite on selvittää millainen suhde Suomessa asuvilla kurdeilla on omaan kansanperinteeseensä. Lisäksi valotetaan perinnesuhteiden taustaa, ja sitä millainen kurdien kansanperinne elää Suomessa. Metodologisesti ja epistemologisesti tukeudun tutkielmassa folkloristiseen muistitietotutkimukseen. Lainaan ajatuksia myös sosiaalipsykologian piirissä kehittyneestä laadullisesta asennetutkimuksesta. Taustalla vaikuttaa kansanperinteen ja nationalismien yhteyksien tutkimus – erityisesti teoriat kansanperinteiden käyttämisestä kansan embleemeinä. Edellä mainittujen ohella analyyttinen viitekehys rakentuu käsitteistä diasporinen tietoisuus; etninen identiteetti; identiteettimerkki ja identiteettityö sekä metafolklore. Nämä käsitteet tavoittavat sen, mitkä seikat sekä olosuhteet ja jaetut tulkinnat muokkaavat tutkittavien perinnesuhteita, ja miten. Tutkimusaineistona on käytetty kokoamaani väljästi strukturoituun teemahaastatteluun perustuvaa haastatteluaineistoa. Aineisto koostuu yksilö-, pari- ja perhehaastatteluista. Yhteensä haastattelunauhoja kertyi lähes 25 tuntia, mikä on litteroituna noin 400 liuskaa. Täydentävinä aineistoina on käytetty videoita kahdesta kurdikulttuuria esittelevästä tilaisuudesta sekä neljää populaaria tietoa kurdeista välittävää internetsivustoa. Repertoaari- ja teema-analyysin avulla luokittelemaani haastatteluaineistoa tulkitsen tutkielmassa kansanperinteeseen kohdistuvia asenteita ilmaisevia argumentteja jäljittävän lähiluennan kautta. Tutkimuksessa selvisi, että kansanperinteen ilmiöistä erityisesti kansantanssi, kurdivaatteet ja kulttuurinsisäinen huumori ovat identiteettimerkkejä, joiden kautta peilataan omaa suhdetta kurdiuteen ja selitetään kurdikulttuurin erityislaatua. Tutkielman tulokset vahvistavat, että Suomessa asuvien kurdien perinnesuhteita ja perinteenkannattajuutta muokkaavat yksityisellä tasolla äidinkielen taitotaso, maahantuloikä ja perheen harrastuneisuus kansanperinteeseen. Analyysissa kuitenkin avautuu myös se, että Suomessa asuvien kurdien perinnesuhteita muokkaa voimakkaasti tietoisuus kurdien diasporasta ja siihen johtaneista olosuhteista sekä niiden vaikutuksista omaan kulttuuriin ja kansanperinteeseen. Tämä kollektiivinen ja poliittinen ulottuvuus on erityisen merkityksellinen oman kansanperinteen tulkitsemisessa ulospäin. Kansanperinteeseen kohdistetaan voimakkaan positiivisia asenteita ja omaa kansanperinnettä arvostetaan kansallisena aarteena. Kansanperinteiden tulkitaan kertovan kansan historiasta ja luonteesta tavalla, joka haastaa virallisen kurdialueilla valtaapitävien valtioiden historiankirjoituksen ja monipuolistaa kuvaa Lähi-idän kulttuuripiiristä. Tämän arvostuksen kautta kansanperinne koetaan hedelmällisenä kansallisen itsetunnon lähteenä ja positiivisen kulttuurisen erottautumisen mahdollisuutena. Lisäksi kansanperinteeseen kohdistuu kuitenkin asenne, jossa tulkitaan kansanperinne katoavaksi tai vähintään katoamisvaarassa olevaksi aarteeksi. Tästä syntyy arvostavien asenteiden kanssa jännite, jossa katoamisen oletus tai pelko sävyttää ilmaistua arvostusta nostalgialla ja/ tai diasporan todellisuuden ja taustojen kritiikillä. Haastatteluaineistosta käy selville, ettei kansanperinteiden läsnäoloa omassa elämässä aina tiedosteta. Monet kansanperinteen ilmiöt ja tekstuaalisetkin sisällöt kuitenkin elävät Suomessa asuvien kurdien parissa yhä sekä kokoonnuttaessa juhlimaan että jokapäiväisessä arjessa.

