Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants.

BACKGROUND: Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. METHODS: We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m(2) [underweight], 18·5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), ≥40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. FINDINGS: We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m(2) (95% credible interval 21·3-22·1) in 1975 to 24·2 kg/m(2) (24·0-24·4) in 2014 in men, and from 22·1 kg/m(2) (21·7-22·5) in 1975 to 24·4 kg/m(2) (24·2-24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m(2) in central Africa and south Asia to 29·2 kg/m(2) (28·6-29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m(2) (21·4-22·3) in south Asia to 32·2 kg/m(2) (31·5-32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5-17·4) to 8·8% (7·4-10·3) in men and from 14·6% (11·6-17·9) to 9·7% (8·3-11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8-29·2) in men and 24·0% (18·9-29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4-4·1) in 1975 to 10·8% (9·7-12·0) in 2014 in men, and from 6·4% (5·1-7·8) to 14·9% (13·6-16·1) in women. 2·3% (2·0-2·7) of the world's men and 5·0% (4·4-5·6) of women were severely obese (ie, have BMI ≥35 kg/m(2)). Globally, prevalence of morbid obesity was 0·64% (0·46-0·86) in men and 1·6% (1·3-1·9) in women. INTERPRETATION: If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. FUNDING: Wellcome Trust, Grand Challenges Canada.

Understanding Flood Regime Changes in Europe: a state-of-the-art assessment

There is growing concern that flooding is becoming more frequent and severe in Europe. A better understanding of flood regime changes and their drivers is therefore needed. The paper reviews the current knowledge on flood regime changes in European rivers that has traditionally been obtained through two alternative research approaches. The first approach is the data-based detection of changes in observed flood events. Current methods are reviewed together with their challenges and opportunities. For example, observation biases, the merging of different data sources and accounting for nonlinear drivers and responses. The second approach consists of modelled scenarios of future floods. Challenges and opportunities associated with flood change scenarios are discussed such as fully accounting for uncertainties in the modelling cascade and feedbacks. To make progress in flood change research, we suggest that a synthesis of these two approaches is needed. This can be achieved by focusing on long duration records and flood-rich and flood-poor periods rather than on short duration flood trends only, by formally attributing causes of observed flood changes, by validating scenarios against observed flood regime dynamics, and by developing low-dimensional models of flood changes and feedbacks. The paper finishes with a call for a joint European flood change research network.

Case-Crossover Analysis of Air Pollution Health Effects: A Systematic Review of Methodology and Application

Case-crossover is one of the most used designs for analyzing the health-related effects of air pollution. Nevertheless, no one has reviewed its application and methodology in this context. Objective: We conducted a systematic review of case-crossover (CCO) designs used to study the relationship between air pollution and morbidity and mortality, from the standpoint of methodology and application.Data sources and extraction: A search was made of the MEDLINE and EMBASE databases.Reports were classified as methodologic or applied. From the latter, the following information was extracted: author, study location, year, type of population (general or patients), dependent variable(s), independent variable(s), type of CCO design, and whether effect modification was analyzed for variables at the individual level. Data synthesis: The review covered 105 reports that fulfilled the inclusion criteria. Of these, 24 addressed methodological aspects, and the remainder involved the design’s application. In the methodological reports, the designs that yielded the best results in simulation were symmetric bidirectional CCO and time-stratified CCO. Furthermore, we observed an increase across time in the use of certain CCO designs, mainly symmetric bidirectional and time-stratified CCO. The dependent variables most frequently analyzed were those relating to hospital morbidity; the pollutants most often studied were those linked to particulate matter. Among the CCO-application reports, 13.6% studied effect modification for variables at the individual level.Conclusions: The use of CCO designs has undergone considerable growth; the most widely used designs were those that yielded better results in simulation studies: symmetric bidirectional and time-stratified CCO. However, the advantages of CCO as a method of analysis of variables at the individual level are put to little use

