Ecological and Epidemiological Analyses of Multiple Sclerosis Relapse Rate

The underlying cause of many human autoimmune diseases is unknown, but several environmental factors are implicated in triggering the self-destructive immune reactions. Multiple Sclerosis (MS) is a chronic autoimmune disease of the central nervous system, potentially leading to persistent neurological deterioration. The cause of MS is not known, and apart from immunomodulatory treatments there is no cure. In the early phase of the disease, relapsing-remitting MS (RR-MS) is characterized by unpredictable exacerbations of the neurological symptoms called relapses, which can occur at different intervals ranging from 4 weeks to several years. Microbial infections are known to be able to trigger MS relapses, and the patients are instructed to avoid all factors that might increase the risk of infections and to properly use antibiotics as well as to take care of dental hygiene. Among those environmental factors which are known to increase susceptibility to infections, high ambient air inhalable particulate matter levels affect all people within a geographical region. During the period of interest in this thesis, the occurrence of MS relapses could be effectively reduced by injections of interferon, which has immunomodulatory and antiviral properties. In this thesis, ecological and epidemiological analyses were used to study the possible connection between MS relapse occurrence, population level viral infections and air quality factors, as well as the effects of interferon medication. Hospital archive data were collected retrospectively from 1986-2001, a period in time ranging from when interferon medication first became available until just before other disease-modifying MS therapies arrived on the market. The grouped data were studied with logistic regression and intervention analysis, and individual patient data with survival analysis. Interferons proved to be effective in the treatment of MS in this observational study, as the amount of MS exacerbations was lower during interferon use as compared to the time before interferon treatment. A statistically significant temporal relationship between MS relapses and inhalable particular matter (PM₁₀) concentrations was found in this study, which implies that MS patients are affected by the exposure to PM₁₀. Interferon probably protected against the effect of PM₁₀, because a significant increase in the risk of exacerbations was only observed in MS patients without interferon medication following environmental exposure to population level specific viral infections and PM₁₀. Apart from being antiviral, interferon could thus also attenuate the enhancement of immune reactions caused by ambient air PM₁₀. The retrospective approach utilizing carefully constructed hospital records proved to be an economical and reliable source of MS disease information for statistical analyses.

Project owner’s and outside engineering consultant’s role in power plant implementation projects

The purpose of this study was to investigate the nature of co-operation between a project owner and an outside engineering consultant in combined heat and power plant implementation projects. Moreover, as another focal subject of the study was to familiarize the purchasing behavior of the energy producer and how an outside engineering consultant participated into different stages of the purchasing process. The study was carried out as a multiple case study including altogether six Finnish power plant implementation projects that had been taken into commercial use during 1995 – 2015. By adjusting the findings of empirical interview data and comparing those to the theoretical framework concerning, among others, Finnish energy production, engineering consulting businesses, delivery methods of construction project and finally the purchasing process, it can be concluded that especially in the power plant implementation projects in the past have a great influence to decisions made during the project. The role of the main engineering consultant is to act as an assistant, who helps to achieve the project goals successfully rather than an advisor who only knows how the project should be conducted. At least in these five project cases this was the case, meaning that the final decision power always remaining with project owner.

Resources and capabilities approach to online strategy – Multiple-case study of Finnish magazines' online services

Most Finnish periodical magazines have a website, often an online service. The objective of this thesis is to understand the magazines’ resources and capabilities and match them with online strategies’ goals and objectives. The thesis’ theoretical part focuses on explaining and classifying resources, capabilities, goals and objectives, and applying everything into Finnish magazine publishing context. In the empirical part, there is a comparative case study of four magazines. The findings indicate that with cooperating, advertising and community hosting capabilities magazines may utilize their human, brand, content and customer base resources. The resources can be further addressed to reach profitability, customer-centricity and brand congruency goals.

