Nupoutuskivun vaikutus vasikan hyvinvointiin

Nupouttamisella tarkoitetaan vasikan sarvenaiheiden tuhoamista sarvien kasvun estämiseksi esimerkiksi kuumapolton avulla. Nykyisin lähes kaikki Suomessa syntyvistä vasikoista nupoutetaan turvallisuusnäkökohtien vuoksi. Suomen eläinlääkintölainsäädännön mukaan riittävät tiedot ja taidot toimenpiteen suorittamiseksi omaava henkilö saa nupouttaa alle neliviikkoisen vasikan. Eläinlääkäri voi jättää tilalle pistoksena tai suun kautta annosteltavaa tulehduskipulääkettä nupoutuskivun hoitoa varten. Nupouttamisen on useissa tutkimuksissa todettu aiheuttavan vasikalle kipua, joka ilmenee muun muassa pakenemisyrityksinä toimenpiteen yhteydessä sekä levottomuutena, sosiaalisen käyttäytymisen vähenemisenä, kohonneena sydämen sykkeenä ja stressihormonien tason nousuna nupoutuksen jälkeen. Tähänastisissa tutkimuksissa nupoutuskipua on tutkittu pisimmillään kahden vuorokauden ajan. Koska kuumapoltolla nupouttaminen saa aikaan syvän palovamman, voidaan olettaa vasikan kokevan useiden päivien ajan kipua, joka vaikuttaa hyvinvointia alentavasti. Nupoutuksen vaikutusta vasikoiden makuukäyttäytymiseen tutkittiin viiden päivän ajan nupoutustoimenpiteen jälkeen olettaen, että useamman päivän mittainen tulehduskipulääkekuuri parantaisi vasikoiden hyvinvointia. Tutkimukseen valittiin satunnaisesti kymmenen sonnivasikkaa (keski-ikä 27± 5,6 vrk). Vasikat satunnaistettiin kahteen hoitoryhmään, joista toiset saivat nupoutuspäivänä ja sen jälkeen ketoprofeenivalmistetta suun kautta yhteensä viiden päivän ajan, ja toiset vastaavasti lumelääkettä. Kaikki vasikat nupoutettiin rauhoitettuina ja paikallispuudutettuina kaasukuumenteista nupoutuskolvia käyttäen. Vasikoita videoitiin kuuden vuorokauden ajan, alkaen vuorokausi ennen nupoutusta. Videoaineisto analysoitiin Cowlog -tietokoneohjelmalla. Vasikoita lääkinneet henkilöt sekä videoiden analysoinnin suorittaja eivät tienneet, kumpaan hoitoryhmään kukin vasikka kuului. Koetilanne oli siis kaksoissokkoutettu. Nupoutuspäivää ei otettu huomioon tuloksissa, koska vasikat nupoutettiin rauhoitettuna. Nupoutustoimenpide lyhensi vasikoiden keskimääräistä yhteenlaskettua makuuaikaa vuorokaudessa 1028,2 ± 23,8 minuutista (päivä ennen nupoutusta) 886,1 ± 23,8 minuuttiin (nupoutuspäivää seuraava päivä). Nupoutuspäivää seuraavana päivänä vasikoiden keskimääräinen kokonaismakuuaika oli tilastollisesti merkittävästi lyhyempi verrattuna kaikkiin muihin päiviin (p<0,05). Tuloksissa oli havaittavissa tilastollinen tendenssi, jonka mukaan lumelääkittyjen vasikoiden makuujaksojen lukumäärä vuorokaudessa (22,7±1,6 kertaa) oli tulehduskipulääkittyihin vasikoihin (17,7±1,6 kertaa) verrattuna suurempi koko seurantajakson aikana (p=0,06). Tulehduskipulääkittyjen vasikoiden makuujaksojen keskimääräinen pituus koko seurantajakson aikana oli merkittävästi suurempi (57,3 ± 3,1 minuuttia) kuin lumelääkittyjen vasikoiden (45,0 ± 3,1 minuuttia) (p=0,02). Nupoutus lyhensi kaikkien vasikoiden päivittäistä kokonaismakuuaikaa, mikä viittaa vasikoiden kokeneen akuuttia kipua tulehduskipulääkityksestä huolimatta. Akuutti kipu ja stressi ilmenivät levottomuutena vasikoiden makuukäyttäytymisessä. Riittävä ja laadukas uni on edellytys vasikan kasvulle ja hyvinvoinnille, mikä tekee aiheesta tärkeän myös taloudellisesta näkökulmasta. Tuloksien perusteella voidaan todeta, että nupoutuksen aiheuttama kipu kestää useita päiviä, mutta jatkotutkimuksia tarvitaan kivunhoitovaihtoehtojen osalta sekä kivun kestosta suuremmalla otannalla.

