Prediction of Complications After Pancreaticoduodenectomy: Validation of a Postoperative Complication Score.

OBJECTIVES: Pancreatic surgery remains associated with important morbidity. Efforts are most commonly concentrated on decreasing postoperative morbidity, but early detection of patients at risk could be another valuable strategy. A simple prognostic score has recently been published. This study aimed to validate this score and discuss possible clinical implications. METHODS: From 2000 to 2012, 245 patients underwent a pancreaticoduodenectomy. Complications were graded according to the Dindo-Clavien Classification. The Braga score is based on American Society of Anesthesiologists score, pancreatic texture, Wirsung duct diameter, and blood loss. An overall risk score (0-15) can be calculated for each patient. Score discriminant power was calculated using a receiver operating characteristic curve. RESULTS: Major complications occurred in 31% of patients compared with 17% in Braga's data. Pancreatic texture and blood loss were independently statistically significant for increased morbidity. Areas under the curve were 0.95 and 0.99 for 4-risk categories and for individual scores, respectively. CONCLUSIONS: The Braga score discriminates well between minor and major complications. Our validation suggests that it can be used as a prognostic tool for major complications after pancreaticoduodenectomy. The clinical implications, that is, whether postoperative treatment strategies should be adapted according to the patient's individual risk, remain to be elucidated.

Does evolution lead to maximizing behavior?

A long-standing question in biology and economics is whether individual organisms evolve to behave as if they were striving to maximize some goal function. We here formalize this "as if" question in a patch-structured population in which individuals obtain material payoffs from (perhaps very complex multimove) social interactions. These material payoffs determine personal fitness and, ultimately, invasion fitness. We ask whether individuals in uninvadable population states will appear to be maximizing conventional goal functions (with population-structure coefficients exogenous to the individual's behavior), when what is really being maximized is invasion fitness at the genetic level. We reach two broad conclusions. First, no simple and general individual-centered goal function emerges from the analysis. This stems from the fact that invasion fitness is a gene-centered multigenerational measure of evolutionary success. Second, when selection is weak, all multigenerational effects of selection can be summarized in a neutral type-distribution quantifying identity-by-descent between individuals within patches. Individuals then behave as if they were striving to maximize a weighted sum of material payoffs (own and others). At an uninvadable state it is as if individuals would freely choose their actions and play a Nash equilibrium of a game with a goal function that combines self-interest (own material payoff), group interest (group material payoff if everyone does the same), and local rivalry (material payoff differences).

Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study.

BACKGROUND: Changing Directions, Changing Lives, the Mental Health Strategy for Canada, prioritizes the development of coordinated continuums of care in mental health that will bridge the gap in services for Inuit populations. OBJECTIVE: In order to target ways of improving the services provided in these contexts to individuals in Nunavik with depression or anxiety disorders, this research examines delays and disruptions in the continuum of care and clinical, individual and organizational characteristics possibly associated with their occurrences. DESIGN: A total of 155 episodes of care involving a common mental disorder (CMD), incident or recurring, were documented using the clinical records of 79 frontline health and social services (FHSSs) users, aged 14 years and older, living in a community in Nunavik. Each episode of care was divided into 7 stages: (a) detection; (b) assessment; (c) intervention; (d) planning the first follow-up visit; (e) implementation of the first follow-up visit; (f) planning a second follow-up visit; (g) implementation of the second follow-up visit. Sequential analysis of these stages established delays for each one and helped identify when breaks occurred in the continuum of care. Logistic and linear regression analysis determined whether clinical, individual or organizational characteristics influenced the breaks and delays. RESULTS: More than half (62%) the episodes of care were interrupted before the second follow-up. These breaks mostly occurred when planning and completing the first follow-up visit. Episodes of care were more likely to end early when they involved anxiety disorders or symptoms, limited FHSS teams and individuals over 21 years of age. The median delay for the first follow-up visit (30 days) exceeded guideline recommendations significantly (1-2 weeks). CONCLUSION: Clinical primary care approaches for CMDs in Nunavik are currently more reactive than preventive. This suggests that recovery services for those affected are suboptimal.

