Probiotic interventions in infancy: Benefit and Safety Assessment of Extended Applications

Immaturity of the gut barrier system in the newborn has been seen to underlie a number of chronic diseases originating in infancy and manifesting later in life. The gut microbiota and breast milk provide the most important maturing signals for the gut-related immune system and reinforcement of the gut mucosal barrier function. Recently, the composition of the gut microbiota has been proposed to be instrumental in control of host body weight and metabolism as well as the inflammatory state characterizing overweight and obesity. On this basis, inflammatory Western lifestyle diseases, including overweight development, may represent a potential target for probiotic interventions beyond the well documented clinical applications. The purpose of the present undertaking was to study the efficacy and safety of perinatal probiotic intervention. The material comprised two ongoing, prospective, double-blind NAMI (Nutrition, Allergy, Mucosal immunology and Intestinal microbiota) probiotic interventions. In the mother-infant nutrition and probiotic study altogether 256 women were randomized at their first trimester of pregnancy into a dietary intervention and a control group. The intervention group received intensive dietary counselling provided by a nutritionist, and were further randomized at baseline, double-blind, to receive probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis) or placebo. The intervention period extended from the first trimester of pregnancy to the end of exclusive breastfeeding. In the allergy prevention study altogether 159 women were randomized, double-blind, to receive probiotics (Lactobacillus rhamnosus GG) or placebo 4 weeks before expected delivery, the intervention extending for 6 months postnatally. Additionally, patient data on all premature infants with very low birth weight (VLBW) treated in the Department of Paediatrics, Turku University Hospital, during the years 1997 - 2008 were utilized. The perinatal probiotic intervention reduced the risk of gestational diabetes mellitus (GDM) in the mothers and perinatal dietary counselling reduced that of fetal overgrowth in GDM-affected pregnancies. Early gut microbiota modulation with probiotics modified the growth pattern of the child by restraining excessive weight gain during the first years of life. The colostrum adiponectin concentration was demonstrated to be dependent on maternal diet and nutritional status during pregnancy. It was also higher in the colostrum received by normal-weight compared to overweight children at the age of 10 years. The early perinatal probiotic intervention and the postnatal probiotic intervention in VLBW infants were shown to be safe. To conclude, the findings in this study provided clinical evidence supporting the involvement of the initial microbial and nutritional environment in metabolic programming of the child. The manipulation of early gut microbial communities with probiotics might offer an applicable strategy to impact individual energy homeostasis and thus to prevent excessive body-weight gain. The results add weight to the hypothesis that interventions aiming to prevent obesity and its metabolic consequences later in life should be initiated as early as during the perinatal period.

Breastfeeding preterm infant from the delivery ward via nicu to home

The aim of this study was to examine how to support breastfeeding of preterm infants immediately after birth in the delivery ward, during their hospital stay in a neonatal intensive care unit (NICU), and at home after hospital discharge. Specifically, the role of early physical contact, maternal breastfeeding attitude, and an internet-based peer support group were investigated. The delivery ward practices concerning the implementation of early physical contact between a mother and her infant admitted to a NICU were examined by a structured survey in two hospitals. An Internet-based, breastfeeding peer-support intervention for the mothers of preterm infants was developed and tested in a randomized controlled design with one year follow-up. The main outcomes were the duration of exclusive and overall breastfeeding, expressing milk, and maternal attitude. In addition, the perceptions of mothers of preterm infants were investigated by analyzing the peer-support group discussions with a qualitative approach. The implementation of early physical contact was different between the two hospitals studied and was based more on hospital routines than the physiological condition of the infant. Preterm infants, who were born before a gestational age (GA) of 32 weeks, were hardly ever allowed to have early contact with their mothers. Both, a higher GA and early physical contact predicted earlier initiation and increased frequency of breastfeeding in the NICU. A maternal breastfeeding-favorable attitude predicted increased frequency of breastfeeding in the NICU and also a longer duration of overall breastfeeding. The actual duration of breastfeeding was, however, shorter than the mothers intended in advance. The internet-based, peer-support intervention had no effect on the duration of breastfeeding, expressing milk, or maternal attitude. The participating mothers enjoyed the possibility of sharing their experiences of preterm infants with other mothers in similar situations. Some of the mothers also experienced being given useful advice for breastfeeding. Based on the mothers’ discussions, a process of breastfeeding preterm infants was created. This included some paradoxical elements in the NICU where, for example, breast milk was emphasized over breastfeeding and support in the hospital varied. Hospital discharge was a critical point, when the mothers faced breastfeeding in reality. Over time, the mothers assimilated their breastfeeding experience into part of being a mother. The care practices related to early physical contact in delivery wards need to be re-evaluated to allow more infants to have a moment with the mother. Maternal attitude could be screened prenatally and attitude-focused interventions developed. Breastfeeding support in the NICU should be standardized. Internet-based breastfeeding peer-support intervention was feasible but additional research is needed.