Identtisten ja epäidenttisten kaksosten puhe : Monotsygoottisten ja ditsygoottisten kaksosten puheen vertailua kesto-, nopeus-, tauko- ja taajuusmittauksin

This thesis presents an experimental study of the speech prosody of identical and non-identical twins. Speech fluency, pauses, speech rate, utterance length and speech frequency were examined phonetically, auditorily, semantically and statistically. The methods included both reading tasks (reading the alphabet, numerical lists, sentences with foreign loan words, holiday theme questions as well as 1.5 pages of text with long sentences and complex words) and spontaneous speech tasks (picture description and answering holiday theme questions). The subjects were Finnish-speaking 22-28-year-old female twins: 8 identical (monozygotic) and 10 non-identical (dizygotic) pairs. One pair was male-female. Comparisons were made between twin groups and between sisters. The data was regathered from four twin pairs, to make it possible to investigate some subjects intra-individually. In addition phoneticians, phonetic students and people without knowledge of phonetic science were tested in two listening experiments. The results showed that the dizygotic twins differed more from each other than monozygotic twins and that monozygotic twin sisters shared more similarities than dizygotic twin sisters. For example, between monozygotic twin sisters smaller differences were found between word count, utterance length and speech rate in spontaneous speech tasks. Dizygotic twin sisters made more different kinds of reading mistakes with the same target words than monozygotic twin sisters, while monozygotic twin sisters made more of the same reading mistakes with the same target words than dizygotic twin sisters. The listening experiments showed that only professional phoneticians were able to recognize the twin sisters. Even though the twins had the possibility to freely choose their speech rate, pausing and speech frequency, they used their own speech patterns; these included the same average speech frequency, average speech rate, type of pausing routine or filled pauses, and other speech mannerisms throughout their speech.

La contextualisation du discours radiophonique par des moyens prosodiques. L’exemple de cinq grands philosophes français du XXe siècle

"Radiodiskurssin kontekstualisointi prosodisin keinoin. Esimerkkinä viisi suurta ranskalaista 1900-luvun filosofia" Väitöskirja käsittelee puheen kontekstualisointia prosodisin keinoin. Toisin sanottuna työssä käsitellään sitä, miten puheen prosodiset piirteet (kuten sävelkulku, intensiteetti, tauot, kesto ja rytmi) ohjaavat puheen tulkintaa vanhastaan enemmän tutkittujen sana- ja lausemerkitysten ohella. Työssä keskitytään seitsemään prosodisesti merkittyyn kuvioon, jotka koostuvat yhden tai usean parametrin silmiinpistävistä muutoksista. Ilmiöitä käsitellään sekä niiden akustisten muotojen että tyypillisten esiintymisyhteyksien ja diskursiivisten tehtävien näkökulmasta. Aineisto koostuu radio-ohjelmista, joissa puhuu viisi suurta ranskalaista 1900-luvun filosofia: Gaston Bachelard, Albert Camus, Michel Foucault, Maurice Merleau-Ponty ja Jean-Paul Sartre. Ohjelmat on lähetetty eri radiokanavilla Ranskassa vuosina 1948–1973. Väitöskirjan tulokset osoittavat, että prosodisesti merkityt kuviot ovat moniulotteisia puheen ilmiöitä, joilla on keskeinen rooli sanotun kontekstualisoinnissa: ne voivat esimerkiksi nostaa tai laskea sanotun informaatioarvoa, ilmaista puhujan voimakasta tai heikkoa sitoutumista sanomaansa, ilmaista rakenteellisen kokonaisuuden jatkumista tai päättymistä, jne. Väitöskirja sisältää myös kontrastiivisia osia, joissa ilmiöitä verrataan erääseen klassisessa pianomusiikissa esiintyvään melodiseen kuvioon sekä erääseen suomen kielen prosodiseen ilmiöön. Tulokset viittaavat siihen, että tietynlaista melodista kuviota käytetään samankaltaisena jäsentämiskeinona sekä puheessa että klassisessa musiikissa. Lisäksi tulokset antavat viitteitä siitä, että tiettyjä melodisia muotoja käytetään samankaltaisten implikaatioiden luomiseen kahdessa niinkin erilaisessa kielessä kuin suomessa ja ranskassa. Yksi väitöskirjan osa käsittelee pisteen ja pilkun prosodista merkitsemistä puheessa. Tulosten mukaan pisteellä ja pilkulla on kummallakin oma suullinen prototyyppinsä: piste merkitään tyypillisesti sävelkulun laskulla ja tauolla, ja pilkku puolestaan sävelkulun nousulla ja tauolla. Merkittävimmät tulokset koskevat kuitenkin tapauksia, joissa välimerkki tulkitaan prosodisesti epätyypillisellä tavalla: sekä pisteellä että pilkulla vaikuttaisi olevan useita eri suullisia vastaavuuksia, ja välimerkkien tehtävät voivat muotoutua hyvin erilaisiksi niiden prosodisesta tulkinnasta riippuen.

