Suomalaiset lääkärit ja Suomen Lääkäriliitto osana hyvinvointivaltiota ja sen terveyspolitiikkaa

Tässä julkaisussa selvitetään Suomen Lääkäriliiton ideoita (makrotaso) ja lääkäreiden (mikrotaso) mielipiteitä hyvinvointivaltiosta ja sen terveyspolitiikasta. Makrotason aineiston muodostavat erilaiset julkiset dokumentit. Aineistot ovat pääosin vuosilta 1970–2007. Dokumentteja analysoidaan sekä määrällisen että laadullisen sisällönanalyysin tai erittelyn keinoin. Mikrotason aineiston muodostaa vuonna 2007 kerätty kyselyaineisto (n = 1 092). Sitä analysoidaan kuvailevin tilastollisin menetelmin ja logistisen regressioanalyysin keinoin. Tulosten perusteella Suomen Lääkäriliitto koki julkisen vallan puuttumisen uhkaksi rakennettaessa universaalia terveydenhuoltojärjestelmää. Uhka kuitenkin väheni julkisen sektorin jatkuvasti laajentuessa. Toisaalta jatkuvana vaatimuksena Lääkäriliiton dokumenteissa esiintyy 1970-luvulta lähtien yksityisen sektorin roolin lisäämisvaateet. 1990-luvun laman jälkeisenä aikana yksityiseen sektoriin liittyvät ideat ovat tulleet yhä selkeämmiksi ja konkreettisemmiksi. Argumenteissaan Lääkäriliitto ei tuo juurikaan esille omia taloudellisia intressejään vaan vetoaa useammin yleiseen hyvään. Kyselyaineistosta tehtyjen analyysien mukaan lääkärit kokevat sosiaaliturvan muuta väestöä useammin liian laajaksi. Lääkärit eivät kuitenkaan halua erityisen voimakkaasti markkinoistaa terveydenhuoltoa, jopa verrattaessa muuhun väestöön. Parhaiten lääkäreiden mielipiteitä sosiaaliturvasta ja terveydenhuoltojärjestelmästä selittävät poliittinen orientaatio ja työskentelysektori. Nuorten lääkäreiden mielipiteet sosiaaliturvasta ja terveydenhuoltojärjestelmästä eivät ole erityisen radikaaleja. Lopuksi tutkimuksessa verrattiin mikro- ja makrotasoa keskenään. Tulosten perusteella Suomen Lääkäriliitto on selvästi radikaalimpi näkemyksissään markkinoistumisesta kuin lääkärit keskimäärin.

Streptomyces scabies and S. turgidiscabies as pathogens causing potato common scab, and potential methods for their control

Tieteellinen tiivistelmä Common scab is one of the most important soil-borne diseases of potato (Solanum tuberosum L.) in many potato production areas. It is caused by a number of Streptomyces species, in Finland the causal agents are Streptomyces scabies (Thaxter) Lambert & Loria and S. turgidiscabies Takeuchi. The scab-causing Streptomyces spp. are well-adapted, successful plant pathogens that survive in soil also as saprophytes. Control of these pathogens has proved to be difficult. Most of the methods used to manage potato common scab are aimed at controlling S. scabies, the most common of the scab-causing pathogens. The studies in this thesis investigated S. scabies and S. turgidiscabies as causal organisms of common scab and explored new approaches for control of common scab that would be effective against both species. S. scabies and S. turgidiscabies are known to co-occur in the same fields and in the same tuber lesions in Finland. The present study showed that both these pathogens cause similar symptoms on potato tubers, and the types of symptoms varied depending on cultivar rather than the pathogen species. Pathogenic strains of S. turgidiscabies were antagonistic to S. scabies in vitro indicating that these two species may be competing for the same ecological niche. In addition, strains of S. turgidiscabies were highly virulent in potato and they tolerated lower pH than those of S. scabies. Taken together these results suggest that S. turgidiscabies has become a major problem in potato production in Finland. The bacterial phytotoxins, thaxtomins, are produced by the scab-causing Streptomyces spp. and are essential for the induction of scab symptoms. In this study, thaxtomins were produced in vitro and four thaxtomin compounds isolated and characterized. All four thaxtomins induced similar symptoms of reduced root and shoot growth, root swelling or necrosis on micro-propagated potato seedlings. The main phytotoxin, thaxtomin A, was used as a selective agent in a bioassay in vitro to screen F1 potato progeny from a single cross. Tolerance to thaxtomin A in vitro and scab resistance in the field were correlated indicating that the in vitro bioassay could be used in the early stages of a resistance breeding program to discard scab-susceptible genotypes and elevate the overall levels of common scab resistance in potato breeding populations. The potential for biological control of S. scabies and S. turgidiscabies using a non-pathogenic Streptomyces strain (346) isolated from a scab lesion and S. griseoviridis strain (K61) from a commercially available biocontrol product was studied. Both strains showed antagonistic activity against S. scabies and S. turgidiscabies in vitro and suppressed the development of common scab disease caused by S. turgidiscabies in the glasshouse. Furthermore, strain 346 reduced the incidence of S. turgidiscabies in scab lesions on potato tubers in the field. These results demonstrated for the first time the potential for biological control of S. turgidiscabies in the glasshouse and under field conditions and may be applied to enhance control of common scab in the future.

