Simplified Treatment of Childhood Acute Bone and Joint Infections

Acute childhood osteomyelitis (OM), septic arthritis (SA), and their combination osteomyelitis with adjacent septic arthritis (OM+SA), are treated with long courses of antimicrobials and immediate surgery. We conducted a prospective multi-center randomized trial among Finnish children at age 3 months to 15 years in 1983-2005. According to the two-by-two factorial study design, children with OM or OM+SA received 20 or 30 days of antimicrobials, whereas those with SA were treated for 10 or 30 days. In addition, the whole series was randomized to be treated with clindamycin or a first-generation cephalosporin. Cases were included only if the causative agent was isolated. The treatment was instituted intravenously, but only for the first 2-4 days. Percutaneous aspiration was done to obtain a representative sample for bacteriology, but all other surgical intervention was kept at a minimum. A total of 265 patients fulfilled our strict inclusion criteria and were analyzed; 106 children had OM, 134 SA, and 25 OM+SA. In the OM group, one child in the long and one child in the short-term treatment group developed sequelae. One child with SA twice developed a late re-infection of the same joint, but the causative agents differed. Regarding surgery, diagnostic arthrocentesis or corticotomy was the only surgical procedure performed in most cases. Routine arthrotomy was not required even in hip arthritis. Serum C-reactive protein (CRP) proved to be a reliable laboratory index in the diagnosis and monitoring of osteoarticular infections. The recovery rate was similar regardless of whether clindamycin or a first-generation cephalosporin was used. We conclude that a course of 20 days of these well-absorbing antimicrobials is sufficient for OM or OM+SA, and 10 days for SA in most cases beyond the neonatal age. A short intravenous phase of only 2-5 days often suffices. CRP gives valuable information in monitoring the course of illness. Besides diagnostic aspiration, surgery should be reserved for selected cases.

Mentoring in an Entrepreneurial Setting - The Mentor's Perspective

This paper discusses mentoring from the mentors' point of view in an entrepreneurial setting. The aim of the paper is to present why mentoring can be considered important for entrepreneurs who are mentors and under what circumstances mentoring is valuable for the mentor. A pilot mentorprogramme was conducted among women entrepreneurs during 1998. A study was made in order to examine the mentors’ perception of the programme. Firstly mentoring and entrepreneurship in Finland are discussed briefly. Secondly the results of the study are presented. The results of the study show that mentoring can be valuable for the mentors both on a vocational and a personal level. However, it is important to choose the mentees of the programme on a rather strict basis. The results demonstrate a need to be careful in choosing mentees.

Sosiaalityön ammattilaiset refleksiivisinä toimijoina : tutkimus erikoistumiskoulutuksesta Margaret Archerin teorian valossa

In Finland, specialized studies in social work (professional licentiate education) were begun in the year 2000. The education is targeted at experienced social workers and leads to a licentiate degree (a degree between master s and doctorate). In this study, the experiences of members of the first study cohort, specializing in social work with children and young people, are examined. The study s theoretical frame of reference is based on the morphogenetic approach, developed by British sociologist Margaret Archer. In it, the potential powers of both an agent as well as social and cultural structures are considered important and worth taking into account. Archer sees reflexivity, a person s ability to analyze herself/himself, as an essential starting point for agency. Thanks to reflexivity, people are able to engage in internal conversations , discuss the concerns that are important to them and form agential projects . In Archer s theory, the social structures and traits of the cultural system are seen as having potential power in relation to people s agential projects; these powers can enable but also restrain the realization of the projects. On the other hand, individuals can try to review the factors affecting their agential projects and find ways of action that facilitate them. The research task is to study the self-understanding of social work professionals in the 21st century, the issues and goals professionally important for them, as well as the contexts framing the realization of these goals. The research questions are as follows: 1) What kind of internal conversations, concerns and agential projects related to their work did the professionals taking part in licentiate education bring to light? 2) What kind of enabling and restraining factors can be identified in their situations? And 3) What kind of social structures and traits related to the cultural system are connected to these factors? The research material was collected by interviewing the students in different phases of their education. In 2001 and 2004 all members of the study group (n = 25) were interviewed. In 2007, 13 students took part. The themes of the internal conversations brought to light in the interviews were divided into four broad thematic categories: professional development, the position of children in social work, multiprofessional work and structural social work. In relation to these themes the students formed different kinds of agential projects. In addition, the study reveals several cultural and social structures that have enabled but also restrained the realization of the agential projects. These structures are linked, for example, to the relations between employees and employers, students and teachers, children and adults as well as between the representatives of different professions. Working conditions which social workers often consider weak are discussed as a focal issue related to many themes. These working conditions become evident, for example, in the great imbalance which exists between the professional tasks and the amount of time that social workers have for them. Difficult situations arise when social workers feel they cannot reach the goals that are professionally important to them because of the strict external conditions of the work.