Speech Rhythm in an Interlanguage Perspective : Finnish Adolescents Speaking English

Speech rhythm is an essential part of speech processing. It is the outcome of the workings of a combination of linguistic and non-linguistic parameters, many of which also have other functions in speech. This study focusses on the acoustic and auditive realization of two linguistic parameters of rhythm: (1) sentence stress, and (2) speech rate and pausing. The aim was to find out how well Finnish comprehensive school pupils realize these two parameters in English and how native speakers of English react to Finnish pupils English rhythm. The material was elicited by means of a story-telling task and questionnaires. Three female and three male pupils representing different levels of oral skills in English were selected as the experimental group. The control group consisted of two female and two male native speakers of English. The stories were analysed acoustically and auditorily with respect to interstress intervals, weak forms, fundamental frequency, pausing, and speech as well as articulation rate. In addition, 52 native speakers of English were asked to rate the intelligibility of the Finnish pupils English with respect to speech rhythm and give their attitudes on what the pupils sounded like. Results showed that Finnish pupils can produce isochronous interstress intervals in English, but that too large a proportion of these intervals contain pauses. A closer analysis of the pauses revealed that Finnish pupils pause too frequently and in inappropriate places when they speak English. Frequent pausing was also found to cause slow speech rates. The findings of the fundamental frequency (F0) measurements indicate that Finnish pupils tend to make a slightly narrower F0 difference between stressed and unstressed syllables than the native speakers of English. Furthermore, Finnish pupils appear to know how to reduce the duration and quality of unstressed sounds, but they fail to do it frequently enough. Native listeners gave lower intelligibility and attitude scores to pupils with more anomalous speech rhythm. Finnish pupils rhythm anomalies seemed to derive from various learning- or learner-related factors rather than from the differences between English and Finnish. This study demonstrates that pausing may be a more important component of English speech rhythm than sentence stress as far as Finnish adolescents are concerned and that interlanguage development is affected by various factors and characterised by jumps or periods of stasis. Other theoretical, methodological and pedagogical implications of the results are also discussed.

Cortical representations for phonological quantity

Different languages use temporal speech cues in different linguistic functions. In Finnish, speech-sound duration is used as the primary cue for the phonological quantity distinction ― i.e., a distinction between short and long phonemes. For the second-language (L2) learners of Finnish, quantity is often difficult to master if speech-sound duration plays a less important role in the phonology of their native language (L1). The present studies aimed to investigate the cortical representations for phonological quantity in native speakers and L2 users of Finnish by using behavioral and electrophysiological methods. Since long-term memory representations for different speech units have been previously shown to participate in the elicitation of the mismatch negativity (MMN) brain response, MMN was used to compare the neural representation for quantity between native speakers and L2 users of Finnish. The results of the studies suggested that native Finnish speakers' MMN response to quantity was determined by the activation of native-language phonetic prototypes rather than by phoneme boundaries. In addition, native speakers seemed to process phoneme quantity and quality independently from each other by separate brain representations. The cross-linguistic MMN studies revealed that, in native speakers of Finnish, the MMN response to duration or quantity-degree changes was enhanced in amplitude selectively in speech sounds, whereas this pattern was not observed in L2 users. Native speakers' MMN enhancement is suggested to be due to the pre-attentive activation of L1 prototypes for quantity. In L2 users, the activation of L2 prototypes or other L2 learning effects were not reflected in the MMN, with one exception. Even though L2 users failed to show native-like brain responses to duration changes in a vowel that was similar in L1 and L2, their duration MMN response was native-like for an L2 vowel with no counterpart in L1. Thus, the pre-attentive activation of L2 users' representations was determined by the degree of similarity of L2 sounds to L1 sounds. In addition, behavioral experiments suggested that the establishment of representations for L2 quantity may require several years of language exposure.

Hiljainen tieto henkilöstön valinnassa : tutkimus työhaastatteluiden arvioinnissa hyödynnettävän tiedon hiljaisesta ulottuvuudesta

This study examined the fundamental question of what really matters when selecting a new employee. The study focused on tacit knowledge used by personnel recruiters when interviewing employees. Knowledge was defined as the best view available, which helps one not to act haphazardly. Tacit knowledge was also defined as a positive concept, and it was seen as a part of personnel recruiters` improving proficiency. The research topic was chosen based on the observed increase in the amount of employment interviews and their importance in society. As recruiting is becoming a more distinct profession, it was reasonable to approach the topic from an educational point of view. The following research problems guided the examination of the phenomenon: 1) Where does the interviewer seek tacit knowledge from during the employment interview? 2) How is tacit knowledge achieved during the employment interview? 3) How does the interviewer defend the significance of the tacit knowledge gained as knowledge that has influence on the selection decision? The research data was collected by interviewing six personnel recruiters who conduct and evaluate employment interviews as part of their work responsibilities. The interview themes were linked to some recently made selection decision in each organization and the preceding employment interview with the selected candidate. In order to conceptualize tacit knowledge, reflective consideration of the interview event was used in the study. The lettered research data was analyzed inductively. As a result of the study, the objects of tacit knowledge in the context of an employment interview culminated into three areas: the applicant s verbal communication, the applicant s non-verbal communication and the interaction between interview participants. Observations directed toward those objects were shown to be intentional and three schemes were found behind them: experiences from previous interviews, applicant s application papers and the aptitude for the work responsibilities. The question of gaining knowledge was answered with the concept of procedural knowledge. Personnel recruiters were found to have four different, but interconnected ways to encounter knowledge during an employment interview: understanding, evaluative, revealing, and approving knowing. In order to explain the importance given to tacit knowledge, it was examined in connection with the most prevalent practices in the personnel selection industry. The significance of knowledge as the kind of knowledge that has an impact on the decision was supported by references to collective opinion (other people agree with it), circumstance (interview s short duration), or using some instrument (structured interview). The study revealed new aspects of employment selection process through examining tacit knowledge. The characteristics of the inductive analysis of the research data may also be utilized, when applicable, in tacit knowledge research within other contexts.