Barn owl feathers as biomonitors of mercury: sources of variation in sampling procedures.

Given their central role in mercury (Hg) excretion and suitability as reservoirs, bird feathers are useful Hg biomonitors. Nevertheless, the interpretation of Hg concentrations is still questioned as a result of a poor knowledge of feather physiology and mechanisms affecting Hg deposition. Given the constraints of feather availability to ecotoxicological studies, we tested the effect of intra-individual differences in Hg concentrations according to feather type (body vs. flight feathers), position in the wing and size (mass and length) in order to understand how these factors could affect Hg estimates. We measured Hg concentration of 154 feathers from 28 un-moulted barn owls (Tyto alba), collected dead on roadsides. Median Hg concentration was 0.45 (0.076-4.5) mg kg(-1) in body feathers, 0.44 (0.040-4.9) mg kg(-1) in primary and 0.60 (0.042-4.7) mg kg(-1) in secondary feathers, and we found a poor effect of feather type on intra-individual Hg levels. We also found a negative effect of wing feather mass on Hg concentration but not of feather length and of its position in the wing. We hypothesize that differences in feather growth rate may be the main driver of between-feather differences in Hg concentrations, which can have implications in the interpretation of Hg concentrations in feathers. Finally, we recommend that, whenever possible, several feathers from the same individual should be analysed. The five innermost primaries have lowest mean deviations to both between-feather and intra-individual mean Hg concentration and thus should be selected under restrictive sampling scenarios.

Supplier's position in project marketing networks

The present study explores relationships between project marketers and their customers in project marketing context. The purpose of the study is to increase the understanding on supplier’s position in project marketing networks. Project marketing is representing a high volume in the international business, and the industrial network approach and the project marketing research cannot fully explain a supplier’s position in project marketing networks. Increased knowledge on project networks can also contribute to industrial marketing research more generally. Data for the present study was collected firstly during the pilot case study from project buyers in the paper and the steel industry in interviews. Secondly an entire project marketing case concerning a steel industry case was used as a data source. The data included interviews, correspondence between the supplier and the buyer, and project documents. The data of the pilot case was analysed with contents analysis, and in the case a deeper analysis based on the developed Stage Dimension framework was used. Supplier’s position in project marketing networks is a hierarchical and dynamic concept including a supplier’s position on the highest level. The dimensions of the position concept are the intermediate level, and the dimensions are based on the underlying components. Supplier’s position is composed from four organization related dimensions, and two individual actor related dimensions. The composition of the supplier’s position varies during the project marketing process, and consequently the relative importance of the dimensions is changing over the process. Supplier’s position in project marketing networks is shaped by incremental and radical changes. Radical changes are initiated by critical events. The study contributes to the research of industrial networks and project marketing. The theoretical contribution of the study is threefold: firstly it proposes a structure of the position concept in project marketing networks, secondly it proposes the Position Stage Dimension Component (PSDC) model for the development of supplier’s position during the project marketing process, and thirdly the study widens the critical event concept to cover the project marketing process both on the organizational and individual level. In addition to the theoretical contributions there are several managerial implications for planning and implementing marketing strategies in the project context.

CTCPS-MAC - Batería Para el Estudio de las Condiciones de Trabajo de Carácter Psicosocial

El estudio de las condiciones de trabajo de carácter psicosocial CTCPS-MAC consta de 75 ítems que agrupan cuatro dimensiones, que se pueden evaluar por separado y un total de 14 factores. Tiene como intención la evaluación de la percepción que tiene la población trabajadora de las condiciones de trabajo de carácter psicosocial en su propio entorno laboral así como de los factores individuales y los síntomas subjetivos y alteraciones de la salud.