Tarkkuuselektroniikkatuotteen elinkaariarviointi tuotesuunnittelun tueksi

Tämän diplomityön tarkoituksena oli tutkia tarkkuuselektroniikkatuotteen ympäristönäkökohtia elinkaariarvioinnin avulla. Työn osana tehtiin elinkaariarviointi (LCA) kahdelle tarkkuuselektroniikkatuotteelle. LCA:ssa keskityttiin elinkaaren kehdosta-asiakkaalle-vaiheisiin. Työn tavoitteena oli tuottaa määrällistä ja laadullista tietoa valittujen tuotteiden ympäristövaikutuksista. Selvitys tehtiin yrityksen tuotesuunnittelun tueksi. LCA:n inventaarioanalyysiin kerättiin prosessikohtaista tietoa selvityksen aikana. Myös kaupallista LCA-ohjelmaa ja sen tarjoamia tietopankkeja hyödynnettiin elinkaariarvioinnin toteuttamisessa. Teoriaosassa esitellään LCA-menetelmä. Lisäksi tarkastellaan elinkaariarviointiin liittyviä tuotekohtaisia ympäristökysymyksiä. Työssä eritellään myös yleisesti tarkkuuselektroniikkatuotteen eri osien elinkaareen vaiheita ja niihin liittyviä ympäristönäkökohtia. Kokeellisessa osassa kuvataan kahdelle tuotteelle tehtyä LCA-tapaustutkimusta. Elinkaariarvioinnin inventaariotiedon lähteet kuvataan. Inventaarioanalyysin ja vaikutusarvioinnin avulla tuodaan esille tuotteiden ympäristökuormaan merkittävimmin vaikuttavat prosessit ja elinkaaren vaiheet. Lisäksi tarkastellaan miten tapaustuotteiden ympäristökuormaa voitaisiin pienentää kahden esimerkin avulla. Lopuksi annetaan suosituksia jatkotoimenpiteistä tuotesuunnitteluun ja tiedonkeruuseen.

Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events: patient level meta-analysis

Objectives: To examine the safety and effectiveness of cobalt-chromium everolimus eluting stents compared with bare metal stents. Design: Individual patient data meta-analysis of randomised controlled trials. Cox proportional regression models stratified by trial, containing random effects, were used to assess the impact of stent type on outcomes. Hazard ratios with 95% confidence interval for outcomes were reported. Data sources and study selection: Medline, Embase, the Cochrane Central Register of Controlled Trials. Randomised controlled trials that compared cobalt-chromium everolimus eluting stents with bare metal stents were selected. The principal investigators whose trials met the inclusion criteria provided data for individual patients. Primary outcomes: The primary outcome was cardiac mortality. Secondary endpoints were myocardial infarction, definite stent thrombosis, definite or probable stent thrombosis, target vessel revascularisation, and all cause death. Results: The search yielded five randomised controlled trials, comprising 4896 participants. Compared with patients receiving bare metal stents, participants receiving cobalt-chromium everolimus eluting stents had a significant reduction of cardiac mortality (hazard ratio 0.67, 95% confidence interval 0.49 to 0.91; P=0.01), myocardial infarction (0.71, 0.55 to 0.92; P=0.01), definite stent thrombosis (0.41, 0.22 to 0.76; P=0.005), definite or probable stent thrombosis (0.48, 0.31 to 0.73; P<0.001), and target vessel revascularisation (0.29, 0.20 to 0.41; P<0.001) at a median follow-up of 720 days. There was no significant difference in all cause death between groups (0.83, 0.65 to 1.06; P=0.14). Findings remained unchanged at multivariable regression after adjustment for the acuity of clinical syndrome (for instance, acute coronary syndrome v stable coronary artery disease), diabetes mellitus, female sex, use of glycoprotein IIb/IIIa inhibitors, and up to one year v longer duration treatment with dual antiplatelets. Conclusions: This meta-analysis offers evidence that compared with bare metal stents the use of cobalt-chromium everolimus eluting stents improves global cardiovascular outcomes including cardiac survival, myocardial infarction, and overall stent thrombosis.

Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events: patient level meta-analysis

Objectives: To examine the safety and effectiveness of cobalt-chromium everolimus eluting stents compared with bare metal stents. Design: Individual patient data meta-analysis of randomised controlled trials. Cox proportional regression models stratified by trial, containing random effects, were used to assess the impact of stent type on outcomes. Hazard ratios with 95% confidence interval for outcomes were reported. Data sources and study selection: Medline, Embase, the Cochrane Central Register of Controlled Trials. Randomised controlled trials that compared cobalt-chromium everolimus eluting stents with bare metal stents were selected. The principal investigators whose trials met the inclusion criteria provided data for individual patients. Primary outcomes: The primary outcome was cardiac mortality. Secondary endpoints were myocardial infarction, definite stent thrombosis, definite or probable stent thrombosis, target vessel revascularisation, and all cause death. Results: The search yielded five randomised controlled trials, comprising 4896 participants. Compared with patients receiving bare metal stents, participants receiving cobalt-chromium everolimus eluting stents had a significant reduction of cardiac mortality (hazard ratio 0.67, 95% confidence interval 0.49 to 0.91; P=0.01), myocardial infarction (0.71, 0.55 to 0.92; P=0.01), definite stent thrombosis (0.41, 0.22 to 0.76; P=0.005), definite or probable stent thrombosis (0.48, 0.31 to 0.73; P<0.001), and target vessel revascularisation (0.29, 0.20 to 0.41; P<0.001) at a median follow-up of 720 days. There was no significant difference in all cause death between groups (0.83, 0.65 to 1.06; P=0.14). Findings remained unchanged at multivariable regression after adjustment for the acuity of clinical syndrome (for instance, acute coronary syndrome v stable coronary artery disease), diabetes mellitus, female sex, use of glycoprotein IIb/IIIa inhibitors, and up to one year v longer duration treatment with dual antiplatelets. Conclusions: This meta-analysis offers evidence that compared with bare metal stents the use of cobalt-chromium everolimus eluting stents improves global cardiovascular outcomes including cardiac survival, myocardial infarction, and overall stent thrombosis.

Exposição humana a substâncias químicas potencialmente tóxicas na dieta e os riscos para saúde

Humans are exposed to a variety of chemicals from the consumption of food, including undesirable compounds such as pesticides and mycotoxins. Chemical human risk assessment is a process intended to estimate the risk to a given population from the exposure to a chemical (or to a chemical group having the same mechanism of action). The process consists of four steps, namely hazard identification, hazard characterization, exposure assessment and risk characterization. Chemical dietary risk assessment is an essential procedure to establish safe food standards. In this review the tools and data sources currently used in the risk assessment process will be discussed.

Very preterm infants in Finland - Use of health care services and economic consequences during the first five years of life

The aim of this thesis was to study the health, the hospitalisations, and the use of communal health care services in very preterm children during the first five years of life. In addition, the effect of very preterm birth and prematurity-related morbidities on the costs of hospitalisations, other health care services and the cost per quality adjusted life years (QALY) were studied. This population-based study included all very preterm children (gestational age (GA) <32 weeks or birth weight<1501g, N=2 064) and full-term controls (GA 37+0−41+6, N=200 609) born in Finland during 2000-2003. The data sources included national register data, costing data from the participating hospitals and parental questionnaires. This study showed that most very preterm infants born in Finland survived without prematurity-related morbidities diagnosed during the first years of life. They required relatively little hospital care after the initial discharge, which accounted for the vast majority of the total four-year hospitalisation costs. However, a minority of children born very preterm later developing morbidities had a long initial length of stay and more re-admissions and outpatient visits during the five-year follow-up period. In particular, the number and costs of non-emergency outpatient visits were considerable in individuals with prematurity-related morbidities. The need and costs of hospitalisations decreased clearly with each follow-up year, even in individuals with morbidities. The health-care related costs during the fifth year of life in children born very preterm without prematurity-related morbidities were close to the costs in infants born healthy at term. The cost per QALY of 19,245 € was at an acceptable level already by four years of age in the very preterm population as a whole. Prematurity-related later morbidities and decreasing GA increased the costs per QALY. As the initial hospital stay accounted for a great majority of the total four-year costs, and the costs of hospitalisation decreased with each follow-up year, the cost per QALY is likely to decrease with age. In conclusion, the majority of costs arising after the initial hospitalisation were associated with morbidities related to prematurity. Therefore offering high-quality neonatal care to prevent later morbidities in very preterm survivors has a long-term impact on the cost per QALY. In addition, this study indicates that when estimating the costs of prematurity after the first year of life, one should calculate not only the hospitalisation costs, but also other costs for social welfare services, primary care, and therapies, as these exceed the hospitalisation costs in very preterm infants during the fifth year of life.