Aivojen jännitevasteiden rekisteröinti useaan äänen piirteeseen yhdellä mittauskerralla terveillä musiikkileikkikoulua käyvillä kaksivuotiailla

The early detection of hearing deficits is important to a child's development. However, examining small children with behavioural methods is often difficult. Research with ERPs (event-related potentials), recorded with EEG (electroencephalography), does not require attention or action from the child. Especially in children's ERP research, it is essential that the duration of a recording session is not too long. A new, faster optimum paradigm has been developed to record MMN (mismatch negativity), where ERPs to several sound features can be recorded in one recording session. This substantially shortens the time required for the experiment. So far, the new paradigm has been used in adult and school-aged children research. This study examines if MMN, LDN (late discriminative negativity) and P3a components can be recorded in two-year-olds with the new paradigm. The standard stimulus (p=0.50) was an 80 dB harmonic tone consisting of three harmonic frequencies (500 Hz, 1000 Hz and 1500 Hz) with a duration of 200 ms. The loudness deviants (p=0.067) were at a level of +6 dB or -6 dB compared to the standards. The frequency deviants (p=0.112) had a fundamental frequency of 550 or 454.4 Hz (small deviation), 625 or 400 Hz (medium deviation) or 750 or 333.3 Hz (large deviation). The duration deviants (p=0.112) had a duration of 175 ms (small deviation), 150 ms (medium deviation) or 100 ms (large deviation). The direction deviants (p=0.067) were presented from the left or right loudspeaker only. The gap deviant (p=0.067) included a 5-ms silent gap in the middle of the sound. Altogether 17 children participated in the experiment, of whom the data of 12 children was used in the analysis. ERP components were observed for all deviant types. The MMN was significant for duration and gap deviants. The LDN was significant for the large duration deviant and all other deviant types. No significant P3a was observed. These results indicate that the optimum paradigm can be used with two-year-olds. With this paradigm, data on several sound features can be recorded in a shorter time than with the previous paradigms used in ERP research.

Haptiisit ja hapteemit : tapaustutkimus kuurosokean henkilön kosketukseen perustuvan kommunikaation kehityksestä

Haptices and haptemes: A case study of developmental process in touch-based communication of acquired deafblind people This research is the first systematic, longitudinal process and development description of communication using touch and body with an acquired deafblind person. The research consists of observational and analysed written and video materials mainly from two informants´ experiences during period of 14 years. The research describes the adaptation of Social-Haptic methods between a couple, and other informants´ experiences, which have been collated from biographies and through giving national and international courses. When the hearing and sight deteriorates due to having an acquired deafblind condition, communication consists of multi-systematic and adaptive methods. A person`s expressive language, spoken or Sign Language, usually remains unchanged, but the methods of receiving information could change many times during a person s lifetime. Haptices are made from haptemes that determines which regulations are analysed. When defining haptemes the definition, classification and varied meanings of touch were discovered. Haptices include sharing a personal body space, meaning of touch-contact, context and using different communication channels. Communication distances are classified as exact distance, estimated distance and touch distance. Physical distance can be termed as very long, long, medium or very close. Social body space includes the body areas involved in sending and receiving haptices and applying different types of contacts. One or two hands can produce messages by using different hand shapes and orientations. This research classifies how the body can be identified into different areas such as body orientation, varied body postures, body position levels, social actions and which side of the body is used. Spatial body space includes environmental and situational elements. Haptemes of movements are recognised as the direction of movements, change of directions on the body, directions between people, pressure, speed, frequency, size, length, duration, pause, change of rhythm, shape, macro and micro movements. Haptices share multidimensional meanings and emotions. Research describes haptices in different situations enhancing sensory information and functioning also as an independent language. Haptices includes social-haptic confirmation system, social quick messages, body drawing, contact to the people and the environment, guiding and sharing art experiences through movements. Five stages of emotional differentiation were identified as very light, light, medium, heavy and very heavy touch. Haptices give the possibility to share different art, hobby and game experiences. A new communication system development based on the analysis of the research data is classified into different phases. These are experimental initiation, social deconstruction, developing the description of Social-Haptic communication and generalisation of the theory as well as finding and conceptualising the haptices and haptemes. The use and description of haptices is a social innovation, which illustrates the adaptive function of the body and perceptual senses that can be taught to a third party. Keywords: deafblindness, hapteme, haptic, haptices, movement, social-haptic communication, social-haptic confirmation system, tactile, touch

