Paimen vailla hiippakuntaa : Kenttäpiispan viran synty ja vaikutus sotilaspapiston asemaan Suomen puolustusvoimissa ja kirkossa vuosina 1939 - 1944

The main purpose of this research is to shed light on the factors that gave rise to the office of Field Bishop in the years 1939-1944. How did military bishophood affect the status of the head of military pastoral care and military clergy during these years? The main sources of my research are the collections in the Finnish National Archives, and I use a historical-qualitative method. The position of the military clergy was debated within both the Church and the Defence Forces before 1939. At that stage, Church law did not yet recognize the office of the leading military priest, the Field Dean. There had been a motion in 1932 to introduce the office of a military bishop, but the bishops' synod blocked it. The concept of Field Bishop appeared for the first time in 1927 in a Finnish military document, which dealt with pastoral care in the Polish military. The Field Dean in Finland had regularly proposed improvements to the salary of the military clergy before the Winter War. After the Winter War, arguments were made for strengthening the position of the military clergy: these arguments were based on the increased respect shown towards this clergy, especially due to their role in the care of the fallen, which had become their task during the war. Younger members of the military clergy in particular supported the demands to improve their position within the Church and the army. The creation of a Field Bishop was perceived as strengthening the whole military clergy, as the Field Bishop was envisioned as a bishop within the Church and a general within the Defence Forces. During that time the Field Dean was still without any military rank. The idea of a Field Bishop was recommended to Mannerheim in June 1940, after which the Defence Forces lent their support to the cause. The status of the military clergy, in Church law, made it to the agenda of the Church council in January 1941, thanks largely to the younger priests' group influence and Mannerheim's leverage. The bishops opposed the notion of a Field Bishop mostly on theological grounds but were ready to concede that the position the Field Dean in Church law required further defining. The creation of the office of Field Bishop was blocked in the Church law committee report issued close to the beginning of the Continuation War. The onset of that war, however, changed the course of events, as the President of the Republic appointed Field Dean Johannes Björklund as Field Bishop. Speculation has abounded about Mannerheim's role in the appointment, but the truth of the matter is not clear. The title of Field Bishop was used to put pressure on the Church, and, at the same time, Mannerheim could remain detached from the matter. Later, in September 1941, the Church council approved the use of the Field Bishop title to denote the head of military pastoral care in Church law, and Field Bishops were assigned some of the duties formerly pertaining to bishops. Despite all expectations and hopes, the new office of Field Bishop did not affect the status of the military clergy within the Defence Forces, as no ranks were established for them, and their salary did not improve. However the office of the Field Bishop within Army HQ was transformed from a bureau into a department in the summer of 1942. At the beginning of the Continuation War, the Field Bishop was criticized by certain military and Church clergy for favouring Russian Orthodox Christians in Eastern Karelia. Björklund agreed in principle with most of the Lutheran clergy on the necessity of Lutheranizing East Karelia but had to take into account the realities at Army HQ. As well, at the same time the majority of the younger clergy were serving in the army, and there was a lack of parish priests on the home front. Bishop Lehtonen had actually expressed the wish that more priests could have been released from the front to serve in local parishes. In his notes Lehtonen accused Björklund of trying to achieve the position of Field Bishop by all possible means. However, research has revealed a varied group of people behind the creation of the office of Field Bishop, including in particular younger clergy and the Defence Forces.

