Keskeytyksiä elämässä : Naisten toimijuudet aborttikertomuksissa

The present study focuses on the question of agency in the narratives of women who have experienced an abortion. The study scrutinizes agency by analyzing narratives and their context, that is, how narratives are entwined with cultural discourses and societal practices. The study thus addresses also the wider framework within which experiences and actions can be constructed in abortion narratives in the contemporary Finnish society. The women who wrote their stories or were interviewed were of different ages and had different social and religious backgrounds. Many variations of agency were found when abortion experiences were analyzed through the women s embodied and historically specific accounts. Independent and rational choices are entwined with emotions and choices made together with other people. Intimate relationships with family and friends have an important role in the choices regarding abortion. These relationships do not, however, simply belong in the private sphere but reflect the wider socio-cultural meanings of social bonds and family ties. Women s agency with regard to abortion is also constructed in encounters with the medical profession and within the wider framework of abortion legislation. The Finnish legislation grants women an abortion within certain parameters but not solely on the basis of a woman s wish to have an abortion. The data consists primarily of written narratives and interviews. All together 39 women shared their experiences with the researcher. The analysis focuses on decision-making regarding abortion, depictions of freedom and responsibility, emotions around abortion and expressions of values and religious views. The links between the women's experiences and the wider socio-cultural norms and institutions are analyzed through materials consisting of public debate on abortion in the media, ethical statements as well as literature and legislation on abortion. The analysis sheds light on the tensions apparent in the women's narratives between the legal status of abortion and more traditional views on abortion. The study demonstrates that the freedom linked to abortion is not solely to do with the right to have an abortion but also how abortion can be experienced, understood and where one can talk about the experience afterwards. The analysis reveals that Christian values shape women's experiences but that there are also new religious ways to deal with the ethical considerations brought about by abortion. Annually over 10 000 Finnish women experience an abortion, which is a situation involving ethical considerations. The study provides a nuanced account of the ways in which one can think and act when going through an abortion.

An Analysis of the Concept of Citizenship: Legal, Political and Social Dimensions

The thesis aims at analyzing concept of citizenship in political philosophy. The concept of citizenship is a complex one: it does not have a definitive explication, but it nevertheless is a very important category in contemporary world. Citizenship is a powerful ideal, and often the way a person is treated depends on whether he or she has the status of a citizen. Citizenship includes protection of a person’s rights both at home and abroad. It entails legal, political and social dimension: the legal status as a full member of society, the recognition of that status by fellow citizens and acting as a member of society. The thesis discusses these three dimensions. Its objective is to show how all of them, despite being insufficient in some aspects, reach something important about the concept. The main sources of the thesis are Civic Republicanism by Iseult Honohan (Routledge 2002), Republicanism by Philip Pettit (Clarendon Press 1997), and Taking Rights Seriously by Ronald Dworkin (1997). In addition, the historical part of the thesis relies mainly on the works of Aristotle, Immanuel Kant, Adam Smith, Quentin Skinner, James Pocock and James Tully. The writings of Will Kymlicka, John Rawls, Chantal Mouffe, and Shane Phelan are referred to in the presentation and critique of the liberal tradition of thought. Hannah Arendt and Seyla Benhabib’s analysis of Arendt’s philosophy both address the problematic relations between human rights and nation-states as the main guarantors of rights. The chapter on group rights relies on Peter Jones’ account of corporate and collective rights, after which I continue to Seumas Miller’s essay on the (liberal) account of group rights and their relation to the concept of citizenship. Republicanism and Political Theory (2002) edited by Cécile Laborde and John Maynor is also references. David Miller and Maurizio Viroli represent the more “rooted” version of republicanism. The thesis argues that the full concept of citizenship should be seen as containing legal, political and social dimensions. The concept can be viewed from all of these three angles. The first means that citizenship is connected with certain rights, like the right to vote or stand for election, the right to property and so on. In most societies, the law guarantees these rights to every citizen. Then there is also the social dimension, which can be said to be as important as the legal one: the recognition of equality and identities of others. Finally, there is the political dimension, meaning the importance of citizens’ participation in the society, which is discussed in connection with the contemporary account of republicanism. All these issues are discussed from the point of view of groups demanding for group-specific rights and equal recognition. The challenge with these three aspects of citizenship is, however, that they are difficult to discuss under one heading. Different theories or discourses of citizenship each approach the subject from different starting points, which make reconciling them sometimes hard. The fundamental questions theories try to answer may differ radically depending on the theory. Nevertheless, in order to get the whole image of what the citizenship discourses are about all the aspects deserve to be taken into account.

