In the Shadow of Freedom : Life on board the oil tanker

The aim of this study was to look at the freedom of ordinary people as they construct it. The scope, however, was limited to contemporary Finnish sailors and their freedom discourses. The study belongs to the field of the anthropology of religions, which is part of comparative religion. Worldview, which is one of the key concepts in comparative religion, provided the broader theoretical basis of the study. The data consisted of 92 interviews with Finnish professional seafarers conducted in 1996, 1999, 2000 and 2005, field journals that were written during two periods of fieldwork in 1996 and 1999-2000, and correspondence with some of the seafarers during 1999-2005. The analysis process incorporated new rhetoric and metaphor theory. The thesis is in three parts. The first part discusses the methodological challenges of this type of ethnography, the second an ethnography of modern Finnish shipworld focuses on work, organization, hierarchy and gender, and the third part discusses the freedom concepts of seafarers. It was found that seafarers use two kinds of freedom discourse. The first is in line with the stereotypical Jack Tar, a free-roving sailor who is not bound to land and its mundane routines, and the second views shipworld as freedom from freedom, meaning one is not responsible for one s own actions because one is not free to make a choice. It was also found that seafarers are well aware of the stereotypical images that are attached to their profession: they not only deny them, but also utilize, reflect on and construct them.

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.

Other Side of This Life : Death, Value, and Social Being in Thomas Pynchon's Fiction

This dissertation analyzes the interrelationship between death, the conditions of (wo)man s social being, and the notion of value as it emerges in the fiction of the American novelist Thomas Pynchon (1937 ). Pynchon s present work includes six novels V. (1963), The Crying of Lot 49 (1966), Gravity s Rainbow (1973), Vineland (1990), Mason & Dixon (1997), Against the Day (2006) and several short stories. Death constitues a central thematic in Pynchon s work, and it emerges through recurrent questions of mortality, suicide, mass destruction, sacrifice, afterlife, entropy, the relationship between the animate and the inanimate, and the limits of representation. In Pynchon, death is never a mere biological given (or event); it is always determined within a certain historical, cultural, and ideological context. Throughout his work, Pynchon questions the strict ontological separation of life and death by showing the relationship between this separation and social power. Conceptual divisions also reflect the relationship between society and its others, and death becomes that through which lines of social demarcation are articulated. Determined as a conceptual and social "other side", death in Pynchon forms a challenge to modern culture, and makes an unexpected return: the dead return to haunt the living, the inanimate and the animate fuse, and technoscientific attempts at overcoming and controlling death result in its re-emergence in mass destruction and ecological damage. The questioning of the ontological line also affects the structuration of Pynchon's prose, where the recurrent narrated and narrative desire to reach the limits of representation is openly associated with death. Textualized, death appears in Pynchon's writing as a sudden rupture within the textual functioning, when the "other side", that is, the bare materiality of the signifier is foregrounded. In this study, Pynchon s cultural criticism and his poetics come together, and I analyze the subversive role of death in his fiction through Jean Baudrillard s genealogy of the modern notion of death from L échange symbolique et la mort (1976). Baudrillard sees an intrinsic bond between the social repression of death in modernity and the emergence of modern political economy, and in his analysis economy and language appear as parallel systems for generating value (exchange value/ sign-value). For Baudrillard, the modern notion of death as negativity in relation to the positivity of life, and the fact that death cannot be given a proper meaning, betray an antagonistic relation between death and the notion of value. As a mode of negativity (that is, non-value), death becomes a moment of rupture in relation to value-based thinking in short, rationalism. Through this rupture emerges a form of thinking Baudrillard labels the symbolic, characterized by ambivalence and the subversion of conceptual opposites.

Temporal acuity in developmental dyslexia across the life span : Tactile, auditory, visual, and crossmodal estimations