Perinatal mortality and maternal health in rural China

Background and context Since the economic reforms of 1978, China has been acclaimed as a remarkable economy, achieving 9% annual growth per head for more than 25 years. However, China's health sector has not fared well. The population health gains slowed down and health disparities increased. In the field of health and health care, significant progress in maternal care has been achieved. However, there still remain important disparities between the urban and rural areas and among the rural areas in terms of economic development. The excess female infant deaths and the rapidly increasing sex ratio at birth in the last decade aroused serious concerns among policy makers and scholars. Decentralization of the government administration and health sector reform impacts maternal care. Many studies using census data have been conducted to explore the determinants of a high sex ratio at birth, but no agreement has been so far reached on the possible contributing factors. No study using family planning system data has been conducted to explore perinatal mortality and sex ratio at birth and only few studies have examined the impact of the decentralization of government and health sector reforms on the provision and organization of maternal care in rural China. Objectives The general objective of this study was to investigate the state of perinatal health and maternal care and their determinants in rural China under the historic context of major socioeconomic reforms and the one child family planning policy. The specific objectives of the study included: 1) to study pregnancy outcomes and perinatal health and their correlates in a rural Chinese county; 2) to examine the issue of sex ratio at birth and its determinants in a rural Chinese county; 3) to explore the patterns of provision, utilization, and content of maternal care in a rural Chinese county; 4) to investigate the changes in the use of maternal care in China from 1991 to 2003. Materials and Methods This study is based on a project for evaluating the prenatal care programme in Dingyuan county in 1999-2003, Anhui province, China and a nationwide household health survey to describe the changes in maternal care utilization. The approaches used included a retrospective cohort study, cross sectional interview surveys, informant interviews, observations and the use of statistical data. The data sources included the following: 1) A cohort of pregnant women followed from pregnancy up to 7 days after birth in 20 townships in the study county, collecting information on pregnancy outcomes using family planning records; 2) A questionnaire interview survey given to women who gave birth between 2001 and 2003; 3) Various statistical and informant surveys data collected from the study county; 4) Three national household health interview survey data sets (1993-2003) were utilized, and reanalyzed to described the changes in maternity care utilization. Relative risks (RR) and their confidence intervals (CI) were calculated for comparison between parity, approval status, infant sex and township groups. The chi-square test was used to analyse the disparity of use of maternal care between and within urban and rural areas and its trend across the years in China. Logistic regression was used to analyse the factors associated with hospital delivery in rural areas. Results There were 3697 pregnancies in the study cohort, resulting in 3092 live births in a total population of 299463 in the 20 study townships during 1999-2000. The average age at pregnancy in the cohort was 25.9 years. Of the women, 61% were childless, 38% already had one child and 0.3% had two children before the current pregnancy. About 90% of approved pregnancies ended in a live birth while 73% of the unapproved ones were aborted. The perinatal mortality rate was 69 per thousand births. If the 30 induced abortions in which the gestational age was more than 28 weeks had been counted as perinatal deaths, the perinatal mortality rate would have been as high as 78 per thousand. The perinatal mortality rate was negatively associated with the wealth of the township. Approximately two thirds of the perinatal deaths occurred in the early neonatal period. Both the still birth rate and the early neonatal death rate increased with parity. The risk of a stillbirth in a second pregnancy was almost four times that for a first pregnancy, while the risk of early neonatal deaths doubled. The early neonatal mortality rate was twice as high for female as for male infants. The sex difference in the early neonatal mortality rate was mainly attributable to mortality in second births. The male early neonatal mortality rate was not affected by parity, while the female early neonatal mortality rate increased dramatically with parity: it was about six times higher for second births than for first births. About 82% early neonatal deaths happened within 24 hours after birth, and during that time, girls were almost three times more likely to die than boys. The death rate of females on the day of birth increased much more sharply with parity than that of males. The total sex ratio at birth of 3697 registered pregnancies was 152 males to 100 females, with 118 and 287 in first and second pregnancies, respectively. Among unapproved pregnancies, there were almost 5 live-born boys for each girl. Most prenatal and delivery care was to be taken care of in township hospitals. At the village level, there were small private clinics. There was no limitation period for the provision of prenatal and postnatal care by private practitioners. They were not permitted to provide delivery care by the county health bureau, but as some 12% of all births occurred either at home or at private clinics; some village health workers might have been involved. The county level hospitals served as the referral centers for the township hospitals in the county. However, there was no formal regulation or guideline on how the referral system should work. Whether or not a woman was referred to a higher level hospital depended on the individual midwife's professional judgment and on the clients' compliance. The county health bureau had little power over township hospitals, because township hospitals had in the decentralization process become directly accountable to the township government. In the township and county hospitals only 10-20% of the recurrent costs were funded by local government (the township hospital was funded by the township government and the county hospital was funded by the county government) and the