Vastaus välikysymykseen nykyisestä talouspolitiikasta (Pääministerin vastaus talouspolitiikkaa koskevaan välikysymykseen eduskunnassa 28.5.1953)

Puhe

Operative Treatment of Ovarian Cancer and Borderline Tumors in Different Hospital Categories in Finland

Surgery is the cornerstone of ovarian cancer treatment and maximal cytoreduction is important. In the early 1980’s primary surgical treatment of ovarian cancer was performed in over 80 hospitals in Finland. The significance of the operative volume of the hospital, of the training of the surgeons and of centralization of surgical treatment has been widely discussed. The aim of the present study was to evaluate the outcome of surgical treatment of ovarian cancer in different hospital categories retrospectively and prospectively, and to analyze if any differences are reflected in survival. The retrospective study included 3851 ovarian cancer patients operated between 1983 and 1994 in Finland. The data was analyzed according to hospital category (university, central, and other) and by quartiles of the hospital operative volume. The results showed that patients operated in the highest operative volume hospitals had the best relative survival. When stratifying the analysis by the period of diagnosis (1983-1988 and 1989-1994), the university hospitals improved their performance the most. The prospective part of the thesis was initiated in 1999 and included 307 patients with invasive ovarian cancer and 65 patients with an ovarian borderline tumor. The baseline and 5-year surveys used a questionnaire that was filled in by the operating surgeons. For analysis of the 5-year followup data, the hospitals were divided into three categories (<10, 10-20, or >20 patients operated in 1999). The effect of the surgical volume was analyzed also as a continuous variable (1-47 operations per year). In university hospitals, pelvic lymphadenectomy was performed in 88 %, and para-aortic lymphadenectomy in 73 %, of the patients with stage I disease. The corresponding figures ranged from 11 % to 21 % in the other hospitals. For stage III ovarian cancer patients operated by gynecological oncologists, the estimated odds ratio for no macroscopic residual tumor was 3.0 times higher (95 % CI 1.2-7.5) than for those operated by general gynecologists. In the university and other hospitals 82% of the patients received platinum-based chemotherapy. Platinum + taxane combination was given to 63 % of the patients in the university and in 49 % in the other hospitals (p = 0.0763). Only a minority of the patients with tumors of borderline malignancy were staged according to recommendations, most often multiple peritoneal biopsies and omentectomy were neglected. FIGO stage, patient age, and residual tumor were independent prognostic factors of cancer-specific 5-year survival. A higher hospital operative volume was also a significant prognostic factor for better cancer-specific survival (p = 0.036) and disease-free survival (p = 0.048). In conclusion, ovarian cancer patients operated in high-volume university hospitals were more often optimally debulked and had a significantly better cancer-specific survival than patients operated in other hospitals. These results favor centralization of primary surgical treatment of ovarian cancer.

Toimintasuunnitelman laatiminen ohutlevytuotteita ja hitsauskokoonpanoja valmistavalle yritykselle

Tämän diplomityön tavoitteena oli luoda ohutlevytuotteita ja hitsauskokoonpanoja valmistavalle yritykselle kokonaisvaltainen toimintasuunnitelma ja esitellä erilaisia tuotantomalleja case-esimerkkien avulla. Työn aikana kartoitettiin yrityksennykytilannetta ja ongelmakohtia, pohdittiin nykyistä konekantaa ja löytyneitä pullonkauloja. Lisäksi suunniteltiin korjaustoimenpiteitä ja mitä tulisi tehdä, kun tulevaisuudessa yrityksen liikevaihto tulee kasvamaan ja yritystä tullaan laajentamaan. Pääpaino oli myös laskelmilla, joissa selvitettiinmahdollisten investointien tuntihintaa. Tuntihinnan avulla laadittiin taulukoita, joiden avulla ulosmyyntihinta on helppo määrittää. Tuntihinta kytkettiin sijoitetulle pääomalle haluttuun tuottoprosenttiin.

Keis. Suomen Jääkeri-Rykmentti, Keis. Suomen Jalkaväin-Rykmentti vuonna 1826 : M. v. Wright piirittänyt

Tukhulmissa : Painettu M. G. Lundbergin Kirja-pajassa 1831

Métamorphoses identitaires en situation de mobilité

Identity metamorphoses in a context of mobility This study has its roots in the current upsurge in student mobility and in the scientific debates about the concepts of identity and intercultural communication. Based on a corpus of interviews with French Erasmus students in Finland, the study blends in theories of postmodern identity, intercultural hermeneutics and discourse analysis to examine how the students construct themselves and diverse ‘othernesses’ (included theirs) when they talk about their experiences. The use of the French pronoun on, pronoun switches, and virtual voices (ex: I said to myself...) allowed to pinpoint the students’ unstable identity metamorphoses in their discourses: integration of liquid and solid selves, infidelity in identification with the French but also with Erasmus ‘tribes’, and games of identity. Though the exchange experience appears as interesting for the students, the results show that many and varied misconceptions about identity, culture, intercultural communication, language use, and strangeness lead the students to evaluate their experiences negatively. The implication of the study is that students should be prepared for their time abroad, not so much in terms of ‘grammars of culture’ (e.g. ‘Finns behave in such and such ways’, ‘the French are...’), but through the development of competences to analyse the identity metamorphoses that take place in intercultural encounters and prevent people from meeting each other as diverse individuals. This could make study abroad one of the best training periods for postmodernity and globalization.