Kuka suunnittelee mainokset? Tutkimus mainosalan kulisseista,yhteistyökäytännöistä ja ristiriidoista. Mainonnan suunnittelijan näkökulma

Tutkimus kuvaa tapahtumia mainonnan suunnittelun kulissien takana ja niiden vaikutusta suunnittelutyöhön mainonnan suunnittelijan näkökulmasta. Lähestymistapa on systeemiteoreettinen: tutkimuksessa tarkastellaan sekä mainostoimiston suunnittelijoiden, projektijohtajien ja muiden mainonnan suunnitteluun osallistuvien keskinäistä vuorovaikutusta että mainostoimiston ja mainoksia tilaavan asiakkaan vuorovaikutuksen asettamia rajoja ja mahdollisuuksia. Keskeinen työväline on Kurt Lewinin kentän käsite. Tutkimuksessa se konkretisoituu esitystavaksi mainonnan suunnittelun olennaisista piirteistä, jotka ovat toisistaan riippuvaisia. Tutkimusta pohjustaa ajatus mainonnan suunnittelun perusrakenteesta, joka on riippumaton taloudellisista, yhteiskunnallisista tai mainostoimialan liiketoimintaympäristön muutoksista. Mainostoimistossa työtä tehdään usein ryhmässä. Ydinryhmä muodostuu kirjoittavan ja visuaalisen suunnittelijan työparista, mutta projektijohtaja on avainasemassa hoitaessaan yhteydenpitoa mainostoimiston asiakkaaseen. Tutkimustyötä viitoittivat kysymykset mainonnan suunnittelijoiden tehtävästä ja asemasta, työssä koetuista haasteista sekä osuudesta ja vastuusta lopullisissa töissä. Keskiössä ovat suunnittelutyötä raamittavat haasteet, jotka ohjaavat suunnittelijoiden kykyjä ja haluja toteuttaa luovuuttaan. Tutkimus ammentaa teoreettisia aineksia työnjaon ja tiimityön käsitteiden ohella vallan tilanteisuudesta ja suhteista sekä sosiaalisen pääoman ja luottamuksen moniaineksisuudesta. Tutkimuksen aineisto kerättiin syksyllä 2008 ja alkuvuodesta 2009 haastattelemalla suomalaisten mainostoimistojen suunnittelijoita. Haastatteluaineisto koostuu kymmenestä ryhmähaastattelusta, johon kuhunkin osallistui 3–4 suunnittelijaa. Muu aineisto sisältää toimialan tilastoja ja julkaisuja sekä yksityisiä sähköpostikirjeenvaihtoja ja keskusteluja mainosammattilaisten kanssa. Haastatteluaineisto analysoitiin Milesin ja Hubermannin aineistolähtöisen sisällönanalyysin avulla ja sitä täydennettiin retorisella diskurssianalyysilla. Analyysin alkuvaiheessa koemetodina sovellettiin Straussin ja Corbinin aineistolähtöisen teorian (grounded theory) kolmivaiheista koodausta. Tutkimuksen tuloksena on malli mainonnan suunnittelun kentän jännitteistä, jotka johtavat toimimaan tietyllä tavalla. Mainonnan suunnittelijan tehtävinä näyttäytyvät vaikuttaminen, asiakkaan tarpeiden tunnistaminen ja tyydyttäminen sekä omakohtainen menestyminen. Suunnittelijan asema näyttää työssä koettujen haasteiden kautta häilyvän asiantuntijuuden ja alihankkijuuden välimaastossa. Työn henkilökohtaisina haasteina piirtyvät tarmokkuuden ja jatkuvan oivaltamisen vaateet. Ulkoisina tekijöinä talouden, teknologian ja sen myötä median murros sekä haastaa että kehittää: alituiseen kiireeseen näytetään verhoavan pulmia, joiden todellinen alkuperä paikantuu muualle. Keskeiset ristiriidat ja toiminnan edellytykset ilmenevät juuri yhteistyössä: mainostoimiston sisäinen yhteistyö ja asiakkaan antama palaute ovat merkittäviä tekijöitä luottamuksen taustalla. Siten avoin ja vastavuoroinen kommunikaatio piirtyy olennaiseksi asetettujen tavoitteiden saavuttamisessa ja asiakkaan menestymisessä. Mainonnan suunnittelussa tärkeäksi kysymykseksi nousevat portinvartijoiden roolit. Mainostoimiston sisäisessä työskentelyssä projektijohtajat hallinnoivat suunnitteluresursseja, välittävät tietoa asiak kaalta suunnittelijalle ja päinvastoin sekä tekevät tärkeimmät päätökset. Asiakkaan puolella mainoksia tilaava asiakashenkilö hallinnoi valjastamiaan resursseja, mutta varsinainen päätöksenteko tapahtuu tämän esimiehen toimesta. Tulosten valossa on perusteltua uskoa, että mainonnan suunnittelijat kokevat oman työnsä arvon alentuneen ja päätösvaltansa vähentyneen. Mainostoimialan murroksen kannalta tutkimus tuo esiin uudenlaisen tiimityön ymmärtämisen ja korostaa yksilöiden vahvuuksien tunnistamisen merkitystä. Kiristyvässä taloudessa se suuntaa huomion sekä mainostoimistojen että niiden asiakasyritysten sisäisten ja ulkoisten resurssien tehokkaaseen ja tuottavaan hyödyntämiseen ja organisoimiseen. Sosiologisesti tutkimus tarjoaa yhdenlaisen näkökulman ryhmätyön ulottuvuuksiin ja työelämän yhteistyöhaasteiden pohtimiseen. Siten tutkimuksen tuloksilla voi nähdä arvoa myös muiden kuin mainosalan yhteistyökäytäntöjentarkasteluun.