Early Childhood Caries and a Community Trial of its Prevention in Tehran, Iran

Varhaislapsuuden karies ja sen ehkäisy kehittyvän terveydenhuollon maassa Varhaislapsuuden karies on merkittävä kansanterveysongelma varsinkin lapsirikkaissa maissa ja väestöissä. Karieksen hoitaminen vie paljon voimavaroja ja aiheuttaa mittavia taloudellisia seuraamuksia. Karies voi ilmaantua lapselle jo vauvaikäisenä, pian ensimmäisten maitohampaiden puhjettua suuhun. Alle 3-vuotiaiden karieksesta on kuitenkin niukasti tilastotietoja. Maailman terveysjärjestökin suosittaa tietojen keräämistä vasta 3-vuotiaiden ikäryhmästä. Heistä kariesta sairastaa Suomessa 16 %, Yhdysvalloissa 25 %, Englannissa 30 %, Iranissa 46 % ja Saudi-Arabiassa 61 %. Tämä väitöstutkimus selvitti karieksen esiintymistä ja sen vaaratekijöitä 1─3-vuotiailla Teheranissa. Lisäksi tutkimus arvioi perusterveydenhuoltoon sisällytetyn karieksen ehkäisyn tuloksellisuutta. Tutkimuskohteiksi arvottiin Teheranista 18 neuvolaa. Jokaisessa oltiin 4 päivää, jolloin kaikkia rokotuksiin tulleita 1─3-vuotiaita äiteineen pyydettiin osallistumaan tutkimukseen. Kahta lukuun ottamatta kaikki äidit suostuivat, ja aineistoon tuli kaikkiaan 504 lasta äiteineen. Kaikki 1-vuotiaat, 242 lasta äiteineen, valittiin karieksen ehkäisykokeiluun. Sitä varten neuvolat jaettiin kolmeen ryhmään, joista kaksi (A ja B) oli koeryhmiä ja yksi (C) oli vertailuryhmä. Tutkimus alkoi äidin haastattelulla. Siinä selvitettiin perheen koulutus- ja tulotaso sekä lapsen ruokinnasta imetyksen kesto, yösyötöt ja päiväaikaan nautitut makeat. Vielä kysyttiin lapsen ja äidin suuhygieniatavoista ja äidin kokemuksista lapsen suun puhdistamisessa. Sitten hammaslääkäri tutki lapsen suun ja kirjasi karieksen ja hammasplakin esiintymät. Suun tutkimuksen jälkeen äiti ja lapsi siirtyivät rokotushuoneeseen. Koeryhmissä (A ja B) äidit saivat terveydenhoitajalta suunterveyttä koskevan esitteen ja kehotuksen lukea se huolellisesti. Lisäksi ryhmässä A terveydenhoitaja kertoi suun ja hampaiden terveydenhoidosta saman esitteen avulla, ja neuvolan henkilökunta muistutti suunhoidon tärkeydestä puhelimitse kahdesti seuraavan puolen vuoden kuluessa. Vertailuryhmässä äideille ei annettu suunhoidon ohjeita. Kaikissa ryhmissä äitejä muistutettiin seuraavan rokotuskerran ajankohdasta, muttei mainittu tulevaa toista hammastarkastusta. Varhaislapsuuden kariesta sairasti ikäryhmästä riippuen 3─26 % tutkituista 1─3-vuotiaista, ja 65─76 %:lla oli hammasplakkia. Äideistä 68 % harjasi hampaansa päivittäin ja 39 % puhdisti lapsensa suun päivittäin. Mitä useammin äiti harjasi omat hampaansa, sitä paremmin hän huolehti lapsen suun puhtaudesta. Rintaruokinta oli yleistä eikä lisännyt kariesvaaraa. Yöllä pullomaitoa saavilla karies oli 5 kertaa yleisempää kuin muilla. Neuvolassa saatu ohjeistus ehkäisi selvästi karieksen syntyä puolen vuoden kokeessa.

