An Infant with Food Allergy and Eczema in the Family – The Mental and Economic Burden of Caring

Allergic diseases including food allergy and eczema in an infant in combination with the everyday activities of caring for a family will pose challenges to parents. Only fragments of these challenges are revealed to health care professionals. Families have varying mental, social and economic resources to help them care for an allergic infant, and all such resources are important in determining how families succeed in meeting these challenges and the quality of the infant’s care. This study evaluated the whole burden to the family caused by an infant's allergic disease during the first 24 months of life. As the primary caregiver during this period is usually the mother, her perspective was considered important. Ecocultural theory, which considers families as capable of modifying the positive and negative forces facing them, was taken as the frame of reference. Data were collected as part of an ongoing prospective mother-infant study, and the methods included severity scoring of atopic dermatitis, dietary records, health-related quality of life measurements and assessments of the use of health care services and medications for treating the infant’s eczema, food allergy and asthma. Interviews with mothers were analysed by deductive content analysis on the basis of ecocultural theory and the family empowerment model. The theme “Living an ordinary family life” guided the organization of family activities essential for treating the infant's food allergy and eczema. These activities were sources of both strain and support for the mothers, the allergy-related supporting factors being the mother’s own knowledge of the allergy, hopes for an improvement in the infant’s condition, social support and work. An infant’s food allergy at the age of one year caused considerable strain for the mother in cases where the introduction of new foods into the child’s diet was delayed. This delay was still causing the mother additional strain when the child was 24 months of age. The infants waking at night at the ages of 12 and 24 months because of itching related to eczema caused strain for the mothers. The infants’ health-related quality of life was impaired at ages of 6 and 12 months compared with healthy infants. The principal reasons for impairments were itching, scratching and sleep disturbances at 6 and 12 months and treatment difficulties at 6 months. Problems with getting to sleep were reported at all stages irrespective of eczema and were also present in healthy infants. The economic impact of the treatment of allergic diseases on families during the first 24 months was 131 EUR (2006 value) in cases of eczema and 525 EUR in cases of food allergy. From the societal perspective, the costs of food allergy were a median of 3183 EUR (range 628–11 560 EUR) and of eczema a median of 275 EUR (range 94–1306 EUR). These large variations in costs in food allergy and eczema indicate that disease varies greatly . In conclusion, food allergy and eczema cause extra activities and costs to families which arrange these disease-related activities in such a way that they support the leading family theme “Living an ordinary family life”. Health care professionals should consider this thematic character of family life and disease-related activities in order to ensure that new treatments are sustainable, meaningful and tailored to daily activities. In addition, those mothers who are experiencing difficulties with food allergic infants or infants with eczema should be recognized early and provided with individual encouragement and support from health clinics. In the light of the present results, early detection of symptoms and effective parental guidance can contribute to the well-being and health-related quality of life of the child and family.

People and the intertidal : human induced changes, biodiversity loss, livelihood implications and management in the Western Indian Ocean

Vad händer i tidvattenzonen? Var går gränsen mellan land och hav, vad händer i tidvattenzonen och vem ansvarar för detta? I västra Indiska oceanen (VIO) kan avståndet mellan den lägsta nivån för lågvattnet och den högsta nivån för högvattnet vara flera kilometer och nivåskillnaderna upp till 6 meter och detta skapar ett stort och föränderligt område. Syftet med min avhandling är att öka förståelsen för tidvattenzonen i tropiska och subtropiska västra Indiska oceanen. Sammanfattningsvis visar mina studier att det finns ett mycket stort värde i den komplexa tidvattenzonen, men också att det här området hotas från både land och hav, genom t.ex. överexploatering, erosion och föroreningar. Uttnyttjandet av tidvattenzonen är stort och min avhandling har visat att aktiviteter såsom fiske i form av plocking av musslor och andra ryggradslösa djur och hamnaktiviteter påverkar den biologiska mångfalden negativt, vilket leder till försämrad levnadsstandard för resursutnyttjande människor i regionen. För att förbättra situationen krävs det mer forskning, miljöövervakning och bättre förvaltning av tidvattenzonen. Experter i regionen har rangordnat förslag på förvaltningsstrategier som skulle kunna testas för att förbättra miljön och skapa ett mer hållbart nyttjande. Avhandlingen visar även att det är möjligt att använda fjärranalysteknik såsom satellitbildsanalys för att kvantifiera mängden sjögräsvegetation (i form av biomassa), vilket kan ha stor betydelse för att förbättra storskalig miljöövervakning av kustnära naturtyper (habitat). I avhandlingsarbetet har jag använt mig av ett multidisciplinärt tillvägagångssätt och använt metoder såsom ekologisk och biologisk provtagning, intervjuer, observationer, diskussionsgrupper, frågeformulär och fjärranalys. Resultaten presenterade i denna avhandling ger en ökad kunskap om tidvattenzonen i utvecklingsländerna inom VIO-regionen som kan användas för att initiera och fortsätta att utveckla hållbara förvaltningsstrategier av biologiska resurser.

