New aspects of the diagnosis of Helicobacter pylori infection

Aims: Helicobacter pylori infection, although the prevalence is declining in Western world, is still responsible for several clinically important diseases. None of the diagnostic tests is perfect and in this study, the performance of three stool antigen tests was assessed. In areas of high H. pylori prevalence, the definition of patients with the greatest benefit from eradication therapy may be a problem; the role of duodenal gastric metaplasia in categorizing patients at risk for duodenal ulcer was evaluated in this respect. Whether persistent chronic inflammation and elevated H. pylori antibodies after successful eradication are associated with each other or with atrophic gastritis, a long term sequelae of H. pylori infection, were also studied. Patients and methods: The three stool antigen tests were assessed in pre- and post-eradication settings among 364 subjects in two studies as compared to the rapid urease test (RUT), histology, culture, the 13C-urea breath test (UBT) and enzyme immunoassay (EIA) based H. pylori serology. The association between duodenal gastric metaplasia with duodenal ulcer was evaluated in a retrospective study including 1054 patients gastroscopied due to clinical indications and 154 patients previously operated for duodenal ulcer. The extent of duodenal gastric metaplasia was assessed from histological specimens in different patient groups formed on the basis of gastroscopy findings and H. pylori infection. Chronic gastric inflammation (108 patients) and H. pylori antibodies and serum markers for atrophy (77 patients) were assessed in patients earlier treated for H. pylori. Results: Of the stool antigen tests studied, the monoclonal antibody-based EIA-test showed the highest sensitivity and specificity both in the pre-treatment setting (96.9% and 95.9%) and after therapy (96.9% and 97.8%). The polyclonal stool antigen test and the in-office test had at baseline a sensitivity of 91% and 94%, and a specificity of 96% and 89%, respectively and in a post-treatment setting, a sensitivity of 78% and 91%, and a specificity of 97%, respectively. Duodenal gastric metaplasia was strongly associated with H. pylori positive duodenal ulcer (odds ratio 42). Although common still five years after eradication, persistent chronic gastric inflammation (21%) and elevated H. pylori antibodies (33%) were neither associated with each other nor with atrophic gastritis. Conclusions: Current H. pylori infection can feasibly be diagnosed by a monoclonal antibody-based EIA test with the accuracy comparable to that of reference methods. The performance of the polyclonal test as compared to the monoclonal test was inferior especially in the post-treatment setting. The in-office test had a low specificity for primary diagnosis and hence positive test results should probably be confirmed with another test before eradication therapy is prescribed. The presence of widespread duodenal gastric metaplasia showed promising results in detecting patients who should be treated for H. pylori due to an increased risk of duodenal ulcer. If serology is used later on in patients with earlier successfully treated for H. pylori, it should be taken into account that H. pylori antibodies may persist elevated for years for unknown reason. However, this phenomenon was not found to be associated with persistent chronic inflammation or atrophic changes.

HALLINNONTASOJEN V��LINEN DIALOGI JA ERITYISOPETUKSEN MUUTOS BYROKRAATTISENA INSTITUUTIONA : - Kymppikuntien loppuraportin ja Erityisopetuksen strategian sis��ll��nanalyyttinen vertailu