Sekä että : Ironia koherenssina ja inkoherenssina

The interpretation of irony in this study is seen as being crucially dependent on the notion of coherence. Coherence depends on a complex interplay of contextual features, which is why all interpretations must be seen as socio-cultural processes. An utterance is perceived as coherent if it makes sense and if it hangs together. Incoherent utterances can result in an ironic interpretation; however, the incoherence must also be perceived as being intentional, and intentionality in turn is a sign of the ironist's rejecting stance. The study does not encompass the notion of irony of fate nor situational irony that is unintentional. Irony is defined in this study as a combination of five components. It is seen as (1) a negative attitude that reflects (2) the intention of the ironist, and (3) has a target and most often (4) a victim too. Essential to irony is its fifth component, the fact that one or more of these four components must be inferred from co- or context. The componential definition of irony is crucial in deciding whether an interpretation is ironic or not, and the definition makes it possible to discern the differences as well as the similarities between different kinds of irony. The method of the study is experimental: 12 Finnish newspaper texts that could be considered to be ironic were interpreted by 107 informants. The interpretation of one of the texts was based on unelicited feedback given by readers of a weekly magazine. The responses were analyzed to determine (a) whether the texts were perceived as being coherent or incoherent and (b) whether the informants appealed to any of the five components of irony. The results of the analyses of the informants' responses indicate that differences between the ironic and non-ironic interpretations of the texts can be explained in terms of whether or not the informant regarded the text as being coherent. The thesis also discusses the shortcomings of other accounts of irony: the Gricean theory of conversational implicature, speech act theory, irony as rhetoric, irony as pretense, irony as echoic mention, and irony as framing. In contrast to these other accounts, the study focuses on irony as a textual phenomenon and underlines the importance of socio-cultural context in the interpretation of irony. Key words: irony, coherence, incoherence, the componential definition of irony, interpretation of linguistic utterances.

Spinaalistenoosipotilaiden psyykkinen hyvinvointi ennen leikkaushoitoa ja sen jälkeen

Surgical treatment of lumbar spinal stenosis (LSS) is a treatment option for those patients who remain severely symptomatic after a course of conservative treatment. Majority of the patients treated surgically enjoy good-to-excellent outcomes with respect to pain alleviation and functional recovery. However, between 20% and 40% of the patients who have surgery for LSS do not benefit from it. The knowledge of the psychological factors associated with recovery and treatment outcome is still scarce. The aim of this study was to assess LSS patients selected for surgical treatment. Specifically, the study assessed the prevalence of depression (Beck Depression Inventory, BDI) before surgical treatment and three months after the treatment. Also preoperative life satisfaction (four-item Life Satisfaction scale) of the LSS patients was studied. Furthermore, the patients satisfaction with surgery outcome at the three months postoperative stage was studied. One-fifth (20%) of the LSS-patients were found to have depression preoperatively. The patients assessments of the pain intensity or location were not associated with depression. The factors that did associate with depression were subjective disability of everyday living and poor life satisfaction. In addition to this, low sense of coherence and poor life satisfaction were associated with depression in logistic regression models. Significant associations were seen between preoperative depression and postoperative high disability scores, high symptom severity scores and higher pain intensity ratings. The patients with continuous depression (60% of the patients who had preoperative depression) showed less improvement in symptom severity, disability, pain and walking capacity than the patients who did not experience depression at any stage. In those patients who recovered from depression (35% of the patients with preoperative depression), the postoperative improvement was rather similar to the improvement seen in the normal mood group. One-fourth (25%) of the preoperative patients with LSS were found to be dissatisfied with life. The dissatisfied patients were significantly younger and had more self-reported somatic comorbidity. The dissatisfied patients had also elevated subjective disability scores and more extensive pain locations. Also lower coping resources and higher BDI scores were associated with life dissatisfaction. Younger age and somatic comorbidity were associated with life dissatisfaction in regression models. Two-thirds (66%) of the patients were at least clearly satisfied with the surgery outcome at three months postoperative stage. In group comparisons, the lack of physical, functional and emotional well-being was associated with the patients dissatisfaction with the surgery outcome. Younger age, postoperative symptom severity, disability and depression were independently associated with dissatisfaction with the surgery outcome. The results show that depression and psychological well-being are important factors with respect to LSS patients functional ability and recovery both before and three months after surgical treatment. Therefore, the clinical practice recommendations should include an assessment of depression