Contextualizing entrepreneurial intentions : a multiple case study on entrepreneurial cognition and perception

Avhandlingen behandlar entreprenöriella intentioner och individens uppfattningar om entreprenörskap. Om vi vill främja entreprenörskap så räcker det inte att vi förstår vilken nytta samhället kan ha av entreprenörer (arbetsplatser, mera skatteinkomster osv.). Vi måste förstå varför entreprenörskap är intressant och attraktiv ur individens synvinkel. Just den frågan har varit central inom kognitiv entreprenörskapsforskning de senaste 10 åren har vår förståelse för entreprenörer ökat betydligt tack vare den forskningen. Problemet med existerande forskning är att uppfattad genomförbarhet och uppfattad attraktivitet, dvs. de attityder som sägs leda till entreprenöriella intentioner, beskriver enbart vilken attityd individen generellt har till entreprenörskap. Enligt tidigare forskningsresultat så är det skillnad på generella attityder till en handling och attityder till att genomföra just den handlingen. Vill vi veta om individen kan tänka sig starta och driva ett företag så måste vi alltså studera individens attityd till att utföra just den specifika handlingen. Enligt avhandlingens forskningsresultat så kan vi lära oss mera om attityder till entreprenörskap genom att studera också motivation och mål. På så sätt kan vi förstå varför en del väljer att bli entreprenörer medan andra väljer att låta bli, även om de utåt sett har samma möjligheter att bli entreprenörer.

Autologous Stem Cell Transplantation In Multiple Myeloma

Background. Multiple myeloma (MM) is the second most common hematologic malignancy after lymphomas In Finland: the annual incidence of MM is approximately 200. For three decades the median survival remained at 3 to 4 years from diagnosis until high-dose melphalan treatment supported by autologous stem cell transplantation (ASCT) became the standard of care for newly diagnosed MM since the mid 1990’s and the median survival increased to 5 – 6 years. This study focuses on three important aspects of ASCT, namely 1) stem cell mobilization, 2) single vs. double ASCT as initial treatment, and 3) the role of minimal residual disease (MRD) for longterm outcome. Aim. The aim of this series of studies was to evaluate the outcomes of MM patients and the ASCT procedure at the Turku University Central Hospital, Finland. First, we tried to identify which factors predict unsuccessful mobilization of autologous stem cells. Second, we compared the use of short-acting granulocyte-colony stimulating factor (GCSF) with long-acting G-CSF as mobilization agents. Third, one and two successive ASCTs were compared in 100 patients with MM. Fourth, for patients in complete response (CR) after stem cell transplantation (SCT), patient-specific probes for quantitative allele-specific oligonucleotide polymerase-chain reaction (qASO-PCR) measurements were designed to evaluate MRD and its importance for long-term outcome. Results. The quantity of previous chemotherapy and previous interferon use were significant pre-mobilization factors that predicted mobilization failure, together with some factors related to mobilization therapy itself, such as duration and degree of cytopenias and occurrence of sepsis. Short-acting and long-acting G-CSF combined with chemotherapy were comparable as stem cells mobilizers. The progression free (PFS) and overall survival (OS) tended to be longer after double ASCT than after single ASCT with a median follow-up time of 4 years, but this difference disappeared as the follow-up time increased. qASO-PCR was a good and sensitive divider of the CR patients into two prognostic groups: MRD low/negative (≤ 0.01%) and MRD high (>0.01%) groups with a significant difference in PFS and suggestively also in OS. Conclusions. When the factors prediciting a poor outcome of stem cell mobilization prevail, it is possible to identify those patients who need specific efforts to maximize the mobilization efficacy. Long-acting pegfilgrastim is a practical and effective alternative to short-acting filgrastim for mobilization therapy. There is no need to perform double ASCT on all eligible patients. MRD assessment with qASO-PCR is a sensitive method for evaluation of the depth of the CR response and can be used to predict long-term outcome after ACST.

