Meaning in life and perceived quality of life in Switzerland: results of a representative survey in the German, French and Italian regions.

BACKGROUND: The concept of meaning in life (MIL) has become a central one in recent years, particularly in psycho-oncology and palliative care. The Schedule for Meaning in Life Evaluation (SMILE) has been developed to allow individuals to choose the life areas that they consider to be important for their own MIL. This approach relates to the "World Health Organisation" definition of quality of life (QOL) as an individual's perception of his own position. The aims of this study were (i) to assess MIL in a representative sample of the Swiss population according to the three linguistic regions and (ii) to evaluate whether MIL constitutes a significant determinant of the perceived QOL. METHODS: A telephone survey of the Swiss population, performed by a professional survey company, was conducted between November and December 2013. The interview included the SMILE, perceived QOL (0-10) and health status (1-5), and various sociodemographic variables. In the SMILE, an index of weighting (IOW, 20-100), an index of satisfaction (IOS, 0-100), and a total SMILE index (IOWS, 0-100) are calculated from the areas mentioned by the participants as providing MIL. RESULTS: Among the 6671 telephonic contacts realized, 1015 (15 %) participants completed the survey: 405 French, 400 German and 210 Italian participants. "Family" (80.2 %), "occupation/work" (51 %), and "social relations" (43.3 %) were the most cited MIL-relevant categories. Italian participants listed "health" more frequently than German and French participants (50.4 % vs 31.5 % and 24.8 % respectively, χ(2) = 12.229, p = .002). Age, gender, education, employment, and marital status significantly influenced either the MIL scores or the MIL-relevant categories. Linear regression analyses indicate that 24.3 % of the QOL variance (p = .000) is explained by health status (B = .609, IC = .490-.728, p = .000), MIL (B = .034, IC = .028-.041, p = .000) and socioeconomic status (F = 11.01, p = .000). CONCLUSION: The major finding of our analysis highlights the positive and significant influence of MIL on the perceived QOL in a representative sample of a general, multilingual and multicultural population. This result indicates that the existential dimension is not only determinant for QOL in some critical life events, as shown e.g. in psycho-oncology and palliative care, but also in everyday life.

Information Needs and Concerns of Patients with Inflammatory Bowel Disease: What Can We Learn from Participants in a Bilingual Clinical Cohort?

BACKGROUND: Inflammatory Bowel Disease (IBD) patients are confronted with needs and concerns related to their disease. AIM: To explore information expectations of patients included in a national bilingual IBD cohort in Switzerland (SIBDC). METHODS: This is a mixed-methods study, comprising 1) a semi-narrative survey sent to 1506 patients from the SIBDC and 2) two focus groups conducted with 14 patients to explore and assess the relevance of the survey's findings. Data collected within the framework of the SIBDC was used to characterize survey's responders. RESULTS: 728 patients (48%) replied to the survey: 52.5% females, 56% Crohn's disease (CD), 87% secondary/tertiary level educated, 70% full/part-time employed. On average, 47% of patients sought for information, regardless of the disease stage; 27% of them were dissatisfied with information received at the time of first symptoms. During flares, 43% were concerned about drugs and therapies; in remission, 57% had concerns on research and developments; 27% searched for information linked to daily disease management. Information-seeking increased when active disease, for CD with high levels of perceived stress (OR = 2.47; p = 0.003), and for all with higher posttraumatic stress symptoms. The focus groups confirmed a perceived lack of information about general functioning, disease course, treatments and their risks, extra-intestinal symptoms and manifestations. CONCLUSIONS: Information remains insufficient for IBD patients. Lack of information in specific domains can potentially cause stress and hinder detection of symptoms. Better information should be considered as a potentially important component in improving patients' outcomes in IBD.