Taustaa Kehityksellinen dysleksia (lukivaikeus) on erityinen lukemaan oppimisen vaikeus, johon liittyy usein myös vaikeuksia kirjoittamaan oppimisessa. Lukivaikeuden oletetaan useissa tapauksissa johtuvan vaikeudesta käsitellä kielen äännerakenteita (fonologinen prosessointi). Tämä poikkeavuus voi olla joko lukivaikeuden perimmäinen syy tai vaihtoehtoisesti ongelmat äänteiden käsittelyssä voivat heijastaa jotain vielä perustavamman tason vaikeutta. Eräs tällainen ehdotettu perustavan tasoin syy on poikkeavuus aistien toiminnoissa, erityisesti aistien aikatarkkuudessa. Aikatarkkuudella tarkoitetaan kykyä ja rajoja siinä, kuinka nopeasti esitettyä aistitiedon virtaa henkilö kykenee vastaanottamaan ja käsittelemään. Monet arjen toiminnot lukemisen rinnalla edellyttävät aistien erittäin tarkkaa ajallista erottelukykyä (esimerkiksi kuulo puheen ymmärtämisessä, tunto pintamateriaalin tunnistamisessa). Aikatarkkuusvaikeuksien esiintyvyyttä lukivaikeudessa on tutkittu aiemminkin, mutta yksimielisyyteen ei ole päästy siitä, onko kaikilla lukivaikeuksisilla näitä ongelmia tai mihin aisteihin vaikeudet mahdollisesti rajoittuvat. Myöskään ei tiedetä, havaitaanko aikatarkkuuden ongelmia kaiken ikäisillä lukivaikeuksisilla vai vaihteleeko mahdollinen ongelmien kuva iän mukana. Lisäksi on epäselvää, kuinka aikatarkkuuden ongelmat itseasiassa ovat yhteydessä kielen käsittelyn ja varsinaisen lukemisen vaikeuksiin. Tutkimussarjan aihe Tässä tutkimussarjassa aikatarkkuutta tutkittiin kolmessa yksittäisessä aistissa, joita olivat tunto, näkö ja kuulo, sekä kolmessa aistien välisessä yhdistelmässä, joita olivat audiotaktiilinen (kuulo-tunto), visuotaktiilinen (näkö-tunto) ja audiovisuaalinen (näkö-kuulo). Aikatarkkuutta arvioitiin kahdella eri menetelmällä, jotta saataisiin lisää tietoa siitä, missä tietyssä aikatarkkuuden osa-alueessa lukivaikeuksisilla mahdollisesti on vaikeuksia. Ensimmäisessä tehtävässä tutkittavan tuli arvioida, ovatko esitetyt ei-kielelliset ärsykkeet samanaikaisia vai eriaikaisia. Toisessa tehtävässä koehenkilön tuli arvioida esitettyjen ei-kielellisten ärsykkeiden esitysjärjestys. Molemmissa tehtävissä määriteltiin millisekuntitasolla (sekunnin tuhannesosa) se esitysnopeus, jolla koehenkilö kykeni arvioimaan ärsykkeiden ajalliset suhteet oikein. Englanninkielinen demonstraatio aikatarkkuustehtävistä löytyy internetistä (http://www.helsinki.fi/hum/ylpsy/neuropsy). Itse aikatarkkuustehtävien lisäksi tutkimussarjassa arvioitiin tutkimushenkilöiden päättelykykyä, kielellisiä toimintoja ja lukemista. Tutkimushenkilöt Tutkimuksiin osallistui 53 lukivaikeuksista ja 66 sujuvaa lukijaa, jotka oli jaettu kolmeen pääikäryhmään: lapset (8-12 vuotta), nuoret aikuiset (20-36 vuotta) ja ikääntyneemmät aikuiset (20-59 vuotta). Ikääntyneempien aikuisten ryhmä oli edelleen jaettu ikävuosikymmenluokkiin, mikä mahdollisti sen tutkimisen, vaikuttaako lisääntyvä aikuisikä lukivaikeuksisten aikatarkkuuteen (20-29, 30-39, 40-49 ja 50-59 -vuotiaat). Tutkimussarjan tulokset Aikatarkkuuden ongelmat lukivaikeuksisilla olivat yleistyneitä yli iän, aistien ja tehtävien Lukivaikeuksiset kaikissa pääikäryhmissä (lapset, nuoret aikuiset, ikääntyneemmän aikuiset) tarvitsivat samanikäisiä sujuvia lukijoita hitaamman esitystahdin, jotta he kykenivät arvioimaan ei-kielellisten ärsykkeiden ajallisen esitystavan oikein. Tämä aikatarkkuuden ongelma havaittiin lukivaikeuksisilla kaikissa aisteissa (tunto, kuulo, näkö) ja niiden yhdistelmissä (audiotaktiilinen, visuotaktiilinen, audiovisuaalinen). Lukivaikeuksisten aikatarkkuusongelmat ilmenivät edelleen molemmissa tehtävätyypeissä (samanaikaisuuden ja järjestyksen arvioinnissa). Aikatarkkuus ja sen ongelmat olivat yhteydessä äänteiden käsittelyyn Aikatarkkuus oli yhteydessä äänteiden käsittelykykyyn (fonologiseen prosessointiin), niin lapsilla kuin aikuisillakin, kaikissa aisteissa, niiden yhdistelmissä ja tehtävätyypeissä. Yhteys ei-kielellisen aikatarkkuuden ja kielellisten toimintojen välillä oli kuitenkin selkeämpi lukivaikeuksisilla kuin sujuvilla lukijoilla. Tämä tarkoittaa, että etenkin lukivaikeuksisilla ryhmätason huono aikatarkkuus oli yhteydessä huonoon äänteiden käsittelyyn (fonologiseen prosessointiin) ja päinvastoin. Suoraa yhteyttä lukemisen ja aikatarkkuuden välillä ei