Epidemiological studies of childhood and adolescence headache

The main purpose of this study was to examine the changes in the prevalence, incidence, and characteristics of headache in childhood and adolescence. In addition, the predictors of the change in the occurrence of childhood headache and the association between adolescent headache and behavior were studied. The occurrence and characteristics of headache were investigated as part of a prospective follow-up study, where 6-year-old children and their families (n=1132) were followed to the age of 12-years (n=1126). The study design entailed both a cohort and case-control group. The incidence of headache and the association between headache and behavior were studied in another cohort, consisting of 11-year-old twins (n=5393), who were followed to the age of 17 (n=4159). The prevalence rates of headache increased during the follow-up, especially in boys whose mothers suffered from frequent headache. The incidence rates of frequent headache changed the most in girls between ages of 11 and 14. Early-onset migraine and tension-type headache were equal predictors of migraine at age 12. The age-related changes observed in pain localization, concurrent symptoms and triggers were considerable. Headache frequency was significantly associated with externalizing and internalizing problem behaviors and adaptive behaviors as rated by parents, but only with externalizing problem behaviors as rated by teachers. Headache both in children and adolescents is characterized by its changing nature. Its prevention and treatment should take familial, environmental and psychosocial aspects into account.

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.

Neurobiology of pathological gambling. Brain imaging and epidemiological studies

Pathological gambling, a form of behavioral addiction, refers to maladaptive, compulsive gambling behavior severely interfering with an individual’s normal life. The prevalence of pathological gambling has been estimated to be 1–2% in western societies. The reward deficiency hypothesis of addiction assumes that individuals that have, or are prone, to addictions have blunted mesolimbic dopamine reward signaling, which leads to compulsive reward seeking in an attempt to compensate for the malfunctioning brain reward network. In this research project, the effects of gambling were measured using brain [11C] raclopride PET during slot machine gambling and possible brain structural changes associated with pathological gambling using MRI. The subjects included pathological gamblers and healthy volunteers. In addition, impulse control disorders associated with Parkinson’s disease were investigated by using brain [18F]fluorodopa PET and conducting an epidemiological survey. The results demonstrate mesolimbic dopamine release during gambling in both pathological gamblers and healthy volunteers. Striatal dopamine was released irrespective of the gambling outcome, whether the subjects won or not. There was no difference in gambling induced dopamine release between pathological gamblers and control subjects, although the magnitude of the dopamine release correlated with gambling related symptom severity in pathological gamblers. The results also show that pathological gambling is associated with extensive abnormality of brain white matter integrity, as measured with diffusion tensor imaging, similar to substance-addictions. In Parkinson’s disease patients with impulse control disorders, enhanced brain [18F] fluorodopa uptake in the medial orbitofrontal cortex was observed, indicating increased presynaptic monoamine function in this region, which is known to influence signaling in the mesolimbic system and reward processing. Finally, a large epidemiological survey in Finnish Parkinson’s disease patients showed that compulsive behaviors are very common in Parkinson disease and they are strongly associated with depression. These findings demonstrate the role of dopamine in pathological gambling, without support for the concept of reward deficiency syndrome.

Identification of research trends in the field of separation processes. Application of epidemiological model, citation analysis, text mining, and technical analysis of the financial markets

Choice of industrial development options and the relevant allocation of the research funds become more and more difficult because of the increasing R&D costs and pressure for shorter development period. Forecast of the research progress is based on the analysis of the publications activity in the field of interest as well as on the dynamics of its change. Moreover, allocation of funds is hindered by exponential growth in the number of publications and patents. Thematic clusters become more and more difficult to identify, and their evolution hard to follow. The existing approaches of research field structuring and identification of its development are very limited. They do not identify the thematic clusters with adequate precision while the identified trends are often ambiguous. Therefore, there is a clear need to develop methods and tools, which are able to identify developing fields of research. The main objective of this Thesis is to develop tools and methods helping in the identification of the promising research topics in the field of separation processes. Two structuring methods as well as three approaches for identification of the development trends have been proposed. The proposed methods have been applied to the analysis of the research on distillation and filtration. The results show that the developed methods are universal and could be used to study of the various fields of research. The identified thematic clusters and the forecasted trends of their development have been confirmed in almost all tested cases. It proves the universality of the proposed methods. The results allow for identification of the fast-growing scientific fields as well as the topics characterized by stagnant or diminishing research activity.