Supporting older people’s independent living at home through social and health care collaboration

Tässä tutkimuksessa tarkasteltiin ikäihmisten kotona asumista sosiaali- ja terveydenhuollon yhteistyön näkökulmasta. Tutkimuksen tarkoituksena oli lisätä ymmärrystä iäkkäiden kotihoidon asiakkaiden voimavaroista arjesta selviytymisen näkökulmasta, ja tutkia miten asiakkaiden hoito sosiaali- ja terveydenhuollon yhteistyönä toteutuu. Tutkimus oli poikkileikkaustutkimus, jossa sovellettiin kuvailevaa ja vertailevaa tutkimusasetelmaa. Tutkimusaineisto kerättiin yhden länsisuomalaisen kunnan kotihoidon asiakkailta (≥65 v.) ja heitä hoitavilta ammattihenkilöiltä. Kotihoidon 21 iäkästä asiakasta kuvasivat omia voimavarojaan arjesta selviytymisen näkökulmasta sekä kokemuksiaan hoidon toteutumisesta ammattihenkilöiden yhteistyönä. Aineisto kerättiin avoimella haastattelulla ja analysoitiin sisällön analyysillä. Lisäksi 25 kotihoidon ammattihenkilöä: 13 kotipalvelun työntekijää, 11 kotisairaanhoitajaa ja lääkäri kuvasivat kokemuksiaan iäkkään asiakkaan hoidon toteutumisesta ammattihenkilöiden yhteistyönä. Aineisto kerättiin fokusryhmähaastattelulla ja analysoitiin sisällön analyysillä. Näiden tulosten sekä aikaisemman kirjallisuuden perusteella laadittiin strukturoitu kyselylomake, jolla analysoitiin ja vertailtiin asiakkaiden ja ammattihenkilöiden näkemyksiä siitä, miten asiakkaiden hoito sosiaali- ja terveydenhuollon yhteistyönä toteutui. Esitestausten jälkeen kyselylomake lähetettiin 200 kotihoidon asiakkaalle ja 570 heitä hoitavalle kotihoidon työntekijälle: 485 kotipalvelun työntekijälle, 81 kotisairaanhoitajalle ja 4 lääkärille. Kyselyyn vastasi 120 asiakasta (60 %) ja 370 ammattihenkilöä (65 %). Ryhmien välisten erojen tarkastelussa käytettiin ristiintaulukointia, Pearsonin khin neliötestiä ja Fisherin tarkan todennäköisyyden testiä. Iäkkäiden asiakkaiden kuvauksissa voimavarat muodostuivat elämänhallinnan tunteesta ja toimintatahdon säilymisestä. Asiakkaat ammensivat arkeen voimaa harrastuksista ja sosiaalisesta verkostosta, mutta ulkopuolisten asettamat elämisen ehdot, terveydentilan heikkeneminen sekä yksinäisyys asettivat ikäihmisen ja hänen voimavaransa suurten haasteiden eteen. Tulokset osoittivat, että ammattihenkilöiden toiminta oli osittain ristiriidassa ikäihmisten omien odotusten kanssa, eikä se kaikilta osin tukenut asiakkaiden omia voimavaroja. Ammattihenkilöt tekivät hoitoon liittyviä päätöksiä ja toimintoja asiakkaiden puolesta, vaikka asiakkaille itselleen oli tärkeää elämänhallinnan tunne ja toimintatahdon säilyminen. Asiakkaiden voimavarojen tukemista moniammatillisena yhteistyönä vaikeuttivat ammattihenkilöiden vaikeus tunnistaa asiakkaiden omia voimavaroja sekä niitä uhkaavia tekijöitä, tiedon kulun ongelmat, tavoitteeton ja epäyhtenäinen tapa toimia sekä ammattihenkilöiden vastakkain asettuvat näkemyserot ja toimintatavat. Asiakkaiden ja ammattihenkilöiden näkemykset toteutetusta hoidosta erosivat toisistaan tilastollisesti merkitsevästi (p<0.05). Asiakkaat arvioivat sekä itsenäiseen toimintaan tukemisen että fyysisen, psyykkisen ja sosiaalisen tuen toteutuneen työntekijöitä huonommin. Yhteistyön kehittämishaasteita kotihoidossa ovat asiakkaan oman elämänsä asiantuntijuuden vahvistaminen, toimintakulttuurin muuttaminen asiakaslähtöiseksi tavoitteelliseksi toiminnaksi, ammattihenkilöiden roolien ja vastuun selkiyttäminen sekä tiedon kulun menetelmien kehittäminen. Tutkimus vahvistaa gerontologisen hoitotieteen tietoperustaa ja tuottaa uutta tietoa, jota voidaan soveltaa sosiaali- ja terveysalan koulutuksessa ja johtamisessa