The rise of Special education numbers in Finland has caused a situation where Finland s ten largest LEA s so called kymppikunnat (ten communes) have expressed their growing concern of organizing the special education in the current institutional settings. The LEA s started the conversation of redefining special education system in 2004. Their aim was to target the governments attention to the problematics of special education. By the request of the Ministry of Education the LEA s prepared a final report concerning the central questions in the Finnish special education system. On the basis of the LEA s survey it became even clearer that the legislation, funding system and curriculum are tightly linked together. The following LEA s took part into the writing process Espoo, Helsinki, Jyv��skyl��, Kuopio, Lahti, Lappeenranta, Tampere, Turku and Vantaa. The report was hand over to the Ministry of Education at 18.8.2006. After the delivery the Ministry organized special education development group meetings 17 times in the year 2007. The result of the LEA s report and the development meetings was a new Special Education Strategy 2007. I am observing the dialogue between administrational levels in governmental institutions change process. The research is a content analysis where I compare the Erityist�� tukea tarvitsevan oppilaan opetuksen j��rjest��misen uudistaminen osana yhten��ist�� perusopetusta- kohti laatua ja joustavuutta (The renewal of the organization of teaching for student with special educational needs as part of unified education for all - towards quality and flexibility) document to Erityisopetuksen strategia (Special education strategy) document. My aim was to find out how much of their own interests have the LEA s been able to integrate into the official governmental documentation. The data has been organized and analyzed quantitatively with Macros created as additional parts in Microsoft Excel software. The document material has also been arranged manually on sentence based categorization into an Excel matrix. The results have been theoretically viewed from the special education reform dialogue perspective, and from the angle of the change process of a bureaucratic institution. My target has been to provide a new viewpoint to the change of special education system as a bureaucratic institution. The education system has traditionally been understood as a machine bureaucracy. By the review provided in my pro gradu analysis it seems however that the administrational system in special education is more of a postmodern network bureaucracy than machine bureaucracy. The system appears to be constructed by overlapping, crossing and complex networks where things are been decided. These kinds of networks are called "governance networks . It seems that the governmental administrational - and politic levels, the third sector actors and other society s operators are mixed in decision making.

Sairaanhoitajat ty��n imussa? Palkkaty��n sis��ll��n ja kulttuuristen l��ht��kohtien tasapainossa

Tutkimuksen tavoitteena on selvitt����, mik�� saa pitk��n ty��uran tehneet sairaanhoitajat innostumaan ty��st����n. Taustalla on yhteiskunnallinen tilanne, jossa ty��el��m��n vetovoimaisuuden lis����minen ja ik����ntyvien ty��ntekij��iden ty��ss�� jaksaminen ovat keskeisi�� poliittisia tavoitteita. Aihetta l��hestyt����n positiivisesta psykologiasta l��ht��isin olevan ty��n imun k��sitteen avulla. Se on m����ritelty pysyv��ksi, ���my��nteiseksi, tunne- ja motivaatiot��yttymyksen tilaksi, jota luonnehtivat tarmokkuus, omistautuminen ja uppoutuminen ty��h��n��� (Hakanen 2009a, 9). Tutkimuksessa kysyt����n, voidaanko ty��n imua ymm��rt���� my��s sosiologisesta n��k��kulmasta. Oletuksena on, ett�� k��sitteen taustalla on muutakin kuin psykologisesta perinteest�� k��sin j��sentyv���� vaihtelua. Empiirisen aineiston muodostavan 11 sairaanhoitajan koko ty��uraa ja nykyist�� ty��t�� koskevat tiettyihin teemoihin ankkuroidut syv��haastattelut. Otosta poimittaessa on etsitty sellaisia haastateltavia, jotka kokevat kantavansa ty��n imua. Aineiston analyysitapana on k��ytetty matriisin avulla sovellettua kvalitatiivista sis��ll��nanalyysi��. Ty��n imua hahmotetaan analyysiss�� henkil��historiallisten haastatteluiden ��� menneen, nykyisen ja tulevan ��� kautta. Pyrkimyksen�� on etsi�� tarinoita mahdollisesti yhdist��v���� kulttuurista muotoa ja ymm��rt����, mihin se perustuu. Analyysin nojalla vastuurationaalisuuden k��site (esim. Korvaj��rvi 1986) n��ytt��isi j��sent��v��n osan haastateltavien suhteesta ty��h��ns��. Avain ty��n imun l��ytymiseen n��iss�� tarinoissa on kuitenkin se, kuinka haastateltavilla on ollut henkil��kohtainen halu menn�� eteenp��in ja kyky�� ratkaista ongelmia ty��uransa aikana ja nykyisess�� ty��ss����n. T��m�� havainto tulkitaan Max Weberin (1922, 1980) k��sitteiden ��� arvorationaalisen ja p����m����r��rationaalisen toiminnan v��liseen suhteen ��� avulla. Tulokseksi syntyy oletus siit��, ett�� analyysin kohteena olevissa tarinoissa on kyse yhteisest�� kulttuurisesta tarinasta siit��, millainen on hyv�� ihminen, miten hyv�� ihminen toteuttaa itse����n ty��ss�� ja miten h��n tekee ty��t����n: tarmokkaasti, omistautuen ja uppoutuen. Henkil��kohtainen halu menn�� eteenp��in ja kyky ratkaista ongelmia nojaa sairaanhoitajien erityiseen eetokseen, kutsumusty��h��n ja hoivan moraaliin tavalla, joka on rakenteellisesti yht��l��inen protestanttisuutta leimaavan yksil��llisen jumalasuhteen kanssa. Lis��ksi analyysin perusteella esitet����n, ett�� ty��n imun edellytys on arvorationaalisen eetoksen lis��ksi oikeanlainen, riitt��v��t ty��n voimavarat sis��lt��v�� ymp��rist��, jossa hoitoty��n keskeiset palkinnot on mahdollista saavuttaa. T��ll��in palkkaty��n sis��lt�� kohtaa kulttuuriset l��ht��kohdat, ja tulos n��kyy ty��n imuna. Keskeisimm��t taustoittavat l��hteet ovat Henriksson, Lea & Wrede, Sirpa (toim.) (2004a). Hyvinvointity��n ammatit ja Hakanen, Jari (2009a). Ty��n imun arviointimenetelm�� (Utrecht Work Engagement Scale). Sosiologisen tulkinnan kannalta t��rkein teoreettinen l��hde on Weber, Max (1980): Protestanttinen etiikka ja kapitalismin henki.