Marketing Plan of Electric Vehicle Charging Solutions to USA

The purpose of the Thesis was to evaluate the business environment of electrical vehicle charging equipment (EVSE) in USA, find the key issues of entering the US EVSE markets and to form a marketing plan for possible market entry. The external market research analyzed the environment, customers, competitors and demand of EVSEs. In the internal analysis the focus was on resources and capabilities, offering, performance, business relations and US related issues. The research about the business environment was done using already available information from market studies and seminars. In external analysis there were also two semi-structured interviews from market experts used. The internal analysis was done mostly by interviews, but also company’s internal data sources were used. The interviews were semi-constructed and included eight interviewees from each part of EVSE value chain. The research findings were analyzed using SWOT analysis, which was converted to a so called TOWS matrix for extracting strategies. As a result of the Thesis, valuable information about the US markets and their requirements for EVSEs was gained. By matching the strengths of the case company and market requirements, customer segmentation and targeting were done and a marketing plan was constructed for the case company to help their management to evaluate the feasibility of possible market entry and investments to USA.

Business Intelligencen hyödyntäminen autoalan liiketoiminnassa

Tämän pro gradu -tutkielman tavoitteena on selvittää, miten Business Intelligencea voidaan hyödyntää autoalan liiketoiminnassa Suomessa. Työssä tutkitaan erityisesti autoalan tietotarpeita, tietolähteitä, tiedon analysointia sekä tiedon hyödynnettävyyttä liiketoiminnan ohjaamisessa ja päätöksenteossa. Työn tutkimusstrategiana käytettiin tapaustutkimusta, jonka kohderyhmänä oli viisi suomalaista autoalan suuryritystä. Tutkimuksen empiirinen aineisto hankittiin haastattelemalla yritysten Business Intelligence -toiminnoista vastaavia henkilöitä. Tutkimuksen tulosten perusteella Business Intelligence merkitsi yrityksille ensisijaisesti toiminnanohjausta ja sen seurantaa, sekä korkealaatuisen tiedon tuottamista päätöksentekoa varten. Keskeisiksi tietotarpeiksi luokiteltiin asiakkaisiin, ajoneuvoihin, sisäisiin prosesseihin, liiketoimintatapahtumiin, kilpailijoihin, toimialaan ja asiakastyytyväisyyteen liittyvät tiedot. Tutkimuksen tulosten perusteella tiedon hankinnassa tulee huomioida sekä sisäisen liiketoimintatiedon analyyttinen hyödyntäminen että systemaattinen tiedon hankinta myös ulkoisista lähteistä. Yritykset kokivat Business Intelligence -toimintojen parantaneen tiedon laatua, tehostaneen toiminnanohjausta sekä mahdollistaneen yhteneväisen liiketoiminnan johtamisen organisaation eri tasoilla.