Occupational burnout and health

Occupational burnout and heath Occupational burnout is assumed to be a negative consequence of chronic work stress. In this study, it was explored in the framework of occupational health psychology, which focusses on psychologically mediated processes between work and health. The objectives were to examine the overlap between burnout and ill health in relation to mental disorders, musculoskeletal disorders, and cardiovascular diseases, which are the three commonest disease groups causing work disability in Finland; to study whether burnout can be distinguished from ill health by its relation to work characteristics and work disability; and to determine the socio-demographic correlates of burnout at the population level. A nationally representative sample of the Finnish working population aged 30 to 64 years (n = 3151-3424) from the multidisciplinary epidemiological Health 2000 Study was used. Burnout was measured with the Maslach Burnout Inventory - General Survey. The diagnoses of common mental disorders were based on the standardized mental health interview (the Composite International Diagnostic Interview), and physical illnesses were determined in a comprehensive clinical health examination by a research physician. Medically certified sickness absences exceeding 9 work days during a 2-year period were extracted from a register of The Social Insurance Institution of Finland. Work stress was operationalized according to the job strain model. Gender, age, education, occupational status, and marital status were recorded as socio-demographic factors. Occupational burnout was related to an increased prevalence of depressive and anxiety disorders and alcohol dependence among the men and women. Burnout was also related to musculoskeletal disorders among the women and cardiovascular diseases among the men independently of socio-demographic factors, physical strenuousness of work, health behaviour, and depressive symptoms. The odds of having at least one long, medically-certified sickness absence were higher for employees with burnout than for their colleagues without burnout. For severe burnout, this association was independent of co-occurring common mental disorders and physical illnesses for both genders, as was also the case for mild burnout among the women. In a subgroup of the men with absences, severe burnout was related to a greater number of absence days than among the women with absences. High job strain was associated with a higher occurrence of burnout and depressive disorders than low job strain was. Of these, the association between job strain and burnout was stronger, and it persisted after control for socio-demographic factors, health behaviour, physical illnesses, and various indicators of mental health. In contrast, job strain was not related to depressive disorders after burnout was accounted for. Among the working population over 30 years of age, burnout was positively associated with age. There was also a tendency towards higher levels of burnout among the women with low educational attainment and occupational status and among the unmarried men. In conclusion, a considerable overlap was found between burnout, mental disorders, and physical illnesses. Still, burnout did not seem to be totally redundant with respect to ill health. Burnout may be more strongly related to stressful work characteristics than depressive disorders are. In addition, burnout seems to be an independent risk factor for work disability, and it could possibly be used as a marker of health-impairing work stress. However, burnout may represent a different kind of risk factor for men and women, and this possibility needs to be taken into account in the promotion of occupational health.

ADHD-aikuisten psykologinen kuntoutus : Neljän uuden lyhytintervention tutkimus

ADHD (attention deficit hyperactivity disorder) is developmental neurobiological disability. In adults, the prevalence of ADHD has been estimated to be about 4 %. In addition to the difficulties of attention, the problems in executive functioning are typical. The psychiatric comorbidities are common. The most extensively studied treatments are pharmacological. There is also evidence about the usefulness of the cognitive-behavioural therapy (CBT) in the treatment of adults with ADHD. There are some preliminary results about the effectiveness of cognitive training and hypnosis in children, but there is no scientific proof in adults. This dissertation is based on two intervention studies. In the first study, the usefulness of the new group CBT (n = 29) and the maintenance of the symptom reduction in the follow-up of six months were studied. In the second study, the usefulness of short hypnotherapy (n = 9), short individual CBT (n = 10) and computerized cognitive training (n = 9) were examined by comparing groups with each other and to the control group (n = 10). The participation in the group CBT and the participants' satisfaction were good. There were no changes in self-reports during waiting period of three months. After the rehabilitation, the symptoms decreased. Participants having symptom reduction during rehabilitation maintained their benefit through 6-month follow-up period. In a combined ADHD symptom score based on self-reports, seven participants in the hypnotherapy, six in the CBT, two in the cognitive training and two controls improved. Using independent evaluations, improvement was found in six of the hypnotherapy, seven of the CBT, two of the cognitive training and three of the control participants. There was no treatment-related improvement in cognitive performance. Thus, in the hypnotherapy and CBT groups, some encouraging improvement was seen. In the cognitive training group, there was improvement in the trained tasks but no generalization of the improvement. The results support the earlier results from the usefulness of CBT in the treatment of adults with ADHD. Also the hypnotherapy seems a useful rehabilitation. More research is needed to evaluate the usefulness of cognitive training. These promising results warrant further studies with more participants and with longer treatment duration. Also different measures of cognitive functioning and quality of life are needed. It is important in addition to the medication to arrange psychosocial interventions for the ADHD adults.

