The effect of the birth hospital and the time of birth on the outcome of Finnish very preterm infants

The purpose of this study was to evaluate the effect of the birth hospital and the time of birth on mortality and the long-term outcome of Finnish very low birth weight (VLBW) or very low gestational age (VLGA) infants. This study included all Finnish VLBW/VLGA infants born at <32 gestational weeks or with a birth weight of ≤1500g, and controls born full-term and healthy. In the first part of the study, the mortality of VLBW/VLGA infants born in 2000–2003 was studied. The second part of the study consisted of a five-year follow-up of VLBW/VLGA infants born in 2001–2002. The study was performed using data from parental questionnaires and several registers. The one-year mortality rate was 11% for live-born VLBW/VLGA infants, 22% for live-born and stillborn VLBW/VLGA infants, and 0% for the controls. In live-born and in all (including stillbirths) VLBW/VLGA infants, the adjusted mortality was lower among those born in level III hospitals compared with level II hospitals. Mortality rates of live-born VLBW/VLGA infants differed according to the university hospital district where the birth hospital was located, but there were no differences in mortality between the districts when stillborn infants were included. There was a trend towards lower mortality rates in VLBW/VLGA infants born during office hours compared with those born outside office hours (night time, weekends, and public holidays). When stillborn infants were included, this difference according to the time of birth was significant. Among five-year-old VLBW/VLGA children, morbidity, use of health care resources, and problems in behaviour and development were more common in comparison with the controls. The health-related quality of life of the surviving VLBW/VLGA children was good but, statistically, it was significantly lower than among the controls. The median and the mean number of quality-adjusted life-years were 4.6 and 3.6 out of a maximum five years for all VLBW/VLGA children. For the controls, the median was 4.8 and the mean was 4.9. Morbidity rates, the use of health care resources, and the mean quality-adjusted life-years differed for VLBW/VLGA children according to the university hospital district of birth. However, the time of birth, the birth hospital level or university hospital district were not associated with the health-related quality of life, nor with behavioural and developmental scores of the survivors at the age of five years. In conclusion, the decreased mortality in level III hospitals was not gained at the expense of long-term problems. The results indicate that VLBW/VLGA deliveries should be centralized to level III hospitals and the regional differences in the treatment practices should further be clarified. A long-term follow-up on the outcome of VLBW/VLGA infants is important in order to recognize the critical periods of care and to optimise the care. In the future, quality-adjusted life-years can be used as a uniform measure for comparing the effectiveness of care between VLBW/VLGA infants and different patient groups

Prenatal and perinatal risk factors for bipolar disorder

Bipolar disorder (BPD) is a severe mental disorder associated with considerable morbidity and mortality. Prenatal insults have been shown to be associated with later development of mental disorders and there is a growing interest in the potential role of prenatal and perinatal risk factors in the development of BPD. The aims of this thesis were to describe the overall study design of the Finnish Prenatal Study of Bipolar Disorders (FIPS-B) and demographic characteristics of the sample. Furthermore, it was aimed to examine the association of parental age, parental age difference, perinatal complications and maternal smoking during pregnancy with BPD. This thesis is based on FIPS-B, a nested case-control study using several nationwide registers. The cases included all people born in Finland between January 1st 1983 and December 31st 1998 and diagnosed with BPD according to the Finnish Hospital Discharge Register (FHDR) before December 31st 2008. Controls for this study were people who were without BPD, schizophrenia or diagnoses related to these disorders, identified from the Population Register Centre (PRC), and matched two-fold to the cases on sex, date of birth (+/- 30 days), and residence in Finland on the first day of diagnosis of the matched case. Conditional logistic regression models were used to examine the association between risk factors and BPD. This study included 1887 BPD cases and 3774 matched controls. The mean age at diagnosis was 19.3 years and females accounted for 68% of the cases. Mothers with the lowest educational level had the highest odds of having BPD in offspring. Being born in Eastern and Southern region of Finland increased the odds of having BPD later in life. A U-shaped distribution of odds ratio was observed between paternal age and BPD in the unadjusted analysis. Maternal age and parental age difference was not associated with BPD. Birth by planned caesarean section was associated with increased odd of BPD. Smoking during pregnancy was not associated with BPD in the adjusted analyses. Region of birth and maternal educational level were associated with BPD. Both young and old father’s age was associated with BPD. Most perinatal complications and maternal smoking during pregnancy were not associated with BPD. The findings of this thesis, considered together with previous literature, suggest that the pre- and perinatal risk factor profile varies among different psychiatric disorders.