O inacreditável emprego de produtos químicos perigosos no passado

This work describes an overview of the use of chemicals in several commercial applications along the XXth century. The use of chemicals by men was largely empirical for many centuries, since there was no organized chemical and toxicological knowledge. During the XIXth century the chemical industry gained a crucial role in the development of technology, as evidenced by the extraordinary increase of new products and their incorporation into everyday life. Chemistry was considered a science capable of solving any problem, little regard being paid to the consequences of the widespread use of new chemicals. Efficiency was more important than safety and consumer information. From tragedies and the development of knowledge on toxicology men adopted more careful protocols before a new chemical was proposed for use. Modern life could not exist without the large-scale employment of a variety of chemicals but information on their responsible and conscious use is now essential. Products that were once considered the "last word in technology" have eventually proven dangerous to humans and the environment in the short or long time range. Previous knowledge on the toxicological dangers and the properties of a given substance or product before commercialization is necessary for safe handling.

Experiència dels cuidadors i les cuidadores principals informals que tenen cura d'un familiar vell amb demència des de fa més de quatre anys

El treball que es presenta vol respondre la pregunta de quina és l’experiència dels cuidadors i les cuidadores principals informals que tenen cura d’un familiar vell amb demència des de fa més de 4 anys. Després de plantejar les hipòtesis de partida, es defineixen els objectius generals i específics i s’expliquen l’interès, la justificació, la rellevància i l’aportació d’aquest estudi. En l’apartat corresponent a l’estat de la qüestió i la fonamentació conceptual, després de fer una revisió bibliogràfica, es descriuen els elements que formen part d’aquesta temàtica: perfils dels receptors de cures i de les cuidadores, significat de tenir cura, vida quotidiana i qualitat de vida i descripció del model conceptual de Virginia Henderson. En el capítol següent s’exposen la metodologia, el paradigma i el mètode d’investigació utilitzats en aquest treball, així com les matrius d’anàlisi del contingut i del discurs. A partir d’aquí s’exposen els resultats en funció dels objectius plantejats. En la discussió, s’analitzen i s’interpreten les dades obtingudes i es contraposen amb altres estudis, a més de fer-se una reflexió personal sobre els aprenentatges adquirits i una proposta de línies de treball futures. A continuació s’exposen unes conclusions per resumir la informació obtinguda. En la secció de referències bibliogràfiques es detallen les fonts consultades, i en els annexos hi consten els models d’entrevista i de matriu per a l’anàlisi de dades, el full de consentiment informat, així com el buidatge i l’anàlisi de les entrevistes.

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.