Open Environmental Information Upon Disclosure Request in China: The Paradox of Legal Mobilization

Taking a realist view that law is one form of politics, this dissertation studies the roles of citizens and organizations in mobilizing the law to request government agencies to disclose environmental information in China, and during this process, how the socio-legal field interacts with the political-legal sphere, and what changes have been brought about during their interactions. This work takes a socio-legal approach and applies methodologies of social science and legal analysis. It aims to understand the paradox of why and how citizens and entities have been invoking the law to access environmental information despite the fact that various obstacles exist and the effectiveness of the new mechanism of environmental information disclosure still remains low. The study is largely based on the 28 cases and eight surveys of environmental information disclosure requests collected by the author. The cases and surveys analysed in this dissertation all occurred between May 2008, when the OGI Regulations and the OEI Measures came into effect, and August 2012 when the case collection was completed. The findings of this study have shown that by invoking the rules of law made by the authorities to demand government agencies disclosing environmental information, the public, including citizens, organizations, law firms, and the media, have strategically created a repercussive pressure upon the authorities to act according to the law. While it is a top-down process that has established the mechanism of open government information in China, it is indeed the bottom-up activism of the public that makes it work. Citizens and organizations’ use of legal tactics to push government agencies to disclose environmental information have formed not only an end of accessing the information but more a means of making government agencies accountable to their legal obligations. Law has thus played a pivotal role in enabling citizen participation in the political process. Against the current situation in China that political campaigns, or politicization, from general election to collective actions, especially contentious actions, are still restrained or even repressed by the government, legal mobilization, or judicialization, that citizens and organizations use legal tactics to demand their rights and push government agencies to enforce the law, become de facto an alternative of political participation. During this process, legal actions have helped to strengthen the civil society, make government agencies act according to law, push back the political boundaries, and induce changes in the relationship between the state and the public. In the field of environmental information disclosure, citizens and organizations have formed a bottom-up social activism, though limited in scope, using the language of law, creating progressive social, legal and political changes. This study emphasizes that it is partial and incomplete to understand China’s transition only from the top-down policy-making and government administration; it is also important to observe it from the bottom-up perspective that in a realistic view law can be part of politics and legal mobilization, even when utterly apolitical, can help to achieve political aims as well. This study of legal mobilization in the field of environmental information disclosure also helps us to better understand the function of law: law is not only a tool for the authorities to regulate and control, but inevitably also a weapon for the public to demand government agencies to work towards their obligations stipulated by the laws issued by themselves.

Service paradox in a product oriented company: A service business development case

The master´s thesis had three aims; to develop a service portfolio, to support the management of services through the developed portfolio, and evaluate effects of service differentiation strategy on the future selection of services. The product oriented case company in service paradox is Hilti (Suomi) Oy, which is entering systematic service management era, supported by the late strategic change. Low return on service business investments is referred as service paradox. The project was carried out as a case study, where the primary information source was twenty-one conducted interviews. The theory part focuses on marketing logics, service strategies, and categorization of services. The empirical part contributes in solving the aim related research questions. As a result of the case study a service portfolio was created, next further steps in service management were suggested, and the effect on selection of services by service differentiation strategy was evaluated. The main goal of creating service portfolio contributes to systematic management of services, which required revising at the case company.

Standing before a sentence : Moore’s paradox and a perspective from within language

