Medicines information sources and services for consumers : A special focus on the Internet and people with depression

The range of consumer health and medicines information sources has diversified along with the increased use of the Internet. This has led to a drive to develop medicines information services and to better incorporate the Internet and e-mail into routine practice in health care and in community pharmacies. To support the development of such services more information is needed about the use of online information by consumers, particularly of those who may be the most likely to use and to benefit from the new sources and modes of medicines communication. This study explored the role and utilization of the Internet-based medicines information and information services in the context of a wider network of information sources accessible to the public in Finland. The overall aim was to gather information to develop better and more accessible sources of information for consumers and services to better meet the needs of consumers. Special focus was on the needs and information behavior among people with depression and using antidepressant medicines. This study applied both qualitative and quantitative methods. Consumer medicines information needs and sources were identified by analyzing the utilization of the University Pharmacy operated national drug information call center (Study I) and surveying Finnish adults (n=2348) use of the different medicines information sources (Study II). The utilization of the Internet as a source of antidepressant information among people with depression was explored by focus group discussions among people with depression and with current or past use of the antidepressant(s) (n=29, Studies III & IV). Pharmacy response to the needs of consumers in term of providing e-mail counseling was assessed by conducting a virtual pseudo customer study among the Finnish community pharmacies (n=161, Study V). Physicians and pharmacists were the primary sources of medicines information. People with mental disorders were more frequent users of telephone- and Internet-based medicines information sources and patient information leaflets than people without mental disorders. These sources were used to complement rather than replace information provided face-to-face by health professionals. People with depression used the Internet to seek facts about antidepressants, to share experiences with peers, and for the curiosity. They described that the access to online drug information was empowering. Some people reported lacking the skills necessary to assess the quality of online information. E-mail medication counseling services provided by community pharmacies were rare and varied in quality. Study results suggest that rather than discouraging the use of the Internet, health professionals should direct patients to use accurate and reliable sources of online medicines information. Health care providers, including community pharmacies should also seek to develop new ways of communicating information about medicines with consumers. This study determined that people with depression and using antidepressants need services enabling interactive communication not only with health care professionals, but also with peers. Further research should be focused on developing medicines information service facilitating communication among different patient and consumer groups.

Between Herbals et alia: Intertextuality in Medieval English Herbals

This study reports a corpus-based study of medieval English herbals, which are texts conveying information on medicinal plants. Herbals belong to the medieval medical register. The study charts intertextual parallels within the medieval genre, and between herbals and other contemporary medical texts. It seeks to answer questions where and how herbal texts are linked to each other, and to other medical writing. The theoretical framework of the study draws on intertextuality and genre studies, manuscript studies, corpus linguistics, and multi-dimensional text analysis. The method combines qualitative and quantitative analyses of textual material from three historical special-language corpora of Middle and Early Modern English, one of which was compiled for the purposes of this study. The text material contains over 800,000 words of medical texts. The time span of the material is from c. 1330 to 1550. Text material is retrieved from the corpora by using plant name lists as search criteria. The raw data is filtered through qualitative analysis which produces input for the quantitative analysis, multi-dimensional scaling (MDS). In MDS, the textual space that parallel text passages form is observed, and the observations are explained by a qualitative analysis. This study concentrates on evidence of material and structural intertextuality. The analysis shows patterns of affinity between the texts of the herbal genre, and between herbals and other texts in the medical register. Herbals are most closely linked with recipe collections and regimens of health: they comprise over 95 per cent of the intertextual links between herbals and other medical writing. Links to surgical texts, or to specialised medical texts are very few. This can be explained by the history of the herbal genre: as herbals carry information on medical ingredients, herbs, they are relevant for genres that are related to pharmacological therapy. Conversely, herbals draw material from recipe collections in order to illustrate the medicinal properties of the herbs they describe. The study points out the close relationship between medical recipes and recipe-like passages in herbals (recipe paraphrases). The examples of recipe paraphrases show that they may have been perceived as indirect instruction. Keywords: medieval herbals, early English medicine, corpus linguistics, intertextuality, manuscript studies

Ruumiillinen esine, materiaalinen suku : Tutkimus Pyhä Anna itse kolmantena -aiheisista keskiajan puuveistoksista Suomessa