Effects of Mean Luminance Changes on Human Contrast Perception

Background When we are viewing natural scenes, every saccade abruptly changes both the mean luminance and the contrast structure falling on any given retinal location. Thus it would be useful if the two were independently encoded by the visual system, even when they change simultaneously. Recordings from single neurons in the cat visual system have suggested that contrast information may be quite independently represented in neural responses to simultaneous changes in contrast and luminance. Here we test to what extent this is true in human perception. Methodology/Principal Findings Small contrast stimuli were presented together with a 7-fold upward or downward step of mean luminance (between 185 and 1295 Td, corresponding to 14 and 98 cd/m2), either simultaneously or with various delays (50–800 ms). The perceived contrast of the target under the different conditions was measured with an adaptive staircase method. Over the contrast range 0.1–0.45, mainly subtractive attenuation was found. Perceived contrast decreased by 0.052±0.021 (N = 3) when target onset was simultaneous with the luminance increase. The attenuation subsided within 400 ms, and even faster after luminance decreases, where the effect was also smaller. The main results were robust against differences in target types and the size of the field over which luminance changed. Conclusions/Significance Perceived contrast is attenuated mainly by a subtractive term when coincident with a luminance change. The effect is of ecologically relevant magnitude and duration; in other words, strict contrast constancy must often fail during normal human visual behaviour. Still, the relative robustness of the contrast signal is remarkable in view of the limited dynamic response range of retinal cones. We propose a conceptual model for how early retinal signalling may allow this.

Representation of Thermodynamic Properties of Dilute Multi-Component Solutions--Options and Constraints

The different formalisms for the representation of thermodynamic data on dilute multicomponent solutions are critically reviewed. The thermodynamic consistency of the formalisms are examined and the interrelations between them are highlighted. The options are constraints in the use of the interaction parameter and Darken's quadratic formalisms for multicomponent solutions are discussed in the light of the available experimental data. Truncatred Maclaurin series expansion is thermodynamically inconsistent unless special relations between interaction parameters are invoked. However, the lack of strict mathematical consistency does not affect the practical use of the formalism. Expressions for excess partial properties can be integrated along defined composition paths without significant loss of accuracy. Although thermodynamically consistent, the applicability of Darken's quadratic formalism to strongly interacting systems remains to be established by experiment.

An Axiom of Military Law : Applicability of National Criminal Law to Military Personnel and Associated Civilians Abroad

States regularly deploy elements of their armed forces abroad. When that happens, the military personnel concerned largely remain governed by the penal law of the State that they serve. This extraterritorial extension of national criminal law, which has been treated as axiomatic in domestic law and ignored by international law scholarship, is the subject of this dissertation. The first part of the study considers the ambit of national criminal law without any special regard to the armed forces. It explores the historical development of the currently prevailing system of territorial law and looks at the ambit that national legal systems claim today. Turning then to international law, the study debunks the oddly persistent belief that States enjoy a freedom to extend their laws to extraterritorial conduct as they please, and that they are in this respect constrained only by some specific prohibitions in international law. Six arguments historical, empirical, ideological, functional, doctrinal and systemic are advanced to support a contrary view: that States are prohibited from extending the reach of their legal systems abroad, unless they can rely on a permissive principle of international law for doing so. The second part of the study deals specifically with State jurisdiction in a military context, that is to say, as applied to military personnel in the strict sense (service members) and various civilians serving with or accompanying the forces (associated civilians). While the status of armed forces on foreign soil has transformed from one encapsulated in the customary concept of extraterritoriality to a modern regulation of immunities granted by treaties, elements of armed forces located abroad usually do enjoy some degree of insulation from the legal system of the host State. As a corollary, they should generally remain covered by the law of their own State. The extent of this extraterritorial extension of national law is revealed in a comparative review of national legislation, paying particular attention to recent legal reforms in the United States and the United Kingdom two states that have sought to extend the scope of their national law to cover the conduct of military contractor personnel. The principal argument of the dissertation is that applying national criminal law to service members and associated civilians abroad is distinct from other extraterritorial claims of jurisdiction (in particular, the nationality principle or the protective principle of jurisdiction). The service jurisdiction over the armed forces has a distinct aim: ensuring the coherence and indivisibility of the forces and maintaining discipline. Furthermore, the exercise of service jurisdiction seeks to reduce the chances of the State itself becoming internationally liable for the conduct of its service members and associated civilians. Critically, the legal system of the troop-deploying State, by extending its reach abroad, seeks to avoid accountability gaps that might result from immunities from host State law.

