Lower limb amputation in Northern Netherlands: Unchanged incidence from 1991-1992 to 2003-2004

Background Investigating population changes gives insight into effectiveness and need for prevention and rehabilitation services. Incidence rates of amputation are highly varied, making it difficult to meaningfully compare rates between studies and regions or to compare changes over time. Study Design Historical cohort study of transtibial amputation, knee disarticulation, and transfemoral amputations resulting from vascular disease or infection, with/without diabetes, in 2003-2004, in the three Northern provinces of the Netherlands. Objectives To report the incidence of first transtibial amputation, knee disarticulation, or transfemoral amputation in 2003-2004 and the characteristics of this population, and to compare these outcomes to an earlier reported cohort from 1991 to 1992. Methods Population-based incidence rates were calculated per 100,000 person-years and compared across the two cohorts. Results Incidence of amputation was 8.8 (all age groups) and 23.6 (≥45 years) per 100,000 person-years. This was unchanged from the earlier study of 1991-1992. The relative risk of amputation was 12 times greater for people with diabetes than for people without diabetes. Conclusions Investigation is needed into reasons for the unchanged incidence with respect to the provision of services from a range of disciplines, including vascular surgery, diabetes care, and multidisciplinary foot clinics. Clinical relevance This study shows an unchanged incidence of amputation over time and a high risk of amputation related to diabetes. Given the increased prevalence of diabetes and population aging, both of which present an increase in the population at risk of amputation, finding methods for reducing the rate of amputation is of importance.

Small State Cultures of Consensus : State Traditions and Consensus-Seeking in the Neo-Corporatist and Neutrality Policies in Post-1945 Austria and Finland

Austria and Finland are persistently referred to as the “success stories” of post-1945 European history. Notwithstanding their different points of departure, in the course of the Cold War both countries portrayed themselves as small and neutral border-states in the world dictated by superpower politics. By the 1970s, both countries frequently ranked at the top end in various international classifications regarding economic development and well-being in society. This trend continues today. The study takes under scrutiny the concept of consensus which figures centrally in the two national narratives of post-1945 success. Given that the two domestic contexts as such only share few direct links with one another and are more obviously different than similar in terms of their geographical location, historical experiences and politico-cultural traditions, the analogies and variations in the anatomies of the post-1945 “cultures of consensus” provide an interesting topic for a historical comparative and cross-national examination. The main research question concerns the identification and analysis of the conceptual and procedural convergence points of the concepts of the state and consensus. The thesis is divided into six main chapters. After the introduction, the second chapter presents the theoretical framework in more detail by focusing on the key concepts of the study – the state and consensus. Chapter two also introduces the comparative historical and cross-national research angles. Chapter three grounds the key concepts of the state and consensus in the historical contexts of Austria and Finland by discussing the state, the nation and democracy in a longer term comparative perspective. The fourth and fifth chapter present case studies on the two policy fields, the “pillars”, upon which the post-1945 Austrian and Finnish cultures of consensus are argued to have rested. Chapter four deals with neo-corporatist features in the economic policy making and chapter five discusses the building up of domestic consensus regarding the key concepts of neutrality policies in the 1950s and 1960s. The study concludes that it was not consensus as such but the strikingly intense preoccupation with the theme of domestic consensus that cross-cut, in a curiously analogous manner, the policy-making processes studied. The main challenge for the post-1945 architects of Austrian and Finnish cultures of consensus was to find strategies and concepts for consensus-building which would be compatible with the principles of democracy. Discussed at the level of procedures, the most important finding of the study concerns the triangular mechanism of coordination, consultation and cooperation that set into motion and facilitated a new type of search for consensus in both post-war societies. In this triangle, the agency of the state was central, though in varying ways. The new conceptions concerning a small state’s position in the Cold War world also prompted cross-nationally perceivable willingness to reconsider inherited concepts and procedures of the state and the nation. At the same time, the ways of understanding the role of the state and its relation to society remained profoundly different in Austria and Finland and this basic difference was in many ways reflected in the concepts and procedures deployed in the search for consensus and management of domestic conflicts. For more detailed information, please consult the author.

