Oireista puhuminen lääkärin vastaanotolla : Keskustelunanalyyttinen tutkimus lääkärin kysymyksistä

Talking about symptoms during medical consultation. A conversation analytical study of doctors questions This linguistically oriented conversation analytic study investigates doctors questions and patients answers during medical consultation. The focus is on 1) the syntactic constructions of the doctors questions concerning the patients symptoms, 2) the function of different types of syntactic constructions, and 3) the sequential placement of the questions. The data used in the study consist of 57 videotaped doctor patient encounters in Finnish primary health care. The study shows that the traditional division between open and closed questions is vague and needs to be examined further. Open wh-questions and closed yes/no questions form heterogeneous classes: some of the closed questions can be treated as open and vice versa. Wh-questions which occur during the physical examination are often constructed to elicit short answers. These questions can consist of one word (e.g. milloin when ) which does not move to a new topic but supports the unfinished activity of palpation. During the verbal examination, wh-questions are formulated to elicit long descriptions as answers. For example, by asking mites + X ( what about + X), the doctor can open up a new topic and simultaneously give the patient the opportunity to discuss the topic from his/her perspective. Almost half of the yes/no questions project longer than just a minimal answer (e.g. a short confirmation or rejection). In these questions, the doctors use verbal elements which show that more than just a minimal answer is required. They can, for example, add an indefinite element (joku some or mitään any ) to a yes/no question, add a conjunctive vai ( or ) to the end of the question and thus open a space for various types of answers, or add a suggested answer to the question. In addition, the results show that declarative questions not only check understanding, but display the doctor s diagnosing process, check whether the doctor can move on to the next topic or action, and display implicitly the doctor s idea of what is connected and what is relevant. One aim of the study is to describe how different syntactic structures work together. A typical question chain consists of two or three questions. The first question is an open wh-question that elicits a new topic and creates different types of presuppositions. Contingent questions are constructed as yes/no questions that seek an affirmative answer or as declarative sentences that seek confirmation. Contingent questions can function as repair initiators and thus support achieving mutual understanding. Therefore, they are tools for the doctor to construct a description of the medical problem collaboratively with the patient. The results add to the results of previous studies on questions in medical consultation, but also suggest some corrections. They provide additional evidence for the idea that different types of syntactic constructions are useful in different types of settings. However, they also show that the variety of questions that doctors use is more manifold and diverse than the variety introduced in earlier studies and textbooks.

Expert Identity in Development of Core-Task-Oriented Working Practices for Mastering Demanding Situations

The point of departure in this dissertation was the practical safety problem of unanticipated, unfamiliar events and unexpected changes in the environment, the demanding situations which the operators should take care of in the complex socio-technical systems. The aim of this thesis was to increase the understanding of demanding situations and of the resources for coping with these situations by presenting a new construct, a conceptual model called Expert Identity (ExId) as a way to open up new solutions to the problem of demanding situations and by testing the model in empirical studies on operator work. The premises of the Core-Task Analysis (CTA) framework were adopted as a starting point: core-task oriented working practices promote the system efficiency (incl. safety, productivity and well-being targets) and that should be supported. The negative effects of stress were summarised and the possible countermeasures related to the operators' personal resources such as experience, expertise, sense of control, conceptions of work and self etc. were considered. ExId was proposed as a way to bring emotional-energetic depth into the work analysis and to supplement CTA-based practical methods to discover development challenges and to contribute to the development of complex socio-technical systems. The potential of ExId to promote understanding of operator work was demonstrated in the context of the six empirical studies on operator work. Each of these studies had its own practical objectives within the corresponding quite broad focuses of the studies. The concluding research questions were: 1) Are the assumptions made in ExId on the basis of the different theories and previous studies supported by the empirical findings? 2) Does the ExId construct promote understanding of the operator work in empirical studies? 3) What are the strengths and weaknesses of the ExId construct? The layers and the assumptions of the development of expert identity appeared to gain evidence. The new conceptual model worked as a part of an analysis of different kinds of data, as a part of different methods used for different purposes, in different work contexts. The results showed that the operators had problems in taking care of the core task resulting from the discrepancy between the demands and resources (either personal or external). The changes of work, the difficulties in reaching the real content of work in the organisation and the limits of the practical means of support had complicated the problem and limited the possibilities of the development actions within the case organisations. Personal resources seemed to be sensitive to the changes, adaptation is taking place, but not deeply or quickly enough. Furthermore, the results showed several characteristics of the studied contexts that complicated the operators' possibilities to grow into or with the demands and to develop practices, expertise and expert identity matching the core task. They were: discontinuation of the work demands, discrepancy between conceptions of work held in the other parts of organisation, visions and the reality faced by the operators, emphasis on the individual efforts and situational solutions. The potential of ExId to open up new paths to solving the problem of the demanding situations and its ability to enable studies on practices in the field was considered in the discussion. The results were interpreted as promising enough to encourage the conduction of further studies on ExId. This dissertation proposes especially contribution to supporting the workers in recognising the changing demands and their possibilities for growing with them when aiming to support human performance in complex socio-technical systems, both in designing the systems and solving the existing problems.