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

Tieteellinen tiivistelm�� 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.

From trading to eCommunity management

"The increasing pressure for enterprises to join into agile business networks is changing the requirements on the enterprise computing systems. The supporting infrastructure is increasingly required to provide common facilities and societal infrastructure services to support the lifecycle of loosely-coupled, eContract-governed business networks. The required facilities include selection of those autonomously administered business services that the enterprises are prepared to provide and use, contract negotiations, and furthermore, monitoring of the contracted behaviour with potential for breach management. The essential change is in the requirement of a clear mapping between business-level concepts and the automation support for them. Our work has focused on developing B2B middleware to address the above challenges; however, the architecture is not feasible without management facilities for trust-aware decisions for entering business networks and interacting within them. This paper discusses how trust-based decisions are supported and positioned in the B2B middleware."

Safeguarding against new privacy threats in inter-enterprise collaboration environments

Inter-enterprise collaboration has become essential for the success of enterprises. As competition increasingly takes place between supply chains and networks of enterprises, there is a strategic business need to participate in multiple collaborations simultaneously. Collaborations based on an open market of autonomous actors set special requirements for computing facilities supporting the setup and management of these business networks of enterprises. Currently, the safeguards against privacy threats in collaborations crossing organizational borders are both insufficient and incompatible to the open market. A broader understanding is needed of the architecture of defense structures, and privacy threats must be detected not only on the level of a private person or enterprise, but on the community and ecosystem levels as well. Control measures must be automated wherever possible in order to keep the cost and effort of collaboration management reasonable. This article contributes to the understanding of the modern inter-enterprise collaboration environment and privacy threats in it, and presents the automated control measures required to ensure that actors in inter-enterprise collaborations behave correctly to preserve privacy.

Sairaanhoitajat ty��n imussa? Palkkaty��n sis��ll��n ja kulttuuristen l��ht��kohtien tasapainossa