Radio Frequency Measurement Method for Detecting Bearing Currents in Induction Motors

Induction motors are widely used in industry, and they are generally considered very reliable. They often have a critical role in industrial processes, and their failure can lead to significant losses as a result of shutdown times. Typical failures of induction motors can be classified into stator, rotor, and bearing failures. One of the reasons for a bearing damage and eventually a bearing failure is bearing currents. Bearing currents in induction motors can be divided into two main categories; classical bearing currents and inverter-induced bearing currents. A bearing damage caused by bearing currents results, for instance, from electrical discharges that take place through the lubricant film between the raceways of the inner and the outer ring and the rolling elements of a bearing. This phenomenon can be considered similar to the one of electrical discharge machining, where material is removed by a series of rapidly recurring electrical arcing discharges between an electrode and a workpiece. This thesis concentrates on bearing currents with a special reference to bearing current detection in induction motors. A bearing current detection method based on radio frequency impulse reception and detection is studied. The thesis describes how a motor can work as a “spark gap” transmitter and discusses a discharge in a bearing as a source of radio frequency impulse. It is shown that a discharge, occurring due to bearing currents, can be detected at a distance of several meters from the motor. The issues of interference, detection, and location techniques are discussed. The applicability of the method is shown with a series of measurements with a specially constructed test motor and an unmodified frequency-converter-driven motor. The radio frequency method studied provides a nonintrusive method to detect harmful bearing currents in the drive system. If bearing current mitigation techniques are applied, their effectiveness can be immediately verified with the proposed method. The method also gives a tool to estimate the harmfulness of the bearing currents by making it possible to detect and locate individual discharges inside the bearings of electric motors.

Lukion opettajien ääni - Aineenopettajien käsityksiä muutoksista ja visioista lukiossa