Tiedonhakustrategiat World Wide Webissä

Tutkimuksen tarkoituksena on selvittää, millaisia tiedonhakustrategioita tiedonhakijatkäyttävät etsiessään tietoa Internetistä. Käyttäjät luokitellaan kolmeen ryhmään tiedonhakustrategiansa mukaan. Haku-suuntautuneet käyttäjät käyttävät enimmäkseen hakukoneita, niin koko Internetin kattavia kuin sivustojen sisäisiäkin. Linkkisuuntautuneet taas joko tietävät tai arvaavat kohdesivuston osoitteen tai käyttävät laajoja hierarkkisia hakemistoja tiedon löytämiseen. He navigoivat mielummin sivustollakin linkkejä käyttäen eivätkä yleensä käytä hakutoimintoa. Eriytyneet käyttäjät eivät säännönmukaisesti suosi kumpaakaan tapaa, vaan valitsevat strategian tehtävän mukaan. Tietoa kerättiin kahdella tavalla: WWW-sivulla olleella kyselylomakkeella ja tiedonhakutestillä, jossa käyttäjille annettiin suoritettavaksi erilaisia tiedonhakutehtäviä. Tiedonhakutehtävät lajiteltiin kolmeen ryhmään sen mukaan, mitä strategiaa ne suosivat: hakustrategiaa suosivat, linkkistrategiaa suosivat ja neutraalit tehtävät. Tutkimusongelmana oli selvittää, kuinka tehtävän tyyppi ja ATK- ja Internet-kokemus vaikuttavat tiedonhakustrategian valintaan. Kävi ilmi, ettei käyttäjien suuntautuneisuus tiettyyn strategiaan vaikuta tiedonhakustrategian valintaan, vaan ainoastaan tehtävän tyyppi oli merkitsevä tekijä. Aikaisemman tutkimustiedon valossa kokeenet suosivat haku-suuntautunutta strategiaa. Tässä tutkimuksessa havaittiin, että kokemus lisäsi molempien strategioiden käyttöä yhtäläisesti, mutta tämä ilmiö oli havaittavissa ainoastaan kysely-lomakkeen pohjalta, ei testeissä. Molempien tiedonhakustrategioiden käyttö lisääntyy kokemuksen myötä, mutta suhteelliset osuudet pysyvät samoina. Syyksi sille, että kokeneet eivät suosineet hakustrategiaa, esitetään sitä, että tehtävät olivat liian helppoja, jolloin kokemus ei pääse auttamaan. Oleellisia eroja suoritusajoissa tai hakustrategian vaihdon tiheydessä ei havaittu suhteessa kokemukseen, ainoastaan suhteessa tehtävän tyyppiin.Tämäkin selitettiin toisentyyppisten tehtävien helppoudella. Tutkimuksessa pohditaan lisäksi asiantuntijuuden syntyä tiedonhakukontekstissa sekä esitetään metatietohypoteesi, jonka mukaan tiedonhakustrategian valintaan vaikuttaa tärkeänä tekijänä käyttäjän metatieto hakupalveluista. Metatietoon kuuluu tieto siitä, mitä hakukoneita on saatavilla, mitä tietoa verkosta kannattaa hakea, millä yrityksillä ja yhteisöillä on sisältörikkaat sivut jne, ja minkä tyyppistä tietoa yleensä on saatavilla. Kaikenkaikkiaan strategian valintaan esitetään taustalle kolmen tason tiedon vaikutusta: 1) oma asiantuntemus haettavasta alasta, 2) metatieto Internetin tiedonhakupalveluista sekä 3) tekninen tieto siitä, kuinka hakukoneet toimivat. Avainsanat: tiedonhaku, tiedonhakustrategia, hakukone, WWW, metatieto, kognitiivinen psykologia

Properties of intramuscular connective tissue in pork and poultry with reference to weakening of structure

The most common connective tissue research in meat science has been conducted on the properties of intramuscular connective tissue (IMCT) in connection with eating quality of meat. From the chemical and physical properties of meat, researchers have concluded that meat from animals younger than physiological maturity is the most tender. In pork and poultry, different challenges have been raised: the structure of cooked meat has weakened. In extreme cases raw porcine M. semimembranosus (SM) and in most turkey M. pectoralis superficialis (PS) can be peeled off in strips along the perimysium which surrounds the muscle fibre bundles (destructured meat), and when cooked, the slices disintegrate. Raw chicken meat is generally very soft and when cooked, it can even be mushy. The overall aim of this thesis was to study the thermal properties of IMCT in porcine SM in order to see if these properties were in association with destructured meat in pork and to characterise IMCT in poultry PS. First a 'baseline' study to characterise the thermal stability of IMCT in light coloured (SM and M. longissimus dorsi in pigs and PS in poultry) and dark coloured (M. infraspinatus in pigs and a combination of M. quadriceps femoris and M. iliotibialis lateralis in poultry) muscles was necessary. Thereafter, it was investigated whether the properties of muscle fibres differed in destructured and normal porcine muscles. Collagen content and also solubility of dark coloured muscles were higher than in light coloured muscles in pork and poultry. Collagen solubility was especially high in chicken muscles, approx. 30 %, in comparison to porcine and turkey muscles. However, collagen content and solubility were similar in destructured and normal porcine SM muscles. Thermal shrinkage of IMCT occurred at approximately 65 °C in pork and poultry. It occurred at lower temperature in light coloured muscles than in dark coloured muscles, although the difference was not always significant. The onset and peak temperatures of thermal shrinkage of IMCT were lower in destructured than in normal SM muscles, when the IMCT from SM muscles exhibiting ten lowest and ten highest ultimate pH values were investigated (onset: 59.4 °C vs. 60.7 °C, peak: 64.9 °C vs. 65.7 °C). As the destructured meat was paler than normal meat, the PSE (pale, soft, exudative) phenomenon could not be ruled out. The muscle fibre cross sectional area (CSA), the number of capillaries per muscle fibre CSA and per fibre and sarcomere length were similar in destructured and normal SM muscles. Drip loss was clearly higher in destructured than in normal SM muscles. In conclusion, collagen content and solubility and thermal shrinkage temperature vary between porcine and poultry muscles. One feature in the IMCT could not be directly associated with weakening of the meat structure. Poultry breast meat is very homogenous within the species.