Embobied Object, Material Family. Late-Medieval Wood Sculptures Depicting Saint Anne with the Virgin and Child in Finland Saint Anne, the mother of the Virgin Mary, was one of the most popular saints in Western Europe in the late Middle Ages. She was often depicted with two other figures, the Virgin and the Christ Child (Anna Selbdritt). The dissertation examines the polychrome wood sculptures showing this motif, with a special focus on those remaining in Finland. It investigates the meanings these sculptures had to their observers in the fifteenth-century Finland. The study sheds light to important material heritage which is little known and offers new insights into the cult and imagery of the holy grandmother. Methodologically the study is based on iconology and post-formalist art history, and it appropriates concepts such as spatiality, sanctity, corporeality, and gender. Taking a comparative approach it knits together larger tendencies and local people and incidents. By conflating methodological domains it renews the ways how fragmentary wood sculptures, lacking documentary written sources, can be contextually interpreted and comprehended. The sculptures are analyzed from three angles. Firstly, the study explores the sculptures by focusing on their materiality and facture, which is to consider them as records of their own making. The analysis provides new information concerning the quantity, location, and current condition of the sculptures and it also elucidates problems regarding attribution, dating, display, and craftsmanship. The book presents the results of the empirical study of 45 Saint Anne groups; these works are individually described in the large Appendix. Secondly, the works are contextualized to the specific historical conditions in which they were observed. The study discusses closely the circumstances in the Turku Cathedral around the shrine of Saint Anne, the popular belief, and the piety of individual persons. The sculptures, deemed as the embodiments of the holy characters, interacted with the devotees. Thirdly, the works are examined within the wider theological and ideological currents of the era centered on the body and Incarnation. Saint Anne with the Virgin and Child motif demonstrated the Carnal Trinity, the motherly side of the Holy Trinity. The dissertation argues that Saint Anne was interpreted as the female counterpart or, in a mythical sense, wife of God. Furthermore, the Child s implicit, simultaneous presence as a suffering or dead man imbues the sculptures with a sense of the Passion, thus associating them with the pietà and the Mater dolorosa motifs. The naked Christ Child underlines him as the offering and, eventually, the Eucharistic wafer. The study suggests that the sculptures mediate continuity and the bloodline between the generations by the intertwined and repeated gestures, clothing and positions of the portrayed figures. Regardless of the ostensible homeliness of the sculptures, so readily reiterated by earlier scholars, these sculptures represented creation and birth through the carnal yet holy mothers.

Dark Spots, Bubbles, and Shells in the Lobes of Extragalactic Radio Sources

Based on maps of the extragalactic radio sources Cyg A, Her A, Cen A, 3C 277.3 and others, arguments are given that the twin-jets from the respective active galactic nucleus ram their channels repeatedly through thin, massive shells. The jets are thereby temporarily choked and blow radio bubbles. Warm shell matter in the cocoon shows up radio-dark through electron-scattering.

Visions of Past Glory: Nationalism and the Construction of Early Finnish History

The study is an examination of how the distant national past has been conceived and constructed for Finland from the mid-sixteenth century to the Second World War. The author argues that the perception and need of a national 'Golden Age' has undergone several phases during this period, yet the perceived Greatness of the Ancient Finns has been of great importance for the growth and development of the fundamental concepts of Finnish nationalism. It is a question reaching deeper than simply discussing the Kalevala or the Karelianism of the 1890s. Despite early occurrences of most of the topics the image-makers could utilize for the construction of an Ancient Greatness, a truly national proto-history only became a necessity after 1809, when a new conceptual 'Finnishness' was both conceived and brought forth in reality. In this process of nation-building, ethnic myths of origin and descent provided the core of the nationalist cause - the defence of a primordial national character - and within a few decades the antiquarian issue became a standard element of the nationalist public enlightenment. The emerging, archaeologically substantiated, nationhood was more than a scholarly construction: it was a 'politically correct' form of ethnic self-imaging, continuously adapting its message to contemporary society and modern progress. Prehistoric and medieval Finnishness became even more relevant for the intellectual defence of the nation during the period of Russian administrative pressure 1890-1905. With independence the origins of Finnishness were militarized even further, although the 'hot' phase of antiquarian nationalism ended, as many considered the Finnish state reestablished after centuries of 'dependency'. Nevertheless, the distant past of tribal Finnishness and the conceived Golden Age of the Kalevala remained obligating. The decline of public archaeology is quite evident after 1918, even though the national message of the antiquarian pursuits remained present in the history culture of the public. The myths, symbols, images, and constructs of ancient Finnishness had already become embedded in society by the turn of the century, like the patalakki cap, which remains a symbol of Finnishness to this day. The method of approach is one of combining a broad spectrum of previously neglected primary sources, all related to history culture and the subtle banalization of the distant past: school books, postcards, illustrations, festive costumes, drama, satirical magazines, novels, jewellery, and calendars. Tracing the origins of the national myths to their original contexts enables a rather thorough deconstruction of the proto-historical imaginary in this Finnish case study. Considering Anthony D. Smith's idea of ancient 'ethnies' being the basis for nationalist causes, the author considers such an approach in the Finnish case totally misplaced.