Posted Workers and Free Movement of Services in the European Union – the Impact on National Employment and Immigration Law

This thesis examines posting of workers within the free movement of services in the European Union. The emphasis is on the case law of the European Court of Justice and in the role it has played in the liberalisation of the service sector in respect of posting of workers. The case law is examined from two different viewpoints: firstly, that of employment law and secondly, immigration law. The aim is to find out how active a role the Court has taken with regard these two fields of law and what are the implications of the Court’s judgments for the regulation on a national level. The first part of the thesis provides a general review of the Community law principles governing the freedom to provide services in the EU. The second part presents the Posted Workers’ Directive and the case law of the European Court of Justice before and after the enactment of the Directive from the viewpoint of employment law. Special attention is paid to a recent judgment in which the Court has taken a restrictive position with regard to a trade union’s right to take collective action against a service provider established in another Member State. The third part of the thesis concentrates, firstly, on the legal status of non-EU nationals lawfully resident in the EU. Secondly, it looks into the question of how the Court’s case law has affected the possibilities to use non-EU nationals as posted workers within the freedom to provide services. The final chapter includes a critical analysis of the Court’s case law on posted workers. The judgments of the European Court of Justice are the principal source of law for this thesis. In the primary legislation the focus is on Articles 49 EC and 50 EC that lay down the rules concerning the free movement of services. Within the secondary legislation, the present work principally concentrates on the Posted Workers’ Directive. It also examines proposals of the European Commission and directives that have been adopted in the field of immigration. The conclusions of the case study are twofold: while in the field of employment law, the European Court of Justice has based its judgments on a very literal interpretation of the Posted Workers’ Directive, in the field of immigration its conclusions have been much more innovative. In both fields of regulation the Court’s judgments have far-reaching implications for the rules concerning posting of workers leaving very little discretion for the Member States’ authorities.

Kansankirkko, uskonnonvapaus ja valtio : Suomen evankelis-luterilaisen kirkon kirkolliskokouksen tulkinta uskonnonvapaudesta 1963-2003

A national church, freedom of religion, and the state The interpretation of freedom of religion formulated by the Synod of the Evangelical Lutheran Church of Finland in reference to the relationship between the Church and the state from 1963 to 2003 This paper discusses the interpretation of freedom of religion formulated by the Synod of the Evangelical Lutheran Church of Finland during the years 1963-2003. The effect of these formulations and decisions made by the Synod on the relationship between the Church and the state is also discussed as the relationship has been a central issue in the debate about freedom of religion in Finland. Active co-operation with the state caused a dispute in the Church during this period. Another cause for concern for the Synod, a strong defender of the national church, was the weakening position of the Church in a society undergoing many changes. As the Synod of 1963 discussed the status of the Church, the Church began to reflect upon its identity as a national church, and to evaluate freedom of religion in the country, as well as the relationship between the Church and the state. Some of the radicals of the 1960s and 1970s presented the Church as an obstacle to freedom of religion. The Synod was keen to emphasize that, in accordance with international agreements on human rights, freedom of religion means the freedom to have and follow a religion, and also that freedom of religion was a right of the majority in Finnish society. As an active guardian of the rights of its members, the Synod defended such issues as the teaching of religion in schools. Throughout the dispute, the Church focused on its right to act freely and, according to its identity, to express spirituality in the society. At the end of the 1960s, several efforts to reform the law on the freedom of religion and the relationship between the Church and the state gained favour in the Synod. These formulations of the Church were the basis for the work of a parliamentary committee in the 1970s, but no significant changes resulted. Instead, freedom of religion in Finland was judged to be fairly good. The committee paper did, however, lead to preparations for greater independence of the Church. The Synod at the time chose to react to the changes presented to it, but it was not before the 1990s that the Synod became an active force of reform in these matters. Though the Synod, particularly from the 1970s onwards, began clearly to favour the improvement of the position of other religious communities in Finland, it felt it had reason to be cautious as each church and religious community had the freedom to decide individually its relationship with the state. Any changes that would have weakened the position of the Church in Finnish society were met with disapproval in the Synod. Even though some theological concerns regarding the national identity of the Church were raised, the Synod emphasized issues of church policy. Keen to preserve and protect its legal status in society, the Synod judged that this status supported the freedom of action enjoyed by the Church as well as the freedom of religion.