Imagon merkitys paikan markkinoinnissa: Kaupunki-imagon nykytila kohderyhmittäin

Tämän tutkimuksen tarkoituksena oli selvittää imagon merkitystä kohde-ryhmälähtöisessä paikan markkinoinnissa. Tavoitteena oli mitata kaupun-gin ulkoisen imagon nykytilaa ja tunnistaa paikan markkinoinnin keskeisiä kohderyhmiä. Tutkimuksessa arvioitiin miten kaupunki-imagot vaihtelivat kohderyhmittäin ja mitä viestintäkanavia kohderyhmät käyttivät tiedon-hakuun. Tutkimuksen kohteena oli vuoden 2009 alussa monikuntaliitoksen myötä syntynyt uusi Kouvola, Suomen 10. suurin kaupunki. Empiirinen osa toteutettiin kvantitatiivisena, kuvailevana ja kartoittavana, kyselytutkimuk-sena Helsingissä Oma Koti -09 messutapahtumassa. Pääkohderyhmänä olivat pääkaupunkiseudun asukkaat. Pääosalla kyselyyn vastanneista (n=725) oli omakohtainen kokemus Kouvolasta ja tietoa vastaajat hakivat eniten internetistä. Johtopäätöksenä voidaan todeta että kokonaismielikuva Kouvolan imagosta oli yli 80 %:sesti positiivinen. Kaupunki-imago ei vaihdellut suuresti tunnis-tettujen kohderyhmien välillä. Imagoattribuuttien perusteella imago perustui kodikkuuteen ja hyvään arkeen. Kaupunkia pidetään asumisen ja vapaa-ajanvieton kannalta vetovoimaisena. Muuttohalukkuuteen vaikuttivat eniten elämäntilanne, kesämökin tai työpaikan löytyminen.

Rukoile ja työtä tee. Onni Puhakan kehitys innovaattorista oman tien kulkijaksi

Pray and work. The development of Onni Puhakka: from innovator to nonconformist This ethnological biographical study examines the modernization which began in the mid-1800s, continued into the mid-1900s, and has changed Finnish society in many ways. This era has been studied on a general level quite extensively, but this work explores the life and everyday experiences of Onni Puhakka (1870−1955), a farmer who spent most of his life in the town of Liperi. The goal is to find new perspectives on the development of the modernization process in society through the experiences of an individual. In this study, a central theme is the rural co-operative movement represented in Finland by Pellervo as well as its development in this country and as a significant undertaking in Onni Puhakka’s life. The co-operative movement was one of the most significant sectors affecting modernization in rural communities. The main character in the study is the grandfather of the present author, and thus this research belongs to the newly accepted ethnological research tradition of studying one’s own community. Written documents, mainly collected and preserved by Onni Puhakka himself during his lifetime, form the research material. The material consists mainly of Puhakka’s extensive correspondence, personal notes and diaries, documents related to his farm, and photographs taken by him. Earlier research and other written material examining the general development of the period were used to provide a background for the study. The co-operative movement formed a comprehensive ideology for Onni Puhakka, in which the possibilities for the development of both individuals and the community were combined. His life was based on a religious conviction, and he felt that the co-operative movement was the application of Christian love for one’s neighbour in practice. At the beginning of his active working career, Puhakka was an innovator, a reformer at the forefront of progress, but quite soon he became a sworn critic of the development of the co-operative movement in particular. One of Puhakka’s criticisms of the co-operative movement was the shifting of decision-making power to professional managers and central organizations, far from the reach of local actors. A fundamental reason for his dissatisfaction was the development within the co-operative movement in which the ideological background was forgotten, and economic goals and making a profit took an excessive significance. This assessment of the co-operative movement made by Onni Puhakka and his predictions about its development were not unfounded. This has been shown by several studies examining the development of both the Pellervo and working class cooperative movements. The professionalization of management, managerialism, as well as the direct links between professional managers of local co-operatives and central organizations have lead to the situation in which fewer and fewer people make the decisions, and management has as its goal economic success and growth. Co-operative enterprises that have grown in size have become estranged from the everyday life of their members. Instead of taking care of relations with the membership of the co-op, competitive ability and the market share have become the most important concerns of the management. As the membership has become alienated, their interest in large-scale co-ops has also become largely economic. A significant change among the membership of the Pellervo movement occurred at the stage when the co-operative movement shifted from rural areas to urban centres. This meant that the commitment of the membership became much looser than it had been in the farmers’ production and consumer co-ops. From the point of view of its members, the nature of the co-operative movement has become diametrically opposed to its point of departure: the active members who previously formed the subject of the co-operative movement have become the object of the economic activities of that same movement. The co-operative movement has been transformed from the progressive agent of change of its early years into a business activity which no longer has any significant task as a social reformer. This study confirms the observations of the latest research on modernization which states that modernization has not been a straightforward and inevitable development that has lead to the present situation. For example, the criticism directed by Puhakka toward the co-operative movement includes information that shows that a few others who were initially actively involved also criticized the development of the movement. Despite his occasional frustration, Onni Puhakka continued his criticism and attempts to get the co-operative movement to change its course and return to its ‘roots’. In the early years of the cooperative movement he probably did not differ much from the other pioneers in the sense that many of them had adopted and internalized the same values and motive for being involved that he had. However, Puhakka differed from his colleagues in the sense that he was able to believe in what he called the “fundamental values” of the co-operative movement longer than many of them.