Tulevaisuusorientaatio on tullut entistä tärkeämmäksi myös koulumaailmassa johtuen yhteiskunnassa nopeasti eteen tulevista muutoksista. On myös esitetty epäilyjä, että tulevaisuuteen reagoimisessa heikoin tilanne olisikin juuri kuntatason päätöksenteossa. Ymmärrys ja tieto opettajan työstä nimenomaan opettajan omasta perspektiivistä tarkasteltuna mahdollistavat lähtökohdan ja edellytykset todelliselle koulun uudistamiselle. Peruskysymys, johon tässä tutkimuksessa etsittiin vastausta oli: Millaisia ovat lukion aineenopettajien käsitykset lukion muutosprosesseista ja miten he visioivat oman lukionsa ja yleensä lukioiden tulevaisuutta? Aineiston keruu osui ajankohtaan, joka oli hyvin otollinen tulevaisuuden tarkasteluun, sillä uusi opetussuunnitelma otettiin käyttöön kaikissa Suomen lukioissa viimeistään lukuvuonna 2005-2006. Tutkimuksessa oli mukana kaksi hyvin erilaista lukiota Länsi-Suomen läänistä eli pieni maaseudun lukio ja hyvin suuri kaupunkilukio. Tutkimusaineiston keruu eteni kaksivaiheisesti: informoitu kysely ja teemahaastattelu. Tutkimusjoukon suuruus oli yhteensä 20, joista puolet oli miehiä ja puolet naisia. Aineenopettajien käsityksiä muutoksista ja visioista tutkittiin fenomenografisen tutkimusotteen avulla. Fenomenografiassa kiinnostuksen kohteena ovat ihmisten erilaiset käsitykset todellisuudesta ja näin saatava ymmärrys tavoista, joilla ihmiset kokevat tilanteita ja maailmaa. Organisaation muutosprosesseja voidaan kutsua myös oppimiseksi. Tutkimuksen oppivan organisaation näkökulmat perustuivat juuri yhteistyössä tapahtuvaan yhteisen toiminnan kehittämiseen. Aineenopettajien käsityksiä työyhteisöstään tarkasteltiin seuraavista oppivan organisaatiomallin näkökulmista: vuorovaikutus, päätöksenteko sekä rehtorin ja aineenopettajan rooli ja asema työyhteisössä. Aineenopettajien keskeisimmät käsitykset muutoksista lukiossa viime vuosina kohdistuivat aineenopettajan ammattirooliin ja lukio-opiskelijaan sekä opiskelijalta vaadittaviin lukio-opintoihin. Muutokset ammattiroolissa korostavat tutkimustulosten perusteella aineenopettajilta vaadittavia muitakin kuin opetettavien aineiden hallintataitoja. Suoranaista ammattitaidon puutetta opettajat kokivat varsinkin ryhmänohjaustehtävien yhteydessä, osittain myös uusien oppimisympäristöjen, esimerkiksi verkkopedagogisten taitojen, yhteydessä. Opettajien lisäkoulutuksen tarve koetaan konkreettisena, mutta sekä koulutusten sisältöihin, järjestelyihin ja ajankohtiin että koulun sijais- ym. järjestelyihin kaivattaisiin parannuksia. Verrattuna aikaisempiin tutkimuksiin näyttäisi siltä, että luokaton lukio on saanut opettajat enenevässä määrin huolestumaan opiskelijoiden syrjäytymisriskistä ja hyvinvoinnista. Opiskelijoiden syrjäytymisriskin kasvu lukio-opintojen aikana nouseekin yhdeksi lukion pessimistiseksi skenaarioksi. Muista pessimistisistä skenaarioista lukiolle, jotka saattoi johtaa tutkimustuloksista, voidaan mainita työyhteisön demokratiavajeen syveneminen sekä opetussuunnitelmasisältöjen ja ylioppilastutkintovaatimusten välisen kuilun syveneminen. Aineenopettajien käsitykset oman lukionsa visioista olivat sisällöiltään pääosin välineellisiä ja ne kohdentuivat kaikki opiskelijoihin. Esimerkiksi työyhteisöllisiä kehittämisajatuksia ei visioissa ilmennyt. Myöskään visioinnin dynaamisuus ei aineistossa korostunut. Aineenopettajien käsitykset visioiden arvopohjasta heijastivat perinteistä suomalaista arvomaailmaa eli itsekuria, velvollisuudentuntoa, kuuliaisuutta esivaltaa kohtaan ja perinteisten arvojen kunnioittamista. Sen sijaan antiikista perityviä Sokrateen edustamia keskustelua ja auktoriteettien kyseenalaistamista ei arvoissa ilmennyt, eikä myöskään uusliberalistista individualismia. Käsitykset visioiden synnystä näyttävät parhaiten selittävän opettajan muita käsityksiä liittyen visioon, visiointiin ja työyhteisöllisiin vaikutusmahdollisuuksiin sekä opettajan tulevaisuusorientoitumiseen.. Käsitykset vision syntytaustasta voidaan jakaa seuraaviin pää- ja alakategorioihin: 1. auktoriteettikeskeinen visiointi: johdon linjaus tai valtakunnallinen linjaus, 2. yhteisökeskeinen visiointi: yhteisöllinen linjaus tai toiminnallinen linjaus ja 3. yksilökeskeinen visiointi. Pessimistisimmiksi eli vähiten tulevaisuusorientoituneiksi opettajiksi työyhteisössä osoittautuivat ne opettajat, jotka pitivät oman lukionsa visiota koulun johdon sanelemana. Monet teoriat oppivasta organisaatiosta korostavat johtajuuden merkitystä työyhteisöä kehitettäessä. Johtajuuden merkitys nousi tämänkin tutkimuksen aineistosta keskeisesti esiin. Pyrkimystä kohti oppivaa organisaatiota opettajien puheista löytyy paljonkin, esimerkkeinä viittaukset johtajuuden ja vuorovaikutustapojen kehittämistarpeisiin. Sen sijaan opettajien puheet omista työyhteisöllisistä kehittymistarpeistaan, ns. alaistaidot, jäivät vähäisiksi. Tutkimustuloksista on luotu sovellusmalli kouluyhteisöjen visioinnin ja muun kehittämistyön tueksi.