Luovuus ja itsetuntemus ohjaajantyössä

This research deals with obstacles and opportunities with respect to creativity. It mainly focuses on the author's most meaningful discoveries as an individual and a professional in the field of theatre during the past two years of her education. The research is a description of that transitional phase in her life. Firstly, the research discusses creativity and presence. Secondly, it describes the author personally and professionally and compares her earlier and current ways of working. It contemplates the obstacles and opportunities considering her self-knowledge and creativity, and disucsses the problems she has faced on the way to freedom and well-being. Following this, the author presents the tools for increasing her creativity, self-knowledge and body awareness in theatre work: the Gestalt Method, Acting with the Inner Partner and the Authentic Movement. She discusses the relativity between overall well-being in life and the quality of theatre work. The final section of the present research discusses the process of directing the play Suurin on rakkaus in 2006. It deals with issues such as self-knowledge in directing, group management, the importance of terror and excitement in directing and ways of enduring both. The conclusion explanes the reasons behind the author's capability of working with small groups, with creative and passionate theatre workers. It also lists the benefits of exploring one's passions, cooperating with enthusiastic and creative artists and the pursuit for balance in art and in everyday life.

Travelling in a Palimpsest : Finnish nineteenth-century painters' encounters with Spanish art and culture

Utgångspunkten för avhandlingen är finländska konstnärsresor till Spanien under 1800-talet, och kontakterna med spansk konst och kultur. Endast ett fåtal finländare reste till Spanien, och inledningsvis utrycktes intresset för spansk konst i form av kopior efter gamla mästare, utförda både efter original utanför Spanien, och reproduktioner. Denna föga imponerande start efterföljdes av ett litet antal målare som verkligen reste till Spanien under 1800-talets senare hälft: Adolf von Becker (1831–1909), Albert Edelfelt (1854–1905) och Venny Soldan (1863–1945). Jag undersöker hur deras syn på landet manifesterades i deras resebilder i förhållande till den växande turistindustrin. Syftet med avhandlingen är att visa hur den resande målaren, likt en turist, föreställde sig, upplevde och tolkade den främmande kulturen, och hur detta avbildades och uttrycktes i deras resebilder. Vid sidan av ikonografisk analys och stilkritik utnyttjas forskningsmetoder från turismteorin. Resultatet av undersökningen visar att de flesta konstnärerna dyrkade konsten på Prado-museet, beundrade flamenco, Andalusiens vackra kvinnor, tjurfäktningar och zigenarna. De längtade efter en förgången och exotisk tid, samtidigt som de följde de vältrampade turiststigarna och hänfördes av de sedvanliga sevärdheterna; de reste i ett delvis mytiskt och delvis verkligt land. Likt turister (i allmänhet), såg de det de ville se, och sökte sig till på förhand inpräntade mentala (före)bilder. Resebilderna kan med fog tolkas som medvetet konstruerade minnen från resan, souvenirs d’Espagne. Samtidigt förstärkte och upprätthöll valen av motiv uppfattningen att Spaniens äldre konst och samtida kultur var mer ”äkta” (autentiska) än den kultur man själv tillhörde. Spanien uppfattades som en kvarleva från en förgången tid som hölls levande i nuet

Herrn Johann Gerhard Schellers, ehemaligen Pastoris zu Hermstedt und Stobra Reise-Beschreibung nach Lappland und Bothnien : worinnen sowohl die dasige Landes-Art in deutlichen Abtheilungen und nöthigen Figuren aus eigenem Augenschein, gezeiget, als auch die Gelegenheit zur Reise und Rückreise kürtzlich angeführet wird : abermahls dem Druck übergeben von Gottlieb David Friedrich Scheller Rev. Min. Candid.

Digital reproduction, The National Library of Finland, Centre for Preservation and Digitisation, Mikkeli

Waste Management in Commercial Activity: State-of-the-Art and the Potential Innovation in the Urban Areas of Hanoi, Vietnam

As the rapid development of the society as well as the lifestyle, the generation of commercial waste is getting more complicated to control. The situation of packaging waste and food waste – the main fractions of commercial waste in different countries in Europe and Asia is analyzed in order to evaluate and suggest necessary improvements for the existing waste management system in the city of Hanoi, Vietnam. From all waste generation sources of the city, a total amount of approximately 4000 tons of mixed waste is transported to the composting facility and the disposal site, which emits a huge amount of 1,6Mt of GHG emission to the environment. Recycling activity is taking place spontaneously by the informal pickers, leads to the difficulty in managing the whole system and uncertainty of the overall data. With a relative calculation, resulting in only approximately 0,17Mt CO2 equivalent emission, incinerator is suggested to be the solution of the problem with overloaded landfill and raising energy demand within the inhabitants.

Casus vulneris cum fractura olecrani et ruptura ancyloseos verae complicati; quem venia exper. fac. med. praeside Joh. Agap. Törngren, m. d. chir. [et] art. obst. professore p. [et] o. Pro gradu medico publicae submittit censurae Andreas Jacobus Hjertman, stip. publ. Obstrob. [!] In audit. med. die XXVI Octob. MDCCCXVI, h. a. & p. m. s

Dedikaatio: Carolus Mannerheim.