Tuulivoimatoimialan yrityksen nykytilan analyysi ja asiakaslähtöinen liiketoimintastrategia

Tämä tutkimus on tehty tuulivoimatoimialalla toimivan yrityksen toimeksiannosta. Tutkimuksen tavoitteena oli luoda kohdeyritykselle liiketoimintastrategiaehdotus. Kohdeyrityksen toiveena oli saada tutkimukseen myös teorian näkemys asiakaslähtöisyydestä. Tutkimuksen on tarkoitus antaa yritykselle pohtimisen aihetta liiketoimintastrategian luomiseen ja toimia pohjana, kun yhtiön johto tekee päätöksiä tulevasta strategiasta. Tutkimuksessa tehtiin perusteellinen tuulivoimatoimialan analyysi toimialaraporttien ja yrityksen johdon ja henkilökunnan haastattelujen avulla. Lisäksi kartoitettiin kohdeyrityksen nykytilaa ja strategista asemaa alalla suorittamalla SWOT-analyysi ja toimialan rakenteellinen analyysi. Tutkimuksessa selvitettiin myös keinoja kilpailuedun saavuttamiseksi asiakaslähtöisyyden avulla. Tietoja yrityksen toiminnasta on kerätty haastattelemalla yhtiön johtoa ja henkilökuntaa sekä osallistumalla aktiivisesti yhtiön jokapäiväiseen toimintaan. Tutkimuksen tuloksena syntyi kohdeyrityksen liiketoimintatilanteeseen soveltuva liiketoimintastrategia, jolla on mahdollista saavuttaa kilpailuetua tuulivoimatoimialalla. Asiakaslähtöisyys huomioitiin tutkimuksessa tuomalla asiakasjohtamisen malli strategiatyöhön. Tutkimuksessa luotiin kaksi erilaista segmentointimallia, joiden avulla yritys voi kohdentaa toimintaansa oikeille asiakkaille oikealla tavalla. Asiakaslähtöinen liiketoimintastrategiaehdotus muodostettiin hyödyntämällä teorian näkemyksiä ja työssä tehtyjen analyysien tuloksia.

Understanding the in vitro dissolution rate of glasses with respect to future clinical applications