Métodos para análise de ácido clorogênico

This paper describes the analytical methods for determination of total chlorogenic acid (CGA) and their individual isomers. Spectrofotometric methods are adequate for total CGA analysis in green coffee but they can provide inflated results for coffee products. High pressure liquid chromatography (HPLC) with gel permeation column and ultraviolet (UV) monitoring is adequate for the simultaneous analysis of total CGA, alkaloids and sugars in coffee products. HPLC-UV-reversed phase is a simple, rapid and precise method for the determination of the individual isomers of CGA. Gas chromatography (GC) also is applied to the analysis of the individual isomers but phenolic acids need to be derivatized before analysis. Both HPLC- and GC-mass spectrometry provide an unequivocal identification of the individual isomers. The capillary electrophoresis method is simple, rapid and adequate to the simultaneous analysis of polyphenols and xanthines. Advantages and limitations of each method are discussed throughout the text.

Ammatillisen osaamisen tukeminen muuttuvissa toimintaympäristöissä : tutkimus ikääntyvien työntekijöiden näkökulmasta

The purpose of the study was to describe the experiences of received support of aging employees and their work related self-image in changing working environments. Firstly, theaim was to discover how the support from organisations and leaders was verified. Secondly, the aim was to get answers how employees experienced themselves as workers and as learners in the current work context. Thirdly, the aim was to compare different knowledge information stages and company cultures and how they have influenced the experiences of professional competence development among aging employees. In addition the education- and career backgrounds were investigated to gain more understanding of their role in experiencing support and relation to the occupational self-image. The theoretical frame of reference of this researchis multidisciplinary. The theoretical part focuses on the meaning of work for human being from a sociological, late-modern perspective. On the other hand it examines the ageing process from a physiological and also from a perspective of age discrimination and life control. The occupational selfimage and the strength of motivation has an effect on learning in working life which is crucial and firmpart individual trajectories. According to the theoretical review company culture, leadership and especially the managers' role as a creator of a learning atmosphere are increasingly critical for aging adults' learning when the role of informal work-based learning is increasing. The empirical data was collected with aquestionnaire and interviews, which were carried out in May to October 2001. The data consists of 263 respondents of which further eight persons were interviewed. All respondents were over the age of 45 and represented all levels of their organisations in an IT-technology firm and a chemical industry plant. The central findings in this research show that the aging adults have experienced that theemployers do care about the development of their occupational skills. On the other hand there are fewer concrete activities to reveal this support. There is anobvious disproportion between the expressed aims and the realisation of the activities. Signs of age discrimination are few. The style of management has becomemore supporting for self directed activities which are seen to support adults learning. Higher education and individual activity to seek possibilities to learnwere encouraging the development of occupational skills. Age itself was not a crucial aspect when comparing the experiences among younger (45-54 years) and older (55-64 years) groups. Job satisfaction and professional self esteem seemed tobe considerably strong. The individual characteristics were more important elements in developing occupational skills than the age. The degree of anxiety at work was low. In addition among the older group the strong feeling of coherence and the occupational self image were significant for supporting the professional competence. The motivation to learn was also stable. Among the seniors there was some slight evidence of declining motivation. In the IT-firm the support was experienced stronger for aging employees than in the chemical industry plant. Thosewho had experienced support in the chemical industry plant had higher educational background than the others. In IT-firm they also experienced more support from the manager than in the chemical industry plant. The results show that it is more likely that the differences are caused mostly by the stage of information intensity and the character of company culture which is determined by the activities. IT-business demands constantly accommodation to changes and the chemical industry plant which is representing more traditional business field, where the atmosphere of learning is determined by the traditions of company culture, the changes are carried out slowly.