hospitals collected user fees to balance their budgets. Also the staff salaries depended on fee incomes by the hospital. The hospitals could define the user charges themselves. Prenatal care consultations were however free in most township hospitals. None of the midwives made postnatal home visits, because of low profit of these services. The three national household health survey data showed that the proportion of women receiving their first prenatal visit within 12 weeks increased greatly from the early to middle 1990s in all areas except for large cities. The increase was much larger in the rural areas, reducing the urban-rural difference from more than 4 times to about 1.4 times. The proportion of women that received antenatal care visits meeting the Ministry of Health s standard (at least 5 times) in the rural areas increased sharply from 12% in 1991-1993 to 36% in 2001-2003. In rural areas, the proportion increase was much faster in less developed areas than in developed areas. The hospital delivery rate increased slightly from 90% to 94% in urban areas while the proportion increased from 27% to 69% in rural areas. The fastest change was found to be in type 4 rural areas, where the utilization even quadrupled. The overall difference between rural and urban areas was substantially narrowed over the period. Multiple logistic regression analysis shows that time periods, residency in rural or urban areas, income levels, age group, education levels, delivery history, occupation, health insurance and distance from the nearest health care facilities were significantly associated with hospital delivery rates. Conclusions 1. Perinatal mortality in this study was much higher than that for urban areas as well as any reported rate from specific studies in rural areas of China. Previous studies in which calculations of infant mortality were not based on epidemiological surveys have been shown to underestimate the rates by more than 50%. 2. Routine statistics collected by the Chinese family planning system proved to be a reliable data source for studying perinatal health, including still births, neonatal deaths, sex ratio at birth and among newborns. National Household Health Survey data proved to be a useful and reliable data source for studying population health and health services. Prior to this research there were few studies in these areas available to international audiences. 3.Though perinatal mortality rate was negatively associated with the level of township economic development, the excess female early neonatal mortality rate contributed much more to high perinatal mortality rate than economic factors. This was likely a result of the role of the family planning policy and the traditional preferences for sons, which leads to lethal neglect of female newborns and high perinatal mortality. 4. The selective abortions of female foetuses were likely to contribute most to the high sex ratio at birth. The underreporting of female births seemed to have played a secondary role. The higher early neonatal mortality rate in second-born as compared to first-born children, particularly in females, may indicate that neglect or poorer care of female newborn infants also contributes to the high sex ratio at birth or among newborns. Existing family planning policy proved not to effectively control the steadily increased birth sex ratio. 5. The rural-urban gap in service utilization was on average significantly narrowed in terms of maternal healthcare in China from 1991 to 2003. This demonstrates that significant achievements in reducing inequities can be made through a combination of socio-economic development and targeted investments in improving health services, including infrastructure, staff capacities, and subsidies to reduce the costs of service utilization for the poorest. However, the huge gap which persisted among cities of different size and within different types of rural areas indicated the need for further efforts to support the poorest areas. 6. Hospital delivery care in the study county was better accepted by women because most of women think delivery care was very important while prenatal and postnatal care were not. Hospital delivery care was more systematically provided and promoted than prenatal and postnatal care by township hospital in the study area. The reliance of hospital staff income on user fees gave the hospitals an incentive to put more emphasis on revenue generating activities such as delivery care instead of prenatal and postnatal care, since delivery care generated much profits than prenatal and postnatal care . Recommendations 1. It is essential for the central government to re-assess and modify existing family planning policies. In order to keep national sex balance, the existing practice of one couple one child in urban areas and at-least-one-son a couple in rural areas should be gradually changed to a two-children-a-couple policy throughout the country. The government should establish a favourable social security policy for couples, especially for rural couples who have only daughters, with particular emphasis on their pension and medical care insurance, combined with an educational campaign for equal rights for boys and girls in society. 2. There is currently no routine vital-statistics registration system in rural China. Using the findings of this study, the central government could set up a routine vital-statistics registration system using family planning routine work records, which could be used by policy makers and researchers. 3. It is possible for the central and provincial government to invest more in the less developed and poor rural areas to increase the access of pregnant women in these areas to maternal care services. Central government together with local government should gradually provide free maternal care including prenatal and postnatal as well as delivery care to the women in poor and less developed rural areas. 4. Future research could be done to explore if county and the township level health care sector and the family planning system could be merged to increase the effectiveness and efficiency of maternal and child care. 5. Future research could be done to explore the relative contribution of maternal care, economic development and family planning policy on perinatal and child health using prospective cohort studies and community based randomized trials. Key words: perinatal health, perinatal mortality, stillbirth, neonatal death, sex selective abortion, sex ratio at birth, family planning, son preference, maternal care, prenatal care, postnatal care, equity, China