Glycogen debranching enzyme activity in the muscles of meat producing animals

Muscle glycogen exists in two forms: low molecular weight pro-glycogen and high molecular weight macro-glycogen. The degradation of glycogen to glucose 1 phosphate and free glucose is catalysed by glycogen phosphorylase together with glycogen debranching enzyme (GDE). The process in which glycogen is broken down via anaerobic pathways to lactate, results in the acidification of the muscles and has a great influence on meat quality. Thus, the overall aim of this thesis was to characterise the post mortem action of GDE in muscles of meat production animals (pigs, cattle and chickens). Interest was focused on the differences in GDE activity between fast twitch glycolytic muscles and slow twitch oxidative muscles. The effects of pH, temperature, RN genotype (PRKAG3 gene), and of time post mortem on GDE activity were also investigated. This thesis showed that there are differences in GDE activity between animal species and between different muscles of an animal. It was shown that in pigs and cattle, higher GDE activity and phosphorylase activity exists in the fast twitch glycolytic muscles than in slow twitch oxidative muscles of the same animal. Thus, the high activity of these enzymes enables a faster rate of glycogenolysis in glycolytic M. longissimus dorsi compared to oxidative M. masseter. In chicken muscles, the GDE activity was low compared to pig or cattle muscles. Furthermore, the GDE activity in the glycolytic M. pectoralis superficialis was lower than in more oxidative M. quadriceps femoris despite the high phosphorylase activity in the former. The relative ratios between phosphorylase and GDE activity were higher in fast twitch glycolytic muscles than in slow twitch oxidative muscles of all studied animals. This suggests that the relatively low GDE activity compared to the phosphorylase activity in fast twitch glycolytic muscles may be a protection mechanism in living muscle against a very fast pH decrease. Chilling significantly decreased GDE activity and below 15 C porcine GDE was almost inactive. The effect of pH on GDE activity was only minor at the range normally found in post mortem muscles (pH 7.4 to 5.0). The GDE activity remained level for several hours after slaughter. During the first hours post mortem, GDE activity was similar in RN- carrier pigs and in wild type pigs. However, the GDE activity declined faster in M. longissimus dorsi from wild type pigs than in the RN carrier pigs, the difference between genotypes was significant after 24 h post mortem. Pro-glycogen and macro-glycogen contents were higher, pH decrease was faster and ultimate pH was lower in RN- carrier pigs than in wild type pigs. In the RN- carriers, the prolonged high GDE activity level may enable an extended pH decrease and lower ultimate pH in their muscles. In conclusion, GDE is not the main factor determining the rate or the extent of post mortem glycogenolysis, but under certain conditions, such as in very fast chilling, the inhibition of GDE activity in meat may reduce the rate of pH decrease and result in higher ultimate pH. The rate and extent of pH decrease affects several meat quality traits.

Kymijoen vaelluskalojen nousureittien avaamisen kustannusten ja hyötyjen arviointi

The objective of this thesis is to evaluate different means of increasing natural reproduction of migratory fish, especially salmon, in the river Kymijoki. The original stocks of migratory fish in Kymijoki were lost by the 1950s because of hydropower plants and worsened quality of water in the river. Nowadays the salmon stocks is based on hatchery-reared fish, even though there is significant potential of natural smolt production in the river. The main problem in the natural reproduction is that the migratory fish cannot ascend to the reproduction areas above the Korkeakoski and Koivukoski hydropower plants. In this thesis alternative projects which aim to open these ascencion routes and their costs and benefits are evaluated. The method used in the evaluation is social cost-benefit analysis. The alternative projects evaluated in this thesis consist of projects that aim to change the flow patterns between the eastern branches of Kymijoki and projects that involve building a fish ladder. Also different combinations of these projects are considered. The objective of this thesis is to find the project that is the most profitable to execute; this evaluation can be done in comparing the net present values of the projects. In addition to this, a sensitivity analysis will be made on the parameter values that are most uncertain. We compare the net present values of the projects with the net present values of hatchery-reared smolt releases, so we can evaluate, if the projects or the smolt releases are more socially profitable in the long term. The results of this thesis indicate that especially the projects that involve building a fish ladder next to the Korkeakoski hydropower plant are the most socially profitable. If this fish ladder would be built, the natural reproduction of salmon in the Kymijoki river could become so extensive, that hatchery-reared smolt releases could even be stopped. The results of the sensivity analysis indicate that the net present values of the projects depend especially on the initial smolt survival rate of wild salmon and the functioning of the potential fish ladder in Korkeakoski. Also the changes of other parameter values influence the results of the cost-benefit analysis, but not as significantly. When the net present values of the projects and the smolt releases are compared, the results depend on which period of time is selected to count the average catches of reared salmon. If the average of the last 5 years catches is used in counting the net benefits of smolt releases, all the alternative projects are more profitable than the releases. When the average of the last 10 years is used, only building of the fish ladder in Korkeakoski and all the project combinations are more profitable than the smolt releases.