Yliopistohakijan päätöksentekoprosessi markkinointiviestinnän näkökulmasta

Tutkielman tavoitteena on selventää yliopistohakijan päätöksentekoprosessia. Jotta yliopistohakijan päätöksentekoon pystyttiin tarkemmin tutustumaan, selvitettiin informaationhakua hyödyllisien viestintäkanavien ja vaihtoehtojen vertailua tärkeiden valintakriteerien avuilla. Tutkielmassa tarkasteltiin myös sitoutuneisuutta ja subjektiivista tietotasoa, jotta hakijan viitekehystä pystyttiin tarkemmin ymmärtämään. Yliopistohakijoihin kohdistuvaa mainonnan tehokkuutta selvitettiin kolmen mainoksen avulla. Tutkielman empiirinen osa toteutettiin kvantitatiivisena internet -pohjaisena kyselytutkimuksena tilastollisin menetelmin. Otos (n=290) koostui valmennuskurssilla olevista opiskelijoista keväällä 2010. Vastausprosentiksi saatiin 33 %. Johtopäätöksenä voidaan todeta, että yliopistohakijan päätöksentekoprosessi on hyvin monimutkainen. Monimutkaisuutta prosessiin tuo useiden attribuuttien vaikuttavuus päätöksenteossa. Tutkielma on tuottanut viitekehyksen, jonka avulla voidaan havaita yliopistohakijalle tärkeät viestintäkanavat sekä valintakriteerit. Tutkielman avulla myös havaittiin, että yliopistohakijat ovat korkeasti sitoutuneita yliopistohakuun.

Public-Private Partnerships: Managing organizational change for acquiring value creative capabilities

The objective of the dissertation is to examine organizational responses of public actors to customer requirements which drive the transformation of value networks and promote public-private partnership in the electricity distribution industry and elderly care sectors. The research bridges the concept of offering to value networks where capabilities can be acquired for novel product concepts. The research contributes to recent literature, re-examining theories on interactions of customer requirements and supply management. A critical realist case study approach is applied to this abductive the research which directs to describe causalities in the analyzed phenomena. The presented evidence is based on three sources, which are in-depth interviews, archival analysis and the Delphi method. Service provision requires awareness on technology and functionalities of offering. Moreover, service provision includes interactions of multiple partners, which suggests the importance of the co-operative orientation of actors. According to the findings,portfolio management has a key role when intelligent solutions are implemented in public service provision because its concepts involve a variety of resources from multiple suppliers. However, emergent networks are not functional if they lack leaders who have access to the customer interface, have power to steer networks and a capability to build offerings. Public procurement policies were recognized to focus on a narrow scope in which price is a key factor in decisions. In the future, the public sector has to implement technology strategies and portfolio management, which mean longterm platform development and commitment to partnerships. On the other hand, the service providers should also be more aware of offerings into which their products will be integrated in the future. This requires making the customer’s voice in product development and co-operation in order to increase the interconnectivity of products.

The Role of Tactical Marketing Decisions on New Product Performance: The Moderating Effect of Entry Timing

This study focuses on observing how Finnish companies execute their new product launch processes. The main objective was to find out how entry timing moderates the relationship between launch tactics (namely product innovativeness, price and emotional advertising) and new product performance (namely sales volume and customer profitability). The empirical analysis was based on data collected in Lappeenranta University of Technology. The sample consisted of Finnish companies representing different industries and innovation activities. Altogether 272 usable responses were received representing a response rate of 37.67%. The measures were first assessed by using exploratory factor analysis (EFA) in PASW Statistics 18 and then further verified with confirmatory factor analysis (CFA) in LISREL 8.80. To test the hypotheses of the moderating effects of entry timing, hierarchical regression analysis was used in PASW Statistics 18. The results of the study revealed that the effect of product innovativeness on new product sales volume is dependent on entry timing. This implies that companies should carefully consider what would be the best time for entering the market when launching highly innovative new products. The results also depict a positive relationship between emotional advertising and new product sales volume. In addition, partial support was found for a positive relationship between pricing and new product customer profitability.