Paradigms in Statistical Inference for Finite Populations; Up to the 1950s

Modern sample surveys started to spread after statistician at the U.S. Bureau of the Census in the 1940s had developed a sampling design for the Current Population Survey (CPS). A significant factor was also that digital computers became available for statisticians. In the beginning of 1950s, the theory was documented in textbooks on survey sampling. This thesis is about the development of the statistical inference for sample surveys. For the first time the idea of statistical inference was enunciated by a French scientist, P. S. Laplace. In 1781, he published a plan for a partial investigation in which he determined the sample size needed to reach the desired accuracy in estimation. The plan was based on Laplace s Principle of Inverse Probability and on his derivation of the Central Limit Theorem. They were published in a memoir in 1774 which is one of the origins of statistical inference. Laplace s inference model was based on Bernoulli trials and binominal probabilities. He assumed that populations were changing constantly. It was depicted by assuming a priori distributions for parameters. Laplace s inference model dominated statistical thinking for a century. Sample selection in Laplace s investigations was purposive. In 1894 in the International Statistical Institute meeting, Norwegian Anders Kiaer presented the idea of the Representative Method to draw samples. Its idea was that the sample would be a miniature of the population. It is still prevailing. The virtues of random sampling were known but practical problems of sample selection and data collection hindered its use. Arhtur Bowley realized the potentials of Kiaer s method and in the beginning of the 20th century carried out several surveys in the UK. He also developed the theory of statistical inference for finite populations. It was based on Laplace s inference model. R. A. Fisher contributions in the 1920 s constitute a watershed in the statistical science He revolutionized the theory of statistics. In addition, he introduced a new statistical inference model which is still the prevailing paradigm. The essential idea is to draw repeatedly samples from the same population and the assumption that population parameters are constants. Fisher s theory did not include a priori probabilities. Jerzy Neyman adopted Fisher s inference model and applied it to finite populations with the difference that Neyman s inference model does not include any assumptions of the distributions of the study variables. Applying Fisher s fiducial argument he developed the theory for confidence intervals. Neyman s last contribution to survey sampling presented a theory for double sampling. This gave the central idea for statisticians at the U.S. Census Bureau to develop the complex survey design for the CPS. Important criterion was to have a method in which the costs of data collection were acceptable, and which provided approximately equal interviewer workloads, besides sufficient accuracy in estimation.

Hintakartelli toistettuna pelinä: teoriasta pääkaupunkiseudun bensiinin vähittäismyyntimarkkinoille

Tutkielman tarkoituksena oli soveltaa toistetun pelin teoria- ja empiriapohjaa suomalaiseen tutkimusaineistoon. Kartellin toimintadynamiikka on mallinnettu peliteorian osa-alueen, toistetun pelin kentäksi. Toistetussa pelissä samaa, kerran pelattua peliä pelataan useita kierroksia. Äärettömästi toistetusta pelistä muodostuu toistetun pelin yleinen teoria (The Folk Theorem), jossa jokaisella pelaajalla on yksilöllisesti rationaalinen käytössykli. Toisen pelaajan kanssa tehty yhteistyö kasvattaa pelaajan käytössykliltä kertyvää kokonaishyötyä. Kartellitutkimuksessa ei voi ohittaa oikeustieteellistä näkökulmaa, joten sekin on tiivistetysti mukana esityksessä. Äänettömässä tai implisiittisessä kartellissa ( tacit collusion ) ei avoimen kartellin tavoin ole osapuolten välistä kommunikointia, mutta sen lopputulos on sama. Tästä syystä äänetön kartelli on yhdenmukaistettuna käytöksenä kielletty. Koska myös tunnusmerkit ovat osin samat, kartellitutkimus on saanut arvokasta mittausaineistoa paljastuneiden kartellien käytöksestä. Pelkkään hintatiedostoonkin perustuvalla tutkimuksella on vankka teoreettinen ja empiirinen pohja. Oikeuskirjallisuudessa ja käytännössä hintayhteneväisyyden on yhdessä muiden tunnusmerkkien kanssa katsottu olevan indisio kartellista. Bensiinin vähittäismyyntimarkkinat ovat rakenteellisesti otollinen kenttä toistetulle pelille. Tutkielman empiirisessä osuudessa kohteena olivat pääkaupunkiseudun bensiinin vähittäismyyntimarkkinat ja tiedosto sisälsi otoksia hinta-aikasarjoista ajalta 1.8.2004 - 30.6.2005 kaikkiaan 116:ltä jakeluasemalta Espoosta, Helsingistä ja Vantaalta. Tutkimusmenetelmänä oli toistettujen mittausten varianssianalyysi post hoc-vertailuin. Tilastollisesti merkitsevä hinnoitteluyhtenevyys lähellä sijaitsevien asemien kesken löytyi 47 asemalta, ja näin ollen näillä asemilla on yksi kartellin tunnusmerkeistä. Hinnoitteluyhtenevyyden omaavat asemat muodostivat liikenneyhteyksien mukaan jaetuilla kilpailualueillaan ryhmittymiä ja kaikkiaan tällaisia yhtenevästi hinnoittelevia ryhmittymiä oli 21. Näistä ryhmittymistä 9 oli ns. sekapareja eli osapuolina olivat kylmäasema ja liikenneasema. Useimmissa tapauksissa oli kyseessä alueensa kalleimmin hinnoitteleva kylmäasema. Tutkielman tärkeimmät lähteet: Abrantes-Metz, Rosa M. – Froeb, Luke M. – Geweke, John F. – Taylor, Cristopher T. (2005): A Variance screen for collusion. Working paper no. 275, Bureau of economics, Federal Trade Commission, Washington DC 20580. Dutta, Prajit K. (1999): Strategies and Games, Theory and Practice. The MIT Press, Cambridge, Massachusetts, London, England. Harrington, Joseph E. (2004): Detecting cartels. Working paper. John Hopkins University. Ivaldi, Marc – Jullien, Bruno – Rey, Patric – Seabright, Paul – Tirole, Jean (2003): The Economics of Tacit Collusion. EU:n komission kilpailun pääosaston julkaisu. Phlips, Louis (1996): On the detection of collusion and predation. European Economic Review 40 (1996), 495–510.