Peritoneal dialysis and neurological outcome in infants and small children

Although improved outcomes for children on peritoneal dialysis (PD) have been seen in recent years, the youngest patients continue to demonstrate inferior growth, more frequent infections, more neurological sequelae, and higher mortality compared to older children. Also, maintain-ing normal intravascular volume status, especially in anuric patients, has proven difficult. This study was designed to treat and monitor these youngest PD patients, which are relatively many due to the high prevalence of congenital nephrotic syndrome of the Finnish type (CNF, NPHS1) in Finland, with a strict protocol, to evaluate the results and to improve metabolic balance, growth, and development. A retrospective analysis of 23 children under two years of age at onset of PD, treated between 1995 and 2000, was performed to obtain a control population for our prospective PD study. Respectively, 21 patients less than two years of age at the beginning of PD were enrolled in prospective studies between 2001 and 2005. Medication for uremia and nutrition were care-fully adjusted during PD. Laboratory parameters and intravascular volume status were regu-larly analyzed. Growth was analyzed and compared with midparental height. In a prospective neurological study, the risk factors for development and the neurological development was determined. Brain images were surveyed. Hearing was tested. In a retrospective neurological study, the data of six NPHS1 patients with a congruent neurological syndrome was analyzed. All these patients had a serious dyskinetic cerebral palsy-like syndrome with muscular dysto-nia and athetosis (MDA). They also had a hearing defect. Metabolic control was mainly good in both PD patient groups. Hospitalization time shortened clearly. The peritonitis rate diminished. Hypertension was a common problem. Left ventricular hypertrophy decreased during the prospective study period. None of the patients in either PD group had pulmonary edema or dialysis-related seizures. Growth was good and catch-up growth was documented in most patients in both patient groups during PD. Mortality was low (5% in prospective and 9% in retrospective PD patients). In the prospective PD patient group 11 patients (52%) had some risk factor for their neuro-development originating from the predialysis period. The neurological problems, detected be-fore PD, did not worsen during PD and none of the patients developed new neurological com-plications during PD. Brain infarcts were detected in four (19%) and other ischemic lesions in three patients (14%). At the end of this study, 29% of the prospectively followed patients had a major impairment of their neurodevelopment and 43% only minor impairment. In the NPHS1+MDA patients, no clear explanation for the neurological syndrome was found. The brain MRI showed increased signal intensity in the globus pallidus area. Kernic-terus was contemplated to be causative in the hypoproteinemic newborns but it could not be proven. Mortality was as high as 67%. Our results for young PD patients were promising. Metabolic control was acceptable and growth was good. However, the children were significantly smaller when compared to their midparental height. Although many patients were found to have neurological impairment at the end of our follow-up period, PD was a safe treatment whereby the neurodevelopment did not worsen during PD.