Med avstamp i ett satsbegrepp som inspirerats av Ludwig Wittgenstein, där sats och kontext betraktas som internt förbundna och där den verkliga användningen av en sats är central för dess mening, visar avhandlingen hur filosofers olika uppfattning om den filosofiska terminologins roll och möjligheter har följder för deras sätt att uppfatta och behandla filosofiska frågeställningar. Moores paradox fungerar som testfall. Denna kända filosofiska frågeställning har diskuterats sedan 1940-talet och kretsar kring hävdandet av satsen ”Jag tror att det regnar och det regnar inte”. Problemet är att det vore märkligt för en talare att hävda satsen om sig själv: det verkar finnas ett logiskt hinder för att hävda en sats även om den är välformad, kunde vara sann och inte på ett entydigt sätt innehåller en kontradiktion. Moores paradox behandlas genom att granska några lösningsförslag (framförda av bl.a. G.E. Moore, J. L. Austin, J. Searle) och de uppfattningar om språket som de förutsätter. Genom att kontrastera dessa med ett användarperspektiv där språkets användning i meningsfulla sammanhang förväntas spela en central roll i behandlingen av paradoxen visar författaren hur också den intellektuella kontext inom vilken en filosof betraktar paradoxen spelar en avgörande roll för vilka mått som krävs för att upplösa den. Istället för att föreslå en egen lösning presenteras en behandling av paradoxen genom en diskussion och utredning av de grundvillkor som leder till att den uppstår. Här intar satsbegreppet en central plats. Avhandlingen är författad inom traditionen efter den senare Wittgenstein (närmare bestämt den gren som ansluter sig till en s.k. terapeutisk filosofisyn) men går i dialog med filosofiskt arbete som ligger utanför traditionen. Författaren strävar både till att medla mellan, sammanföra och särskilja olika temata som behandlats på ett sätt inom traditionen och på andra sätt utanför den och använder sig här av metaforen att filosofera inifrån i kontrast till utanför språket. Avhandlingens huvudsakliga bidrag är till metafilosofin genom dess fokus på filosofins metod. ------------------------------------------------------------ Mooren paradoksi on tunnettu filosofinen ongelma, josta on keskusteltu 1940-luvulta alkaen. Paradoksin keskeisenä osana esiintyy väitelause ”Uskon, että ulkona sataa, mutta ulkona ei sada”. Ongelman lähtökohta on, että olisi merkillistä jos puhuja esittäisi lauseen itseään koskevana väitteenä: väite näyttää olevan loogisesti mahdoton esittää, vaikka se on hyvinmuodostettu, mahdollisesti tosi, eikä yksiselitteisellä tavalla sisällä kontradiktiota. Tässä väitöskirjassa Mooren paradoksi esiintyy esimerkkinä filosofisesta ongelmasta, jossa mm. lausekäsitteellä on keskeinen rooli ja jonka avulla voidaan muodostella ns. kielensisäinen filosofinen näkökulma. Mooren paradoksia käsitellään tarkastelemalla muutamia ratkaisuehdotuksia (mm. G.E. Mooren, J.L. Austinin, J. Searlen esittämät) ja niitä kielikäsityksiä joita nämä ratkaisuehdotukset edellyttävät. Asettamalla vastakkain ratkaisuehdotukset ja käyttäjänäkymä, jossa kielenkäyttö mielekkäissä konteksteissa asetetaan keskeiseen asemaan paradoksin käsittelyssä, kirjoittaja osoittaa miten myös paradoksin filosofisen tarkastelun intellektuaalinen konteksti on hyväksyttävien toimenpiteiden löytämisen kannalta ratkaisevaa. Uuden ratkaisun sijaan kirjoittaja ehdottaa paradoksin terapeuttista käsittelyä: keskustelua ja selontekoa niistä perusehdoista, jotka johtavat sen syntyyn. Tässä käsittelyssä lausekäsite on keskipisteenä – erityisesti Ludwig Wittgensteinin inspiroima lausekäsitys, jossa lauseen mielekkyyden kannalta sen todellinen käyttö mielekkäässä kontekstissa on ratkaiseva tekijä. Väitöskirja liittyy myöhäisiwittgensteinilaiseen perinteeseen, johon kuuluu ns. terapeuttinen filosofiankäsitys, mutta teos keskustelee myös tradition ulkopuolisten ajattelijoiden kanssa yrittäen yhdistää, sovitella ja myös eritellä teemoja, joita käsitellään yhdellä tavalla tradition sisällä ja toisella tavalla sen ulkopuolella. Väitöskirjan pääasiallinen panos sijoittuu metafilosofiaan, koska sen mielenkiinnon kohteena ovat erityisesti filosofian menetelmät.