Book Review: "The Interface: IBM and the Transformation of Corporate Design, 1945-1975", John Harwood, Minneapolis: University of Minnesota Press, 2011

Within the history of twentieth-century design, there are a number of well-known objects and stories that are invoked time and time again to capture a pivotal moment or summarize a much broader historical transition. For example, Marcel Breuer’s Model B3 chair is frequently used as a stand-in for the radical investigations of form and new industrial materials occurring at the Bauhaus in the mid-1920s. Similarly, Raymond Loewy’s streamlined pencil sharpener has become historical shorthand for the emergence of modern industrial design in the 1930s. And any discussion of the development of American postwar “organic design” seems incomplete without reference to Charles and Ray Eames’s molded plywood leg splint of 1942. Such objects and narratives are dear to historians of modern design. They are tangible, photogenic subjects that slot nicely into exhibitions, historical surveys, and coffee-table best sellers...

Kaupungin savut ja käryt : Helsingin ilmansuojelu 1945-1982

The smoke and fumes of the city: Air protection in Helsinki from 1945 to 1982 This dissertation examines air pollution and air protection in post-war Helsinki. The period studied ends in 1982 when the Air Protection Act entered into force, thus institutionalising air protection in Finland as a socially governed environmental matter. The dissertation is based on the research traditions of environmental politics and urban environmental history. The development of air protection is approached from the perspectives of politicisation and institutionalisation. The dissertation also investigates how air pollution grew into a social issue and presents various discursive ways of analysing air pollution and protection. The primary research material consists of municipal documents and newspapers, while supplementary material includes journal articles and interviews. The event history of air protection is described through an analysis of the material, including source criticism. The social ways of dealing with air pollution and the emergence of air protection are analysed in the light of case-specific air quality disputes from both factual and discursive perspectives. This approach enables the contextualisation of the development of air protection as part of the local history of post-war Helsinki. The dissertation presents the major sources of air pollution in Helsinki and describes the deterioration of air quality in a society which emphasised the primacy of economic prosperity. The air issue emerged during the 1950s in neighbourhood disputes and was exacerbated into a larger problem in the late 1960s. Concurrent to the formation of the field of environmental protection in Finland, an air protection organisation was established in the 1970s in Helsinki. As a result, air protection became a regular part of municipal government. Air protection in Helsinki developed from small-scale policies focused on individual cases into a large, institutionalised air protection system managed by experts. The dissertation research material gave rise to the following major research themes: the economic dimension of the air issue, the role of science in the formation of the environmental problem, and the establishment of norms for acceptable air quality and reasonable limits to air pollution in the urban environment. The paper also discusses the inequitable distribution of the negative effects of air pollution between the residents of different districts. The dissertation concludes that air protection in Helsinki became a local success story although it was long marred by inefficiency and partial failure.

Kämpän kotihengetär vai hyvä jätkä? : Pohjois-Suomen kämppäemännät ja sukupuolen merkitys kämppäelämässä 1945-1975