Evidence in European Asylum Procedures

This thesis explores the particular framework of evidentiary assessment of three selected appellate national asylum procedures in Europe and discusses the relationship between these procedures, on the one hand, and between these procedures and other legal systems, including the EU legal order and international law, on the other. A theme running throughout the thesis is the EU strivings towards approximation of national asylum procedures and my study analyses the evidentiary assessment of national procedures with the aim of pinpointing similarities and differences, and the influences which affect these distinctions. The thesis first explores the frames construed for national evidentiary solutions by studying the object of decision-making and the impact of legal systems outside the national. Second, the study analyses the factual evidentiary assessment of three national procedures - German, Finnish and English. Thirdly, the study explores the interrelationship between these procedures and the legal systems influencing them and poses questions in relation to the strivings of EU and methods of convergence. The thesis begins by stating the framework and starting points for the research. It moves on to establish keys of comparison concerning four elements of evidentiary assessment that are of importance to any appellate asylum procedure, and that can be compared between national procedures, on the one hand, and between international, regional and national frameworks, on the other. Four keys of comparison are established: the burden of proof, demands for evidentiary robustness, the standard of proof and requirements for the methods of evidentiary assessment. These keys of comparison are then identified in three national appellate asylum procedures, and in order to come to conclusions on the evidentiary standards of the appellate asylum procedures, relevant elements of the asylum procedures in general are presented. Further, institutional, formal and procedural matters which have an impact on the evidentiary standards in the national appellate procedures are analysed. From there, the thesis moves on to establish the relationship between national evidentiary standards and the legal systems which affect them, and gives reasons for similarities and divergences. Further, the thesis studies the impact of the national frameworks on the regional and international level. Lastly, the dissertation makes a de lege ferenda survey of the relationship between EU developments, the goal of harmonization in relation to national asylum procedures and the particular feature of evidentiary standards in national appellate asylum procedures. Methodology The thesis follows legal dogmatic methods. The aim is to analyse legal norms and legal constructions and give them content and context. My study takes as its outset an understanding of the purposes for legal research also regarding evidence and asylum to determine the contents of valid law through analysis and systematization. However, as evidentiary issues traditionally are normatively vaguely defined, a strict traditional normative dogmatic approach is not applied. For the same reason a traditionalist and strict legal positivism is not applied. The dogmatics applied to the analysis of the study is supported by practical analysis. The aim is not only to reach conclusions concerning the contents of legal norms and the requirements of law, but also to study the use and practical functioning of these norms, giving them a practcial context. Further, the study relies on a comparative method. A functionalist comparative method is employed and keys of comparison are found in evidentiary standards of three selected national appellate asylum procedures. The functioning equivalences of German, Finnish and English evidentiary standards of appellate asylum procedures are compared, and they are positioned in an European and international legal setting. Research Results The thesis provides results regarding the use of evidence in national appellate asylum procedures. It is established that evidentiary solutions do indeed impact on the asylum procedure and that the results of the procedure are dependent on the evidentiary solutions made in the procedures. Variations in, amongst other things, the interpretation of the burden of proof, the applied standard of proof and the method for determining evidentiary value, are analysed. It is established that national impacts play an important role in the adaptation of national appellate procedures to external requirements. Further, it is established that the impact of national procedures on as well the international framework as on EU law varies between the studied countries, partly depending on the position of the Member State in legislative advances at the EU level. In this comparative study it is, further, established that the impact of EU requirements concerning evidentiary issues may be have positive as well as negative effects with regard to the desired harmonization. It is also concluded that harmonization using means of convergence that primaly target legal frameworks may not in all instances be optimal in relation to evidentiary standards, and that more varied and pragmatic means of convergence must be introduced in order to secure harmonization also in terms of evidence. To date, legal culture and traditions seem to prevail over direct efforts at procedural harmonization.

Elämästä autofiktioksi : Lajitradition jäljillä Pirkko Saision romaanisarjassa Pienin yhteinen jaettava, Vastavalo ja Punainen erokirja