Leadership in the mobile smartphone market

The mobile telecommunications industry has been going through an enormous revolution, especially after mid-1990 when smartphones were introduced to the market. As a consequence, the smartphone market’s dynamism is requesting companies to operate differently in the way they do business. After a long period occupying the leader position in the smartphones manufacturers’ rank, Nokia was outperformed by Apple and Samsung during 2011 and since then has been on the third place. Nevertheless, Nokia is battling for regaining the leadership in such a competitive and high-velocity growing market and that is what this research is about. This research covers the competitive and strategic forces that shape dynamic industries whereas the main purpose is to elucidate the main factors that contribute to a company’s above-average performance and ultimately determine its leadership in the mobile smartphone market. Therefore, this exploratory qualitative research was conducted as a desk research, which utilized various secondary sources of data in the knowledge area of strategic management such as theories about competitive advantages and dynamic capabilities of firms, innovation, and strategy. This research is enriched with a case study about Nokia: how the company has been organizing its corporate structure to support the strategies and hence how it has been competing in the smartphone market is analyzed, taking into account many contemporary data sources, including market analysts’ and business experts’ opinions. As a result of the classic literature exploration and the case study assay, a framework for deeper analysis of the competitiveness of firms in dynamic markets was developed. The conclusion that emerged from this research is that the success of a firm results from the interplay of various factors. To regain the leader position in the mobile smartphone market is a challenging task that requires Nokia to reinvent its core strategy for taking charge of the smartphones’ industry transformation through for example the adoption of the open innovation concept. It is imperative that Nokia designs and implement a breakthrough strategy as well as embraces the uncertainty of the smartphone market competition as an opportunity for discontinuous innovation development with the ultimate goal of recovering the leadership.

Studies of Solar Activity with Emphasis on Quasi-Periodic Oscillations

In this thesis mainly long quasi-periodic solar oscillations in various solar atmospheric structures are discussed, based on data obtained at several wavelengths, focussing, however, mainly on radio frequencies. Sunspot (Articles II and III) and quiet Sun area (QSA) (Article I) oscillations are investigated along with quasi-periodic pulsations (QPP) in a flaring event with wide-range radio spectra (Article IV). Various oscillation periods are detected; 3–15, 35–70 and 90 minutes (QSA), 10-60 and 80-130 minutes (in sunspots at various radio frequencies), 3-5, 10-23, 220-240, 340 and 470 minutes (in sunspots at photosphere) and 8-12 and 15-17 seconds (in a solar flare at radio frequencies). Some of the oscillation periods are detected for the first time, while some of them have been confirmed earlier by other research groups. Solar oscillations can provide more information on the nature of various solar structures. This thesis presents the physical mechanisms of some solar structure oscillations. Two different theoretical approaches are chosen; magnetohydrodynamics (MHD) and the shallow sunspot model. These two theories can explain a wide range of solar oscillations from a few seconds up to some hours. Various wave modes in loop structures cause solar oscillations (<45 minutes) both in sunspots and quiet Sun areas. Periods lasting more than 45 minutes in the sunspots (and a fraction of the shorter periods) are related to sunspot oscillations as a whole. Sometimes similar oscillation periods are detected both in sunspot area variations and respectively in magnetic field strength changes. This result supports a concept that these oscillations are related to sunspot oscillations as a whole. In addition, a theory behind QPPs at radio frequencies in solar flares is presented. The thesis also covers solar instrumentation and data sources. Additionally, the data processing methods are presented. As the majority of the investigations in this thesis focus on radio frequencies, also the most typical radio emission mechanisms are presented. The main structures of the Sun, which are related to solar oscillations, are also presented. Two separate projects are included in this thesis. Solar cyclicity is studied using the extensively large solar radio map archieve from Metsähovi Radio Observatory (MRO) at 37 GHz, between 1978 and 2011 (Article V) covering two full solar cycles. Also, some new solar instrumentation (Article VI) was developed during this thesis.

Business intelligence viewpoint on managerial decision-making : Ill-structured problems and decision support systems