Tutkielmassa tarkastellaan Pohjois-Suomen savottakämpillä vuosien 1945 1975 välillä työskennelleitä kämppäemäntiä. Kämppäemännät toimivat metsätyöntekijöiden yhteisasunnoissa ruuanlaittajina ja siivoojina. Savottakämpille alettiin palkata kokkeja 1900-luvun alussa ja 1930-luvulta eteenpäin puutavarayhtiöt alkoivat huolehtia heidän palkkaamisestaan. Yhtiöiden palkkaamien ruuanlaittajien ammattinimikkeesi vakiintui kämppäemäntä. Kämppämajoitus väheni 1970-luvun myötä kun metsätyössä siirryttiin työntekijöiden kotikuljetuksiin. Pohjois-Suomessa kämppätyömaita ja kämppäemäntiä oli kuitenkin 1980-luvun lopulle asti. Kämppäemännät työskentelivät maskuliinisella metsäalalla kämppäyhteisöjen ainoina naisina. Tutkielmassa kysytäänkin, minkälaisia käsityksiä ja määritelmiä kämppäemännyyteen yhdistettiin ja miten kämppäemännän sukupuoli näkyy näissä määritelmissä. Lisäksi kysytään, minkälaisina kämpän sisäiset sukupuolten väliset suhteet näyttäytyivät. Tarkastelussa hyödynnetään Yvonne Hirdmanin sukupuolijärjestelmän käsitettä. Tutkimuskysymyksiä lähestytään kolmesta näkökulmasta: Ensin tarkastellaan, miten kämppäemännyyttä määritellään aikalaiskirjallisuudessa. Tässä tarkastelussa tärkeimpänä lähdeaineistona toimivat kämppäemännille suunnatut oppaat. Toiseksi tarkastellaan, miten kämppäemäntinä toimineet naiset vastasivat näihin määritelmiin ja minkälaiseksi he kokivat kämpillä vallinneet sukupuolten väliset suhteet. Kolmanneksi kuvataan, mitä savottakämpillä majoittuneet metsäalalla toimineet miehet näkivät hyvän kämppäemännän ominaisuuksiksi ja minkälaisiksi he kokivat emännän aseman kämppäyhteisössä. Kahden viimeisen näkökulman lähdeaineistona toimii muistitietoaineisto. Kämppäemännät toimivat savottakämpillä erilaisten odotusten ristipaineessa. Kämppäemännän oppaat määrittelevät heidän roolinsa feminiiniseksi ja äidilliseksi. Ne luovat kämppäemännän työstä naisten yhteiskunnallisen roolin mukaista määrittelemällä kämpän kodiksi ja emännän sen hengettäreksi, joka huolehtii miesten hyvinvoinnista. Kämpillä majoittuneet miehet sen sijaan arvostavat kämppäemäntää, joka on rempseä ja huumorintajuinen. Kämppäemännän kuului sopeutua kämpän maskuliiniseen kulttuuriin, mikä onnistui parhaiten osallistumalla sen huumoriin. Kämpän sukupuolijärjestelmä perustui sukupuolitettuun työnjakoon ja kämppätilan sukupuolenmukaiseen jakamiseen. Kämpän keittiö ja emännän huone olivat naisille kuuluvaa yksityisaluetta, josta oltiin yhteydessä miesten puolelle vain tarjoiluluukun välityksellä. Sukupuolten erillään pitämistä perusteltiin kämppäemännän suojelemisella, mutta sen tavoitteena oli myös estää sukupuolisuhteiden syntyminen kämpän miesten ja kämppäemännän välille. Kämppäemäntä olikin virallisesti rauhoitettu ja emännän koskemattomuudesta huolehtiminen oli kämppäyhteisön vastuulla. Kämppäelämässä syntyi kuitenkin seurustelusuhteita ja mahdollisesti myös sukupuolisuhteita. Näistä ei kuitenkaan mielellään kerrota haastatteluissa. Myös seksuaalista häirintää esiintyi. Kämppäemännät kuitenkin korostavat miesten kunnioittavaa suhtautumista heihin. He korostavat, etteivät sukupuolten väliset suhteet olleet ongelmallisia ja painottavat omaa sukupuolimoraaliaan. Kämppäemännät näkevät itsensä kämppäyhteisön jäsenenä, eivätkä halua puhua pahaa muusta yhteisöstä. Vaikeita tilanteita kuvatessaan he korostavat omaa aktiivisuuttaan ja selviytymistään. Kämppäemännät luovat itsestään kuvaa selviytyjinä ja vahvoina naisina.

Fra jungledyr og cykelmyg til frysepunkt og længsel efter kærlighed Et strejftog gennem dansk litteratur på finsk efter 1945

Abstract (A journey through Danish literature translated into Finnish after 1945): Nearly 80 per cent of all literary translations from Danish into Finnish are done after the Second World War. These translations are obviously only a small selection of the Danish national literature, but nevertheless capture important trends and currents in it. Based on a selection of translated works, the article allows a broad introduction to Danish literature available in Finnish. It focuses on children's and youth literature, feminist literature and realistic, magic and civilization critical novels.