Pirkko Saisio's trilogy Pienin yhteinen jaettava (The Smallest Shared Dividend, 1998), Vastavalo (Against the Light, 2000), and Punainen erokirja (The Red Book of Separation, 2003), depicts the development of a masculine girl who at the end of the trilogy comes out as a homosexual women, a mother, and a writer. The main character is named Pirkko Saisio, and many of the events are picked from Saisio's real life. Nevertheless, the author wants the trilogy to be read as a novel, not a memoir. The present study analyses the generic elements of Saisio s trilogy and contextualizes the narrative identity that Saisio is creating in her fiction. Following Alastair Fowler s theory of genres as types without strict borders and a tendency to hybridity, the trilogy is linked to several genres. Serge Doubrovsky s genre concept of autofiction is the basis for the analysis: it explains the trilogy s borderline identity between autobiography and novel, and designates the main elements that render Saisio s autobiographical narrative into fiction. Both Doubrovsky and Saisio emphasize the role of the unconscious in writing, and at the same time stress the importance of a skilled composition. As well as autofiction, the trilogy is analyzed as a Bildungsroman, a confession and conversion narrative, a coming-out -narrative and a portrait-of-the-artist novel. Each genre is illuminated by its paradigmatic work: Wilhelm Meister s Apprenticeship by Goethe, The Confessions by St. Augustine, and The Well of Loneliness by Radclyffe Hall. The parallelisms between Saisio s trilogy and the typical plots of the genres and thematics of the classics show how the tradition works in Saisio s text. The thematic parallelisms highlight Saisio s concern for the conflicts that occur between an individual and the surrounding society, while the similarities in plots question the autobiographicality of Saisio s narrative but also clarify how Saisio refines the traditional genres. Read in the light of Saisio s trilogy, the classics are shown to have their gender-transgressive elements that the non-normative reader can identify with. Saisio s text also challenges universalizing claims about genre and gender. As a narrative of identity it follows the example of 1970s essentialistic coming-out stories, but at the same time depicts the notion of identity in a manner that manifests postmodern ideas about identity as multiple and ever-transforming. Keywords: autobiographicality, autofiction, identity narrative, genre research, Bildungsroman, conversion narrative, confession, coming-out story, a portrait-of-an-artist novel

Valokuvallistettu luonto : I. K. Inhan tuotanto luonnon merkityksellistäjänä

Photographized nature I. K. Inha s work as a signification of nature The dissertation examines, through the work of the Finnish photographer and writer I. K. Inha (formerly Konrad Into Nyström) (1865 1930), the different ways in which the signification of nature is achieved. The principal material consists of Inha s work from 1890 to 1925, from which a number of photographs and texts are considered and upon which the photographization of nature is contemplated. The dissertation addresses the issue of how nature is conceived and how the act of photographizing it can be defined. The methodical context of the study is composed of three thematic baskets that structure the material and which consist of narrations on Finnish national perception, nature conservation and understanding the world. In the first case nature is seen as the natural environment encompassing lakes, seashores, forests, and hills, which at the time were often perceived from a utilitarian viewpoint. By the photographization they generated a pictorial narrative that could be shared. The natural environment was thus turned into landscape by means of photography, following the global pictorial concepts picturesque and sublime, as well as the national canons that had been developed in literature and the visual arts. In the narrations concerning nature conservation, the photographization did not merely occur within the limits of presuppositions, but rather nature was given the opportunity to unfold itself. While the photograph was being established as a basis for supporting nature conservation or to highlight the destruction of nature at the hand of Man, an attempt was made to represent subjects that were difficult to convey in photographs, such as nature s power or the miracle of growth. The thesis suggests, that in the third case the concept of nature broke away from its strict interconnection with the natural environment and led to a contemplation of nature that is perceivable in a person. In this context the photograph and the photographization are interpreted as an attempt to understand a person and his or her very existence in the world, while this same existential wonder is seen as being embodied in Inha s portrait of a rune singer and in his photographs of forest interior and water. Further, the thesis asks whether photographing nature could be interpreted as an action similar to the idea of the phenomenological reduction as a means of bypassing the photographer s prevailing way of being.

Finlandssvenska åsikter om och attityder till modern språkpåverkan

The study describes and analyzes Finland Swedes attitudes to modern-day linguistic influence, the relationship between informants explicitly reported views and the implicit attitudes they express towards language influence. The methods are primarily sociolinguistic. For the analysis of opinions and attitudes I have further developed and tested a new tool in attitude research. With statistical correlation analysis of data collected through a quantitative survey I describe the views that Swedish-language Finns (N=500) report on the influence of English, on imports, and on domain loss. With experimental matchedguise techniques, I study Finland-Swedes (N=600) subconscious reactions to English imports in spoken text. My results show that the subconscious reactions in some respects differ markedly from the views informants explicitly report that they have: informants respond that they would like English words that come into Swedish to be replaced by Swedish replacement words, but in a matched-guise test on their subconscious attitudes, the informants consider English words in a Swedish context to have a positive effect. The topic is further dealt with in interviews where I examine 36 informants implicit attitudes through interactional sociolinguistic analyses. This study comes close to pragmatic discourse analysis in its focus on pragmatic particles and modality. The study makes a rather strict distinction between explicitly expressed opinions and implicit, subconscious attitudes. The quantitative analyses suggest that the opinions we express can be tied to the explicit in language. The outcome of the matched-guise test shows that it is furthermore possible to find subconscious, implicit attitudes that people in actual situations rely on when they make decisions. The discourse analysis finds many subconscious signals, but it also shows that the signals arise in interaction with one s interlocutor, the situation, and the norms in the society. To account for this I have introduced the concept of socioconscious attitude. Socioconscious attitudes reflect not only the traditions and values the utterer grew up with, but also the speaker s relation to the social situation (s)he takes part in.