kuitenkaan havaittu. Lisääntyvä aikuisikä heikensi lukivaikeuksisten aikatarkkuutta suhteettoman paljon Tiedonkäsittelyn nopeuden on toistuvasti osoitettu hidastuvan normaalissa ikääntymisessä. Lisääntyvä aikuisikä (20-59 -vuotiailla) heikensikin sekä sujuvien että lukivaikeuksisten aikatarkkuutta. Toisin sanoen, mitä iäkkäämmästä aikuisesta oli kysymys, sitä hitaammin hänelle tuli esittää ärsykkeet, jotta hän kykeni arvioimaan niiden ajalliset suhteet oikein. Tämä ikään liittyvä tavanomainen hidastuminen oli kuitenkin yllättäen suhteettoman nopeaa lukivaikeuksisilla. Toisin sanoen, jo nuorilla lukivaikeuksisilla havaittu aikatarkkuuden vaikeus (ryhmäero verrattuna sujuviin lukijoihin) ei pysynyt saman suuruisena, vaan ryhmien ero kasvoi aikuisiän lisääntyessä. Tulosten merkitys Lukivaikeuden osoitettiin tässä tutkimussarjassa olevan yhteydessä yleistyneeseen vaikeuteen käsitellä ajassa nopeasti muuttuvaa ei-kielellistä aistitietoa (yli aistien ja niiden yhdistelmien, tehtävätyyppien, tutkittavien iän). Tämä osoittaa, että lukivaikeus ei ole ongelma, joka rajoittuu vain kielellisen materiaalin käsittelyn vaikeuksiin (äänteiden käsittely, lukeminen, kirjoittaminen). Nyt havaitut vaikeudet eivät myöskään rajoittuneet vain niihin aisteihin, jotka selkeimmin liittyvät lukemiseen (näkö) ja puhuttuun kieleen (kuulo); Ongelmia esiintyi myös muissa aisteissa (tunto). Lukivaikeuksisten lukijoiden ryhmätasolla havaittu aikatarkkuuden ongelma ei kuitenkaan heijastunut yksilötasolle; Jokainen lukivaikeuksinen ei ollut huono aikatarkkuustehtävissä. Näin ollen ei siis voida väittää, että kaikkien lukivaikeuksisten äänteiden käsittelyn tai lukemaan oppimisen vaikeudet voisivat selittyä aistien toimintojen poikkeavuudella. Aikatarkkuuden ongelmat eivät olleet yhteydessä varsinaiseen lukemiseen. Sekä lukivaikeuksisilla lapsilla että aikuisilla todettiin kuitenkin selkeä yhteys aikatarkkuuden ongelmien ja lukemaan oppimisen keskeisen ennakkoehdon, fonologisen prosessoinnin, välillä. Saattaa siis olla, että synnynnäinen aistien toimintojen poikkeavuus vaikuttaa yksilön suoriutumiseen jo ennen varsinaista lukemaan oppimista, kun ne taidot kehittyvät (fonologinen prosessointi), joille myöhempi lukemaan oppiminen perustuu. Ikäännyttäessä havaittu lukivaikeuksisten suhteettoman nopea aikatarkkuuden heikkeneminen osoittaa, että lukivaikeus ei voi olla ongelma, joka koskee vain lapsuusikää, tai vaikeus, joka johtuu vain kehityksen viivästymästä joka kurottaisiin iän myötä umpeen. Tulosten ymmärtämiseksi onkin muistettava kaksi seikkaa. Lukivaikeus on ensinnäkin yhdistetty synnynnäisiin, pieniin, poikkeavuuksiin aivojen rakenteissa ja toiminnoissa. Toisaalta tavanomaiseen ikääntymiseen liittyy se, että aivot kykenevät yhä huonommin korjaamaan ja kiertämään (kompensoimaan) pieniä vaurioita. Tämän perusteella tutkimussarjan tuloksista voidaan päätellä, että lukivaikeuksisten jo synnynnäisesti heikentyneet aivojen kompensointimahdollisuudet eivät ole yhtä tehokkaita puskuroimaan ikääntymisen tavanomaisia vaikutuksia kuin sujuvilla lukijoilla. Yllättävää kuitenkin on, että tämä korostunut heikkeneminen havaittiin jo suhteellisen nuorilla, työikäisillä, lukivaikeuksisilla, ennen 60 ikävuotta. Samanlaista ikäännyttäessä korostuvaa vaikeutta ei lukivaikeuksilla kuitenkaan havaittu päättelyssä, kielellisissä toiminnoissa tai itse lukemisessa. Vaikuttaakin siis siltä, että ne toiminnot, joita on harjaannutettu aktiivisesti, eivät heikkene kasvavan aikuisiän myötä yhtä suhteettomasti. Alkuperäiset artikkelit Laasonen M, Tomma-Halme J, Lahti-Nuuttila P, Service E, and Virsu V (2000) Rate of information segregation in developmentally dyslexic children, Brain and Language, 75(1), 66-81. Laasonen M, Service E, and Virsu V (2001) Temporal order and processing acuity of visual, auditory, and tactile perception in developmentally dyslexic young adults, Cognitive, Affective, and Behavioral Neuroscience, 1(4), 394-410. Laasonen M, Service E, and Virsu V (2002) Crossmodal temporal order and processing acuity in developmentally dyslexic young adults, Brain and Language, 80(3), 340-354. Laasonen M, Lahti-Nuuttila P, and Virsu V (2002) Developmentally impaired processing speed decreases more than normally with age, NeuroReport, 13(9), 1111-1113.