Vaikka liiketoimintatiedon hallintaa sekä johdon päätöksentekoa on tutkittu laajasti, näiden kahden käsitteen yhteisvaikutuksesta on olemassa hyvin rajallinen määrä tutkimustietoa. Tulevaisuudessa aiheen tärkeys korostuu, sillä olemassa olevan datan määrä kasvaa jatkuvasti. Yritykset tarvitsevat jatkossa yhä enemmän kyvykkyyksiä sekä resursseja, jotta sekä strukturoitua että strukturoimatonta tietoa voidaan hyödyntää lähteestä riippumatta. Nykyiset Business Intelligence -ratkaisut mahdollistavat tehokkaan liiketoimintatiedon hallinnan osana johdon päätöksentekoa. Aiemman kirjallisuuden pohjalta, tutkimuksen empiirinen osuus tunnistaa liiketoimintatiedon hyödyntämiseen liittyviä tekijöitä, jotka joko tukevat tai rajoittavat johdon päätöksentekoprosessia. Tutkimuksen teoreettinen osuus johdattaa lukijan tutkimusaiheeseen kirjallisuuskatsauksen avulla. Keskeisimmät tutkimukseen liittyvät käsitteet, kuten Business Intelligence ja johdon päätöksenteko, esitetään relevantin kirjallisuuden avulla – tämän lisäksi myös dataan liittyvät käsitteet analysoidaan tarkasti. Tutkimuksen empiirinen osuus rakentuu tutkimusteorian pohjalta. Tutkimuksen empiirisessä osuudessa paneudutaan tutkimusteemoihin käytännön esimerkein: kolmen tapaustutkimuksen avulla tutkitaan sekä kuvataan toisistaan irrallisia tapauksia. Jokainen tapaus kuvataan sekä analysoidaan teoriaan perustuvien väitteiden avulla – nämä väitteet ovat perusedellytyksiä menestyksekkäälle liiketoimintatiedon hyödyntämiseen perustuvalle päätöksenteolle. Tapaustutkimusten avulla alkuperäistä tutkimusongelmaa voidaan analysoida tarkasti huomioiden jo olemassa oleva tutkimustieto. Analyysin tulosten avulla myös yksittäisiä rajoitteita sekä mahdollistavia tekijöitä voidaan analysoida. Tulokset osoittavat, että rajoitteilla on vahvasti negatiivinen vaikutus päätöksentekoprosessin onnistumiseen. Toisaalta yritysjohto on tietoinen liiketoimintatiedon hallintaan liittyvistä positiivisista seurauksista, vaikka kaikkia mahdollisuuksia ei olisikaan hyödynnetty. Tutkimuksen merkittävin tulos esittelee viitekehyksen, jonka puitteissa johdon päätöksentekoprosesseja voidaan arvioida sekä analysoida. Despite the fact that the literature on Business Intelligence and managerial decision-making is extensive, relatively little effort has been made to research the relationship between them. This particular field of study has become important since the amount of data in the world is growing every second. Companies require capabilities and resources in order to utilize structured data and unstructured data from internal and external data sources. However, the present Business Intelligence technologies enable managers to utilize data effectively in decision-making. Based on the prior literature, the empirical part of the thesis identifies the enablers and constraints in computer-aided managerial decision-making process. In this thesis, the theoretical part provides a preliminary understanding about the research area through a literature review. The key concepts such as Business Intelligence and managerial decision-making are explored by reviewing the relevant literature. Additionally, different data sources as well as data forms are analyzed in further detail. All key concepts are taken into account when the empirical part is carried out. The empirical part obtains an understanding of the real world situation when it comes to the themes that were covered in the theoretical part. Three selected case companies are analyzed through those statements, which are considered as critical prerequisites for successful computer-aided managerial decision-making. The case study analysis, which is a part of the empirical part, enables the researcher to examine the relationship between Business Intelligence and managerial decision-making. Based on the findings of the case study analysis, the researcher identifies the enablers and constraints through the case study interviews. The findings indicate that the constraints have a highly negative influence on the decision-making process. In addition, the managers are aware of the positive implications that Business Intelligence has for decision-making, but all possibilities are not yet utilized. As a main result of this study, a data-driven framework for managerial decision-making is introduced. This framework can be used when the managerial decision-making processes are evaluated and analyzed.

Limits of Meritocracy. How Fields of Study and Gender Segregation Affect Social Stratification in Finland