"Politiikka on kirkossa" : Keskustapuolueen kirkkopoliittisten tavoitteiden muotoutuminen vuosina 1966–1978

This study in church history deals with the formation of aims in the church politics of the Centre Party during a period of extensive politicisation in Finnish society – 1966 to 1978. The focus is on the processes of creating political input within the party organisation. The most important source material consists of the records of the highest party organs as well as material from the party office and the party’s committee for church politics. In the late 1960s, at a time of leftist radicalism in Finnish society, issues concerning the Church were seldom dealt with in the highest party organs, even though informal discussion took place within the party. This phase was followed by a conservative reaction in society during the 1970s. The rightist trend as well as the ongoing politicisation process substantially strengthened the role of church politics in the party. An aim of great importance was to prevent those supporters who belonged to the Lutheran revival movements from moving into the Finnish Christian League. Therefore it became increasingly important to prove that the Centre Party was defending the Church as well as so-called Christian values in state politics, e.g., by advocating religious instruction in schools. The Centre Party also defended the independence and legal status of the Church, at the same time positioning itself against Finland’s Social Democratic Party. Many party members were of the opinion that the church politics should have been about defending the Church and Christian values in state politics instead of defending the proportional share of the party’s seats in the ecclesiastical decision-making system. Nevertheless, the struggle for hegemony between the Centre Party and the Social Democrats was reflected in the Evangelical Lutheran Church particularly since 1973. Thus the aims of church politics were increasingly directed towards ecclesiastical elections and appointments in the 1970s. To justify its activities in church elections, the party stressed that it was not politicising the Church. To the contrary, it was asserted that the church leaders themselves had politicised the Church by favouring the Social Democrats. These alleged efforts to affiliate the Church with one political party were strictly condemned in the Centre Party. But when it came to the political parties’ activity in church elections, opinions diverged. Generally, the issues of church politics resembled those of the party’s trade union politics in the 1970s.

Kansankirkko, uskonnonvapaus ja valtio : Suomen evankelis-luterilaisen kirkon kirkolliskokouksen tulkinta uskonnonvapaudesta 1963-2003

A national church, freedom of religion, and the state The interpretation of freedom of religion formulated by the Synod of the Evangelical Lutheran Church of Finland in reference to the relationship between the Church and the state from 1963 to 2003 This paper discusses the interpretation of freedom of religion formulated by the Synod of the Evangelical Lutheran Church of Finland during the years 1963-2003. The effect of these formulations and decisions made by the Synod on the relationship between the Church and the state is also discussed as the relationship has been a central issue in the debate about freedom of religion in Finland. Active co-operation with the state caused a dispute in the Church during this period. Another cause for concern for the Synod, a strong defender of the national church, was the weakening position of the Church in a society undergoing many changes. As the Synod of 1963 discussed the status of the Church, the Church began to reflect upon its identity as a national church, and to evaluate freedom of religion in the country, as well as the relationship between the Church and the state. Some of the radicals of the 1960s and 1970s presented the Church as an obstacle to freedom of religion. The Synod was keen to emphasize that, in accordance with international agreements on human rights, freedom of religion means the freedom to have and follow a religion, and also that freedom of religion was a right of the majority in Finnish society. As an active guardian of the rights of its members, the Synod defended such issues as the teaching of religion in schools. Throughout the dispute, the Church focused on its right to act freely and, according to its identity, to express spirituality in the society. At the end of the 1960s, several efforts to reform the law on the freedom of religion and the relationship between the Church and the state gained favour in the Synod. These formulations of the Church were the basis for the work of a parliamentary committee in the 1970s, but no significant changes resulted. Instead, freedom of religion in Finland was judged to be fairly good. The committee paper did, however, lead to preparations for greater independence of the Church. The Synod at the time chose to react to the changes presented to it, but it was not before the 1990s that the Synod became an active force of reform in these matters. Though the Synod, particularly from the 1970s onwards, began clearly to favour the improvement of the position of other religious communities in Finland, it felt it had reason to be cautious as each church and religious community had the freedom to decide individually its relationship with the state. Any changes that would have weakened the position of the Church in Finnish society were met with disapproval in the Synod. Even though some theological concerns regarding the national identity of the Church were raised, the Synod emphasized issues of church policy. Keen to preserve and protect its legal status in society, the Synod judged that this status supported the freedom of action enjoyed by the Church as well as the freedom of religion.