Mielikuvat transformatiivisen oppimisen välineenä : Tutkimus mielikuvaoppimisesta luontevan esiintymistavan löytämiseksi

The research focus of this study is imagery-based learning aimed at discovering an authentic way of public speaking in the context of transformative learning. The experiences of the participants in this learning process were also a subject of study. This learning process consisted of both guided and independent imagery-based training techniques. Critical reflection plays an important role in transformative learning. Actions, and interpretations and assumptions guiding them, are recognised and subjected to critical reflection. The goal of the learning process is an authentic and wide meaning perspective. Imagery-based training benefits from the gap between the new and the old experience of public speaking, and this is utilised as an activating factor for learning. The study is qualitative, looking at the imagery learning process and its outcomes from the subjective viewpoint of the participants personal experience. The imagery training acted as an intervention in the process of learning authentic public performance. The number of participants in this study was ten, five men and five women from four different working backgrounds. There were 80 individual training sessions, each attended by one person. The author conducted the imagery-based training. For each participant the learning process took roughly nine months. The research data consisted in the answers to questions in writing, diary entries, interviews and researcher notes. The data gathered by these methods was compiled into a personal report for each participant. The learners perceived authentic public speaking performance at the end of the learning process as wider, more flexible and more genuine than at the start of the training. Authenticity was defined through an internal process of becoming aware instead of some external characteristics. The learners understood the process of imagery learning as training for public performance and as an opportunity to become familiar with one s own personal way of acting and with one s own attitudes. They also perceived it as a tool that enabled the observation of personal experiences from different points of view. The learners reflected on ways of acting related to public speaking as well as on contributing factors to performance anxiety during the imagery learning process. Towards the end of the learning process, even critical reflection took place. The learners were categorized into three groups according to differences in their learning processes: the participants, the actors and the critical reflectors. This grouping reflected the relative amount of transformation in their learning processes. The participants became aware of their actions and assumptions. They took part in guided training sessions only. Worries in private life also had some consequences to their training in imagery learning. Apart from than becoming more conscious, the learning process did not yield much difference to the public speaking experiences of the participants. The actors attended both guided imagery training sessions and did individual training on their own. They became aware of their assumptions and their ways of acting. The encounter of the new and the old way of acting stimulated their learning. The actors advanced towards their own goals or even achieved them. The critical reflectors recognised their own assumptions and ways of acting and started to reflect critically on their own attitudes, as well as external attitudes and interpretations. Their assumptions, interpretations and experiences of public performance started to change in a positive direction. The learning process of the critical reflectors was functioning as a transformative process. This learning process revealed old assumptions hindering learning and old ways of acting resulting from these assumptions, thus opening up an opportunity for critical reflection and transformation. Avainsanat Nyckelord imagery learning, imagery-based training, transformative learning, reflection, critical reflection, public speaking anxiety, authentic public performance