Restorative treatment practices and dentist-related factors

This study aimed at elucidating real-life aspects of restorative treatment practices. In addition, dentists' views and perceptions of and variation in restorative treatment practices with respect to dentist-related factors were evaluated. Reasons for placement and replacement of restoration, material selection, posterior restoration longevity, and the use of local anesthesia were assessed on two cross-sectional data sets. Data from the Helsinki Public Dental Service (PDS) included details on 3057 restorations performed by dentists (n=134) during routine clinical work in 2001. The other PDS data from Vantaa were based on 205 patient records of young adults containing information on 1969 restorations investigated retrospectively from 1994-1996 backwards; 51 dentists performed the restorations. In addition, dentists’ self-reported use of local anesthesia and estimates of restoration longevity were investigated by means of a nationwide questionnaire sent to 592 general dental practitioners selected by systematic sampling from the membership list of the Finnish Dental Association in 2004. All data sets included some background information on dentists such as gender, year of birth or graduation, and working sector. In PDS in 2001, primary caries was the reason for placement of restoration more often among patients aged under 19 years than among older patients (p<0.001). Among patients over 36 years of age, replacements represented the majority. Regarding dentist-related factors, replacements of restorations were made by younger dentists more frequently than by older dentists (p<0.001). In PDS in 1994-1996, the replacement rate of posterior restorations was greater among female dentists than among male dentists (p=0.01), especially for amalgams (p=0.008). The mean age of replaced posterior restoration among young adults was 8.9 (SD 5.2) years for amalgam and 2.4 (SD 1.4) years for tooth-colored restorations, the actual replacement rate for all existing posterior restorations being 7% in PDS in 1994-1996. Of all restorative materials used, a clear majority (69%) were composites in PDS in 2001. Local anesthesia was used in 48% of cases and more frequently for older patients (55%) than for patients aged under 13 years (35%) (p<0.001). Younger dentists more often used local anesthesia for primary restoration than did the older dentists (p<0.001), especially for primary teeth (p=0.005). Working sector had an impact on dentists’ self-reported use of local anesthesia and estimates of restoration longevity; public sector dentists reported using local anesthesia more frequently than private sector dentists for Class II (p=0.04) and for Class III restorations (p=0.01). Private sector dentists gave longer estimates of posterior composite longevity than public sector dentists (p=0.001). In conclusion, restorative treatment practices seem to vary according to patient age and also dentist-related factors. Replacements of restorations are common for adults. For children, clear underuse of local anesthesia prevails.

Pain among employees : risk factors and consequences

The overall objective of this study was to gain epidemiological knowledge about pain among employee populations. More specifically, the aims were to assess the prevalence of pain, to identify socio-economic risk groups and work-related psychosocial risk factors, and to assess the consequences in terms of health-related functioning and sickness absence. The study was carried out among the municipal employees of the City of Helsinki. Data comprised questionnaire survey conducted in years 2000-2002 and register data on sickness absence. Altogether 8960 40-60 year old employees participated to the survey (response rate 67%). Pain is common among ageing employees. Approximately 29 per cent of employees reported chronic pain and 15 per cent acute pain, and about seven per cent reported moderately or severely limiting disabling chronic pain. Pain was more common among those with lower level of education or in a low occupational class. -- Psychosocial work environment was associated with pain reports. Job strain, bullying at workplace, and problems in combining work and home duties were associated with pain among women. Among men combining work and home duties was not associated with pain, whereas organizational injustice showed associations. Pain affects functional capacity and predicts sickness absence. Those with pain reported lower level of both mental and physical functioning than those with no pain, physical functioning being more strongly affected than mental. Bodily location of pain or whether pain was acute or chronic had only minor impact on the variation in functioning, whereas the simple count of painful locations was associated with widest variation. Pain accounted for eight per cent of short term (1-3 day) sickness absence spells among men and 13 per cent among women. Of absence spells lasting between four and 14 days pain accounted for 23 per cent among women and 25 per cent among men, corresponding figures for over 14 day absence spells being 37 and 30 per cent. The association between pain and sickness absence was relatively independent of physical and psychosocial work factors, especially among women. The results of this study provide a picture of the epidemiology of pain among employees. Pain is a significant problem that seriously affects work ability. Information on risk groups can be utilized to make prevention measures more effective among those at high risk, and to decrease pain rates and thereby narrow the differences between socio-economic groups. Furthermore, the work-related psychosocial risk factors identified in this study are potentially modifiable, and it should be possible to target interventions on decreasing pain rates among employees.

Devolution of forest-related rights: Comparative analyses of six developing countries

The study focused on the different ways that forest-related rights can be devolved to the local level according to the current legal frameworks in Laos, Nepal, Vietnam, Kenya, Mozambique and Tanzania. The eleven case studies represented the main ways in which forest-related rights can be devolved to communities or households in these countries. The objectives of this study were to 1) analyse the contents and extent of forest-related rights that can be devolved to the local level, 2) develop an empirical typology that represents the main types of devolution, and 3) compare the cases against a theoretical ideal type to assess in what way and to what extent the cases are similar to or differ from the theoretical construct. Fuzzy set theory, Qualitative Comparative Analysis and ideal type analysis were used in analysing the case studies and in developing an empirical typology. The theoretical framework, which guided data collection and analyses, was based on institutional economics and theories on property rights, common pool resources and collective action. On the basis of the theoretical and empirical knowledge, the most important attributes of rights were defined as use rights, management rights, exclusion rights, transfer rights and the duration and security of the rights. The ideal type was defined as one where local actors have been devolved comprehensive use rights, extensive management rights, rights to exclude others from the resource and rights to transfer these rights. In addition, the rights are to be secure and held perpetually. The ideal type was used to structure the analysis and as a tool against which the cases were analysed. The contents, extent and duration of the devolved rights varied greatly. In general, the results show that devolution has mainly meant the transfer of use rights to the local level, and has not really changed the overall state control over forest resources. In most cases the right holders participate, or have a limited role in the decision making regarding the harvesting and management of the resource. There was a clear tendency to devolve the rights to enforce rules and to monitor resource use and condition more extensively than the powers to decide on the management and development of the resource. The empirical typology of the cases differentiated between five different types of devolution. The types can be characterised by the devolution of 1) restricted use and control rights, 2) extensive use rights but restricted control rights, 3) extensive rights, 4) insecure, short term use and restricted control rights, and 5) insecure extensive rights. Overall, the case studies conformity to the ideal type was very low: only two cases were similar to the ideal type, all other cases differed considerably from the ideal type. The restricted management rights were the most common reason for the low conformity to the ideal type (eight cases). In three cases, the short term of the rights, restricted transfer rights, restricted use rights or restricted exclusion rights were the reason or one of the reasons for the low conformity to the ideal type. In two cases the rights were not secure.