Strong Evidence for ZZ Production in pp̅ Collisions at √s=1.96 TeV

We report the first measurement of the cross section for Z boson pair production at a hadron collider. This result is based on a data sample corresponding to 1.9 fb-1 of integrated luminosity from ppbar collisions at sqrt{s} = 1.96 TeV collected with the CDF II detector at the Fermilab Tevatron. In the llll channel, we observe three ZZ candidates with an expected background of 0.096^{+0.092}_{-0.063} events. In the llnunu channel, we use a leading-order calculation of the relative ZZ and WW event probabilities to discriminate between signal and background. In the combination of llll and llnunu channels, we observe an excess of events with a probability of $5.1\times 10^{-6}$ to be due to the expected background. This corresponds to a significance of 4.4 standard deviations. The measured cross section is sigma(ppbar -> ZZ) = 1.4^{+0.7}_{-0.6} (stat.+syst.) pb, consistent with the standard model expectation.

IT-Innovationer i svenska bygg- och fastighetssektorn

Utvecklingen inom informationsteknologin (IT) har under de senaste decennierna bidragit till stora förändringar i vårt samhälle och i våra industrier. Tillgången till bland annat persondatorer, mobiltelefoner och Internet har förändrat vårt sätt att hantera information och att kommunicera. Att IT också ökat företags och industriers produktivitet och effektivitet har kunnat mätas. Detta har utgjort bakgrunden till avhandlingens frågeställning, nämligen hur IT har påverkat bygg- och fastighetssektorn. Syftet har varit att undersöka hur och i vilken utsträckning IT används inom sektorn, samt varför användningen inom sektorn sker på det sättet och i den utsträckningen. Fem datainsamlingar har utförts för att uppfylla forskningens syfte. Tre har utförts kvantitativt genom enkätundersökningar och två kvalitativt genom intervjustudier. Den kvantitativa delen inleddes med att skapa enkätverktyget, vilket sedan använts tre gånger. Datainsamlingarna har skett under perioden 1998 till 2009 och de skapar därmed, förutom ögonblicksbilder, ett longitudinellt perspektiv på utvecklingen. Tre fokusområden har identifierats som särskilt intressanta ur ett sektorsperspektiv: elektroniska affärer (EDI), elektronisk dokumenthantering (EDM) samt byggnadsinformationsmodeller (BIM). Dessa har studerats både kvantitativt och kvalitativt. Undersökningarna visar att tillgången till IT-infrastruktur inom sektorn är god, men att IT huvudsakligen används för att effektivisera befintliga arbetssätt och processer med fokus på administration. IT har också bidragit starkt till bättre kommunikationer. Dock används IT i liten omfattning för att skapa nya produkter, processer eller affärsmodeller. Entreprenörerna är de som använder IT i lägst utsträckning. Bygg- och fastighetssektorns starkt projektbaserade organisation medför svårigheter för innovationsspridning, särskilt när innovationerna kräver engagemang från flera aktörer. Tre sådana innovationer, EDM, EDI och BIM har under de senaste åren börjat spridas inom sektorn där EDM hittills nått högst användning och BIM lägst. Olika modeller för införande och implementering av IT i företagen inom sektorn har använts för att studera vilka faktorer som påverkar beslut på olika nivåer. Den praktiska nyttan eller det förväntade resultatet av varje innovation är en starkt pådrivande faktor för beslut. Initiala beslut för införande har visat sig ske på olika nivåer. För EDM sker detta i projekt, för EDI i de enskilda företagen och för BIM hos individer. EDM har tydligast fullföljt implementeringsmodellens steg, följt av EDI och därefter BIM. Fokusområdet BIM har störst potential att skapa positiva effekter samt påverkar processer och metoder i störst utsträckning. Tidiga tillämpare bland företagen har börjat tillsätta resurser för dessa förändringar, men det har ännu inte skett i samma omfattning som för de två andra områdena.