From a "Student" to a Lifelong "Consumer" : Constructions of Educability in Adult Students' Narrative Life Histories

The focus of this study was to examine the constructions of the educable subject of the lifelong learning (LLL) narrative in the narrative life histories of adult students at general upper secondary school for adults (GUSSA). In this study lifelong learning has been defined as a cultural narrative on education, “a system of political thinking” that is not internally consistent, but has contradictory themes embedded within it (Billig et al., 1988). As earlier research has shown and this study also confirms, the LLL narrative creates differences between those who are included and those who fall behind and are excluded from the learning society ideal. Educability expresses socially constructed interpretations on who benefit from education and who should be educated and how. The presupposition in this study has been that contradictions between the LLL narrative and the so-called traditional constructions of educability are likely to be constructed as the former relies on the all-inclusive interpretation of educability and the latter on the meritocratic model of educating individuals based on their innate abilities. The school system continues to uphold the institutionalized ethos of educability that ranks students into the categories “bright”, “mediocre”, and “poor” (Räty & Snellman, 1998) on the basis of their abilities, including gender-related differences as well as differences based on social class. Traditional age-related norms also persist, for example general upper secondary education is normatively completed in youth and not in adulthood, and the formal learning context continues to outweigh both non-formal and informal learning. Moreover, in this study the construction of social differences in relation to educability and, thereafter unequal access to education has been examined in relation to age, social class, and gender. The biographical work of the research participants forms a peephole that permits the examination of the dilemmatic nature of the constructions of educability in this study. Formal general upper secondary education in adulthood is situated on the border between the traditional and the LLL narratives on educability: participation in GUSSA inevitably means that one’s ability and competence as a student and learner becomes reassessed through the assessment criteria maintained by schools, whereas according to the principles of LLL everyone is educable; everyone is encouraged to learn throughout their lives regardless of age, social class, or gender. This study is situated in the field of adult education, sociology of education, and social psychological research on educability, having also been informed by feminist studies. Moreover, this study contributes to narrative life history research combining the structural analysis of narratives (Labov & Waletzky, 1997), i.e. mini-stories within life history, with the analysis of the life histories as structural and thematic wholes and the creation of coherence in them; thus, permitting both micro and macro analyses. On accounting for the discontinuity created by participation in general upper secondary school study in adulthood and not normatively in youth, the GUSSA students construct coherence in relation to their ability and competence as students and learners. The seven case studies illuminate the social differences constructed in relation to educability, i.e. social class, gender, age, and the “new category of student and learner”. In the data of this study, i.e. 20 general upper secondary school adult graduates’ narrative life histories primarily generated through interviews, two main coherence patterns of the adult educable subject emerge. The first performance-oriented pattern displays qualities that are closely related to the principles of LLL. Contrary to the principles of lifewide learning, however, the documentation of one’s competence through formal qualifications outweighs non-formal and informal learning in preparation for future change and the competition for further education, professional careers, and higher social positions. The second flexible learning pattern calls into question the status of formal, especially theoretical and academically oriented education; inner development is seen as more important than such external signs of development — grades and certificates. Studying and learning is constructed as a hobby and as a means to a more satisfactory life as opposed to a socially and culturally valued serious occupation leading to further education and career development. Consequently, as a curious, active, and independent learner, this educable but not readily employable subject is pushed into the periphery of lifelong learning. These two coherence patterns of the adult educable subject illuminate who is to be educated and how. The educable and readily employable LLL subject is to participate in formal education in order to achieve qualifications for working life, whereas the educable but not employable subject may utilize lifewide learning for her/his own pleasure. Key words: adult education, general upper secondary school for adults, educability, lifelong learning, narrative life history