Sähköasemainvestointihankkeen määrittely

Tämän työn tavoitteena oli tehdä perusteltu esitys kahden suunnitellun sähköaseman toiminnan aloittamisen ajankohdasta sekä rakentamisen kestosta lupamenettelyineen. Työssä oli pyrkimys perustella asemien maantieteellinen sijainti, toteutustapa, rakenne sekä sähköasemien syöttöön tarvittavien 110 kV johtojen alustava rakenne ja reitti. Työssä on tarkasteltu uuden sähköaseman verkosto- ja kustannusvaikutuksia, sähköasemarakenteita ja niiden valintaa, sähköasemainvestointihankkeen vaiheita ja rakennuttamisprosessin läpivientiin tarvittavaa aikaa. Verkoston nykytilaa, käyttövarmuutta ja selviytymistä kuormituksen kasvusta on tarkasteltu sähköasemien toiminnan aloittamisen ajankohtien määrittämiseksi. Työn keskeisin painopiste oli sähköasemien rakentamisajankohdan määrittäminen. Sähköasemien toiminnan aloittamisen ajankohdan määrääväksi tekijäksi muodostuivat sähköasemien korvaustilanteet. Nykytilassa Valkealan haja-asutusalueen sähkönjakelua ei voida taata yksittäisen sähköaseman korvaustilanteessa, minkä takia sähköasemahankkeen valmistelu on aloitettava välittömästi. Kouvolan ydinkeskustan alueen maakaapeliverkon tehonsiirtokyky ja päämuuntajien reservitehokapasiteetti korvaustilanteissa riittävät vielä 5-10 vuotta riippuen suuresti alueen kuormituksen kasvusta.

Conversioni al cattolicesimo a Roma tra Sei e Settecento. La presenza degli scandinavi nell’Ospizio dei Convertendi.