Aristotle on the Perception of Perception : Seeing, Remembering, and Sleeping

This study is an inquiry into three related topics in Aristotle’s psychology: the perception of seeing, the perception of past perception, and the perception of sleeping. Over the past decades, Aristotle’s account of the perception of perception has been studied in numerous articles and chapters of books. However, there is no monograph that attempts to give a comprehensive analysis of this account and to assess its relation and significance to Aristotle’s psychological theory in general as well as to other theories pertaining to the topics (e.g. theories of consciousness), be they ancient, medieval, modern, or contemporary. This study intends to fill this gap and to further the research into Aristotle’s philosophy and into the philosophy of mind. The present study is based on an accurate analysis of the sources, on their Platonic background, and on later interpretations within the commentary tradition up to the present. From a methodological point of view, this study represents systematically orientated research into the history of philosophy, in which special attention is paid to the philosophical problems inherent in the sources, to the distinctions drawn, and to the arguments put forward as well as to their philosophical assessment. In addition to contributing many new findings concerning the topics under discussion, this study shows that Aristotle’s account of the perception of perception substantially differs from many later theories of consciousness. This study also suggests that Aristotle be regarded as a consistent direct realist, not only in respect of sense perception, but also in respect of memory.

Soil sorption-desorption of phosphorus from piggery effluent compared with inorganic sources

The leaching of phosphorus (P) within soils can be a limiting consideration for the sustainable operation of intensive livestock enterprises. Sorption curves are widely used to assist estimation of P retention, though the effect of effluent constituents on their accuracy is not well understood. We conducted a series of P-sorption-desorption batch experiments with an Oxic Haplustalf (soil 1), Haplusterts (soils 2 and 3), and a Natrustalf (soil 4). Phosphorus sources included effluent, orthophosphate-P in a matrix replicating the effluent's salt constituents (the reference solution), and an orthophosphate-P solution. Treated soils were incubated for up to 193 days before sequential desorption extraction. Effluent constituents, probably the organic or particulate components, temporarily increased the vulnerability of sorbed-P to desorption. The increase in vulnerability was removed by 2-113 days of incubation (25 degrees C). Despite vigorous extraction for 20 consecutive days, some P sorbed as part of the treatments of soils 1 and 2 was not desorbed. The increased vulnerability due to effluent constituents lasted a maximum of about one cropping season and, for all other treatments, adsorption curves overestimated vulnerability to desorption. Therefore, adsorption curves provide a conservative estimate of vulnerability to desorption where effluent is used in continued crop production in these soils.