Gone with the Wind? : Immigrant Women and Transnational Everyday Life in Finland

Increased mass migration, as a result of economic hardship, natural disasters and wars, forces many people to arrive on the shores of cultures very different from those they left. How do they manage the legacy of the past and the challenges of their new everyday life? This is a study of immigrant women living in transnational families that act and communicate across national borders on a near-daily basis. The research was carried out amongst immigrant women who were currently living in Finland. The research asks how transnational everyday life is constructed. As everyday life, due to its mundane nature, is difficult to operationalise for research purposes, mixed data collection methods were needed to capture the passing moments that easily become invisible. Thus, the data were obtained from photographic diaries (459 photographs) taken by the research participants themselves. Additionally, stimulated recall discussions, structured questionnaires and participant observation notes were used to complement the photographic data. A tool for analysing the activities devealed in the data was created on the assumption that a family is an active unit that accommodates the current situation in which it is embedded. Everyday life activities were analysed emphasizing social, modal and spatial dimensions. Important daily moments were placed on a continuum: for me , for immediate others and with immediate others . They portrayed everyday routines and exceptions to it. The data matrix was developed as part of this study. The spatial dimensions formed seven units of activity settings: space for friendship, food, resting, childhood, caring, space to learn and an orderly space. Attention was also paid to the accommodative nature of activities; how women maintain traditions and adapt to Finnish life or re-create new activity patterns. Women s narrations revealed the importance of everyday life. The transnational chain of women across generations and countries, comprised of the daughters, mothers and grandmothers was important. The women showed the need for information technology in their transnational lives. They had an active relationship to religion; the denial or importance of it was obvious. Also arranging one s life in Finnish society was central to their narrations. The analysis exposed everyday activities, showed the importance of social networks and the uniqueness of each woman and family. It revealed everyday life in a structured way. The method of analysis that evolved in this study together with the research findings are of potential use to professionals, allowing the targeting of interventions to improve the everyday lives of immigrants.

Routine Measurement of Health-Related Quality of Life in Assessing Cost-Effectiveness in Secondary Health Care

Aims: The aims of this study were 1) to identify and describe health economic studies that have used quality-adjusted life years (QALYs) based on actual measurements of patients' health-related quality of life (HRQoL); 2) to test the feasibility of routine collection of health-related quality of life (HRQoL) data as an indicator of effectiveness of secondary health care; and 3) to establish and compare the cost-utility of three large-volume surgical procedures in a real-world setting in the Helsinki University Central Hospital, a large referral hospital providing secondary and tertiary health-care services for a population of approximately 1.4 million. Patients and methods: So as to identify studies that have used QALYs as an outcome measure, a systematic search of the literature was performed using the Medline, Embase, CINAHL, SCI and Cochrane Library electronic databases. Initial screening of the identified articles involved two reviewers independently reading the abstracts; the full-text articles were also evaluated independently by two reviewers, with a third reviewer used in cases where the two reviewers could not agree a consensus on which articles should be included. The feasibility of routinely evaluating the cost-effectiveness of secondary health care was tested by setting up a system for collecting HRQoL data on approximately 4 900 patients' HRQoL before and after operative treatments performed in the hospital. The HRQoL data used as an indicator of treatment effectiveness was combined with diagnostic and financial indicators routinely collected in the hospital. To compare the cost-effectiveness of three surgical interventions, 712 patients admitted for routine operative treatment completed the 15D HRQoL questionnaire before and also 3-12 months after the operation. QALYs were calculated using the obtained utility data and expected remaining life years of the patients. Direct hospital costs were obtained from the clinical patient administration database of the hospital and a cost-utility analysis was performed from the perspective of the provider of secondary health care services. Main results: The systematic review (Study I) showed that although QALYs gained are considered an important measure of the effectiveness of health care, the number of studies in which QALYs are based on actual measurements of patients' HRQoL is still fairly limited. Of the reviewed full-text articles, only 70 reported QALYs based on actual before after measurements using a valid HRQoL instrument. Collection of simple cost-effectiveness data in secondary health care is feasible and could easily be expanded and performed on a routine basis (Study II). It allows meaningful comparisons between various treatments and provides a means for allocating limited health care resources. The cost per QALY gained was 2 770 for cervical operations and 1 740 for lumbar operations. In cases where surgery was delayed the cost per QALY was doubled (Study III). The cost per QALY ranges between subgroups in cataract surgery (Study IV). The cost per QALY gained was 5 130 for patients having both eyes operated on and 8 210 for patients with only one eye operated on during the 6-month follow-up. In patients whose first eye had been operated on previous to the study period, the mean HRQoL deteriorated after surgery, thus precluding the establishment of the cost per QALY. In arthroplasty patients (Study V) the mean cost per QALY gained in a one-year period was 6 710 for primary hip replacement, 52 270 for revision hip replacement, and 14 000 for primary knee replacement. Conclusions: Although the importance of cost-utility analyses has during recent years been stressed, there are only a limited number of studies in which the evaluation is based on patients own assessment of the treatment effectiveness. Most of the cost-effectiveness and cost-utility analyses are based on modeling that employs expert opinion regarding the outcome of treatment, not on patient-derived assessments. Routine collection of effectiveness information from patients entering treatment in secondary health care turned out to be easy enough and did not, for instance, require additional personnel on the wards in which the study was executed. The mean patient response rate was more than 70 %, suggesting that patients were happy to participate and appreciated the fact that the hospital showed an interest in their well-being even after the actual treatment episode had ended. Spinal surgery leads to a statistically significant and clinically important improvement in HRQoL. The cost per QALY gained was reasonable, at less than half of that observed for instance for hip replacement surgery. However, prolonged waiting for an operation approximately doubled the cost per QALY gained from the surgical intervention. The mean utility gain following routine cataract surgery in a real world setting was relatively small and confined mostly to patients who had had both eyes operated on. The cost of cataract surgery per QALY gained was higher than previously reported and was associated with considerable degree of uncertainty. Hip and knee replacement both improve HRQoL. The cost per QALY gained from knee replacement is two-fold compared to hip replacement. Cost-utility results from the three studied specialties showed that there is great variation in the cost-utility of surgical interventions performed in a real-world setting even when only common, widely accepted interventions are considered. However, the cost per QALY of all the studied interventions, except for revision hip arthroplasty, was well below 50 000, this figure being sometimes cited in the literature as a threshold level for the cost-effectiveness of an intervention. Based on the present study it may be concluded that routine evaluation of the cost-utility of secondary health care is feasible and produces information essential for a rational and balanced allocation of scarce health care resources.