Substrate-mediated purification and characterization of a 3-hydroxybenzoic acid-6-hydroxylase from Micrococcus

3-Hydroxybenzoic acid-6-hydroxylase from Micrococcus sp. was purified to homogeneity in a single step using the substrate-mediated interaction of the enzyme with blue-Sepharose. The enzyme was bound to the affinity matrix in the presence of 3-hydroxybenzoic acid and was eluted in its absence. The molecular weight of the purified enzyme is 70,000 with no subunit structure. The flavoenzyme required the exogenous addition of FAD for its complete activity and had a strict preference for NADH over NADPH. The activity of the enzyme was drastically inhibited by Cu2+ and Hg2+ and the inhibition was reversed by thiol reagents.

Rätt som argument : Leo Mechelin och finska frågan 1886-1912

Right as an Argument. Leo Mechelin and the Finnish Question 1886-1912 At the turn of the 20th century the Finnish Question rose up as a political and juridical issue at the international arena. The vaguely précised position of Finland in the Russian empire led to diverse conclusions concerning the correctness of the February manifesto of 1899. It was predominantly among a European elite of politicians, cultural workers and academics the issue rose some interest. Finns were active making propaganda for their cause, and they put an emphasis on the claim that the right was on the Finnish side. In the study Elisabeth Stubb compare the Finnish, Russian and European statements about the Finnish Question and analyse their use of right as an argument. The Finnish Question offers at the same time a case study of a national entity which possesses a political sphere of life but is not fully independent, and its possibilities to drive its interests in an international context. Leo Mechelin (1839-1914), the leader of the Finnish propaganda organization abroad, is used as a point of departure. The biographical stance is formed into a triangle, where Leo Mechelin, the idea of right and the Finnish Question abroad are the three cornerstones. The treatment of one cornerstone sheds a ligth on the two others. The metaphor of triangulation also worked as a method to reach "a third stance" in a scinetific and political issue that usually is polarised into two opposite alternatives. An adherence to a strict legal right could not in the end offer a complete, unquestionable and satisfactory solution to the Finnsih Question, it was dependent on "the right of state wisdom and sound insight". The Finnish propaganda abroad used almost completely alternative ways of making politics. The propaganda did not have a decisive effect on countries' official politics, but gained unofficial support, especially in the public opinion and in academic statements. Mechelin claimed that the political field was dependent on public opinion and scientific research. Together with the official politics these two fields formed a triangle that shared the task of balancing the political arena and preventing it from making unwise decisions of taking an unjust turn. The international sphere worked as a balancing part in the Finnish Question. Mechelin tried by claiming the status of state for Finland's part to secure the country a place at the official international arena. At the same time, and especially when the claim was not fully adopted, he emphasised, and in a European context worked for, that right would become the guiding light not only for international relations, but also for the policy making in the inner life of the state.

Generalised one-dimensional burgers'equation in relativistic fluiddynamics

This work deals with the effects of weak nonlinearity and weak dissipation on a linear wave in relativistic gasdynamics. Using perturbation and asymptotic expansions, a relativistic analogue of generalised one-dimensional Burgers' equation of classical gasdynamics is derived to describe far-field description of the wave. Steady state solution is presented for strict one-dimensional case.

Uniform algebras generated by holomorphic and close-to-harmonic functions

The initial motivation for this paper is to discuss a more concrete approach to an approximation theorem of Axler and Shields, which says that the uniform algebra on the closed unit disc (D) over bar generated by z and h, where h is a nowhere-holomorphic harmonic function on D that is continuous up to partial derivative D, equals C((D) over bar). The abstract tools used by Axler and Shields make harmonicity of h an essential condition for their result. We use the concepts of plurisubharmonicity and polynomial convexity to show that, in fact, the same conclusion is reached if h is replaced by h + R, where R is a non-harmonic perturbation whose Laplacian is ``small'' in a certain sense.