Arkeologia, historialliset kartat ja paikkatieto

This licentiate thesis is composed of three parts, of which the parts 2 and 3 have been published elsewhere. Part 1 deals with the research history of large-scaled historical maps in Finland. The research done in four disciplines – archaeology, history, art history and geography – is summarized. Compared to the other disciplines, archaeology is characterized by its deep engagement with the location. Because archaeology studies different aspects of the past through material culture, it is the only discipline in which the concrete remains portrayed on the maps are “dug up”. For the archaeologist, historical maps are not merely historical documents with written information and drawings in scale, but actual maps which can be connected with the physical features they were made to illustrate in the first place. This aspect of historical maps is discussed in the work by looking at the early (17th and 18th century) urban cartographic material of two Finnish towns, Savonlinna and Vehkalahti-Hamina. In both cases, the GIS-based relocating of the historical maps highlights new aspects in the early development of the towns. Part 1 ends with a section in which the contents of the entire licentiate thesis are summarized. Part 2 is a peer reviewed article published in English. This article deals with the role of historical maps converted into GIS in archaeological surveys made in Finnish post-medieval towns (16th and 17th centuries). It is based on the surveys made by the author between 2000 and 2003 and introduces a new method for the archaeological surveying of post-medieval towns with wooden houses. The role of archaeology in the sphere of urban research is discussed. The article emphasizes that the methods used in studying the development of southern European towns with stone houses cannot be adequately applied to the wooden towns of the north. Part 3 is a monograph written in Finnish. It discusses large-scaled historical maps and the methods for producing digital spatial information based on historical maps. Since the late 1990’s, archaeological research in Finland has been increasingly directed towards the historical period. As a result, historical cartography has emerged as one of the central sources of information for the archaeologist, too. The main theme of this work is the need for using historical maps as real maps which, surprisingly, has been uncommon in the historical sciences. Projecting historical maps to the very place they were made to illustrate is essential to understanding the maps. This is self-evident for the archaeologist, who is accustomed to studying the material past, but less so to researchers in other historical disciplines that concentrate on written and visual sources of information. With the help of GIS, the historical maps can be concretely linked to the places they were originally made to illustrate. In doing so, and equipped with a cartographic comprehension, new observations can be made and questions asked, which supplement and occasionally challenge the prevailing views.

Fluctuation phenomena in electrochemistry part II. Modelling the noise sources

A discussion of the modelling of the primary and secondary noise sources introduced in the formalism of fluctuation phenomena in a previous report is presented. It is illustrated that the generalisation of the modelling of noise sources in mass transport as given by Tyagai is limited in its applicability. A general procedure for the same is discussed in detail.

Apparent digestibility of some nutrient sources by juvenile mud crab, Scylla serrata (Forskal 1775)

As part of preliminary work aimed at the development of a formulated diet for the mud crab, Scylla serrata, an experiment was conducted with juvenile mud crabs (95.65±2.17 g) to determine apparent digestibility coefficients (ADC) for cellulose, fish meal, shrimp meal, blood meal, soybean meal, wheat flour and cod liver oil. Apparent digestibility coefficients for dry matter (ADCdm), energy (ADCenergy) and protein (ADC protein) were in the ranges 70.0-95.7%, 77.4-97.1% and 57.7-97.9% respectively. Soybean meal had the highest ADCdm and wheat flour had the lowest value (P<0.05), while the ADCdm for fish meal, blood meal and shrimp meal were not different (P?0.05). Similarly, soybean meal had the same ADCenergy as that of fish meal, but higher than those of cod liver oil, blood meal and shrimp meal (P<0.05). Moreover, the ADC protein for blood meal or shrimp meal were not significantly different from fish meal (P?0.05); nevertheless, they were lower than that of soybean meal and higher than that of wheat flour (P<0.05). Of significant interest was the ADCdm (78.0%) and ADCenergy (77.4%) for cellulose, which indicates that plant-based nutrient sources may well be a useful component of formulated diets for mud crabs.

Comparison of odour emission rates measured from various sources using two sampling devices

Two commonly used sampling devices (a wind tunnel and the US EPA dynamic emission chamber), were used to collect paired samples of odorous air from a number of agricultural odour sources. The odour samples were assessed using triangular, forced-choice dynamic olfactometry. The odour concentration data was combined with the flushing rate data to calculate odour emission rates for both devices on all sources. Odour concentrations were consistently higher in samples collected with a flux chamber (ratio ranging from 10:7 to 5:1, relative to wind tunnel samples), whereas odour emission rates were consistently larger when derived from wind tunnels (ratio ranging from 60:1 to 240:1, relative to flux chamber values). A complex relationship existed between emission rate estimates derived from each device, apparently influenced by the nature of the emitting surface. These results have great significance for users of odour dispersion models, for which an odour emission rate is a key input parameter.