¿Feminismo indígena? : Un análisis crítico del discurso sobre los textos de la mujer en el movimiento zapatista 1994-2009

This work analyses texts on indigenous women´s participation in the Mexican Zapatista Army, Ejército Zapatista de Liberación Nacional. The EZLN came to public attention after ten years of clandestine organization in 1994 in Chiapas, a southern state of Mexico neighboring Guatemala. Along the invasion of various municipalities in Chiapas, the Zapatista Army published their own Revolutionary Laws, directed to the Mexican government that included a section on women´s own laws. The indigenous women´s participation in a guerrilla movement in the economically poorest area of Mexico raised many questions among Mexican feminists and some of them fiercely criticized the laws for not being liberating or feminist at all. The question is, did the indigenous women want the laws to be feminist? To answer the main research question How is the position of women constructed in the Zapatista discourse? I analyze texts by various actors in the discourse within the theoretical framework of critical discourse analysis and the feminist theories of intersectionality. The connecting point in this interdisciplinary framework is the question of power and hegemony. The actors in the discourse are the women commanders themselves, the men commanders, the Zapatista spokesperson, subcomandante Marcos and the Mexican feminists. The texts analyzed are the letters of the EZLN to the media and discourses in public reunions, first published in Mexican newspapers and international discussion lists on the Internet and after 2005, on the Zapatista´s own webpage. The results show that instead of discussing whether the Zapatista women´s participation is feminist or not, the action itself provoked such wide discussion of the diversity within the feminist movement that it is a contribution itself. The work also shows that the use of language can be one tool in the quite recent paradigm of intersectionality in feminist theories.

Rikollisia sattumalta? : Naisten keskinäistä haureutta koskevat oikeudenkäynnit 1950-luvun Itä-Suomessa

The main focus of the research is on the genealogy of women's same-sex fornication in Finnish criminal law from 1889/1894 to 1971. Why were women included in the concept of same-sex fornication in Finland and why, where, and when was the law put into effect? Which women were tried, how did the trial proceedings evolve, and what kind of effects did the trials have afterwards? Which concepts were used? These questions have been approached through the analysis of the Finnish Penal Code, the criminal law science and four trial proceedings in Eastern Finland during the 1950s. The research draws on the epistemology of the closet and the concept of heteronormativity adapted from queer theories. It is method critical in utilising ethnography, micro history and feminist ethical self-reflection. The research consists of six scientific refereed articles (see appendix) and of a theoretical introduction. The main results of the research are: 1) The genealogy of Finnish decency [Sittlichkeit] can not be researched without oral histories, due to the late modernisation of Finnish society and the legal system, which does not follow the pattern of English, French and German societies. 2) The inclusion of women's same-sex fornication in the Finnish Penal Code is not incomprehensible when compared to the early modern European legislations and court practices. Women have been punished for the sins of Sodom, though not directly under the 1734 Swedish law. 3) Fornication and decency were ambivalent concepts in the 1889/1894 law, and juridical authorities offered controversial interpretations of them during the late 19th and early 20th centuries. 4) A peak in women's convictions occurred in the 1950s, and most of the trial proceedings took place in rural Eastern Finland. Neither the state nor the police were active in prosecuting; instead, the trial proceedings began "by accident". 5) From 1940 to 1960 police training lacked instructions concerning the interrogation of women suspected of same-sex fornication. 6) The figure of the penitent woman was produced in the chiasmic encounter of confession and police interrogation which moulded and was moulded by the epistemological matrix of shame, honour, and decency. Women's speech acts were judicialised as confessions which enabled the disciplinary tampering with the women's bodies. 7) Gender and personality, more than sexuality, or "criminality" defined the status of the convicted women in their village communities after the trials. 8) Relations between police training, sexuality, and decency have not been well researched in Finland. 9) Decriminalisation in 1971 did not mark the end of homophobic legal discourse, even though the 1999 reform of sexual crimes took the form of gender neutral conceptualisation