Glass is a unique material with a long history. Several glass products are used daily in our everyday life, often unnoticed. Glass can be found not only in obvious applications such as tableware, windows, and light bulbs, but also in tennis rackets, windmill turbine blades, optical devices, and medical implants. The glasses used at present as implants are inorganic silica-based melt-derived compositions mainly for hard-tissue repair as bone graft substitute in dentistry and orthopedics. The degree of glass reactivity desired varies according to implantation situation and it is vital that the ion release from any glasses used in medical applications is controlled. Understanding the in vitro dissolution rate of glasses provides a first approximation of their behavior in vivo. Specific studies concerning dissolution properties of bioactive glasses have been relatively scarce and mostly concentrated to static condition studies. The motivation behind this work was to develop a simple and accurate method for quantifying the in vitro dissolution rate of highly different types of glass compositions with interest for future clinical applications. By combining information from various experimental conditions, a better knowledge of glass dissolution and the suitability of different glasses for different medical applications can be obtained. Thus, two traditional and one novel approach were utilized in this thesis to study glass dissolution. The chemical durability of silicate glasses was tested in water and TRIS-buffered solution at static and dynamic conditions. The traditional in vitro testing with a TRISbuffered solution under static conditions works well with bioactive or with readily dissolving glasses, and it is easy to follow the ion dissolution reactions. However, in the buffered solution no marked differences between the more durable glasses were observed. The hydrolytic resistance of the glasses was studied using the standard procedure ISO 719. The relative scale given by the standard failed to provide any relevant information when bioactive glasses were studied. However, the clear differences in the hydrolytic resistance values imply that the method could be used as a rapid test to get an overall idea of the biodegradability of glasses. The standard method combined with the ion concentration and pH measurements gives a better estimate of the hydrolytic resistance because of the high silicon amount released from a glass. A sensitive on-line analysis method utilizing inductively coupled plasma optical emission spectrometer and a flow-through micro-volume pH electrode was developed to study the initial dissolution of biocompatible glasses. This approach was found suitable for compositions within a large range of chemical durability. With this approach, the initial dissolution of all ions could be measured simultaneously and quantitatively, which gave a good overall idea of the initial dissolution rates for the individual ions and the dissolution mechanism. These types of results with glass dissolution were presented for the first time during the course of writing this thesis. Based on the initial dissolution patterns obtained with the novel approach using TRIS, the experimental glasses could be divided into four distinct categories. The initial dissolution patterns of glasses correlated well with the anticipated bioactivity. Moreover, the normalized surface-specific mass loss rates and the different in vivo models and the actual in vivo data correlated well. The results suggest that this type of approach can be used for prescreening the suitability of novel glass compositions for future clinical applications. Furthermore, the results shed light on the possible bioactivity of glasses. An additional goal in this thesis was to gain insight into the phase changes occurring during various heat treatments of glasses with three selected compositions. Engineering-type T-T-T curves for glasses 1-98 and 13-93 were stablished. The information gained is essential in manufacturing amorphous porous implants or for drawing of continuous fibers of the glasses. Although both glasses can be hot worked to amorphous products at carefully controlled conditions, 1-98 showed one magnitude greater nucleation and crystal growth rate than 13-93. Thus, 13-93 is better suited than 1-98 for working processes which require long residence times at high temperatures. It was also shown that amorphous and partially crystalline porous implants can be sintered from bioactive glass S53P4. Surface crystallization of S53P4, forming Na2O∙CaO∙2SiO2, was observed to start at 650°C. The secondary crystals of Na2Ca4(PO4)2SiO4, reported for the first time in this thesis, were detected at higher temperatures, from 850°C to 1000°C. The crystal phases formed affected the dissolution behavior of the implants in simulated body fluid. This study opens up new possibilities for using S53P4 to manufacture various structures, while tailoring their bioactivity by controlling the proportions of the different phases. The results obtained in this thesis give valuable additional information and tools to the state of the art for designing glasses with respect to future clinical applications. With the knowledge gained we can identify different dissolution patters and use this information to improve the tuning of glass compositions. In addition, the novel online analysis approach provides an excellent opportunity to further enhance our knowledge of glass behavior in simulated body conditions.