Väkirehun määrän vaikutus lypsylehmän säilörehun syöntiin ja tuotokseen

Tämän tutkimuksen tarkoituksena oli selvittää väkirehumäärän vaikutuksia lypsylehmien säilörehun syöntiin ja syöntikäyttäytymiseen sekä tuotokseen lypsykauden alussa. Väkirehun määrän vaikutuksia on tutkittu paljon niukemmalla väkirehustuksella. Tilojen väkirehun osuus rehustuksessa saattaa ylittää jopa 60 %, joten on tärkeää selvittää väkevän rehustuksen vaikutusta lehmiin. Tutkimustietoa väkirehun määrän vaikutuksista säilörehupohjaisella ruokinnalla lypsykauden alussa on myös suhteellisen vähän. Koe suoritettiin Maa- ja elintarviketalouden tutkimuskeskuksessa (MTT) Jokioisissa Minkiön koenavetassa 20.9.2005 - 25.4.2006 välisenä aikana. Koe tehtiin pihaton osastossa, jossa oli säilörehun syöntiä mittaavat vaakakupit. Koe tehtiin jatkuvana ryhmäkokeena satunnaistetun koemallin mukaisesti. Koe-eläiminä oli 30 Ayshire-lehmää, joista 12 oli ensikoita ja 18 vanhempaa lehmää. Eläimet otettiin kokeeseen poikimisen jälkeen ja ne olivat mukana kokeessa 100 ensimmäisen lypsypäivän ajan. Kokeessa oli kaksi ryhmää eli matalan väkirehutason eläimet (MVR) sekä korkean väkirehutason eläimet (KVR). Vähemmän väkirehua saaneet eläimet saivat väkirehua 10 kg (ensikot) tai 13 kg (vanhemmat lehmät) päivässä. Väkevämmän ruokinnan ryhmässä vastaavat väkirehumäärät olivat 15 kg (ensikot) ja 18 kg (vanhemmat lehmät). Herutuksen kesto oli MVR-ryhmässä 11 vuorokautta ja KVR-ryhmässä 17 vuorokautta. Väkirehun määrän lisääminen vähensi säilörehun syöntiä, mutta lisäsi syönnin kokonaismäärää. Toteutuneet väkirehun osuudet kuiva-aineen syönnin kokonaismäärästä olivat 64 % (KVR) ja 52 % (MVR). Syönnin kokonaismäärä oli KVR-ryhmässä keskimäärin 2,1 kg kuiva-ainetta suurempi kuin MVR-ryhmässä. Säilörehun syönti oli MVR-ryhmässä keskimäärin 9,4 kg ka ja KVR-ryhmässä 7,9 kg ka. Korvaussuhde oli 0,41 kg ka säilörehua / kg ka väkirehua. Säilörehun syönnissä oli havaittavissa neljä syöntihuippua, eikä syönnin rytmittyminen poikennut juuri ryhmien välillä. Syöntihuiput tapahtuivat rehunjaon ja lypsyn jälkeen. Lisäksi keskiyöllä oli havaittavissa pienempi syöntihuippu. Enemmän väkirehua saaneet lehmät söivät säilörehua yhtä monta kertaa päivässä, mutta söivät numeerisesti nopeammin. Niiden yksittäinen syöntikerta oli lyhyempi ja sen aikana syöntimäärä oli pienempi kuin MVR-ryhmän eläimillä. Säilörehun syöntimäärä lisääntyi poikimisen jälkeen molemmissa ryhmissä, mutta määrän lisääntyminen tapahtui nopeammin vähemmän väkirehua saaneiden ryhmässä. Syöntimäärän lisääntyminen on selitettävissä kokonaissyöntiajan lisääntymisellä, sekä syöntiajan lisääntymisellä syöntikertaa kohden. Sitävastoin syöntinopeus hidastui lypsykauden edetessä. Tässä kokeessa ei saavutettu tuotosvastetta väkirehun määrää lisäämällä, vaikka rehun kokonaissyönti lisääntyi selvästi. Tuotosvaste oli vain 0,027 kg/kg ka väkirehua. Energiakorjattuna maitona ilmaistuna tuotosvaste oli negatiivinen eli - 0,22 EKM/kg ka. Huono tuotosvaste voi johtua tässä kokeessa väkirehun suuresta määrästä ja koostumuksesta. Suurempi kuiva-aineen syönti näytti kerryttävän KVR-ryhmän eläinten elopainoa maidontuotannon sijaan. Maidon rasva- ja valkuaispitoisuuksissa ei havaittu merkitseviä eroja ryhmien välillä, mutta pitoisuudet olivat pienempiä KVR-ryhmässä MVR-ryhmään verrattuna.