Entsymaattisen hydrolyysin vaikutuksista mikrokiteisen selluloosan rakenteeseen

Cellulose can be used as a renewable raw material for energy production. The utilization requires degradation of cellulose into glucose, which can be done with the aid of enzymatic hydrolysis. In this thesis, various x-ray methods were used to characterize sub-micrometer changes in microcrystalline cellulose during enzymatic hydrolysis to clarify the process and factors slowering it. The methods included wide-angle x-ray scattering (WAXS), small-angle x-ray scattering (SAXS) and x-ray microtomography. In addition, the samples were studied with transmission electron microscopy (TEM). The studied samples were hydrolyzed by enzymes of the Trichoderma reesei species for 6, 24, and 75 hours, which corresponded to 31 %, 58 %, and 68 % degrees of hydrolysis, respectively. Freeze-dried hydrolysis residues were measured with WAXS, SAXS and microtomography, whereas some of them were re-wetted for the wet SAXS and TEM measurements. The microtomography measurements showed a clear decrease in particle size in scale of tens of micrometers. In all the TEM pictures similar cylindrical and partly ramified structures were observed, independent of the hydrolysis time. The SAXS results were ambiguous and partly imprecise, but showed a change in the structure of wet samples in scale of 10-30 nm. According to the WAXS results, the degrees of crystallinity and the crystal sizes remained the same. The gained results support the assuption, that the cellulosic particles are hydrolyzed mostly on their surface, since the enzymes are unable to penetrate into the nanopores of wet cellulose. The hydrolysis therefore proceeds quickly in easily accessible particles and leaves the unaccesible particles almost untouched. The structural changes observed in the SAXS measurements might correspond to slight loosening of the microfibril aggregates, which was seen only in the wet samples because of their different pore structure.

The Nature, Origins, and Consequences of Finnish Shame-Proneness: A Grounded Theory Study

Although shame is a universal human emotion and is one of the most difficult emotions to overcome, its origins and nature as well as its effects on psychosocial functioning are not well understood or defined. While psychological and spiritual counselors are aware of the effects and consequences of shame for an individual s internal well-being and social life, shame is often still considered a taboo topic and is not given adequate attention. This study aims to explain the developmental process and effects of shame and shame-proneness for individuals and provide tools for practitioners to work more effectively with their clients who struggle with shame. This study presents the empirical foundation for a grounded theory that describes and explains the nature, origins, and consequences of shame-proneness. The study focused on Finnish participants childhood, adolescence and adulthood experiences and why they developed shame-proneness, what it meant for them as children and adolescents and what it meant for them as adults. The data collection phase of this study began in 2000. The participants were recruited through advertisements in local and country-wide newspapers and magazines. Altogether 325 people responded to the advertisements by sending an essay concerning their shame and guilt experiences. For the present study, 135 essays were selected and from those who sent an essay 19 were selected for in-depth interviews. In addition to essays and interviews, participants personal notebooks and childhood hospital and medical reports as well as their scores on the Internalized Shame Scale were analyzed. The development of shame-proneness and significant experiences and events during childhood and adolescence (e.g., health, parenting and parents behavior, humiliation, bullying, neglect, maltreatment and abuse) are discussed and the connections of shame-proneness to psychological concepts such as self-esteem, attachment, perfectionism, narcissism, submissiveness, pleasing others, heightened interpersonal subjectivity, and codependence are explained. Relationships and effects of shame-proneness on guilt, spirituality, temperament, coping strategies, defenses, personality formation and psychological health are also explicated. In addition, shame expressions and the development of shame triggers as well as internalized and externalized shame are clarified. These connections and developments are represented by the core category lack of gaining love, validation and protection as the authentic self. The conclusions drawn from the study include a categorization of shame-prone Finnish people according to their childhood and adolescent experiences and the characteristics of their shame-proneness and personality. Implications for psychological and spiritual counseling are also discussed. Key words: shame, internalized shame, external shame, shame development, shame triggers, guilt, self-esteem, attachment, narcissism, perfectionism, submissiveness, codependence, childhood neglect, childhood abuse, childhood maltreatment, emotional abuse, sexual abuse, spiritual abuse, psychological well-being

Efraim Syyrialaisen luostari: Tapausesimerkkejä munkkien luostariin vetäytymisen syistä

Tutkielma on kaksivaiheinen. Ensin esittelen apostolisen, Syyrialaisortodoksisen kirkon historiaa ja luostariperinnettä. Toisen osan tarkoitus on selvittää, liittyykö Pyhän Efraim Syyrialaisen luostarin munkkien luostariinjäämispäätökseen yhteiskunnallisia syitä ja mitä muita mahdollisia syitä voidaan löytää. Vertailen lopuksi varhaisia, 400-luvulla eläneiden kilvoittelijoiden Pyhän Efraim Syyrialaisen, Antonius Suuren ja Simeon Pylväspyhimyksen motiiveita nykykilvoittelijoiden motiiveihin, sikäli kuin se on mahdollista. Selvitän myös, onko Efraim Syyrialaisen esimerkillä ollut merkitystä nykykilvoittelijoille. Empiirinen aineisto kerättiin kahtena vuotena v. 2002 ja 2003. Tutkielmaa varten haastattelin kolmea Efraim Syyrialaisen luostarin munkkia. Pääinformanttini oli ko. luostarin seminaarin teologiopiskelija. Heidän kotitaustansa on syyrialaisortodoksinen, voimakkaasti uskonnollinen. Spiritualiteettia harjoitettiin jo lapsuudessa sekä kotona että kirkossa. Tutkielmani näkökulma on uskontohistoriallinen ja uskontososiologinen. Tutkin miten varhaiset- sekä nykypäivän kilvoittelijat ovat suhtautuneet yhteiskuntaan ja miten he ovat integroituneet luostariinsa. Kysymyksessä on nykypäivän osalta laadullinen tapaustutkimus, jonka metodeina ovat teemahaastattelu, jonka yhtenä osana olivat argumentit ja osallistruva havainnointi. Analysoin vastaukset sisällön analyysiä käyttäen. Haastatellut munkit korostivat syyrian kielen ja tradition opiskelun ja sen siirtämisen tärkeyttä seminaariin opiskelemaan hakeutumisensa, ja sen jälkeen munkiksi jäämisensä perusteluna. Pyhän Efraim Syyrialaisen esimerkin munkit kokivat olevan heille hyvin tärkeän tradition siirtäjän. Opiskelemisen ja matkustamisen mahdollisuus munkkina koettiin myös tärkeänä ja siitä syystä luostariin jäätiin, eli yhteiskunnallinen syy löytyi. Sisällön analyysissä ilmeni, että alkujaan koti edusti munkille primaarista tekijää. Sekundääristä tekijää edustivat kirkkoon kuuluva ryhmä, munkit ja luostari. Kodin ja kirkossa käynnin seurauksena tradition ja syyrian kielen oppimisen halu korostui ja niitä haluttiin lähteä opiskelemaan. Positiiviseksi viiteryhmäksi tällöin muodostuivat seminaariopiskelun aikana munkit ja muut luostarin asukkaat. Luostariin jäämisensä jälkeen primaarin tekijän voidaan huomata vaihtuneen luostariksi ja kodin asema on jäänyt sekundaariseksi. Yhteys luostarin ja ympäröivän yhteiskunnan kanssa tapahtui varhaisena aikana pääasiallisesti siten, että ihmiset tulivat kilvoittelijan luokse. Nykymunkit puolestaan käyvät niiden seurakuntalaisten kotona, jotka eivät pääse yhteisiin jumalanpalveluksiin ja auttavat heitä sielunhoidollisesti ja tarvittaessa taloudellisesti. Kirkon patriarkka Mar Ignatios Zakka I Iwasilla ja metropoliitta Eusthatios Matta Rohamilla on paljon yhteyksiä myös islaminuskoiseen väestönosaa Syyriassa. Ekumeenisia yhteyksiä on munkeillakin runsaasti. Ne mahdollistuvat erilaisissa kirkon kokouksissa ja konferensseissa sekä opiskelupaikkakunnalla Kreikassa.