The role of catechol-O-methyltransferase (COMT) and the effects of COMT inhibition in brain and in cardiovascular and renal pathophysiology

Catechol-O-methyltransferase (COMT) metabolizes catecholamines such as dopamine (DA), noradrenaline (NA) and adrenaline, which are vital neurotransmitters and hormones that play important roles in the regulation of physiological processes. COMT enzyme has a functional Val158Met polymorphism in humans, which affects the subjects COMT activity. Increasing evidence suggests that this functional polymorphism may play a role in the etiology of various diseases from schizophrenia to cancers. The aim of this project was to provide novel biochemical information on the physiological and especially pathophysiological roles of COMT enzyme as well as the effects of COMT inhibition in the brain and in the cardiovascular and renal system. To assess the roles of COMT and COMT inhibition in pathophysiology, we used four different study designs. The possible beneficial effects of COMT inhibition were studied in double-transgenic rats (dTGRs) harbouring human angiotensinogen and renin genes. Due to angiotensin II (Ang II) overexpression, these animals exhibit severe hypetension, cardiovascular and renal end-organ damage and mortality of approximately 25-40% at the age of 7-weeks. The dTGRs and their Sprague-Dawley controls tissue samples were assessed with light microscopy, immunohistochemistry, reverse transcriptase-polymerase chain reaction (RT-PCR) and high-pressure liquid chromatography (HPLC) to evaluate the tissue damages and the possible protective effects pharmacological intervention with COMT inhibitors. In a second study, the consequence of genetic and pharmacological COMT blockade in blood pressure regulation during normal and high-sodium was elucidated using COMT-deficient mice. The blood pressure and the heart rate were measured using direct radiotelemetric blood pressure surveillance. In a third study, the effects of acute and subchronic COMT inhibition during combined levodopa (L-DOPA) + dopa decarboxylase inhibitor treatment in homocysteine formation was evaluated. Finally, we assessed the COMT enzyme expression, activity and cellular localization in the CNS during inflammation-induced neurodegeneration using Western blotting, HPLC and various enzymatic assays. The effects of pharmacological COMT inhibition on neurodegeneration were also studied. The COMT inhibitor entacapone protected against the Ang II-induced perivascular inflammation, renal damage and cardiovascular mortality in dTGRs. COMT inhibitors reduced the albuminuria by 85% and prevented the cardiovascular mortality completely. Entacapone treatment was shown to ameliorate oxidative stress and inflammation. Furthermore, we established that the genetic and pharmacological COMT enzyme blockade protects against the blood pressure-elevating effects of high sodium intake in mice. These effects were mediated via enhanced renal dopaminergic tone and suggest an important role of COMT enzyme, especially in salt-sensitive hypertension. Entacapone also ameliorated the L-DOPA-induced hyperhomocysteinemia in rats. This is important, since decreased homocysteine levels may decrease the risk of cardiovascular diseases in Parkinson´s disease (PD) patients using L-DOPA. The Lipopolysaccharide (LPS)-induced inflammation and subsequent delayed dopaminergic neurodegeneration were accompanied by up-regulation of COMT expression and activity in microglial cells as well as in perivascular cells. Interestingly, similar perivascular up-regulation of COMT expression in inflamed renal tissue was previously noted in dTGRs. These results suggest that inflammation reactions may up-regulate COMT expression. Furthermore, this increased glial and perivascular COMT activity in the central nervous system (CNS) may decrease the bioavailability of L-DOPA and be related to the motor fluctuation noted during L-DOPA therapy in PD patients.