Lippu, uhri, kansakunta : Ryhmäkokemukset ja -rajat Suomessa 1917 1945

This dissertation deals with the notions of sacrifice and violence in connection with the Fin¬nish flag struggles between 1917 and 1945. The study begins with the basic idea that sacrificial thinking is a key element in nationalism and the social cohesion of large groups. The method used in the study combines anthropological notions of totemism with psychoanalytical object relation theory. The aim is to explore the social and psychological elements of the Finnish national flag and the workers flags during the times of crisis and nation building. The phenomena and concepts addressed include self-sacrifice, scapegoating, remembrance of war, inclusion, and exclusion. The research is located at the intersection of nationalism studies and the cultural history of war. The analysis is based primarily on the press debates, public speeches and archival sources of the civic organizations that promoted the Finnish flag. The study is empirically divided into three sections: 1) the years of the Revolution and the Civil War (1917 1918), 2) the interwar period (1919 1938), and 3) the Second World War (1939 1945). The research demonstrates that the modern national flags and workers flags in Finland maintain certain characteristics of primitive totems. When referred to as a totem the flag means an emotionally charged symbol, a reservoir of the collective ideals of a large group. Thus the flag issue offers a path to explore the perceptions and memory of sacrifice and violence in the making of the First Republic . Any given large group, for example a nation, must conceptually pursue a consensus on its past sacrifices. Without productive interpretation sacrifice represents only meaningless violence. By looking at the passions associated with the flag the study also illuminates various group identities, boundaries and crossings of borders within the Finnish society at the same time. The study shows further that the divisive violence of the Civil War was first overcome in the late 1930s when the social democrats adopted a new perception of the Red victims of 1918 they were seen as part of the birth pains of the nation, and not only the martyrs of class struggle. At the same time the radical Right became marginalized. The study also illuminates how this development made the Spirit of the Winter War possible, a genuine albeit brief experience of horizontal brother and sisterhood, and how this spirit was reflected in the popular adoption of the Finnish flag. The experience was not based only on the external and unifying threat posed by the Soviet Union: it was grounded in a sense of unifying sacrifice which reflected a novel way of understanding the nation and its past sacrifices. Paradoxically, the newly forged consensus over the necessity and the rewards of the common sacrifices of the Winter War (1939 1940) made new sacrifices possible during the Continuation War (1941 1944). In spite of political discord and war weariness, the concept of a unified nation under the national flag survived even the absurdity of the stationary war phase. It can be said that the conflict between the idea of a national community and parliamentary party politics dissolved as a result of the collective experience of the Second World War.

Hiippakunta diakoniatyön tekijänä ja tukijana : Diakoniatyön kehitys Mikkelin hiippakunnassa 1945-1991

ABSTRACT The diocese as the agent and advocate of diaconial work. The development of diaconial work in the Mikkeli diocese 1945–1991. The roots of Finnish diacony are in the individual devotional life of Pietism. An acting faith had to be evident in acts of love. Following German institutional diacony, diaconial institutions were established in Finland until congregational diacony emerged alongside these institutions in the 1890s. Pastor Otto Aarnisalo acted as a pathfinder in this. He aimed to unite diacony with the Church and the life of the congregation. Diacony had been based on the idea of volunteering to separate it from statutory social work. In 1944 the church law was amended, which made diacony the concern of every member of the congregation. In the years immediately following the Second World War, discussion took place in the Church of Finland about the direction that diacony should take. In the consequential debate, caritative services overcame social diacony. The diocese administration moved to Mikkeli in 1945, when the majority of the Vyborg diocese became part of the USSR in the armistice negotiations. The Mikkeli diocese acted in its diaconial work with the same objectives as the diaconial solutions of the whole church. The acting principle of the diocese diacony became a form of helping which emphasised assistance of the individual. Especially from the 1960s onwards, the country's industrialisation and the reduction of agricultural trade had an effect on the Mikkeli diocese. The diocese administration, specifically Bishop Martti Simojoki and his successor Osmo Alaja, aimed to open up connections to the political left and people working in industry. At least indirectly this helped the diaconial work in industrial localities. In the Mikkeli diocese, a diaconial committee was established in 1971, and its work was overseen by the diocesan chapter of the bishop's office. This enabled the work of the diocese to be organised for the different areas of diacony. Previously, the diaconial work of the Finnish church had primarily been in nursing. The Health Insurance Law of 1972 brought a change to this when the responsibility for health services was transferred to the municipalities. Diacony began to move towards a psychological and spiritual emphasis. Beginning in the 1970s, the diocese started holding diaconial themed days at prescribed intervals. Although these did not result in great realignments, they did help clarify the direction that diacony would take. Large international collections were also carried out, especially in the 1980s. At the same time, socio-ethical activity vitalised and diversified Christian services. The idea that every member of the congregation should practice diacony was a strong factor in the Mikkeli diocese as well. The diocese's vision for diacony was holistic; Christian service was the responsibility of every member of the congregation. During the period of study (1945–1991), the theology of diacony was rather tenuous. Bishop Kalevi Toiviainen, however, brought forth the viewpoint of church doctrine and officially sanctioned theology. Diacony was part of the complete faith of the Church.