Efraim Syyrialaisen luostari: Tapausesimerkkejä munkkien luostariin vetäytymisen syistä

Tutkielma on kaksivaiheinen. Ensin esittelen apostolisen, Syyrialaisortodoksisen kirkon historiaa ja luostariperinnettä. Toisen osan tarkoitus on selvittää, liittyykö Pyhän Efraim Syyrialaisen luostarin munkkien luostariinjäämispäätökseen yhteiskunnallisia syitä ja mitä muita mahdollisia syitä voidaan löytää. Vertailen lopuksi varhaisia, 400-luvulla eläneiden kilvoittelijoiden Pyhän Efraim Syyrialaisen, Antonius Suuren ja Simeon Pylväspyhimyksen motiiveita nykykilvoittelijoiden motiiveihin, sikäli kuin se on mahdollista. Selvitän myös, onko Efraim Syyrialaisen esimerkillä ollut merkitystä nykykilvoittelijoille. Empiirinen aineisto kerättiin kahtena vuotena v. 2002 ja 2003. Tutkielmaa varten haastattelin kolmea Efraim Syyrialaisen luostarin munkkia. Pääinformanttini oli ko. luostarin seminaarin teologiopiskelija. Heidän kotitaustansa on syyrialaisortodoksinen, voimakkaasti uskonnollinen. Spiritualiteettia harjoitettiin jo lapsuudessa sekä kotona että kirkossa. Tutkielmani näkökulma on uskontohistoriallinen ja uskontososiologinen. Tutkin miten varhaiset- sekä nykypäivän kilvoittelijat ovat suhtautuneet yhteiskuntaan ja miten he ovat integroituneet luostariinsa. Kysymyksessä on nykypäivän osalta laadullinen tapaustutkimus, jonka metodeina ovat teemahaastattelu, jonka yhtenä osana olivat argumentit ja osallistruva havainnointi. Analysoin vastaukset sisällön analyysiä käyttäen. Haastatellut munkit korostivat syyrian kielen ja tradition opiskelun ja sen siirtämisen tärkeyttä seminaariin opiskelemaan hakeutumisensa, ja sen jälkeen munkiksi jäämisensä perusteluna. Pyhän Efraim Syyrialaisen esimerkin munkit kokivat olevan heille hyvin tärkeän tradition siirtäjän. Opiskelemisen ja matkustamisen mahdollisuus munkkina koettiin myös tärkeänä ja siitä syystä luostariin jäätiin, eli yhteiskunnallinen syy löytyi. Sisällön analyysissä ilmeni, että alkujaan koti edusti munkille primaarista tekijää. Sekundääristä tekijää edustivat kirkkoon kuuluva ryhmä, munkit ja luostari. Kodin ja kirkossa käynnin seurauksena tradition ja syyrian kielen oppimisen halu korostui ja niitä haluttiin lähteä opiskelemaan. Positiiviseksi viiteryhmäksi tällöin muodostuivat seminaariopiskelun aikana munkit ja muut luostarin asukkaat. Luostariin jäämisensä jälkeen primaarin tekijän voidaan huomata vaihtuneen luostariksi ja kodin asema on jäänyt sekundaariseksi. Yhteys luostarin ja ympäröivän yhteiskunnan kanssa tapahtui varhaisena aikana pääasiallisesti siten, että ihmiset tulivat kilvoittelijan luokse. Nykymunkit puolestaan käyvät niiden seurakuntalaisten kotona, jotka eivät pääse yhteisiin jumalanpalveluksiin ja auttavat heitä sielunhoidollisesti ja tarvittaessa taloudellisesti. Kirkon patriarkka Mar Ignatios Zakka I Iwasilla ja metropoliitta Eusthatios Matta Rohamilla on paljon yhteyksiä myös islaminuskoiseen väestönosaa Syyriassa. Ekumeenisia yhteyksiä on munkeillakin runsaasti. Ne mahdollistuvat erilaisissa kirkon kokouksissa ja konferensseissa sekä opiskelupaikkakunnalla Kreikassa.