In my PhD dissertation, I have examined a group of people of Scandinavian origin received by Ospizio dei Convertendi. This group has been hitherto largely unknown to historical research. The Ospizio was an institute founded by the Oratorian Congregation in Rome in 1673 to provide religious instruction and material aid to both recent and aspirant converts to Roman Catholicism. My research traces the profile of converts and a typology of motives, examining different factors which influenced the conversion process. I show that the key factors were often of a social rather than a religious nature. Moreover, I have analyzed the hospice in the context of Counter-Reformation charity as well. In terms of numbers, the Scandinavians formed a somewhat marginal yet not insignificant group within the Roman hospice. Out of a total of 2203 guests received between 1673 and 1706, 4.6 % were Scandinavians: 74 Swedes (including Finland and Livonia) and 27 Danes (including Norway). They came from a rigorously Protestant region which reacted to Catholicism with severe legislative measures. Converts to Catholicism risked confiscation of their goods, expulsion or even capital punishment. Since both Sweden and Denmark were practically impenetrable to Catholicism at the time and clandestine missionary attempts often failed before they had even properly started, the Roman Catholic Church shifted its interest towards Northerners arriving in Rome, a preferred destination for young noblemen, artists and migrant craftsmen. The material related to Ospizio dei Convertendi, conserved in the Vatican archives, is a scarcely known yet unusually rich source, not only for the religious history of our continent, but also for social history and the study of migration in early modern Europe. It contains a wealth of information about members of the subordinate classes, of their travels and lives in Europe. The profile delineated in these documents is of individuals who had a wide range of different professions and different aspirations. These documents encompass a vast social spectrum that was highly mobile on a continent which by that time had become pluriconfessional. Therefore, these migrants faced the complex religious reality in their everyday life. The principal corpus of my research consists of two types of manuscript sources created for administrative and in a way also for apologetic purposes of the Roman Catholic Church. My starting point is the Primo registro generale of Ospizio dei Convertendi. This is a volume in which the following information about each guest was registered: name, nationality, city of origin, age, sex, profession, confession professed before converting, date of arrival, departure, abjuration and baptism. Typically, the convert was male, originating from Stockholm or Copenhagen, from 21 to 30 years of age. The biggest occupational groups in descending order were soldiers, noblemen, craftsmen and sailors. Thus the data reflects a multiform reality of interurban and long distance migration, ideals regarding the education of young noblemen and gentry as well as the need of European armies to hire foreign mercenaries in their various campaigns. Against this background the almost total absence of women is hardly surprising: there is only one woman in the material I have studied. The second main source, Nota degl’ospiti ricevuti e spese fatte per essi, sheds more light on the choices of the converts, their motivations and their lives outside Scandinavia before reaching Rome. This narrative material permits an analysis which completes but also goes far beyond the columns of the Institute’s general register. This material consists of reports written by Catholic priests based on an interview conducted upon each guest’s arrival. The material frequently includes information on what the converts would do following their departure from the Institute as well. These sources have a specific narrative form and contain short biographies, list reasons for converting and information about the journey from the North to the Mediterranean - a journey which in many cases took several years. Moreover, they show that certain unorthodox practices such as calling on the saints and pleading for help from them were not uncommon in the Protestant popular religion. The recording of information on conversions from Protestantism to Catholicism reflects both religious and social interest on the part of the receiving institute. The information obtained was used for the purposes of religious teaching, for finding adequate ways of inserting the convert into Italian society so that he could earn a living, and to find effective methods to convert others with a similar cultural and geographical background. The stories recorded were based on interviews with the newly-arrived, information obtained from a travel companion or fellow countrymen, or from written documents the aspirant converts carried with them. These sources illustrate, although sometimes in rather simplified ways, the circumstances and motivations which were relevant to the choice of changing one’s confession. In addition, I have examined petitions addressed to the hospice and other Roman authorities in order to get financial aid. These petitions were written by Italian scrittori, and they contain certain conventions and topoi of presenting the conversion with the purpose of improving the chances of obtaining financial aid. It is through these filters, which may seem initially almost invisible, that the remote voice of the converts reaches us. The results of the analysis are particularly interesting because they disagree with some of the principal conclusions of previous work on the subject. First, earlier research has focused almost exclusively on the conversions of noblemen, and has argued, second, that the Queen Christina of Sweden was the driving force behind their change of confession. The sources examined for this dissertation present a profile of long-distance migrants, many of them members of the subordinate classes, who were looking for ways to make their living in Europe. These people had in many cases left their country of origin several years earlier and not for religious reasons, so, crucially, we are not dealing with confessional migration in these cases. Rather, conversion was a complex process, intricately tied up with strategies of survival, integration and upward social mobility. At the same time, while these components are significant on their own right, they do not necessarily point to the absence of motivations of a more clearly religious nature.

Undersökning, om Nyland och Tavastehus län, i anseende til dess, läge, vidd, climat, våhr-floder, sjöar och vatuleder, naturs förmåner och brister, näringar, folkrikhet, politie och cameral författningar. Andra delen : ... under ... Pehr Adrian Gadds inseende, utgifven och försvarad för lagerkrantsen af Samuel Gabriel Mellenius norr finne. I Åbo Acad. öfre lärosal före m. den [ ] Junii 1789.

Dedicated to: Helena Marg. Lybecker, née Hising.

Beskrifning öfwer de til Sweriges krona lydande lapmarker, : innehollande kort underrättelse så wäl om landets belägenhet och beskaffenhet i gemen, som des inwånares tilstånd och husholdning, deras seder, maner och lefnadsart, samt laster och widskepelser, m.m. : Framgifwen af mag. Pehr Högström missionar och kyrkoherde wid Gelliware.