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

Functional and work disability and treatment received by patients with major depressive disorder

This study is one part of a collaborative depression research project, the Vantaa Depression Study (VDS), involving the Department of Mental and Alcohol Research of the National Public Health Institute, Helsinki, and the Department of Psychiatry of the Peijas Medical Care District (PMCD), Vantaa, Finland. The VDS includes two parts, a record-based study consisting of 803 patients, and a prospective, naturalistic cohort study of 269 patients. Both studies include secondary-level care psychiatric out- and inpatients with a new episode of major depressive disorder (MDD). Data for the record-based part of the study came from a computerised patient database incorporating all outpatient visits as well as treatment periods at the inpatient unit. We included all patients aged 20 to 59 years old who had been assigned a clinical diagnosis of depressive episode or recurrent depressive disorder according to the International Classification of Diseases, 10th edition (ICD-10) criteria and who had at least one outpatient visit or day as an inpatient in the PMCD during the study period January 1, 1996, to December 31, 1996. All those with an earlier diagnosis of schizophrenia, other non-affective psychosis, or bipolar disorder were excluded. Patients treated in the somatic departments of Peijas Hospital and those who had consulted but not received treatment from the psychiatric consultation services were excluded. The study sample comprised 290 male and 513 female patients. All their psychiatric records were reviewed and each patient completed a structured form with 57 items. The treatment provided was reviewed up to the end of the depression episode or to the end of 1997. Most (84%) of the patients received antidepressants, including a minority (11%) on treatment with clearly subtherapeutic low doses. During the treatment period the depressed patients investigated averaged only a few visits to psychiatrists (median two visits), but more to other health professionals (median seven). One-fifth of both genders were inpatients, with a mean of nearly two inpatient treatment periods during the overall treatment period investigated. The median length of a hospital stay was 2 weeks. Use of antidepressants was quite conservative: The first antidepressant had been switched to another compound in only about one-fifth (22%) of patients, and only two patients had received up to five antidepressant trials. Only 7% of those prescribed any antidepressant received two antidepressants simultaneously. None of the patients was prescribed any other augmentation medication. Refusing antidepressant treatment was the most common explanation for receiving no antidepressants. During the treatment period, 19% of those not already receiving a disability pension were granted one due to psychiatric illness. These patients were nearly nine years older than those not pensioned. They were also more severely ill, made significantly more visits to professionals and received significantly more concomitant medications (hypnotics, anxiolytics, and neuroleptics) than did those receiving no pension. In the prospective part of the VDS, 806 adult patients were screened (aged 20-59 years) in the PMCD for a possible new episode of DSM-IV MDD. Of these, 542 patients were interviewed face-to-face with the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN), Version 2.0. Exclusion criteria were the same as in the record-based part of the VDS. Of these, 542 269 patients fulfiled the criteria of DSM-IV MDE. This study investigated factors associated with patients' functional disability, social adjustment, and work disability (being on sick-leave or being granted a disability pension). In the beginning of the treatment the most important single factor associated with overall social and functional disability was found to be severity of depression, but older age and personality disorders also significantly contributed. Total duration and severity of depression, phobic disorders, alcoholism, and personality disorders all independently contributed to poor social adjustment. Of those who were employed, almost half (43%) were on sick-leave. Besides severity and number of episodes of depression, female gender and age over 50 years strongly and independently predicted being on sick-leave. Factors influencing social and occupational disability and social adjustment among patients with MDD were studied prospectively during an 18-month follow-up period. Patients' functional disability and social adjustment were alleviated during the follow-up concurrently with recovery from depression. The current level of functioning and social adjustment of a patient with depression was predicted by severity of depression, recurrence before baseline and during follow-up, lack of full remission, and time spent depressed. Comorbid psychiatric disorders, personality traits (neuroticism), and perceived social support also had a significant influence. During the 18-month follow-up period, of the 269, 13 (5%) patients switched to bipolar disorder, and 58 (20%) dropped out. Of the 198, 186 (94%) patients were at baseline not pensioned, and they were investigated. Of them, 21 were granted a disability pension during the follow-up. Those who received a pension were significantly older, more seldom had vocational education, and were more often on sick-leave than those not pensioned, but did not differ with regard to any other sociodemographic or clinical factors. Patients with MDD received mostly adequate antidepressant treatment, but problems existed in treatment intensity and monitoring. It is challenging to find those at greatest risk for disability and to provide them adequate and efficacious treatment. This includes great challenges to the whole society to provide sufficient resources.