Microarrays in molecular profiling of cancer - focus on head and neck squamous cell carcinoma

Microarrays have a wide range of applications in the biomedical field. From the beginning, arrays have mostly been utilized in cancer research, including classification of tumors into different subgroups and identification of clinical associations. In the microarray format, a collection of small features, such as different oligonucleotides, is attached to a solid support. The advantage of microarray technology is the ability to simultaneously measure changes in the levels of multiple biomolecules. Because many diseases, including cancer, are complex, involving an interplay between various genes and environmental factors, the detection of only a single marker molecule is usually insufficient for determining disease status. Thus, a technique that simultaneously collects information on multiple molecules allows better insights into a complex disease. Since microarrays can be custom-manufactured or obtained from a number of commercial providers, understanding data quality and comparability between different platforms is important to enable the use of the technology to areas beyond basic research. When standardized, integrated array data could ultimately help to offer a complete profile of the disease, illuminating mechanisms and genes behind disorders as well as facilitating disease diagnostics. In the first part of this work, we aimed to elucidate the comparability of gene expression measurements from different oligonucleotide and cDNA microarray platforms. We compared three different gene expression microarrays; one was a commercial oligonucleotide microarray and the others commercial and custom-made cDNA microarrays. The filtered gene expression data from the commercial platforms correlated better across experiments (r=0.78-0.86) than the expression data between the custom-made and either of the two commercial platforms (r=0.62-0.76). Although the results from different platforms correlated reasonably well, combining and comparing the measurements were not straightforward. The clone errors on the custom-made array and annotation and technical differences between the platforms introduced variability in the data. In conclusion, the different gene expression microarray platforms provided results sufficiently concordant for the research setting, but the variability represents a challenge for developing diagnostic applications for the microarrays. In the second part of the work, we performed an integrated high-resolution microarray analysis of gene copy number and expression in 38 laryngeal and oral tongue squamous cell carcinoma cell lines and primary tumors. Our aim was to pinpoint genes for which expression was impacted by changes in copy number. The data revealed that especially amplifications had a clear impact on gene expression. Across the genome, 14-32% of genes in the highly amplified regions (copy number ratio >2.5) had associated overexpression. The impact of decreased copy number on gene underexpression was less clear. Using statistical analysis across the samples, we systematically identified hundreds of genes for which an increased copy number was associated with increased expression. For example, our data implied that FADD and PPFIA1 were frequently overexpressed at the 11q13 amplicon in HNSCC. The 11q13 amplicon, including known oncogenes such as CCND1 and CTTN, is well-characterized in different type of cancers, but the roles of FADD and PPFIA1 remain obscure. Taken together, the integrated microarray analysis revealed a number of known as well as novel target genes in altered regions in HNSCC. The identified genes provide a basis for functional validation and may eventually lead to the identification of novel candidates for targeted therapy in HNSCC.

p53 and DNA damage checkpoint responses in the human prostate

Prostate cancer is the most common noncutaneous malignancy and the second leading cause of cancer mortality in men. In 2004, 5237 new cases were diagnosed and altogether 25 664 men suffered from prostate cancer in Finland (Suomen Syöpärekisteri). Although extensively investigated, we still have a very rudimentary understanding of the molecular mechanisms leading to the frequent transformation of the prostate epithelium. Prostate cancer is characterized by several unique features including the multifocal origin of tumors and extreme resistance to chemotherapy, and new treatment options are therefore urgently needed. The integrity of genomic DNA is constantly challenged by genotoxic insults. Cellular responses to DNA damage involve elegant checkpoint cascades enforcing cell cycle arrest, thus facilitating damage repair, apoptosis or cellular senescence. Cellular DNA damage triggers the activation of tumor suppressor protein p53 and Wee1 kinase which act as executors of the cellular checkpoint responses. These are essential for genomic integrity, and are activated in early stages of tumorigenesis in order to function as barriers against tumor formation. Our work establishes that the primary human prostatic epithelial cells and prostatic epithelium have unexpectedly indulgent checkpoint surveillance. This is evidenced by the absence of inhibitory Tyr15 phosphorylation on Cdk2, lack of p53 response, radioresistant DNA synthesis, lack of G1/S and G2/M phase arrest, and presence of persistent gammaH2AX damage foci. We ascribe the absence of inhibitory Tyr15 phosphorylation to low levels of Wee1A, a tyrosine kinase and negative regulator of cell cycle progression. Ectopic Wee1A kinase restored Cdk2-Tyr15 phosphorylation and efficiently rescued the ionizing radiation-induced checkpoints in the human prostatic epithelial cells. As variability in the DNA damage responses has been shown to underlie susceptibility to cancer, our results imply that a suboptimal checkpoint arrest may greatly increase the accumulation of genetic lesions in the prostate epithelia. We also show that small molecules can restore p53 function in prostatic epithelial cells and may serve as a paradigm for the development of future therapeutic agents for the treatment of prostate cancer We hypothesize that the prostate has evolved to activate the damage surveillance pathways and molecules involved in these pathways only to certain stresses in extreme circumstances. In doing so, this organ inadvertently made itself vulnerable to genotoxic stress, which may have implications in malignant transformation. Recognition of the limited activity of p53 and Wee1 in the prostate could drive mechanism-based discovery of preventative and therapeutic agents.