Towards combining interactive mobile TV and smart spaces : architectures, tools and application development

Technological developments in microprocessors and ICT landscape have made a shift to a new era where computing power is embedded in numerous small distributed objects and devices in our everyday lives. These small computing devices are ne-tuned to perform a particular task and are increasingly reaching our society at every level. For example, home appliances such as programmable washing machines, microwave ovens etc., employ several sensors to improve performance and convenience. Similarly, cars have on-board computers that use information from many di erent sensors to control things such as fuel injectors, spark plug etc., to perform their tasks e ciently. These individual devices make life easy by helping in taking decisions and removing the burden from their users. All these objects and devices obtain some piece of information about the physical environment. Each of these devices is an island with no proper connectivity and information sharing between each other. Sharing of information between these heterogeneous devices could enable a whole new universe of innovative and intelligent applications. The information sharing between the devices is a diffcult task due to the heterogeneity and interoperability of devices. Smart Space vision is to overcome these issues of heterogeneity and interoperability so that the devices can understand each other and utilize services of each other by information sharing. This enables innovative local mashup applications based on shared data between heterogeneous devices. Smart homes are one such example of Smart Spaces which facilitate to bring the health care system to the patient, by intelligent interconnection of resources and their collective behavior, as opposed to bringing the patient into the health system. In addition, the use of mobile handheld devices has risen at a tremendous rate during the last few years and they have become an essential part of everyday life. Mobile phones o er a wide range of different services to their users including text and multimedia messages, Internet, audio, video, email applications and most recently TV services. The interactive TV provides a variety of applications for the viewers. The combination of interactive TV and the Smart Spaces could give innovative applications that are personalized, context-aware, ubiquitous and intelligent by enabling heterogeneous systems to collaborate each other by sharing information between them. There are many challenges in designing the frameworks and application development tools for rapid and easy development of these applications. The research work presented in this thesis addresses these issues. The original publications presented in the second part of this thesis propose architectures and methodologies for interactive and context-aware applications, and tools for the development of these applications. We demonstrated the suitability of our ontology-driven application development tools and rule basedapproach for the development of dynamic, context-aware ubiquitous iTV applications.

Beauty for Sale - An Empirical Study of Appearance-Related Consumption in Finland

This study examines appearance-related consumption in Finland. The theoretical portion discusses appearance-related consumption, on one hand from a consumer culture perspective, as both a possibility and responsibility for everyone; and on the other hand, from the point of view of behaviour and attitudes associated with sociodemographic and lifestyle-related factors. The empirical part of the study concentrates on the following aspects: 1) Finns’ appearance-related consumption patterns, attitudes towards appearance-related consumption and attending to one’s looks through consumption, as well as general changes in consumption patterns and attitudes; 2) gender differences in attitudes and consumption patterns, and their possible changes over time, and; 3) other differences among population groups in attitudes and consumption patterns, and their possible changes over time. The following dissertation utilises data from seven different nationally representative surveys. Data include Finnish Household Budget surveys from 1998 (N=4 359), 2001 (N=5 495) and 2006 (N=4 007), as well as, The Everyday Life and Well-being Survey (N=908) collected in 2011, and Finland 1999 (N=2 417), Finland 2004 (N=3 574) and Finland 2009 (N=1 202) surveys. The study indicates that Finns’ relationship to appearance-related consumption is, generally, somewhat inconsistent. In Finland, a significant share of a household’s total spending, around the EU average, is allocated to products and services related to appearance. In addition, at an attitudinal level, physical appearance is important to most Finnish consumers. However, in many respects, these attitudes reflect a certain reservation towards appearance-related consumption practices. The number of those consumers who see themselves as truly dedicated to attending to their looks through consumption is quite small, whereas the amount of those willing to take a reserved or even negative attitude towards appearance-related consumption is clearly higher. Attitudes towards attending to one’s looks and the importance of appearance-related consumption had not changed during the past decade. Study shows that at present, appearance-related consumption is a form of consumption that is particularly important to women, younger consumers, people with middle or higher income, and those with normal weight. Gender is in the key role when explaining appearance-related consumption and contrary to common belief, gender differences seem to have stayed quite stable. The results also indicate that, to some extent, differences between younger and older age groups might be diminishing.