Nuorten kokemien elämysten yksilölliset ja yhteisölliset merkitykset

Tutkimuksessa tarkastellaan nuorten antamia merkityksiä elämykseksi nimetylle kokemukselle ja tunteelle. Tavoitteena on ollut selvittää elämysten kokemista nuorten näkökulmasta ja suhteuttaa nuorten kokemuksilleen antamia merkityksiä laajemmin nuoruutta ja elämyksien kokemista käsittelevään yhteiskunnalliseen keskusteluun. Elämysten merkityksellistämistä analysoidaan suhteessa identiteetin muodostukseen. Yksilöllisesti koetut elämykset saavat merkityksensä diskursiivisesti rakentuneen todellisuuden ympäröimänä. Tutkimus paikantuu sosiologisen nuorisotutkimuksen ja tunteiden tutkimuksen alaan sekä metodologisesti fenomenologis-konstruktivistisen tutkimuksen alaan. Tutkimuksen taustalla on elämyshakuisuutta käsittelevä teoria. Elämyshakuisuuden tulkinta fenomenologisesta viitekehyksestä tuo käsitteen ymmärtämiseen uuden ulottuvuuden. Elämyshakuisuus kuvaa asennoitumistapaa eli sitä, miten yksilö orientoituu ympäröivään maailmaan. Tällöin ei edellytetä intentionaalisten tekojen tietoista luonnetta. Toiminnalliset prosessit muovautuvat vuorovaikutuksen myötä samaan tapaan kuin ihminen ruumiillisena subjektina muovautuu. Tutkimuksen aineisto koostuu lukion ensimmäisen luokan oppilaiden kirjoituksista (519 kpl), lastensuojeluinstituutioissa ja kuntoutuskeskuksissa asuvien nuorten yksilöteemahaastatteluista (16 nuorta) sekä seikkailualan asiantuntijoiden teemahaastatteluista (20 aikuista). Nuorten kirjoitukset on kerätty vuosina 1996–1997 ja 2002–2003. Aineiston analyysi on aineistolähtöinen. Erilaiset osa-aineistot työssäni avaavat erilaisia näkökulmia elämysten kokemiseen. Aineistojen analyysi ja tutkimukset teoreettiset lähtökohdat ovat rakentuneet analyysin edetessä ja vuorovaikutussuhteessa toisiinsa. Nuorten elämyksiä käsittelevä kerronta on moninaista ja elämyksiä koetaan erilaisissa tilanteissa. Elämykselle ei ole yhtä määritelmää, kokemisen paikkaan tai kokemisen syytä vaan kokemuksen merkitys rakentuu tilanteisesti. Elämys kuitenkin erottuu muista kokemuksista sen muistettavuuden, ainutlaatuisuuden, uutuuden ja intensiivisyyden perusteella. Nuorten elämyksellisissä hetkissä korostuvat harrastusten yhteydessä koetut uudet, erilaiset, yhteisöllisesti jaetut, mutta myös maailmaa nuorille avaavat itsenäisyyden tunnetta ja hallintaa tuottavat kokemukset. Yksi merkittävä uusia elämyksiä ja tietoa tuottava asia nuorten elämässä on seurustelu. Myös matkailu, erilaiset retket ja leirit olivat nuorille elämyksiä tuottavia tilanteita. Kaikilla nuorilla ei kuitenkaan ole sellaisia harrastuksia, joihin he olisivat sitoutuneita tai joissa he pääsisivät ilmaisemaan itseään ja kokemaan onnistumista. Nuorten elämyksiä käsittelevissä hetkissä nuorten vapaa-ajan toiminta, ympäristö ja sosiaaliset suhteet ovat keskeisessä asemassa. Nuoret eivät ensisijaisesti ajatelleet itse etsivänsä tai toisten nuorten etsivän elämyksiä viihdeteollisuuden tuottamista asioista. Elämyksissä arvostettiin aitoutta ja koettu tunne määritti sitä, oliko jokin koettu elämyksenä vai ei. Toisaalta erilaisten päihteiden todettiin mahdollisesti tuottavan elämyksiä, mutta niidenkin yhteydessä korostettiin usein muita asioita kokemusta rakentavina. Nuorten elämyskokemuksissa toisten nuorten merkitys, luottamus, läheisyyteen ja hyväksyntään liittyvät kokemukset korostuvat. Myös aikuisten asiantuntijoiden omaa nuoruutta käsittelevät elämykset olivat emotionaaliselta merkitykseltään hyvin samanlaisia kuin tämän päivän nuorten esittämät. Elämyksiksi miellettyjä kokemuksia pidettiin arvokkaina. Niiden uskottiin suuntaavan yksilön toimintaa.