Tutkimuksen tavoitteena on selvitt����, mik�� saa pitk��n ty��uran tehneet sairaanhoitajat innostumaan ty��st����n. Taustalla on yhteiskunnallinen tilanne, jossa ty��el��m��n vetovoimaisuuden lis����minen ja ik����ntyvien ty��ntekij��iden ty��ss�� jaksaminen ovat keskeisi�� poliittisia tavoitteita. Aihetta l��hestyt����n positiivisesta psykologiasta l��ht��isin olevan ty��n imun k��sitteen avulla. Se on m����ritelty pysyv��ksi, ���my��nteiseksi, tunne- ja motivaatiot��yttymyksen tilaksi, jota luonnehtivat tarmokkuus, omistautuminen ja uppoutuminen ty��h��n��� (Hakanen 2009a, 9). Tutkimuksessa kysyt����n, voidaanko ty��n imua ymm��rt���� my��s sosiologisesta n��k��kulmasta. Oletuksena on, ett�� k��sitteen taustalla on muutakin kuin psykologisesta perinteest�� k��sin j��sentyv���� vaihtelua. Empiirisen aineiston muodostavan 11 sairaanhoitajan koko ty��uraa ja nykyist�� ty��t�� koskevat tiettyihin teemoihin ankkuroidut syv��haastattelut. Otosta poimittaessa on etsitty sellaisia haastateltavia, jotka kokevat kantavansa ty��n imua. Aineiston analyysitapana on k��ytetty matriisin avulla sovellettua kvalitatiivista sis��ll��nanalyysi��. Ty��n imua hahmotetaan analyysiss�� henkil��historiallisten haastatteluiden ��� menneen, nykyisen ja tulevan ��� kautta. Pyrkimyksen�� on etsi�� tarinoita mahdollisesti yhdist��v���� kulttuurista muotoa ja ymm��rt����, mihin se perustuu. Analyysin nojalla vastuurationaalisuuden k��site (esim. Korvaj��rvi 1986) n��ytt��isi j��sent��v��n osan haastateltavien suhteesta ty��h��ns��. Avain ty��n imun l��ytymiseen n��iss�� tarinoissa on kuitenkin se, kuinka haastateltavilla on ollut henkil��kohtainen halu menn�� eteenp��in ja kyky�� ratkaista ongelmia ty��uransa aikana ja nykyisess�� ty��ss����n. T��m�� havainto tulkitaan Max Weberin (1922; 1980) k��sitteiden ��� arvorationaalisen ja p����m����r��rationaalisen toiminnan v��liseen suhteen ��� avulla. Tulokseksi syntyy oletus siit��, ett�� analyysin kohteena olevissa tarinoissa on kyse yhteisest�� kulttuurisesta tarinasta siit��, millainen on hyv�� ihminen, miten hyv�� ihminen toteuttaa itse����n ty��ss�� ja miten h��n tekee ty��t����n: tarmokkaasti, omistautuen ja uppoutuen. Henkil��kohtainen halu menn�� eteenp��in ja kyky ratkaista ongelmia nojaa sairaanhoitajien erityiseen eetokseen, kutsumusty��h��n ja hoivan moraaliin tavalla, joka on rakenteellisesti yht��l��inen protestanttisuutta leimaavan yksil��llisen jumalasuhteen kanssa. Lis��ksi analyysin perusteella esitet����n, ett�� ty��n imun edellytys on arvorationaalisen eetoksen lis��ksi oikeanlainen, riitt��v��t ty��n voimavarat sis��lt��v�� ymp��rist��, jossa hoitoty��n keskeiset palkinnot on mahdollista saavuttaa. T��ll��in palkkaty��n sis��lt�� kohtaa kulttuuriset l��ht��kohdat, ja tulos n��kyy ty��n imuna. Keskeisimm��t taustoittavat l��hteet ovat Henriksson, Lea & Wrede, Sirpa (toim.) (2004a). Hyvinvointity��n ammatit ja Hakanen, Jari (2009a). Ty��n imun arviointimenetelm�� (Utrecht Work Engagement Scale). Sosiologisen tulkinnan kannalta t��rkein teoreettinen l��hde on Weber, Max (1980): Protestanttinen etiikka ja kapitalismin henki.

Orgaanisen aineen huuhtoutuminen ja siihen vaikuttavat tekij��t

English summary: The washing out of organic matter and factors affecting it.