The date of publication is handwritten ʼ1747ʼ.

Talviaikainen happitilanne eräissä Pohjois-Savon järvissä vuosina 1997-2008

Pohjois-Savossa seurattiin talviaikaista happitilannetta vuosina 1997-2008. Seurannan kohteena oli neljä pienehköä järveä (Iso-Valkeinen, Kevätön, Kolmisoppi ja Vehmasjärvi), jotka ovat erityyppisiä syvyydeltään, rehevyystasoltaan ja humuspitoisuudeltaan. Näiden esimerkkijärvien oli tarkoitus antaa yleisemminkin viitteitä happitilanteen kehityksestä talven aikana. Alkutalven tulosten perusteella annettiin vuosittain tiedote, jossa arvioitiin happikatojen mahdollisuutta kevättalven kuluessa. Yleisöllä oli myös mahdollisuus seurata happi- ja lämpötilatuloksia Pohjois-Savon ympäristökeskuksen verkkopalvelun kautta. Hapenkulutusnopeus oli rehevimmässä seurantajärvessä kaksinkertainen verrattuna karumpiin ja syvyyden myötä ero vain korostui. Pohjanläheisessä vesikerroksessa 1 mg/l:n happipitoisuus kului karuissa järvissä noin kahdessa viikossa ja rehevässä noin kolmessa päivässä. Vuosien välinen vaihtelu oli kuitenkin hyvin suurta. Vaihtelu oli suurta myös karuissa järvissä. Veden jäätymisajankohdalla ja veden lämpötilalla on merkittävä vaikutus siihen, millainen kevättalven happitilanteesta muodostui. Seurantajärvien aineiston perusteella voidaan karkeasti arvioida, että kuukauden viivästyminen jäätymisessä tai vesipatsaan viilentyminen ennen jäätymistä asteen verran kylmemmäksi merkitsevät noin kolmanneksen korkeampaa happipitoisuutta kevättalvella. Vesipatsaan happitilanteen heikentymisen sekä ravinne- ja rautapitoisuuksien välillä todettiin vahvat yhteydet. Kaikkien järvien aineistossa happitilanteen heikkeneminen johti voimakkaimmin alusveden ammoniumtyppi-, kokonaisfosfori- ja rautapitoisuuksien kasvuun. Pitoisuusmuutokset olivat talven aikana suurimmat rehevimmässä kohdejärvessä, Kevättömässä, jossa kokonaisfosforipitoisuudet keskimäärin kymmenkertaistuivat, fosfaattifosforipitoisuudet kasvoivat keskimäärin 20-kertaisiksi ja rautapitoisuudet yli seitsenkertaisiksi.

Foreign Direct Investment and Shareholder Wealth Gains: Evidence from Finnish FDI in China

In Finnish discourse, “The China Effect” refers to the surge of offshoring activities by Western companies to China during the past couple of decades. Inspired by event studies concerning announcements of foreign direct investment, this thesis investigates the market’s reaction to Finnish companies’ announcement of FDI targeting the People’s Republic of China. Standard event study methodology is applied to 135 announcements related to subsidiaries, joint ventures and acquisitions between 1997 and 2014. The data is checked for contamination by unrelated coinciding events and outliers. A positive average abnormal return is found to take place on the date of the announcement. Additionally, the abnormal returns are found to exist only for projects announced before 2008, and only when the investment project is new, as opposed to investments made to extend previously established projects. Ownership arrangement and the novelty of facilities do not influence the market’s reaction towards the investment announcement.

Graduale (MS C.III.36, "Ilmajoen Graduale II")

A very small gradual and hymnary, for the most part copied in the last years of the sixteenth century or in the first quarter of the seventeenth. Assuming that Henricus Jacobi indeed signed his name in the sixteenth century (as Kurvinen reports), some of the manuscript was copied in that century: in lieu of a more accurate indicator the date of the manuscript appears to fall between 1589 and Mathias Benedicti's additions in 1635. The book was kept, perhaps even copied but certainly used, at Ilmajoki from the seventeenth century, and came from there to the University Library.