Life events and social support among patients with major depressive disorder

The study is part of a research project of 269 psychiatric patients with major depression, Vantaa Depression Study, in the Department of Mental Health and Alcohol Research of the National Public Health Institute and the Department of Psychiatry of the Peijas Medical Care District. The aim was to study at the onset of MDE psychosocial differences in subgroups of patients and clustering of events into time before depression and its prodromal phase, to study whether more severe life events and less social support predict poorer outcome in all patients, but most among those currently in partial remission, whether social support declines as a consequence of time spent in MDE, is sensitive to improvement, and whether social support is influenced by neuroticism and extraversion. After screening, a semistructured interview (SCAN, version 2.0) was used for the presence of DSM-IV MDE, and other psychiatric diagnoses. Life events and social support were studied with semistructured methods (IRLE, Paykel 1983; IMSR, Brugha et al. 1987), perceived social support and neuroticism/extraversion with questionnaires (PSSS-R, Blumenthal et al. 1987; EPI, Eysenck and Eysenck 1964) at baseline, 6 and 18 months. At the onset of depression life events were common. No major differences between subgroups of patients were found; the younger had more events, whereas those with comorbid alcoholism and personality disorders perceived less support. Although events were distributed evenly between the time before depression, the prodromal phase and the index MDE, two thirds of the patients attributed their depression to some life event. Adversities and poor perceived support influenced the outcome of all psychiatric patients, most in the subgroup of full remission. In the partial remission group, the impact of severe events and in the MDE, perceived support was important. Low objective and subjective support were predicted by longer time spent in MDE. Along with improvement subjective support improved. Neuroticism and extraversion were associated with the size of social network and perceived support and predicted change of perceived support. In conclusion, adversities were common in all phases of depression. They may thus have many roles; before depression they may precipitate it, in the prodromal phase worsen symptoms, and during the MDE, the outcome of depression. Patients often attributed their depression to a life event. Psychosocial subgroup differences were quite small. Perceived support predicted the outcome of depression, and time spent in MDE objective and subjective support. Neuroticism and extraversion may modify the level and change particularly in perceived support, thereby indirectly effecting vulnerability to depression.