Identifying major contributing sources to odour annoyance using a non-specific gas sensor array

Identification of major contributors to odour annoyance in areas with multiple emission sources is necessary to address and resolve odour disputes. In an effort to develop an appropriate tool for this task, odour samples were collected on-site at a piggery and an abattoir (the major odour sources in the area) and at surrounding off-site areas, then analysed using a commercial non-specific chemical sensor array to develop an odour fingerprint database. The developed odour fingerprint database was analysed using two pattern recognition algorithms including a partial least squares-discriminant analysis (PLS-DA) and a Kohonen self-organising map (KSOM). The KSOM model could identify odour samples sourced from the piggery shed 15, piggery pond 8, piggery pond 9, abattoir, motel and others with mean percentage values of 77.5, 65.0, 90.2, 75.7, 44.8 and 64.6%, respectively.

Traffic and nucleation events as main sources of ultrafine particles in high-insolation developed world cities

Road traffic emissions are often considered the main source of ultrafine particles (UFP, diameter smaller than 100 nm) in urban environments. However, recent studies worldwide have shown that - in high-insolation urban regions at least - new particle formation events can also contribute to UFP. In order to quantify such events we systematically studied three cities located in predominantly sunny environments: Barcelona (Spain), Madrid (Spain) and Brisbane (Australia). Three long term datasets (1-2 years) of fine and ultrafine particle number size distributions (measured by SMPS, Scanning Mobility Particle Sizer) were analysed. Compared to total particle number concentrations, aerosol size distributions offer far more information on the type, origin and atmospheric evolution of the particles. By applying k-Means clustering analysis, we categorized the collected aerosol size distributions in three main categories: “Traffic” (prevailing 44-63% of the time), “Nucleation” (14-19%) and “Background pollution and Specific cases” (7-22%). Measurements from Rome (Italy) and Los Angeles (California) were also included to complement the study. The daily variation of the average UFP concentrations for a typical nucleation day at each site revealed a similar pattern for all cities, with three distinct particle bursts. A morning and an evening spike reflected traffic rush hours, whereas a third one at midday showed nucleation events. The photochemically nucleated particles burst lasted 1-4 hours, reaching sizes of 30-40 nm. On average, the occurrence of particle size spectra dominated by nucleation events was 16% of the time, showing the importance of this process as a source of UFP in urban environments exposed to high solar radiation. On average, nucleation events lasting for 2 hours or more occurred on 55% of the days, this extending to >4hrs in 28% of the days, demonstrating that atmospheric conditions in urban environments are not favourable to the growth of photochemically nucleated particles. In summary, although traffic remains the main source of UFP in urban areas, in developed countries with high insolation urban nucleation events are also a main source of UFP. If traffic-related particle concentrations are reduced in the future, nucleation events will likely increase in urban areas, due to the reduced urban condensation sinks.

Mobile assessment of on-road air pollution and its sources along the East-West Highway in Bhutan

Human exposures in transportation microenvironments are poorly represented by ambient stationary monitoring. A number of on-road studies using vehicle-based mobile monitoring have been conducted to address this. Most previous studies were conducted on urban roads in developed countries where the primary emission source was vehicles. Few studies have examined on-road pollution in developing countries in urban settings. Currently, no study has been conducted for roadways in rural environments where a substantial proportion of the population live. This study aimed to characterize on-road air quality on the East-West Highway (EWH) in Bhutan and identify its principal sources. We conducted six mobile measurements of PM10, particle number (PN) count and CO along the entire 570 km length of the EWH. We divided the EWH into five segments, R1-R5, taking the road length between two district towns as a single road segment. The pollutant concentrations varied widely along the different road segments, with the highest concentrations for R5 compared with other road segments (PM10 = 149 µg/m3, PN = 5.74 × 104 particles/cm-3, CO = 0.19 ppm), which is the final segment of the road to the capital. Apart from vehicle emissions, the dominant sources were road works, unpaved roads and roadside combustion activities. Overall, the highest contributions above the background levels were made by unpaved roads for PM10 (6 times background), and vehicle emissions for PN and CO (5 and 15 times background, respectively). Notwithstanding the differences in instrumentation used and particle size range measured, the current study showed lower PN concentrations compared with similar on-road studies. However, concentrations were still high enough that commuters, road maintenance workers and residents living along the EWH, were potentially exposed to elevated pollutant concentrations from combustion and non-combustion sources. Future studies should focus on assessing the dispersion patterns of roadway pollutants and defining the short- and long-term health impacts of exposure in Bhutan, as well as in other developing countries with similar characteristics.