Hearing Impairment and Tinnitus in the Elderly

The purpose of this study was to gather information on hearing impairment and related factors among elderly people. The HHIE-S questionnaire (Hearing Handicap Inventory for Elderly-Screening) and a single hearing question (”Do you feel you have a hearing loss”) were compared to audiometric hearing thresholds (N=164). HHIE-S was reliable for detecting moderate or worse hearing impairment. The single question was equally sensitive and more specific in identifying mild hearing impairment. The prevalence of hearing impairment was evaluated in four age cohorts (70, 75, 80 and 85 years, N=4067) in Turku, Finland. The HHIE-S cut-off score >8 as an indicator of at least mild hearing impairment yielded prevalence values of 37.7% - 54.1%, and a score >18 (moderate or more severe hearing impairment) was 21.1% - 38.9%. The single question test was positive in 25.5% - 46.2%. Hearing aid compliance and problems experienced by hearing aid users were recorded as informed by the participants in a mailed interview (N=249/4067). The hearing aids were used daily by 55.4%, and never by 10.7%. Use sank with advancing age. The disturbance caused by tinnitus among 583 subjects was compared to their level of alexithymia (TAS-20) and depressiveness (BDI). Depressiveness was weakly associated with annoying tinnitus, but not alexithymia. The prevalence of hearing impairment can be measured by enquiry. Hearing aid compliance should be improved by technical means and better counseling. The factors affecting the distress experienced by tinnitus patients need further study.

Localization, Frequency, and Functions of Filled Pauses: Five American Politicians’ Use of er and erm in the Talk Show Larry King Live

Tämän pro gradu– tutkielman tavoitteena oli testata täytettyjen taukojen (er ja erm) esiintymistiheyttä, sijaintia kieliopillisessa rakenteessa sekä funktioita Kjellmerin (2003) korpus-tutkimuksessa. Materiaalina käytin viiden yhdysvaltalaisen poliitikon puhetta keskusteluohjelmasta Larry King Live. Tutkimuksessani sovelsin Kjellmerin tutkimusmenetelmiä, joita muokkasin huomattavasti suppeampaan materiaaliini sopiviksi. Lähestymistapani oli täten induktiivinen toisin kuin testatussa tutkimuksessa. Materiaalini oli tarkoituksellisesti rajattu, sillä halusin selvittää, kuvaavatko Kjellmerin laajaan materiaaliin perustuvat tutkimustulokset myös täytettyjen taukojen käyttöä suppeammassa materiaalissa. Materiaalini (kokonaisuudessaan 101 minuuttia) transkriboin ortografisesti. Analyysissäni arvioin täytettyjen taukojen esiintymistiheyden puhujakohtaisesti ja koko ryhmälle suhteuttamalla täytettyjen taukojen lukumäärän kokonaissanamäärään. Tämän jälkeen tein perinteisen kielioppianalyysin rakenteista, joita edeltää tai joissa esiintyy täytetty tauko, ja täytettyjen taukojen sijainnin perusteella luokittelin ne sana-, lauseke-, ja lausetasolle. Lopuksi analysoin täytettyjen taukojen käyttöä soveltaen Kjellmerin ehdottamia funktioita (hesitaatio, vuorottelujäsennyksen merkitseminen, huomion herättäminen ja kontaktin luominen, korostus ja korjaus) ja niiden piirteitä omaan materiaaliini. Tutkimukseni perusteella täytetyt tauot esiintyvät tutkitun viiden poliitikon puheessa suhteellisen usein. Puhujakohtaiset eroavaisuudet olivat kuitenkin huomattavat. Kieliopillisen luokitteluni mukaan sana-, lauseke- ja lausetasot eivät täysin kuvaa täytettyjen taukojen sijoittumista, sillä täytetyt tauot edelsivät mm. määre-lauseita, jotka eivät vastaa lausetasoa englannin kielessä. Materiaalini funktioanalyysi osoitti, että täytetyt tauot yleensä vastaavat yhtä tai useampaa Kjellmerin ehdottamaa funktioita. Lisäksi tutkimukseni mukaan täytetyillä tauoilla on ainakin yksi rakenteellinen funktio. Analyysini perusteella Kjellmerin tutkimustulokset ovat siis pääosin sovellettavissa suppeampaan materiaaliin. Puutteiksi hänen tutkimuksessaan osoittautuivat funktioanalyysille tärkeän kontekstuaalisen informaation puute sekä keskittyminen täytettyihin taukoihin, jotka esiintyvät vain tietyissä kielioppirakenteissa. Yleisesti voin tutkimukseni pohjalta todeta, että täytetyt tauot ovat vielä vajaasti tunnettuja ja että kieliopillisen sijoituksen ja funktioiden lisätutkimus on tarpeellista.