Essays in Philosophical Moral Psychology

The dissertation consists of four essays and a comprehensive introduction that discusses the topics, methods, and most prominent theories of philosophical moral psychology. I distinguish three main questions: What are the essential features of moral thinking? What are the psychological conditions of moral responsibility? And finally, what are the consequences of empirical facts about human nature to normative ethics? Each of the three last articles focuses on one of these issues. The first essay and part of the introduction are dedicated to methodological questions, in particular the relationship between empirical (social) psychology and philosophy. I reject recent attempts to understand the nature of morality on the basis of empirical research. One characteristic feature of moral thinking is its practical clout: if we regard an action as morally wrong, we either refrain from doing it even against our desires and interests, or else feel shame or guilt. Moral views seem to have a conceptual connection to motivation and emotions – roughly speaking, we can’t conceive of someone genuinely disapproving an action, but nonetheless doing it without any inner motivational conflict or regret. This conceptual thesis in moral psychology is called (judgment) internalism. It implies, among other things, that psychopaths cannot make moral judgments to the extent that they are incapable of corresponding motivation and emotion, even if they might say largely the words we would expect. Is internalism true? Recently, there has been an explosion of interest in so-called experimental philosophy, which is a methodological view according to which claims about conceptual truths that appeal to our intuitions should be tested by way of surveys presented to ordinary language users. One experimental result is that the majority of people are willing to grant that psychopaths make moral judgments, which challenges internalism. In the first article, ‘The Rise and Fall of Experimental Philosophy’, I argue that these results pose no real threat to internalism, since experimental philosophy is based on a too simple conception of the relationship between language use and concepts. Only the reactions of competent users in pragmatically neutral and otherwise conducive circumstances yield evidence about conceptual truths, and such robust intuitions remain inaccessible to surveys for reasons of principle. The epistemology of folk concepts must still be based on Socratic dialogue and critical reflection, whose character and authority I discuss at the end of the paper. The internal connection between moral judgment and motivation led many metaethicists in the past century to believe along Humean lines that judgment itself consists in a pro-attitude rather than a belief. This expressivist view, as it is called these days, has far-reaching consequences in metaethics. In the second essay I argue that perhaps the most sophisticated form of contemporary expressivism, Allan Gibbard’s norm-expressivism, according to which moral judgments are decisions or contingency plans, is implausible from the perspective of the theory of action. In certain circumstances it is possible to think that something is morally required of one without deciding to do so. Morality is not a matter of the will. Instead, I sketch on the basis of Robert Brandom’s inferentialist semantics a weak form of judgment internalism, according to which the content of moral judgment is determined by a commitment to a particular kind of practical reasoning. The last two essays in the dissertation emphasize the role of mutual recognition in the development and maintenance of responsible and autonomous moral agency. I defend a compatibilist view of autonomy, according to which agents who are unable to recognize right and wrong or act accordingly are not responsible for their actions – it is not fair to praise or blame them, since they lacked the relevant capacity to do otherwise. Conversely, autonomy demands an ability to recognize reasons and act on them. But as a long tradition in German moral philosophy whose best-known contemporary representative is Axel Honneth has it, both being aware of reasons and acting on them requires also the right sort of higher-order attitudes toward the self. Without self-respect and self-confidence we remain at the mercy of external pressures, even if we have the necessary normative competence. These attitudes toward the self, in turn, are formed through mutual recognition – we value ourselves when those who we value value us. Thus, standing in the right sort of relations of recognition is indirectly necessary for autonomy and moral responsibility. Recognition and valuing are concretely manifest in actions and institutions, whose practices make possible participation on an equal footing. Seeing this opens the way for a kind of normative social criticism that is grounded in the value of freedom and automomy, but is not limited to defending negative rights. It thus offers a new way to bridge the gap between liberalism and communitarianism.