Lagöversättning som process och produkt : Revideringar och institutioner vid lagöversättning till svenska i Finland

The thesis studies the translation process for the laws of Finland as they are translated from Finnish into Swedish. The focus is on revision practices, norms and workplace procedures. The translation process studied covers three institutions and four revisions. In three separate studies the translation process is analyzed from the perspective of the translations, the institutions and the actors. The general theoretical framework is Descriptive Translation Studies. For the analysis of revisions made in versions of the Swedish translation of Finnish laws, a model is developed covering five grammatical categories (textual revisions, syntactic revisions, lexical revisions, morphological revisions and content revisions) and four norms (legal adequacy, correct translation, correct language and readability). A separate questionnaire-based study was carried out with translators and revisers at the three institutions. The results show that the number of revisions does not decrease during the translation process, and no division of labour can be seen at the different stages. This is somewhat surprising if the revision process is regarded as one of quality control. Instead, all revisers make revisions on every level of the text. Further, the revisions do not necessarily imply errors in the translations but are often the result of revisers following different norms for legal translation. The informal structure of the institutions and its impact on communication, visibility and workplace practices was studied from the perspective of organization theory. The results show weaknesses in the communicative situation, which affect the co-operation both between institutions and individuals. Individual attitudes towards norms and their relative authority also vary, in the sense that revisers largely prioritize legal adequacy whereas translators give linguistic norms a higher value. Further, multi-professional teamwork in the institutions studied shows a kind of teamwork based on individuals and institutions doing specific tasks with only little contact with others. This shows that the established definitions of teamwork, with people co-working in close contact with each other, cannot directly be applied to the workplace procedures in the translation process studied. Three new concepts are introduced: flerstegsrevidering (multi-stage revision), revideringskedja (revision chain) and normsyn (norm attitude). The study seeks to make a contribution to our knowledge of legal translation, translation processes, institutional translation, revision practices and translation norms for legal translation. Keywords: legal translation, translation of laws, institutional translation, revision, revision practices, norms, teamwork, organizational informal structure, translation process, translation sociology, multilingual.

Socioeconomic Status, Occupational Factors and Lifestyle as Predictors of Hospitalisation for Back Disorders

The aim of this dissertation was to examine the determinants of severe back disorders leading to hospital admission in Finland. First, back-related hospitalisations were considered from the perspective of socioeconomic status, occupation, and industry. Secondly, the significance of psychosocial factors at work, sleep disturbances, and such lifestyle factors as smoking and overweight was studied as predictors of hospitalisation due to back disorders. Two sets of data were used: 1) the population-based data comprised all occupationally active Finns aged 25-64, and included hospitalisations due to back disorders in 1996 and 2) a cohort of employees followed up from 1973 to 2000 having been hospitalised due to back disorders. The results of the population-based study showed that people in physically strenuous industries and occupations, such as agriculture and manufacturing, were at an increased risk of being hospitalised for back disorders. The lowest hospitalisation rates were found in sedentary occupations. Occupational class and the level of formal education were independently associated with hospitalisation for back disorders. This stratification was fairly consistent across age-groups and genders. Men had a slightly higher risk of becoming hospitalised compared with women, and the risk increased with age among both genders. The results of the prospective cohort study showed that psychosocial factors at work such as low job control and low supervisor support predicted subsequent hospitalisation for back disorders even when adjustments were made for occupational class and physical workload history. However, psychosocial factors did not predict hospital admissions due to intervertebral disc disorders; only admissions due to other back disorders. Smoking and overweight predicted, instead, only hospitalisation for intervertebral disc disorders. These results suggest that the etiological factors of disc disorders and other back disorders differ from each other. The study concerning the association of sleep disturbances and other distress symptoms with hospitalisation for back disorders revealed that sleep disturbances predicted subsequent hospitalisation for all back disorders after adjustment for chronic back disorders and recurrent back symptoms at baseline, as well as for work-related load and lifestyle factors. Other distress symptoms were not predictive of hospitalisation.