Harrisin ja Atranin argumentit

Keskustelua

Kleine Etyde

Soitinnus: piano.

De elicienda in foro criminali reorum confessione

Painettu uudelleen: Matthiae Calonii opera omnia II. Holmiae 1830. S. 257-307

Regulae quaedam circa collisionem legum observandae

Invocatio: I.N.J.C.

Mikael Agricolan teosten kielen ala-, ylä-, ja -pää-vartaloiset adpositiot

Adpositions with the stems ala, ylä and pää in the language of Mikael Agricola’s writings The language of Mikael Agricola’s (c 1510–1557) writings represents an interesting phase in the development of the Finnish system for adpositions. In the Finnish language, the older Uralic system of postpositions has undergone expansion and a new system of prepositions has been adopted. On the other hand, the adposition system found in Agricola’s writings has also been strongly affected by foreign models, because Agricola’s texts are mainly translations of religious texts, which by and large use a word-for-word translation strategy. In the thesis, I explore Agricola’s use of adpositions; more specifically, which adpositions carry the meaning of ‘being under’ or ‘being over’ something, and in what other functions these adpositions are used. My main focus is on the semantics of the adpositions. I also study the syntactic features of adpositions and adposition structures; these are intertwined with semantics, since the meaning of adpositions is established in the adposition clause. Finally, I compare Agricola’s use of adpositions to the corresponding adpositions of present-day Finnish. Adpositions with stems ala, ylä and pää form an interesting subject for research. Their frequency in the data, however, is highly uneven. The overwhelming majority of the adpositions studied in the thesis are päälle; there are only two occurrences of adpositions with the stem ylä. Adpositions typically denote a location ‘under’ or ‘above’ something. Almost half of the adpositions, however, can be classified as semantically unmotivated and as representing a foreign model in terms of the Finnish language; they do not occur in present-day Finnish. In Agricola’s texts they act in more grammatical roles than the corresponding adpositions of present-day Finnish. In the thesis, the corresponding adpositions in the source languages are carefully analysed. All other uses of the adpositions are marginal in relation to spatial ones and those based on foreign models. The original meanings of the adpositions have not changed much since Agricola, but adpositions considered to originate from foreign models have been intentionally eliminated in presentday standard Finnish. It is also noteworthy that the system of adpositions with the stems ala, ylä and pää has changed since Agricola. His texts include the adposition ala, which corresponds to the modern adposition alle. Likewise the adposition yllä is absent in Agricola, as are the internal locative cases of the adposition pää.

Fractures in older people - incidence, predictors and consequences

In older populations, fractures are common and the consequences of fractures may be serious both for an individual and for society. However, information is scarce about the incidence, predictors and consequences of fractures in population-based unselected cohorts including both men and women and a long follow-up. The objective of this study was to analyse the incidence and predictors of fractures as well as functional decline and excess mortality due to fractures, among 482 men and 695 women aged 65 or older in the municipality of Lieto, Finland from 1991 until 2002. In analyses, Poisson’s, Cox proportional Hazards and Cumulative Logistic regression models were used for the control of several confounding variables. During the 12-year follow-up with a total of 10 040 person-years (PY), 307 (26%) persons sustained altogether 425 fractures of which 77% were sustained by women. The total incidence of fractures was 53.4 per 1000 PY (95% confidence intervals [95% CI]: 47.9 - 59.5) in women and 24.9 per 1000 PY (95% CI: 20.4 - 30.4) in men. The incidence rates of fractures at any sites and hip fractures were associated with increasing age. No significant changes in the ageadjusted incidence rates of fractures were found in either gender during the 12-year follow-up. The predictors of fractures varied by gender. In multivariate analyses, reduced handgrip strength and body mass index (BMI) lower than 30 in women and a large number of depressive symptoms in men were independent predictors of fractures. A compression fracture in one or more thoracic or upper lumbar vertebras on chest radiography at baseline was associated with subsequent fractures in both genders. Lower body fractures independently predicted both short- (0-2 years) and long-term (up to 8 years) functional decline in mobility and activities of daily living (ADL) performance during the 8-year follow-up. Upper body fractures predicted decline in ADL performance during longterm follow-up. In the 12-year follow-up, hip fractures in men (Hazard Ratio [HR] 8.1, 95% CI: 4.4-14.9) and in women (HR 3.0, 95% CI: 1.9-4.9), and fractures at the proximal humerus in men (HR 5.4, 95% CI: 1.6-17.7) were independently associated with excess mortality. In addition, leisure time inactivity in physical exercise predicted independently both functional decline and excess mortality. Fractures are common among older people posing serious individual consequences. Further studies about the effectiveness of preventing falls and fractures as well as improving care and rehabilitation after fractures are needed.