SOCIAL MEDIA IN INTERNATIONAL BRAND COMMUNICATION OF SMES - A multiple case study of small Finnish design-intensive companies

Social media is a rather new phenomenon which has revolutionised the world of online communication. However, academic research on how companies can benefit from social media is lacking. The research objective of this thesis was to examine the use of social media in international brand communication of small Finnish design-intensive companies. Therefore, this research contributes also to the research gap in SME branding. The focus was on communication targeted at consumers. The research was carried out as a mixed methods research employing the questionnaire and multiple case study methods. The questionnaire was used to gather preliminary information on Finnish design-intensive companies and to provide an eligible list of companies for deeper examination. Then, four case companies were studied in more depth. The empirical evidence of the case companies was mainly gathered through theme interviews. The results of the questionnaire shed light on the internationalisation of small Finnish designintensive companies. On average, the companies had internationalised rather quickly after they had been founded. However, the share of exports was rather low in most of the companies. The results revealed also that social media was already used widely in the exporting companies and the use can be expected to grow in future. The findings of the multiple case study suggest that branding activities in small Finnish designintensive companies are constrained by limited resources and skills. In addition, the branding activities are strongly guided by the vision and values of the entrepreneur(s) rather than extensive marketing research. The brand structure was simple in all case companies and they aimed at having a standardised brand image across markets. However, all case companies had faced a need for some adaptation of their international brand communication. Internationally important brand communication channels were international fairs, the internet, word-of-mouth and social media. Social media offered a cost-effective brand communication channel for the case companies. It was used for various purposes, such as creating brand awareness and affecting how the brand is perceived. The entrepreneurs found the use of social media to be rather easy and the case companies had not faced any major challenges. However, the companies had recognised that communication in social media requires consistency and planning. The planning was rather informal and stayed on a general level. Overall, the utilisation of social media in the case companies was limited by a lack of resources. It seemed to affect especially the follow-up of brand communication in social media which stayed rather superficial.

The Finnish it industries in transition. Defining and Measuring the Finnish Software Product and IT Services Industries by Applying Theoretical Frameworks

The starting point of this study is that the prevailing way to consider the Finnish IT industries and industry information often results in a limited and even skewed picture of the sector. The purpose of the study is to contribute and increase knowledge and understanding of the status, structure and evolution of the Finnish IT industries as well as the Finnish IT vendor field and competition. The focus is on software product and IT services industries which form a crucial part of all ICT industries. This study examines the Finnish IT sector from production (supply) as well as market (demand) perspective. The study is based on empirical information from multiple sources. Three research questions were formulated for the study. The first concerns the status of the Finnish IT industries considered by applying theoretical frameworks. The second research question targets at the basis for the future evolution of the Finnish IT industries and, finally, the third at the ability of the available definitions and indicators to describe the Finnish IT industries and IT markets. Major structural changes like technological changes and related innovations, globalization and new business models are drivers of the evolution of the IT industries. The findings of this study emphasize the significant role of IT services in the Finnish IT sector and in connection to that the ability to combine IT service skills, competences and practices with high level software skills also in the future. According to the study the Finnish IT enterprises and their customers have become increasingly dependent on global ecosystems and platforms, applications and IT services provided by global vendors. As a result, more IT decisions are made outside Finland. In addition, IT companies are facing new competition from other than IT industries bringing into market new substitutes. To respond to the new competition, IT firms seek growth by expanding beyond their traditional markets.. The changing global division of labor accentuates the need for accurate information of the IT sector but, at the same time, also makes it increasingly challenging to acquire the information needed. One of the main contributions of this study is to provide frameworks for describing the Finnish IT sector and its evolution. These frameworks help combine empirical information from various sources and make it easier to concretize the structures, volumes, relationships and interaction of both, the production and market side of the Finnish IT industry. Some frameworks provide tools to analyze the vendor field, competition and the basis for the future evolution of the IT industries. The observations of the study support the argument that static industry definitions and related classifications do not serve the information needs in dynamic industries, such as the IT industries. One of the main messages of this study is to emphasize the importance of understanding the definitions and starting points of different information sources. Simultaneously, in the structure and evolution of Finnish IT industries the number of employees has become a more valid and reliable measure than the revenue based indicators.