Early growth and adult health: focus on blood pressure, glucose tolerance status and body composition

Theory of developmental origins of adult health and disease proposes that experiences during critical periods of early development may have consequences on health throughout a lifespan. Thesis studies aimed to characterize associations between early growth and some components of the metabolic syndrome cluster. Participants belong to two epidemiological cohorts with data on birth measurements and, for the younger cohort, on serial recordings of weight and height during childhood. They were born as singletons between 1924-33 and 1934-44 in the Helsinki University Central Hospital, and 500 and 2003 of them, respectively, attended clinical studies at the age of 65-75 and 56-70 years, respectively. In the 65-75 year old men and women, the well-known inverse relationship between birth weight and systolic blood pressure (SBP) was confined to people who had established hypertension. Among them a 1-kg increase in birth weight was associated with a 6.4-mmHg (95% CI: 1.0 to 11.9) decrease in SBP. This relationship was further confined to people with the prevailing Pro12Pro polymorphism of the peroxisome proliferator-activated receptor-γ2 (PPARγ2) gene. People with low birth weight were more likely to receive angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (ACEI/ARB, p=0.03), and, again, this relationship was confined to the carriers of the Pro12Pro (p=0.01 for interaction). These results suggest that the inverse association between birth weight and systolic BP becomes focused in hypertensive people because pathological features of BP regulation, associated with slow fetal growth, become self-perpetuating in adult life. Insulin resistance of the Pro12Pro carriers with low birth weight may interact with the renin-angiotensin system leading to raised BP levels. Habitual physical activity protected men and women who were small at birth, and thus at increased risk for the development of type 2 diabetes, against glucose intolerance more strongly. Among subjects with birth weight ≤3000 g, the odds ratio (OR) for glucose intolerance was 5.2 (95% CI: 2.1 to 13) in those who exercised less than 3 times per week compared to regular exercisers; in those who scored their exercise light compared with moderate exercisers (defined as comparable to brisk walking) the OR was 3.5 (1.5 to 8.2). In the 56-70 year old men a 1 kg increase in birth weight corresponded to a 4.1 kg (95% CI: 3.1 to 5.1) and in women to a 2.9 kg (2.1 to 3.6) increase in adult lean mass. Rapid gain in body mass index (BMI), i.e. crossing from an original BMI percentile to a higher one, before the age of 2 years increased adult lean mass index (LMI, lean mass/height squared) without excess fat accumulation whereas rapid gain in BMI during later childhood, despite the concurrent rise in LMI, resulted in a relatively higher increase in adult body fat mass. These findings illustrate how genes, the environment and their interactions, early growth patterns, and adult lifestyle modify adult health risks which originate from early life.

Physical activity, fitness, abdominal obesity, and cardiovascular risk factors in Finnish men and women : The National FINRISK 2002 Study

Physical inactivity, low cardiorespiratory fitness, and abdominal obesity are direct and mediating risk factors for cardiovascular disease (CVD). The results of recent studies suggest that individuals with higher levels of physical activity or cardiorespiratory fitness have lower CVD and all-cause mortality than those with lower activity or fitness levels regardless of their level of obesity. The interrelationships of physical activity, fitness, and abdominal obesity with cardiovascular risk factors have not been studied in detail. The aim of this study was to investigate the associations of different types of leisure time physical activity and aerobic fitness with cardiovascular risk factors in a large population of Finnish adults. In addition, a novel aerobic fitness test was implemented and the distribution of aerobic fitness was explored in men and women across age groups. The interrelationships of physical activity, aerobic fitness and abdominal obesity were examined in relation to cardiovascular risk factors. This study was part of the National FINRISK Study 2002, which monitors cardiovascular risk factors in a Finnish adult population. The sample comprised 13 437 men and women aged 25 to 74 years and was drawn from the Population Register as a stratified random sample according to 10-year age groups, gender and area. A separate physical activity study included 9179 subjects, of whom 5 980 participated (65%) in the study. At the study site, weight, height, waist and hip circumferences, and blood pressure were measured, a blood sample was drawn, and an aerobic fitness test was performed. The fitness test estimated maximal oxygen uptake (VO2max) and was based on a non-exercise method by using a heart rate monitor at rest. Waist-to-hip ratio (WHR) was calculated by dividing waist circumference with hip circumference and was used as a measure of abdominal obesity. Participants filled in a questionnaire on health behavior, a history of diseases, and current health status, and a detailed 12-month leisure time physical activity recall. Based on the recall data, relative energy expenditure was calculated using metabolic equivalents, and physical activity was divided into conditioning, non-conditioning, and commuting physical activity. Participants aged 45 to 74 years were later invited to take part in a 2-hour oral glucose tolerance test with fasting insulin and glucose measurements. Based on the oral glucose tolerance test, undiagnosed impaired glucose tolerance and type 2 diabetes were defined. The estimated aerobic fitness was lower among women and decreased with age. A higher estimated aerobic fitness and a lower WHR were independently associated with lower systolic and diastolic blood pressure, lower total cholesterol and triglyceride levels, and with higher high-density lipoprotein (HDL) cholesterol and HDL to total cholesterol ratio. The associations of the estimated aerobic fitness with diastolic blood pressure, triglycerides, and HDL to total cholesterol ratio were stronger in men with a higher WHR. High levels of conditioning and non-conditioning physical activity were associated with lower high-sensitivity C-reactive protein (CRP) levels. High levels of conditioning and overall physical activities were associated with lower insulin and glucose levels. The associations were stronger among women than men. A better self-rated physical fitness was associated with a higher estimated aerobic fitness, lower CRP levels, and lower insulin and glucose levels in men and women. In each WHR third, the risk of impaired glucose tolerance and type 2 diabetes was higher among physically inactive individuals who did not undertake at least 30 minutes of moderate-intensity physical activity on five days per week. These cross-sectional data show that higher levels of estimated aerobic fitness and regular leisure time physical activity are associated with a favorable cardiovascular risk factor profile and that these associations are present at all levels of abdominal obesity. Most of the associations followed a dose-response manner, suggesting that already low levels of physical activity or fitness are beneficial to health and that larger improvements in risk factor levels may be gained from higher activity and fitness levels. The present findings support the recommendation to engage regularly in leisure time physical activity, to pursue a high level of aerobic fitness, and to prevent abdominal obesity.