Mechanisms and molecular regulation of mammalian tooth replacement

In most non-mammalian vertebrates, such as fish and reptiles, teeth are replaced continuously. However, tooth replacement in most mammals, including human, takes place only once and further renewal is apparently inhibited. It is not known how tooth replacement is genetically regulated, and little is known on the physiological mechanism and evolutionary reduction of tooth replacement in mammals. In this study I have attempted to address these questions. In a rare human condition cleidocranial dysplasia, caused by a mutation in a Runt domain transcription factor Runx2, tooth replacement is continued. Runx2 mutant mice were used to investigate the molecular mechanisms of Runx2 function. Microarray analysis from dissected embryonic day 14 Runx2 mutant and wild type dental mesenchymes revealed many downstream targets of Runx2, which were validated using in situ hybridization and tissue culture methods. Wnt signaling inhibitor Dkk1 was identified as a candidate target, and in tissue culture conditions it was shown that Dkk1 is induced by FGF4 and this induction is Runx2 dependent. These experiments demonstrated a connection between Runx2, FGF and Wnt signaling in tooth development and possibly also in tooth replacement. The role of Wnt signaling in tooth replacement was further investigated by using a transgenic mouse model where Wnt signaling mediator β-catenin is continuously stabilized in dental epithelium. This stabilization led to activated Wnt signaling and to the formation of multiple enamel knots. In vitro and transplantation experiments were performed to examine the process of extra tooth formation. We showed that new teeth were continuously generated and that new teeth form from pre-existing teeth. A morphodynamic activator-inhibitor model was used to simulate enamel knot formation. By increasing the intrinsic production rate of the activator (β-catenin), the multiple enamel knot phenotype was reproduced by computer simulations. It was thus concluded that β-catenin acts as an upstream activator of enamel knots, closely linking Wnt signaling to the regulation of tooth renewal. As mice do not normally replace teeth, we used other model animals to investigate the physiological and genetic mechanisms of tooth replacement. Sorex araneus, the common shrew was earlier reported to have non-functional tooth replacement in all antemolar tooth positions. We showed by histological and gene expression studies that there is tooth replacement only in one position, the premolar 4 and that the deciduous tooth is diminished in size and disappears during embryogenesis without becoming functional. The growth rates of deciduous and permanent premolar 4 were measured and it was shown by competence inference that the early initiation of the replacement tooth in relation to the developmental stage of the deciduous tooth led to the inhibition of deciduous tooth morphogenesis. It was concluded that the evolutionary loss of deciduous teeth may involve the early activation of replacement teeth, which in turn suppress their predecessors. Mustela putorius furo, the ferret, has a dentition that resembles that of the human as ferrets have teeth that belong to all four tooth families, and all the antemolar teeth are replaced once. To investigate the replacement mechanism, histological serial sections from different embryonic stages were analyzed. It was noticed that tooth replacement is a process which involves the growth and detachment of the dental lamina from the lingual cervical loop of the deciduous tooth. Detachment of the deciduous tooth leads to a free successional dental lamina, which grows deeper into the mesenchyme, and later buds the replacement tooth. A careful 3D analysis of serial histological sections was performed and it was shown that replacement teeth are initiated from the successional dental lamina and not from the epithelium of the deciduous tooth. The molecular regulation of tooth replacement was studied and it was shown by examination of expression patterns of candidate regulatory genes that BMP/Wnt inhibitor Sostdc1 was strongly expressed in the buccal aspect of the dental lamina, and in the intersection between the detaching deciduous tooth and the successional dental lamina, suggesting a role for Sostdc1 in the process of detachment. Shh was expressed in the enamel knot and in the inner enamel epithelium in both generations of teeth supporting the view that the morphogenesis of both generations of teeth is regulated by similar mechanisms. In summary, histological and molecular studies on different model animals and transgenic mouse models were used to investigate tooth replacement. This thesis work has significantly contributed to the knowledge on the physiological mechanisms and molecular regulation of tooth replacement and its evolutionary suppression in mammals.

Topical tacrolimus in atopic dermatitis : Effects of long-term treatment on skin and respiratory symptoms

Objective: Patients with atopic dermatitis often have a poor long-term response to conventional topical or systemic treatments. Staphylococcal superinfections, skin atrophy due to corticosteroid use, and asthma and allergic rhinitis are common. Only a few, usually short-term, studies have addressed the effects of different treatments on these problems. Tacrolimus ointment is the first topical compound suitable for long-term treatment. The aim of this thesis was to evaluate the effects of long-term topical tacrolimus treatment on cutaneous staphylococcal colonization, collagen synthesis, and symptoms and signs of asthma and allergic rhinitis. Methods: Patients with moderate-to-severe atopic dermatitis were treated with intermittent 0.1% tacrolimus ointment in prospective, open studies lasting for 6 to 48 months. In Study I, cutaneous staphylococcal colonization was followed for 6 to 12 months. In Study II, skin thickness and collagen synthesis were followed by skin ultrasound and procollagen I and III propeptide concentrations of suction blister fluid samples for 12 to 24 months and compared with a group of corticosteroid-treated atopic dermatitis patients and with a group of healthy subjects. Study III was a cross-sectional study of the occurrence of respiratory symptoms, bronchial hyper-responsiveness, and sputum eosinophilia in atopic dermatitis patients and healthy controls. In Study V, the same parameters as in Study III were assessed in atopic dermatitis patients before and after 12 to 48 months of topical tacrolimus treatment. Study IV was a retrospective follow-up of the effect of tacrolimus 0.03% ointment on severe atopic blepharoconjunctivitis and conjunctival cytology. Results: The clinical response to topical tacrolimus was very good in all studies (p≤0.008). Staphylococcal colonization decreased significantly, and the effect was sustained throughout the study (p=0.01). Skin thickness (p<0.001) and markers of collagen synthesis (p<0.001) increased in the tacrolimus-treated patients significantly, whereas they decreased or remained unchanged in the corticosteroid-treated controls. Symptoms of asthma and allergic rhinitis (p<0.0001), bronchial hyper-responsiveness (p<0.0001), and sputum eosinophilia (p<0.0001) were significantly more common in patients with atopic dermatitis than in healthy controls, especially in subjects with positive skin prick tests or elevated serum immunoglobulin E. During topical tacrolimus treatment the asthma and rhinitis (p=0.005 and p=0.002) symptoms and bronchial hyper-responsiveness (p=0.02) decreased significantly, and serum immunoglobulin E and sputum eosinophils showed a decreasing trend in patients with the best treatment response. Treatment of atopic blepharoconjunctivitis resulted in a marked clinical response and a significant decrease in eosinophils, lymphocytes, and neutrophils in the conjunctival cytology samples. No significant adverse effects or increase in skin infections occurred in any study. Conclusions: The studies included in this thesis, except the study showing an increase in skin collagen synthesis in tacrolimus-treated patients, were uncontrolled, warranting certain reservations. The results suggest, however, that tacrolimus ointment has several beneficial effects in the long-term intermittent treatment of atopic dermatitis. Tacrolimus ointment efficiently suppresses the T cell-induced inflammation of atopic dermatitis. It has a normalizing effect on the function of the skin measured by the decrease in staphylococcal colonization. It does not cause skin atrophy as do corticosteroids but restores the skin collagen synthesis in patients who have used corticosteroids. Tacrolimus ointment has no marked systemic effect, as the absorption of the drug is minimal and decreases along with skin improvement. The effects on the airway: decrease in bronchial hyper-responsiveness and respiratory symptoms, can be speculated to be caused by the decrease in T cell trafficking from the skin to the respiratory tissues as the skin inflammation resolves, as well as inhibition of epicutaneous invasion of various antigens causing systemic sensitization when the skin barrier is disrupted as in atopic dermatitis. Patients with moderate-to-severe atopic dermatitis seem to benefit from efficient long-term treatment with topical tacrolimus.