Microbial life and deposits in paper machine circuits

Väitöskirjani käsittele mikrobien ja erilaisten kemikaalien rooleja saostumien ja biofilmien muodostumisessa paperi- ja kartonkikoneilla. "Saostuma" tässä työssä tarkoittaa kiinteän aineen kertymää konepinnoille tai rajapinnoille konekierroissa, jotka on tarkoitettu massasulppujen, lietteiden, vesien tai ilman kuljetukseen. Saostumasta tulee "biofilmi" silloin kun sen oleellinen rakennekomponentti on mikrobisolut tai niiden tuotteet. Väitöstyöni työhypoteesina oli, että i. tietämys saostumien koostumuksesta, sekä ii. niiden rakenteesta, biologisista, fysikaalis-kemiallisista ja teknisistä ominaisuuksista ohjaavat tutkijaa löytämään ympäristöä säästäviä keinoja estää epätoivottujen saostumien muodostus tai purkaa jo muodostuneita saostumia. Selvittääkseni saostumien koostumista ja rakennetta käytin monia erilaisia analytiikan työkaluja, kuten elektronimikroskopiaa, konfokaali-laser mikroskopiaa (CLSM), energiadispersiivistä röntgenanalyysiä (EDX), pyrolyysi kaasukromatografiaa yhdistettynä massaspektrometriaan (Py-GCMS), joninvaihtokromatografiaa, kaasukromatografiaa ja mikrobiologisia analyysejä. Osallistuin aktiivisesti innovatiivisen, valon takaisinsirontaan perustuvan sensorin kehittämistyöhön, käytettäväksi biofilmin kasvun mittaukseen suoraan koneen vesikierroista ja säiliöistä. Työni osoitti, että monet paperinvalmistuksessa käytetyistä kemikaaleista reagoivat keskenään tuottaen orgaanisia tahmakerroksia konekiertojen teräspinnoille. Löysin myös kerrostumia, jotka valomikroskooppisessa tarkastelussa oli tulkittu mikrobeiksi, mutta jotka elektronimikroskopia paljasti alunasta syntyneiksi, alumiinihydroksidiksi joka saostui pH:ssa 6,8 kiertokuitua käyttävän koneen viiravesistä. Monet paperintekijät käyttävät vieläkin alunaa kiinnitysaineena vaikka prosessiolot ovat muuttuneet happamista neutraaleiksi. Sitä pidetään paperitekijän "aspiriinina", mutta väitöstutkimukseni osoitti sen riskit. Löysin myös orgaanisia saostumia, joiden alkuperä oli aineiden, kuten pihkan, saippuoituminen (kalsium saippuat) niin että muodostui tahmankasvua ylläpitävä alusta monilla paperi- ja kartonkikoneilla. Näin solumuodoiltaan Deinococcus geothermalista muistuttavia bakteereita kasvamassa lujasti teräskoepalojen pintaan kiinnittyneinä pesäkkeinä, kun koepaloja upotettiin paperikoneiden vesikiertoihin. Nämä deinokokkimaiset pesäkkeet voivat toimia jalustana, tarttumisalustana muiden mikrobien massoille, joka selittäisi miksi saostumat yleisesti sisältävät deinokokkeja pienenä, muttei koskaan pääasiallisena rakenneosana. Kun paperikoneiden käyttämien vesien (raakavedet, lämminvesi, biologisesti puhdistettu jätevesi) laatua tutkitaan, mittausmenetelmällä on suuri merkitys. Koepalan upotusmenetelmällä todettu biofilmikasvu ja viljelmenetelmällä mitattu bakteerisaastuneisuus korreloivat toisiinsa huonosti etenkin silloin kun likaantumisessa oli mukana rihmamaiseti kasvavia bakteereja. Huoli ympäristöstä on pakottanut paperi- ja kartonkikoneiden vesikiertojen sulkemiseen. Vesien kierrätys ja prosessivesien uudelleenkäyttö nostavat prosessilämpötilaa ja lisäävät koneella kiertävien kolloidisten ja liuenneiden aineiden määriä. Tutkin kiertovesien pitoisuuksia kolmessa eriasteisesti suljetussa tehtaassa, joiden päästöt olivat 0 m3, 0,5 m3 ja 4 m3 jätevettä tuotetonnia kohden, perustuen puhdistetun jäteveden uudelleen käyttöön. Nollapäästöisellä tehtaalla kiertovesiin kertyi paljon orgaanisesti sidottua hiiltä (> 10 g L-1), etenkin haihtuvina happoina (maito-, etikka-, propioni- ja voi-). Myös sulfaatteja, klorideja, natriumia ja kalsiumia kertyi paljon, > 1 g L-1 kutakin. Pääosa (>40%) kaikista bakteereista oli 16S rRNA geenisekvenssianalyysien tulosten perusteella sukua, joskin etäistä (< 96%) ainoastaan Enterococcus cecorum bakteerille. 4 m3 päästävältä tehtaalta löytyi lisäksi Bacillus thermoamylovorans ja Bacillus coagulans. Tehtaiden saostumat sisälsivät arkkeja suurina pitoisuuksina, ≥ 108 g-1, mutta tunnistukseen riittävää sekvenssisamanlaisuutta löytyi vain yhteen arkkisukuun, Methanothrix. Tutkimustulokset osoittivat että tehtaan vesikiertojen sulkeminen vähensi rajusti mikrobiston monimuotoisuutta, muttei estänyt liuenneen aineen ja kiintoaineen mineralisoitumista.