Marketed recordings of hymns: old wine in new wineskins? : a musico-sociological study of developments and reception in the Nordic region since 1991

Artikkeli on julkaistu Hymnologi - Nordiskt tidskirft -lehden numerossa 3-4 / 2012.

Towards Perfection Step by Step – User Experience Design and Evaluation in the Context of Digital Libraries

Heli Kautonen's presentation in the LIBER Conference 27 June, 2013 in Munich, Germany.

Fe y esperanza : women's road to leadership and ministry in the Lutheran church of El Salvador 1952-2009

The Lutheran Church of El Salvador made a decision, in 1986, to open the ministry to women. How was it possible in the midst of a Latin American macho culture and after having been influenced by the theologically conservative, North American mission work? This research examines the kinds of internal and external factors which led women to leadership and ministry, and the context in which this development occurred. The roles of women have been scrutinised during several time periods. During 1952-1974 the focus was on women as missionary wives and fundadoras (founding mothers). Women’s roles as laywomen grew in 1975-1985. After the outburst of the civil war in 1980, women advanced to lay leaders. The ministry was opened for women and the first deacon pastors were installed in 1986 and the first presbyter pastors were ordained in 1994. In 2009, more women than ever were working in different levels – from laywomen to leaders – in the Lutheran Church of El Salvador. The research shows that the reasons for the development and changes concerning women’s positions and roles lie in the impact of significant individuals, liberation theology, the feminist and women’s movement, civil war and the theology of life.

State of logistics and transport in the Baltic Sea region in 2025

The world’s pace of change is accelerating and new innovations, inventions and technologies come about every day. Change is unavoidable. It is difficult to keep up and even more difficult to prepare for the future. Even though it is not possible to know exactly what will happen in the future, by studying futures people can better anticipate what might lie ahead. By making decisions and realizing the consequences of their choices today, people and governments are able to actively decide how they will act in the future. Both opportunities and pitfalls lie ahead, which encourages actors to make more farsighted decisions. The Baltic Sea region is an interesting area for futures studies. It comprises 11 nations and more than 100 million inhabitants and entails countries with advanced, high-income economies, like Finland, Germany and Denmark, and developing economies, like Russia, Latvia and Lithuania. The western, eastern, northern and southern parts of the region are separated by the Baltic Sea, which at the same time represents a barrier and a facility for trade and travel between the countries belonging to the region The purpose of this study was to uncover the most probable future of transport and logistics in the Baltic Sea region in 2025 by using the Delphi method. Altogether 109 responses were collected in two separate instances from experts in all the Baltic Sea region countries, 56 of whom were defined as academic respondents and 53 of whom business respondents. Only minor differences in the opinions of academic and business experts were discovered, and the larger differences lie between eastern and western response groups. The Baltic Sea region is a very heterogeneous region and the division is clearest between East and West, which differ in political, economic, social, technological and environmental aspects. The probable future of the Baltic Sea region presented in this study is coherent with previous studies on the same subject. The future of the Baltic Sea region in terms of logistics and transport looks quite bright according to the experts who participated in the study. Trade volumes will grow and the importance of logistics and transport to the competitiveness of the region will increase. Respondents from eastern countries seemed to be more optimistic about the future in general. Most differences between opinions could be explained by the gap in technological and infrastructural development between the East and West. As eastern countries are less-developed in some parts of their economies, it is easier for them to improve the technical condition of infrastructure by merely catching up with the western countries.

Conditions and practices in the commercialisation of innovations in wood industry

The report 'Conditions and practices in the commercialisation of innovation in wood industry' has been written as a part of the Wood Academy project. The report analyses the commercialisation conditions and practices of wood industry by utilising product categorisation based on a conceptual schema which combines the aspects of the transfer of the procession of utility and the degree of form/service utility (or value-added) created or provided by the company. Open innovation approaches help to perceive the possible new product and service innovations as well as the new business models and earning logics in the industry. The report also contains brief company cases to demonstrate theory-to-practice and showcase company examples from successful Finnish companies.