Early Childhood Caries and a Community Trial of its Prevention in Tehran, Iran

Varhaislapsuuden karies ja sen ehkäisy kehittyvän terveydenhuollon maassa Varhaislapsuuden karies on merkittävä kansanterveysongelma varsinkin lapsirikkaissa maissa ja väestöissä. Karieksen hoitaminen vie paljon voimavaroja ja aiheuttaa mittavia taloudellisia seuraamuksia. Karies voi ilmaantua lapselle jo vauvaikäisenä, pian ensimmäisten maitohampaiden puhjettua suuhun. Alle 3-vuotiaiden karieksesta on kuitenkin niukasti tilastotietoja. Maailman terveysjärjestökin suosittaa tietojen keräämistä vasta 3-vuotiaiden ikäryhmästä. Heistä kariesta sairastaa Suomessa 16 %, Yhdysvalloissa 25 %, Englannissa 30 %, Iranissa 46 % ja Saudi-Arabiassa 61 %. Tämä väitöstutkimus selvitti karieksen esiintymistä ja sen vaaratekijöitä 1─3-vuotiailla Teheranissa. Lisäksi tutkimus arvioi perusterveydenhuoltoon sisällytetyn karieksen ehkäisyn tuloksellisuutta. Tutkimuskohteiksi arvottiin Teheranista 18 neuvolaa. Jokaisessa oltiin 4 päivää, jolloin kaikkia rokotuksiin tulleita 1─3-vuotiaita äiteineen pyydettiin osallistumaan tutkimukseen. Kahta lukuun ottamatta kaikki äidit suostuivat, ja aineistoon tuli kaikkiaan 504 lasta äiteineen. Kaikki 1-vuotiaat, 242 lasta äiteineen, valittiin karieksen ehkäisykokeiluun. Sitä varten neuvolat jaettiin kolmeen ryhmään, joista kaksi (A ja B) oli koeryhmiä ja yksi (C) oli vertailuryhmä. Tutkimus alkoi äidin haastattelulla. Siinä selvitettiin perheen koulutus- ja tulotaso sekä lapsen ruokinnasta imetyksen kesto, yösyötöt ja päiväaikaan nautitut makeat. Vielä kysyttiin lapsen ja äidin suuhygieniatavoista ja äidin kokemuksista lapsen suun puhdistamisessa. Sitten hammaslääkäri tutki lapsen suun ja kirjasi karieksen ja hammasplakin esiintymät. Suun tutkimuksen jälkeen äiti ja lapsi siirtyivät rokotushuoneeseen. Koeryhmissä (A ja B) äidit saivat terveydenhoitajalta suunterveyttä koskevan esitteen ja kehotuksen lukea se huolellisesti. Lisäksi ryhmässä A terveydenhoitaja kertoi suun ja hampaiden terveydenhoidosta saman esitteen avulla, ja neuvolan henkilökunta muistutti suunhoidon tärkeydestä puhelimitse kahdesti seuraavan puolen vuoden kuluessa. Vertailuryhmässä äideille ei annettu suunhoidon ohjeita. Kaikissa ryhmissä äitejä muistutettiin seuraavan rokotuskerran ajankohdasta, muttei mainittu tulevaa toista hammastarkastusta. Varhaislapsuuden kariesta sairasti ikäryhmästä riippuen 3─26 % tutkituista 1─3-vuotiaista, ja 65─76 %:lla oli hammasplakkia. Äideistä 68 % harjasi hampaansa päivittäin ja 39 % puhdisti lapsensa suun päivittäin. Mitä useammin äiti harjasi omat hampaansa, sitä paremmin hän huolehti lapsen suun puhtaudesta. Rintaruokinta oli yleistä eikä lisännyt kariesvaaraa. Yöllä pullomaitoa saavilla karies oli 5 kertaa yleisempää kuin muilla. Neuvolassa saatu ohjeistus ehkäisi selvästi karieksen syntyä puolen vuoden kokeessa.