Desorptio/fotoionisaatio ilmanpaineessa takavarikoitujen huumausaineiden, steroidien ja räjähdysaineiden tutkimuksessa

Tutkimuksen tarkoituksena oli selvittää desorptio/fotoionisaatio ilmanpaineessa tekniikan (engl. desorption atmospheric pressure photoionization, DAPPI) soveltuvuutta rikosteknisen laboratorion näytteiden analysointiin. DAPPI on nopea massaspektrometrinen ionisaatiotekniikka, jolla voidaan tutkia yhdisteitä suoraan erilaisilta pinnoilta. DAPPI:ssa käytetään lämmitettyä mikrosirua, joka suihkuttaa höyrystynyttä liuotin- ja kaasuvirtausta kohti näytettä. Näytteen pinnan komponentit desorboituvat lämmön vaikutuksesta, jonka jälkeen ionisoituminen tapahtuu VUV-lampun emittoimien fotonien avulla.DAPPI:lla tutkittiin takavarikoituja huumausaineita, anabolisia steroideja ja räjähdysaineita sekä niiden jäämiä erilaisilta pinnoilta. Lisäksi kartoitettiin DAPPI:n mahdollisuuksia ja rajoituksia erilaisille näytematriiseille ilman näytteiden esikäsittelyä. Takavarikoitujen huumausaineiden tutkimuksessa analysoitiin erilaisia tabletteja, jauheita, kasvirouheita, huumekasveja (khat, oopium, kannabis) ja sieniä. Anabolisia steroideja tunnistettiin tableteista sekä ampulleista, jotka sisälsivät öljymäistä nestettä. Jauheet ripoteltiin kaksipuoliselle teipille ja analysoitiin siltä. Muut näytteet analysoitiin sellaisenaan ilman minkäänlaista esikäsittelyä, paitsi nestemäisten näytteiden kohdalla näyte pipetoitiin talouspaperille, joka analysoitiin DAPPI:lla. DAPPI osoittautui nopeaksi ja yksinkertaiseksi menetelmäksi takavarikoitujen huumausaineiden ja steroidien analysoimisessa. Se soveltui hyvin rikoslaboratorion erityyppisten näytteiden rutiiniseulontaan ja helpotti erityisesti huumekasvien ja öljymäisten steroidiliuosten tutkimusta. Massaspektrometrin likaantuminen pystyttiin ehkäisemään säätämällä näytteen etäisyyttä sen suuaukosta. Likaantumista ei havaittu huolimatta näytteiden korkeista konsentraatioista ja useita kuukausia jatkuneista mittauksista. Räjähdysaineiden tutkimuksessa keskityttiin seitsemän eri räjähdysaineen DAPPI-MS-menetelmän kehitykseen; trinitrotolueeni (TNT), nitroglykoli (NK), nitroglyseriini (NG), pentriitti (PETN), heksogeeni (RDX), oktogeeni (HMX) ja pikriinihappoä Nämä orgaaniset räjähteet ovat nitraattiyhdisteitä, jotka voidaan jakaa rakenteen puolesta nitroamiineihin (RDX ja HMX), nitroaromaatteihin (TNT ja pikriinihappo) sekä nitraattiestereihin (PETN, NG ja NK). Menetelmäkehityksessä räjähdysainelaimennokset pipetoitiin polymetyylimetakrylaatin (PMMA) päälle ja analysoitiin siitä. DAPPI:lla tutkittiin myäs autenttisia räjähdysainejäämiä erilaisista matriiseista. DAPPI:lla optimoitiin jokaiselle räjähdysaineelle sopiva menetelmä ja yhdisteet saatiin näkymään puhdasaineina. Räjähdysainejäämien analysoiminen erilaisista rikospaikkamateriaaleista osoittautui haastavammaksi tehtäväksi, koska matriisit aiheuttivat itsessään korkean taustan spektriin, josta räjähdysaineiden piikit eivät useimmiten erottuneet tarpeeksi. Muut desorptioionisaatiotekniikat saattavat soveltua paremmin haastavien räjähdysainejäämien havaitsemiseksi.