Interpreting marine benthic ecosystem functioning in coastal waters: validating the biological trait concept

Coastal areas harbour high biodiversity, but are simultaneously affected by rapid degradations of species and habitats due to human interactions. Such alterations also affect the functioning of the ecosystem, which is primarily governed by the characteristics or traits expressed by the organisms present. Marine benthic fauna is nvolved in numerous functions such as organic matter transformation and transport, secondary production, oxygen transport as well as nutrient cycling. Approaches utilising the variety of faunal traits to assess benthic community functioning have rapidly increased and shown the need for further development of the concept. In this thesis, I applied biological trait analysis that allows for assessments of a multitude of categorical traits and thus evaluation of multiple functional aspects simultaneously. I determined the functional trait structure, diversity and variability of coastal zoobenthic communities in the Baltic Sea. The measures were related to recruitment processes, habitat heterogeneity, large-scale environmental and taxonomic gradients as well as anthropogenic impacts. The studies comprised spatial scales from metres to thousands of kilometres, and temporal scales spanning one season as well as a decade. The benthic functional structure was found to vary within and between seagrass landscape microhabitats and four different habitats within a coastal bay, in papers I and II respectively. Expressions of trait categories varied within habitats, while the density of individuals was found to drive the functional differences between habitats. The findings in paper III unveiled high trait richness of Finnish coastal benthos (25 traits and 102 cateogries) although this differed between areas high and low in salinity and human pressure. In paper IV, the natural reduction in taxonomic richness across the Baltic Sea led to an overall reduction in function. However, functional richness in terms of number of trait categories remained comparatively high at low taxon richness. Changes in number of taxa within trait categories were also subtle and some individual categories were maintained or even increased. The temporal analysis in papers I and III highlighted generalities in trait expressions and dominant trait categories in a seagrass landscape as well as a “type organism” for the northern Baltic Sea. Some initial findings were made in all four papers on the role of common and rare species and traits for benthic community functioning. The findings show that common and rare species may not always express the same trait categories in relation to each other. Rare species in general did not express unique functional properties. In order to advance the understanding of the approach, I also assessed some issues concerning the limitations of the concept. This was conducted by evaluating the link between trait category and taxonomic richness using especially univariate measures. My results also show the need to collaborate nationally and internationally on safeguarding the utility of taxonomic and trait data. The findings also highlight the importance of including functional trait information into current efforts in marine spatial planning and biomonitoring.

A multimethod examination of contributors to successful on-the-job learning for vocational students