Campylobacter jejuni and C. coli in Finnish poultry production

Campylobacter, mainly Campylobacter jejuni and C. coli, are worldwide recognized as a major cause of bacterial food-borne gastroenteritis. Epidemiological studies have shown handling or eating of poultry to be significant risk factors for human infections. Campylobacter contamination can occur at all stages of a poultry meat production cycle. The aim of this thesis was to study the occurrence and diversity of Campylobacter in broiler and turkey production in Finland. In summer 1999, 2.9 % of slaughtered broiler flocks were Campylobacter-positive. From the isolated strains 94 % were C. jejuni and 6% were C. coli. During years 2005-2006 one turkey parent flock, the hatchery, six different commercial turkey farms and different stages of the slaughterhouse were monitored during one and the half year. No Campylobacter were detected in either of the samples from the turkey parent flock or from the hatchery using the culture method. Instead PCR detected DNA of Campylobacter from the turkey parent flock and samples from the hatchery. Six out of 12 commercial turkey flocks were found negative at the farm level but only two of those were negative at slaughter. Campylobacter-positive samples within the flock at slaughter were detected between 0% and 94% with evisceration and chilling water being the most critical stages for contamination. All of Campylobacter isolates were shown to be C. jejuni. Campylobacter-positive turkey flocks were colonized by a limited number of Campylobacter genotypes both at the farm and slaughter level. In conclusion, in our first study in 1999 a low prevalence of Campylobacter in Finnish broiler flocks was detected and it has remained at a low level during the study period until the present. In the turkey meat production, we found that flocks which were negative at the farm became contaminated with Campylobacter at the slaughter process. These results suggest that proper and efficient cleaning and disinfection of slaughter and processing premises are needed to avoid cross-contamination. Prevention of colonization at the farm by a high level of biosecurity control and hygiene may be one of the most efficient ways to reduce the amount of Campylobacter-positive poultry meat in Finland. With a persistent low level of Campylobacter-positive flocks, it could be speculated that the use of logistic slaughtering, according to Campylobacter status at farm, might have be advantageous in reducing Campylobacter contamination of retail poultry products. However, the significance of the domestic poultry meat for human campylobacteriosis in Finland should be evaluated.

Campylobacter jejuni and C.coli in Finnish poultry production

Campylobacter, mainly Campylobacter jejuni and C. coli, are worldwide recognized as a major cause of bacterial food-borne gastroenteritis (World Health Organization 2010). Epidemiological studies have shown handling or eating of poultry to be significant risk factors for human infections. Campylobacter contamination can occur at all stages of a poultry meat production cycle. In summer 1999, every broiler flock from all three major Finnish poultry slaughterhouses was studied during a five month period. Caecal samples were taken in the slaughterhouses from five birds per flock. A total of 1 132 broiler flocks were tested and 33 (2.9%) of those were Campylobacter-positive. Thirty-one isolates were identified as C. jejuni and two isolates were C. coli. The isolates were serotyped for heat-stable antigens (HS) and genotyped by pulsed-field gel electrophoresis (PFGE). The most common serotypes found were HS 6,7, 12 and 4-complex. Using a combination of SmaI and KpnI patterns, 18 different PFGE types were identified. Thirty-five Finnish C. jejuni strains with five SmaI/SacII PFGE types selected among human and chicken isolates from 1997 and 1998 were used for comparison of their PFGE patterns, amplified fragment length polymorphism (AFLP) patterns, HaeIII ribotypes, and HS serotypes. The discriminatory power of PFGE, AFLP and ribotyping with HaeIII were shown to be at the same level for this selected set of strains, and these methods assigned the strains into the same groups. The PFGE and AFLP patterns within a genotype were highly similar, indicating genetic relatedness. An HS serotype was distributed among different genotypes, and different serotypes were identified within one genotype. From one turkey parent flock, the hatchery, six different commercial turkey farms (together 12 flocks) and from 11 stages at the slaughterhouse a total of 456 samples were collected during one and the half year. For the detection of Campylobacter both conventional culture and a PCR method were used. No Campylobacter were detected in either of the samples from the turkey parent flock or from the hatchery samples using the culture method. Instead PCR detected DNA of Campylobacter in five faecal samples from the turkey parent flock and in one fluff and an eggshell sample. Six out of 12 commercial turkey flocks were found negative at the farm level but only two of those were negative at slaughter. Campylobacter-positive samples within the flock at slaughter were detected between 0% and 94%, with evisceration and chilling water being the most critical stages for contamination. All of a total of 121 Campylobacter isolates were shown to be C. jejuni using a multiplex PCR assay. PFGE analysis of all isolates with KpnI restriction enzyme resulted in 11 PFGE types (I-XI) and flaA-SVR typing yielded nine flaA-SVR alleles. Three Campylobacter-positive turkey flocks were colonized by a limited number of Campylobacter genotypes both at the farm and slaughter level.In conclusion, in our first study in 1999 a low prevalence of Campylobacter in Finnish broiler flocks was detected and it has remained at a low level during the study period until the present. In the turkey meat production, we found that flocks which were negative at the farm became contaminated with Campylobacter at the slaughter process. These results suggest that proper and efficient cleaning and disinfection of slaughter and processing premises are needed to avoid cross-contamination. Prevention of colonization at the farm by a high level of biosecurity control and hygiene may be one of the most efficient ways to reduce the amount of Campylobacter-positive poultry meat in Finland. In Finland, with a persistent low level of Campylobacter-positive flocks, it could be speculated that the use of logistic slaughtering, according to Campylobacter status at farm, might have be advantageous in reducing Campylobacter contamination of retail poultry products. However, the significance of the domestic poultry meat for human campylobacteriosis in Finland should be evaluated.