Hormone therapy in elderly women; a comparative study with alendronate of the effects on bone, cardiovascular risk factors, periodontal conditions and quality of life

Thirty percent of 70-year-old women have osteoporosis; after age of 80 its prevalence is up to 70%. Postmenopausal women with osteoporosis seem to be at an increased risk for cardiovascular events, and deterioration of oral health, as shown by attachment loss of teeth, which is proportional to the severity of osteoporosis. Osteoporosis can be treated with many different medication, e.g. estrogen and alendronate. We randomized 90 elderly osteoporotic women (65-80 years of age) to receive hormone therapy (HT)(2mg E2+NETA), 10mg alendronate, and their combination for two years and compared their effects on bone mineral density (BMD) and turnover, two surrogate markers of the risk of cardiovascular diseases, C-reactive protein (CRP) and E-selectin, as well as oral health. The effect of HT on health-related quality of life (HRQoL) was studied in the population-based cohort of 1663 postmenopausal women (mean age 68 yr) (585 estrogen users and 1078 non-users). BMD was measured with dual-energy X-ray absorptiometry (DXA) at 0, 12 and 24 months. Urinary N-telopeptide (NTX) of type I collagen, a marker of bone resorption, and serum aminoterminal propeptide of human type I procollagen (PINP), a marker of bone formation, were measured every six months of treatment. Serum CRP and E-selectin, were measured at 0, 6, and 12 months. Dental, and periodontal conditions, and gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)-8 levels were studied to evaluate the oral health status and for the mouth symptoms a structured questionnaire was used. The HRQoL was measured with 15D questionnaire. Lumbar spine BMD increased similarly in all treatment groups (6.8-8.4% and 9.1-11.2%). Only HT increased femoral neck BMD at both 12 (4.9%) and 24 months (5.8%), at the latter time point the HT group differed significantly from the other groups. HT reduced bone marker levels of NTX and PINP significantly less than other two groups.Oral HT significantly increased serum CRP level by 76.5% at 6 and by 47.1% (NS) at 12 months, and decreased serum E-selectin level by 24.3% and 30.0%. Alendronate had no effect on these surrogate markers. Alendronate caused a decrease in the resting salivary flow rate and tended to increase GCF MMP-8 levels. Otherwise, there was no effect on the parameters of oral health. HT improved the HRQoL of elderly women significantly on the dimensions of usual activities, vitality and sexual activity, but the overall improvement in HRQoL was neither statistically significant nor clinically important. In conclusion, bisphosphonates might be the first option to start the treatment of postmenopausal osteoporosis in the old age.