LIN28B, LIN28A, KISS1, and KISS1R in idiopathic central precocious puberty

Abstract Background Pubertal timing is a strongly heritable trait, but no single puberty gene has been identified. Thus, the genetic background of idiopathic central precocious puberty (ICPP) is poorly understood. Overall, the genetic modulation of pubertal onset most likely arises from the additive effect of multiple genes, but also monogenic causes of ICPP probably exist, as cases of familial ICPP have been reported. Mutations in KISS1 and KISSR, coding for kisspeptin and its receptor, involved in GnRH secretion and puberty onset, have been suggested causative for monogenic ICPP. Variation in LIN28B was associated with timing of puberty in genome-wide association (GWA) studies. LIN28B is a human ortholog of the gene that controls, through microRNAs, developmental timing in C. elegans. In addition, Lin28a transgenic mice manifest the puberty phenotypes identified in the human GWAS. Thus, both LIN28B and LIN28A may have a role in pubertal development and are good candidate genes for monogenic ICPP. Methods Thirty girls with ICPP were included in the study. ICPP was defined by pubertal onset before 8 yrs of age, and a pubertal LH response to GnRH testing. The coding regions of LIN28B, LIN28A, KISS1, and KISS1R were sequenced. The missense change in LIN28B was also screened in 132 control subjects. Results No rare variants were detected in KISS1 or KISS1R in the 30 subjects with ICPP. In LIN28B, one missense change, His199Arg, was found in one subject with ICPP. However, this variant was also detected in one of the 132 controls. No variation in LIN28A was found. Conclusions We did not find any evidence that mutations in LIN28B or LIN28A would underlie ICPP. In addition, we confirmed that mutations in KISS1 and KISS1R are not a common cause for ICPP.

Effect of drainage basin characteristics on the diffuse load of phosphorus and nitrogen.

Tiivistelm��: Valuma-alueen vaikutus fosforin ja typen hajakuormitukseen.

Ale jaskkot eatnigiella : Alkuper��iskansaliikkeen ja saamen kielen merkitys saamelaisten identiteetille

This study examines the S��mi people and the construction of the S��mi identity and the role of language in the cross-border S��mi movement within the context of the international indigenous movement and discourse between 1962 and 2008. The S��mi movement began as a reaction to state assimilation policies. This led to the birth of indigenous processes strengthening the S��mi cultures and languages. Activities across borders and the ethnopolitical processes in each of the Nordic countries in question also formed the basis of the internationalization of the S��mi people. The discourse on indigenous peoples has grown into a question of human rights, which is examined in different national and international contexts. The study is based on ethnographic data that has been collected via interviews, questionnaires and participant observation with the researched people in different meetings and events. Archive and newsprint material are also used. The approach of the study is auto-ethnographic. The post-colonial theories used in the study strive to destabilize power relations and the distinctions of otherness produced by colonialism, and to reclaim both one's own culture and language in the context of the indigenous movement. A standard model for this type of approach was created by Edward W. Said in his 1978 work Orientalism. The central concepts of the analysis are decolonization, otherness, ethnicity and identity. The dissertation consists of four published articles and an introduction. The subject matter is analyzed on three levels: global, European and Nordic. On the global level, the results demonstrate that the indigenous movement has constructed a new understanding of indigenousness with new rights. International treaties have facilitated the unification of new concepts and rights, such as the right to self-determination and language, also helping in transforming them into rights of the S��mi people on a national level. On the Nordic level, aligning the S��mi culture with indigenous discourse became significant for the process of developing the S��mi identity in the S��mi movement. In this process, the S��mi movement made use of S��mi languages in order to mobilize groups of people and to construct relatedness between different S��mi groups. The realization that one s own language is significant to one's culture has resulted in recreating the vitality, visibility and the legitimation of language in society more generally. The migration of the S��mi people from their traditional territories to increasingly multi-ethnic urban areas alters one's relationship to one's own community as the relationship to cultural traditions changes. Among the urban S��mi, who form a group of ���new S��miness���, linguistic discrimination and assimilation continue because of the lack of legislative and other effective language policy measures to promote the learning and use of the S��mi language.