Magnetic Resocance Imaging Methods in the Follow-up of Multiple Sclerosis and in Farby Disease

Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disorder of the central nervous system. MS is the most common disabling central nervous system (CNS) disease of young adults in the Western world. In Finland, the prevalence of MS ranges between 1/1000 and 2/1000 in different areas. Fabry disease (FD) is a rare hereditary metabolic disease due to mutation in a single gene coding α-galactosidase A (alpha-gal A) enzyme. It leads to multi-organ pathology, including cerebrovascular disease. Currently there are 44 patients with diagnosed FD in Finland. Magnetic resonance imaging (MRI) is commonly used in the diagnostics and follow-up of these diseases. The disease activity can be demonstrated by occurrence of new or Gadolinium (Gd)-enhancing lesions in routine studies. Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are advanced MR sequences which can reveal pathologies in brain regions which appear normal on conventional MR images in several CNS diseases. The main focus in this study was to reveal whether whole brain apparent diffusion coefficient (ADC) analysis can be used to demonstrate MS disease activity. MS patients were investigated before and after delivery and before and after initiation of diseasemodifying treatment (DMT). In FD, DTI was used to reveal possible microstructural alterations at early timepoints when excessive signs of cerebrovascular disease are not yet visible in conventional MR sequences. Our clinical and MRI findings at 1.5T indicated that post-partum activation of the disease is an early and common phenomenon amongst mothers with MS. MRI seems to be a more sensitive method for assessing MS disease activity than the recording of relapses. However, whole brain ADC histogram analysis is of limited value in the follow-up of inflammatory conditions in a pregnancy-related setting because the pregnancy-related physiological effects on ADC overwhelm the alterations in ADC associated with MS pathology in brain tissue areas which appear normal on conventional MRI sequences. DTI reveals signs of microstructural damage in brain white matter of FD patients before excessive white matter lesion load can be observed on conventional MR scans. DTI could offer a valuable tool for monitoring the possible effects of enzyme replacement therapy in FD.

Professional sports and gambling regulation in Finland - Examining the institutional factors of gambling affecting professional sport clubs in Finland

This study examines how to institutional environment of gambling is currently in motion both in Europe and Finland. Furthermore, it examines the criticism by Finnish professional sport clubs directed towards the national gambling monopolies, especially Veikkaus Oy. This criticism addresses the acclaimed issue of low or non-existing sponsorship funds coming to the clubs despite the clubs’ duties to promote Veikkaus Oy in their stadiums etc. In essence the main research objective was to examine the interaction and institutional environments of both Finnish professional sport clubs and gambling regulation. This was done through three sub-objectives: 1) to analyze professional sport as business and its institutional environment 2) to analyze the institutions of gambling in their current state and their potential future 3) to evaluate the potential impact of an institutional change in gambling legislation to the professional sport clubs The findings from Finland were then compared to those of Denmark where an institutional change had occurred in gambling regulation. Empirical data was collected through multiple interviews. Interviewees represented sport clubs (7), sport association (1), sport league (1), Finnish monopoly representatives (2), commercial gambling providers (1), Danish monopoly system representatives (1), Danish sport club (1). In addition a vast amount of secondary data (e.g. Green and white books by EU, court decisions, a variety of studies etc.). Theoretically this study combines the aspects of institutional theory with the theory of professional sports as business. This proved to be a rather new approach and no published literature was found to have done specifically this. The findings of this study are twofold, on the European level it is clear that the momentum if towards a more liberated gambling market while Finland is at the moment trying to go the opposite direction and uphold its monopoly. From the sport club’s level the findings suggest that currently sport clubs do not directly benefit from the funds originated from Veikkaus Oy as these funds are more or less used on the association/league levels. However, the clubs themselves are also lacking in self-criticism as they are lacking in clear sponsorship packages/programs which Veikkaus Oy might be interested in participating. If liberation of the gambling market would occur it is highly possible that that the largest clubs in football and ice-hockey would be the main beneficiaries while smaller clubs and sports could possibly be worse off than currently. These interpretations were well supported by the findings from Denmark.