Cancer incidence, mortality, and pregnancy outcome among women treated for cervical intraepithelial neoplasia

Cervical cancer develops through precursor lesions, i.e. cervical intraepithelialneoplasms (CIN). These can be detected and treated before progression to invasive cancer. The major risk factor for developing cervical cancer or CIN is persistent or recurrent infection with high-risk human papilloma virus (hrHPV). Other associated risk factors include low socioeconomic status, smoking, sexually transmitted infections, and high number of sexual partners, and these risk factors can predispose to some other cancers, excess mortality, and reproductive health complications as well. The aim was to study long-term cancer incidence, mortality, and reproductive health outcomes among women treated for CIN. Based on the results, we could evaluate the efficacy and safety of CIN treatment practices and estimate the role of the risk factors of CIN patients for cancer incidence, mortality, and reproductive health. We collected a cohort of 7 599 women treated for CIN at Helsinki University Central Hospital from 1974 to 2001. Information about their cancer incidence, cause of death, birth of children and other reproductive endpoints, and socio-economic status were gathered through registerlinkages to the Finnish Cancer Registry, Finnish Population Registry, and Statistics Finland. Depending on the endpoints in question, the women treated were compared to the general population, to themselves, or to an age- and municipality-matched reference cohort. Cervical cancer incidence was increased after treatment of CIN for at least 20 years, regardless of the grade of histology at treatment. Compared to all of the colposcopically guided methods, cold knife conization (CKC) was the least effective method of treatment in terms of later CIN 3 or cervical cancer incidence. In addition to cervical cancer, incidence of other HPV-related anogenital cancers was increased among those treated, as was the incidence of lung cancer and other smoking-related cancers. Mortality from cervical cancer among the women treated was not statistically significantly elevated, and after adjustment for socio-economic status, the hazard ratio (HR) was 1.0. In fact, the excess mortality among those treated was mainly due to increased mortality from other cancers, especially from lung cancer. In terms of post-treatment fertility, the CIN treatments seem to be safe: The women had more deliveries, and their incidence of pregnancy was similar before and after treatment. Incidence of extra-uterine pregnancies and induced abortions was elevated among the treated both before and after treatment. Thus this elevation did not occur because they were treated rather to a great extent was due to the other known risk factors these women had in excess, i.e. sexually transmitted infections. The purpose of any cancer preventive activity is to reduce cancer incidence and mortality. In Finland, cervical cancer is a rare disease and death from it even rarer, mostly due to the effective screening program. Despite this, the women treated are at increased risk for cancer; not just for cervical cancer. They must be followed up carefully and for a long period of time; general health education, especially cessation of smoking, is crucial in the management process, as well as interventions towards proper use of birth control such as condoms.

Women and Marital Breakdown in South India : Reconstructing Homes, Bonds and Persons

Women and Marital Breakdown in South India: Reconstructing Homes, Bonds and Persons is an ethnographic analysis of the situation of divorced and separated women and their families in the South Indian city of Bangalore. The study is based on 16 months of anthropological fieldwork, i.e., participant observation and life history interviews among 50 divorced and separated women from different socio-religious backgrounds in their homes, in the women s organisations and in the Family Court. The study follows the divorced and separated women from their natal homes to their affinal homes through homelessness and legal battles to their reconstructed natal, affinal or single homes in order to find out what it means to be a person within hierarchical gender and kinship relations in South India. Marital breakdown impacts on kin relations and discloses the existing gender relations and power structure through its consequences. It makes the transformability of relational personhood as well as the transformability of relational society and culture visible. Although the study reveals the painful history of women s ill-treatment in marriage, family and kinship systems, it also demonstrates the women s rejection of the domination; and shows their ability to re-negotiate and promote changes not only to their own positions but to the whole hierarchical system as well. The study explores the divorced and separated women s manifold dilemmas, complicated legal battles, and endless arrangements when they have to struggle with the very practical problems of supporting themselves financially, finding and making a new home for themselves, and re-arranging relationships with their kin and friends. As marital breakdown fundamentally transforms the women s relational field, it forces them to recreate substitutive relations in a flexible way and, simultaneously, to re-construct themselves and their lives without a ready or positive cultural or behavioural template. This process reveals the agency of the divorced and separated women as well as shedding light on issues of gender and the cultural construction of the person in South India. This topical study explores the previously neglected subject of marital breakdown in India and shows the new meaning of kinship in South India.