Asiakastyytyväisyys ja suosittelukäyttäytyminen vakuutusalalla

Tutkimuksen tarkoitus on tutkia asiakastyytyväisyyttä ja – tyytymättömyyttä sekä suosittelukäyttäytymistä vakuutusalalla. Tavoitteena on selvittää, mitkä tekijät vaikuttavat asiakaskokemukseen ja, miten asiakastyytyväisyystyytyväisyys tai -tyytymättömyys puolestaan vaikuttaa suosittelukäyttäytymiseen. Suosittelun katsotaan ilmaisevan asiakkaan sitoutumista yritykseen. Viime aikoina suosittelukäyttäytymiseen perustuva tutkimus on yleistynyt, koska yritykset ovat huomanneet suosittelun merkityksen ja sen tuottaman arvon liiketoiminnan kannattavuudelle. Sosiaalisen median lisääntyessä suosittelusta on tullut yhä enemmän osa arkeamme. Tutkimuksen teoriaosuudessa käsitellään palvelua, asiakastyytyväisyyttä ja – tyytymättömyyttä sekä suosittelukäyttäytymistä. Empiirisenä aineistona on primaariaineisto kohdeorganisaation asiakkailta. Tämän tutkimuksen kohdeorganisaatio on LähiTapiola Kaakkois-Suomi. Kysely on lähetetty sähköisesti syys-lokakuussa 2014 yrityksessä asioinneille. Tutkimustulosten mukaan tyytyväiset asiakkaat suosittelevat palvelua todennäköisimmin kuin tyytymättömät. Toisaalta havaittiin myös, että suosittelun todennäköisyyden ollessa korkeampi, asiakkaat antoivat enemmän myös rakentavaa palautetta. Tutkimus antoi suuntaa asioista, jotka ovat olennaisimpia kartoittaessa asiakkaan tyytyväisyyttä tai tyytymättömyyttä ja tietoa myös siitä, missä asioissa yrityksen toiminnassa on vielä kehittämistä. Keskittymällä oleellisiin asioihin, voidaan lisätä asiakkaiden tyytyväisyyttä. Tuloksista voidaan myös arvioida henkilökunnan tietämyksen ja koulutuksen lisäämisen tarvetta.

From statin efficacy to everyday effectiveness: Studying the gap in between.

Statins are indicated for preventing cardiovascular disease events. Patients with diabetes have a risk of major cardiovascular events double the risk of their peers without diabetes. Thus, clinical treatment guidelines recommend statins for the management of diabetic dyslipidemia. The evidence base for statin use in cardiovascular disease derives from the randomized controlled statin trials designed to prove statin efficacy under ideal conditions, among a homogenous study population meeting strict trial eligibility criteria. This thesis was implemented as four pharmacoepidemiological statin studies using register data on realworld statin users. The overall purpose was to evaluate the trends, patterns and effectiveness of statin use in everyday life. More specifically, nationwide secular trends in statin use in Finland were analysed, especially among patient groups which had been underrepresented in the statin trials. Furthermore, the benchmarking statin trials in diabetes, the Heart Protection Study and the Collaborative Atorvastatin Diabetes Study, were evaluated for their representativeness for real-world diabetes care with the emphasis placed on adherence to statin use. The association between good adherence and the incidence of major cardiovascular events in the real-world was further investigated in diabetes. These studies demonstrate that statin initiations increased from 1995 to 2005 in Finland. The increase was most pronounced among those aged at least 75 years and was observed already before the publication of rigorous trial data conducted in elderly subjects. Thus, statins seem to have been initiated in clinical practice also going beyond the strict trial eligibility criteria. Nonetheless, low adherence to statin use among the real-world patients with diabetes was found not only to limit the representativeness of the trials for clinical care but also to attenuate in all likelihood their benefits in the real-world. In fact, good adherence to statin use was found to associate with a decreased risk for major cardiovascular events in patients with diabetes. In conclusion, these studies highlight the importance of good adherence to statin use in clinical practice in order to obtain the full therapeutic value demonstrated in the statin trials. Simply increasing the number of statin users will not alone suffice in sharing our common resources appropriately.