Vanhurskautta, oikeutta vai uskollisuutta? : ṣdq -sanue vuoden 1992 Kirkkoraamatun Psalmien kirjassa

Righteousness, justice or faithfulness? The Hebrew Root ṣdq in the Psalter of the Finnish Church Bible of 1992 This study attempts to answer three questions. Firstly, what do the derivates of the root ṣdq mean in the Hebrew Psalter? Secondly, with which equivalents are these Hebrew words translated in the Psalter of the Finnish Church Bible of 1992 and why? And thirdly, how is the translation of the root ṣdq in the Psalter placed in comparison with the translations of the root ṣdq in certain ancient and modern Bible translations? The root ṣdq has a very wide semantic field in Biblical Hebrew. The basic meaning of the root ṣdq is ‘right’ or ‘to be in the right’. The traditional English equivalent of the root ṣdq is righteousness. In many European languages the equivalent of the root ṣdq has some connection with the word ‘right’, but this is not the case in Finnish. The Finnish word vanhurskaus has been present since the first Finnish Bible translation by Mikael Agricola in 1548. However, this word has nothing to do with the Finnish word for ‘right’. The word vanhurskaus has become a very specific religious and theological word in Finnish, and it can be a word that is not obvious or at all understandable even to a native Finnish speaker. In the Psalter of the earlier Finnish Church Bible of 1938 almost every derivate of the root ṣdq (132/139) was translated as vanhurskaus. In the Psalter of the Finnish Church Bible of 1992 less than half of these derivates (67/139) are translated as that. Translators have used 20 different equivalents of the Hebrew derivates of the root ṣdq. But this type of translation also has its own problems. The most disputed is the fact that in it the Bible reader finds no connections between many Bible verses that have obvious connections with each other in the Hebrew Bible. For example, in verse Ps. 118, 15 one finds a Finnish word for ‘saved’ and in verse Ps. 142, 8 one finds another Finnish word for ‘friends’, while in the Hebrew Bible the same word is used in both verses, ṣaddîqīm. My study will prove that it is very challenging to compare or fit together the semantics of these two quite different languages. The theoretical framework for the study consists of biblical semantic theories and Bible translation theories. Keywords: religious language, Bible translations, Book of Psalms.

Silva Fennica Vol. 26, 1992.

Julkaistu Silva Fennica Vol. 26(4) -numeron liitteenä.

Asuntopolitiikka ja vieraskielisen väestön alueellinen keskittyminen Helsingissä vuosina 1992-2005

The aim of the thesis was to study the extent of spatial concentration of immigrant population in Helsinki and to analyse the impact of housing policy on ethnic residential segregation in 1992-2005. For the purpose of the study, immigrant population was defined based on the language spoken at home. The theory of residential segregation by Andersson and Molina formed the main theoretical framework for the study. According to Andersson and Molina ethnic residential segregation results from different dynamic intra-urban migration processes. Institutionally generated migration, i.e. migration patterns generated by various housing and immigrant policies and procedures, is one of the central factors in the development of ethnic segregation. The data of the study consisted of population and housing statistics and housing and immigrant policy documents of Helsinki municipality. Spatial concentration of immigrant population was studied both at district and building levels using GIS-methods and statistical methods. The housing policy of Helsinki municipality was analysed using a method created by Musterd et al. Musterd et al. categorise two types of policy approaches to residential segregation: spatial dispersion policy and compensating policy. The housing policy of Helsinki has a strong focus on social mixing and spatial dispersion of housing stock. Ethnic segregation is regarded as a threat. The importance of ethnic communities and networks is, however, acknowledged and small-scale concentration is therefore not considered harmful. Despite the spatial dispersion policy, the immigrant population is concentrated in the eastern, north-eastern and north-western suburbs of Helsinki. The spatial pattern of concentration was formed already at the beginning of the 1990's when immigration to Finland suddenly peaked. New immigrant groups were housed in the neighbourhoods where public housing was available at the time. Housing policy, namely the location of new residential areas and public housing blocks and the policies of public housing allocation were key factors influencing the residential patterns of immigrant population in the 1990's. The immigration and refugee policies of the state have also had an impact on the development. The concentration of immigrant population has continued in the same areas in the beginning of the 2000's. Dispersion to new areas has mainly taken place within the eastern and north-eastern parts of the city or in the adjacent areas. The migration patterns of native population and the reasonably rapid changes in the housing market have emerged as new factors generating and influencing the ethnic residential segregation in Helsinki in the 2000's. Due to social mixing and spatial dispersion policies, ethnic segregation in Helsinki has so far been fairly small-scale, concentrated in particular housing blocks. The number of residential buildings with a high share of immigrant population is very modest. However, the number of such buildings has doubled between 1996-2002. The concentration of immigrant population concerns mainly the public housing sector. The difference in the level of concentration between the public housing sector and privately owned housing companies is remarkable.