This dissertation critically reviews the idea of meritocracy from both a theoretical and an empirical perspective. Based on a discussion of classical texts of social philosophy and sociology, it is argued that meritocracy as a concept for social stratification is best compatible with the sociological tradition of status attainment research: both frame social inequality in primarily individualistic terms, centring on the role of ascribed (e.g., gender, social background) and achieved (e.g., educational qualifications) characteristics for determining individuals’ socioeconomic rewards. This theoretical argument introduces the research problem at the core of this dissertation: to what extent can the individualistic conception of social stratification be maintained empirically? Fields of study and their interaction with educational attainment levels play a prominent role in the analysis of this question. Drawing on sociological versions of segmented labour market theory, it is assumed that fields of study may channel individuals into heterogeneous political-economic contexts on the labour market, which potentially modify the socioeconomic benefit individuals derive from their qualification levels. The focus on fields of study may also highlight economic differentials between men and women that derive from the persisting segregation of men’s and women’s occupational and educational specializations rather than direct gender discrimination on the labour market. The quantitative analyses in this dissertation consist of three research articles, which are based primarily on Finnish data, but occasionally extend the view to other European countries. The data sources include register-based macro- and microdata as well as survey data. Article I examines the extent and the patterns of gender segregation within the Finnish educational system between 1981 and 2005. The results show that differences between men’s and women’s field specializations have for the most part remained stable during this period, with particularly high levels of gender segregation observed at lower educational levels. The focus in Article II rests on the effects of gender-segregated fields of study on higher education graduates’ occupational status. It is shown that fields of study matter for accessing professional jobs and avoiding low-skilled positions in Finland: at the early career stage, particularly polytechnic graduates from female-dominated fields are less likely to work in professional positions. Finnish university graduates from male-dominated fields were more likely than their peers with different specializations to work as professionals, yet they also faced a greater risk of being sorted into lowskilled jobs if they failed to make use of this advantage. Article III proceeded to analyse the joint impact of educational qualification levels and fields of study on young adults’ median earnings in Finland between 1985 and 2005. The results show that qualification levels do not confer a consistent benefit in the process of earnings stratification. Advanced qualifications raise median earnings most clearly among individuals specializing in the same field of study. When comparing individuals with different field specializations, on the other hand, higher-level qualifications do not necessarily lead to higher median earnings. Overall, the findings of this dissertation reveal a heterogeneous effect of education for achieving social positions, which challenges individual-centred, meritocratic accounts of social stratification and underlines the problematic lack of structural and institutional dimensions in the dominant account of social status attainment.

Benzodiazepines and Cognitive Functioning in Older Adults. With Emphasis on Long-Term Use and Withdrawal

Benzodiazepines (BZD) and benzodiazepine related drugs (RD) are the most commonly used psychotropics among the aged. The use of other psychotropics taken concomitantly with BZD/ RD or their cognitive effects with BZD/RD have not been studied frequently. The aim of this academic thesis was to describe and analyse relationships between the use of BZD/RD alone or concomitantly with antipsychotics, antidepressants, opioids, antiepileptics, opioids and anticholinergics in the aged and their health. Especially, the relationships between long-term use of BZD/RD and cognitive decline were studied. Additionally, the effect of melatonin on BZD/RD withdrawal and the cognitive effects of BZD/RD withdrawal were studied. This study used multiple data sets: the first study (I) was based on clinical data containing aged patients (≥65 years; N=164) admitted to Pori City Hospital due to acute disease. The second data set (Studies II and III) was based on population-based data from the Lieto Study, a clinico-epidemiological longitudinal study carried out among the aged (≥65 years) in the municipality of Lieto. Follow-up data was formed by combining the cohort data collected in 1990-1991 (N=1283) and in 1998-1999 (N=1596) from those who participated in both cohorts (N=617). The third data set (Studies IV and V) was based on the Satauni Study’s data. This study was performed in the City of Pori in 2009-2010. In the RCT part of the Satauni Study, ninety-two long-term users of BZD/RD were withdrawn from their drugs using melatonin against placebo. The change of their cognitive abilities was measured during and after BZD/ RD withdrawal. BZD/RD use was related to worse cognitive and functional abilities, and their use may predict worse cognitive outcomes compared with BZD/RD non-users. Hypnotic use of BZD/RD could be withdrawn with psychosocial support in motivated participants, but melatonin did not improve the withdrawal results compared to those with placebo. Cognitive abilities in psychomotor tests did not show, or showed only modest, improvements for up to six months after BZD/RD withdrawal. This suggests that the cognitive effects of BZD/RD may be longlasting or permanent.