Rekonnektio Maan magnetosfäärissä

Tässä väitöskirjassa perehdytään magneettisen rekonnektion ilmenemismuotoihin ja vaikutuksiin Maan magnetosfäärissä. Keskeisenä tutkimusvälineenä käytetään magnetohydrodynaamista (MHD) Gumics-magnetosfäärisimulaatiota. Työssä kehitetään myös uusia menetelmiä simulaatiossa ilmenevän rekonnektion tunnistamiseksi ja mittaamiseksi. MHD-simulaatio sopii suuren mittakaavan ilmiöiden tarkasteluun, joten kuvaa rekonnektiosta täydennetään pienen mittakaavan piirteiden osalta Cluster-satelliittien avulla. Tärkein tutkimuksen tuoma edistysaskel menetelmien saralla on rekonnektioviivan paikallistaminen topologisesti erityyppisten magneettikenttäviivojen alueiden liitoskohdassa olevana erottajaviivana neljän kentän tienoon menetelmää käyttäen. Tämä topologinen lähestymistapa on hyödyllinen erityisesti magnetopausilla, jonka monimutkainen geometria tekee magneettikentän paikalliseen käyttäytymiseen perustuvien rekonnektioviivan etsintätapojen soveltamisen hankalaksi. Topologisesti määritelty rekonnektioviiva on myös helppo tunnistaa magnetosfäärin globaalin konvektion solmukohdaksi. Magnetopausin rekonnektioviivan käyttäytyminen Gumicsissa noudattaa komponenttirekonnektio-olettamaan pohjautuvia teoreettisia ennusteita. Rekonnektion kvantitatiivinen tarkastelu Gumics-simulaatiossa perustuu energian muuntumiseen, joka lasketaan Poyntingin vektorin divergenssinä tai Poyntingin vuona valitun umpinaisen pinnan läpi. Rekonnektioon liittyvän energian muuntumisen jakautumista magnetopausilla tarkastellaan energian muuntumisen pintatiheyden avulla ja rekonnektion kokonaismäärää rekonnektiotehon avulla. Magnetopausin ja pyrstön rekonnektiotehot ovat simulaatiossa samaa suuruusluokkaa. Tärkeimmät magnetopausin rekonnektiotehoa säätelevät parametrit ovat aurinkotuulen nopeus ja aurinkotuulen magneettikentän suunta. Magnetopausin rekonnektio puolestaan säätelee energian ja aineen pääsyä magnetosfääriin, joskaan magnetopausin läpäisevät vuot eivät ole aivan suoraan verrannollisia rekonnektiotehoon. Pyrstön rekonnektioteho sen sijaan on suoraan verrannollinen magnetopausilta tulevaan energiavuohon; pyrstörekonnektio Gumicsissa on siis ulkoista pakotetta seuraava passiivinen energian käsittelijä. Simulaation tuottama rekonnektio on realistinen magnetosfäärin globaalissa mittakaavassa tarkasteltuna, mutta satelliittihavainnot paljastavat rekonnektiosta simulaation erottelukykyä pienimittakaavaisempia piirteitä. Havaintopuolella tämän väitöstutkimuksen tärkein löytö on protonien diffuusioalueen rakenteeseen kuuluvien Hallin kenttien kääntyminen pyrstön virtalevyn aaltoilun mukana.

Characterization of non-imaging semiconductor X-ray solar monitors

The first observations of solar X-rays date back to late 1940 s. In order to observe solar X-rays the instruments have to be lifted above the Earth s atmosphere, since all high energy radiation from the space is almost totally attenuated by it. This is a good thing for all living creatures, but bad for X-ray astronomers. Detectors observing X-ray emission from space must be placed on-board satellites, which makes this particular discipline of astronomy technologically and operationally demanding, as well as very expensive. In this thesis, I have focused on detectors dedicated to observing solar X-rays in the energy range 1-20 keV. The purpose of these detectors was to measure solar X-rays simultaneously with another X-ray spectrometer measuring fluorescence X-ray emission from the Moon surface. The X-ray fluorescence emission is induced by the primary solar X-rays. If the elemental abundances on the Moon were to be determined with fluorescence analysis methods, the shape and intensity of the simultaneous solar X-ray spectrum must be known. The aim of this thesis is to describe the characterization and operation of our X-ray instruments on-board two Moon missions, SMART-1 and Chandrayaan-1. Also the independent solar science performance of these two almost similar X-ray spectrometers is described. These detectors have the following two features in common. Firstly, the primary detection element is made of a single crystal silicon diode. Secondly, the field of view is circular and very large. The data obtained from these detectors are spectra with a 16 second time resolution. Before launching an instrument into space, its performance must be characterized by ground calibrations. The basic operation of these detectors and their ground calibrations are described in detail. Two C-flares are analyzed as examples for introducing the spectral fitting process. The first flare analysis shows the fit of a single spectrum of the C1-flare obtained during the peak phase. The other analysis example shows how to derive the time evolution of fluxes, emission measures (EM) and temperatures through the whole single C4 flare with the time resolution of 16 s. The preparatory data analysis procedures are also introduced in detail. These are required in spectral fittings of the data. A new solar monitor design equipped with a concentrator optics and a moderate size of field of view is also introduced.