Rapid changes in working life and competence requirements of different professions have increased interest in workplace learning. It is considered an effective way to learn and update professional skills by performing daily tasks in an authentic environment. Especially, ensuring a supply of skilled future workers is a crucial issue for firms facing tight competition and a shortage of competent employees due to the retirement of current professionals. In order to develop and make the most of workplace learning, it is important to focus on workplace learning environments and the individual characteristics of those participating in workplace learning. The literature has suggested various factors that influence adults' and professionals’ workplace learning of profession-related skills, but lacks empirical studies on contextual and individual-related factors that positively affect students' workplace learning. Workers with vocational education form a large group in modern firms. Therefore, elements of vocational students’ successful workplace learning during their studies, before starting their career paths, need to be examined. To fill this gap in the literature, this dissertation examines contributors to vocational students’ workplace learning in Finland, where students’ workplace learning is included in the vocational education and training system. The study is divided into two parts: the introduction, comprised of the overview of the relevant literature and the conclusion of the entire study, and five separate articles. Three of the articles utilize quantitative methods and two use qualitative methods to examine factors that contribute to vocational students’ workplace learning. The results show that, from the students’ perspective, attitudinal, motivational, and organizationrelated factors enhance the student’s development of professionalism during the on-the-job learning period. Specifically, the organization-related factors such as innovative climate, guidance, and interactions with seniors have a strong positive impact on the students’ perceived development of professional skills because, for example, the seniors’ guidance and provision of new viewpoints for the tasks helps the vocational students to gain autonomy at work performance. A multilevel analysis shows that of those factors enhancing workplace learning from the student perspective, innovative climate, knowledge transfer accuracy, and the students’ performance orientation were significantly related to the workplace instructors’ assessment regarding the students’ professional performance. Furthermore, support from senior colleagues and the students’ self-efficacy were both significantly associated with the formal grades measuring how well the students managed to learn necessary professional skills. In addition, the results suggest that the students’ on-the-job learning can be divided into three main phases, of which two require efforts from both the student and the on-the-job learning organization. The first phase includes the student’s application of basic professional skills, demonstration of potential in performing daily tasks, and orientation provided by the organization at the beginning of the on-the-job learning period. In the second phase, the student actively develops profession-related skills by performing daily tasks, thus learning a fluent working style while observing the seniors’ performance. The organization offers relevant tasks and follows the student’s development. The third level indicates a student who has reached the professional level described as a full occupation. The results suggest that constructing the vocational students’ successful on-the-job learning period requires feedback from seniors, opportunities to learn to manage entire work processes, self-efficacy on the part of the students, proactive behavior, and initiative in learning. The study contributes to research on workplace learning in three ways: firstly, it identifies the key individual- and organization-based factors that influence the vocational students’ successful on-the-job learning from their perspective and examines mutual relationships between these factors. Second, the study provides knowledge of how the factors related to the students’ view of successful workplace learning are associated with the workplace instructors’ perspective and the formal grades. Third, the present study finds elements needed to construct a successful on-the-job learning for the students.

Transition : en betydelsefull fas i den långtidssjuka ungas vård

The aim of this caring science thesis is to deepen the understanding for the long-term ill adolescents care. In particular it aims to reach a better understanding of transition in health care, with a focus on how young people perceive health care. The goal is to build a model, a consistent theoretical framework that makes it possible to listen to the adolescent´s own voice, providing a better understanding of what good care consists in from their point of view. This Master's thesis consists of a literature overview on the concept of transition and a themed interview with young patients regarding transition of health care. The overall issue is 1. What is good care during the transition according to the adolescents themselves? 2. How does transition affect the young people's health and lives? The theoretical perspective of this thesis lies in the caring science tradition that has been developed at the Åbo Akademi University department of caring science with the caritative nursing theory as a basis. The epistemological and ontological assumptions are based on the caritative nursing theory, which in itself is ethical. Understanding of the concept of transition is based on A. Meleis transitions theory. The methodological approach is hermeneutical. The theme interview has been analyzed by using S. Kvales method. The material consists of a thematic interview with 10 long-term ill adolescents, about their views of the care received. This thesis research even in how NOBABs standards appears in the litterature as well as how they are implemented from the point of view of young people. The findings of this thesis shows that good care for the adolescent is a true presence with the young and an understanding of the direction in which the young move toward during the transition of care. Good care for an adolescent consists in being recognized as a person who is seen, known, appreciated and understood. Good care for the young involves recognizing her strength and joy of life including the contrast she experiences between health and suffering. To recognize their personal strength and courage supports the adolescents during the process of transitions of care Good care for the young involves responsibility for the individual person and humility in approaching her, giving attention to her view of life and aspirations. Openness and humility in the approach lays the foundation for a trusting relation during the transition of care. A unified theoretical framework is needed to promote the long-term ill adolescents care during transition of care. When the young and her individual needs is the centerpiece of healthcare creates this the basis for empowering care that supports the young in her quest for health. This master thesis adds a given model to the long-term ill adolescents` healthcare.

Pharmacokinetic/pharmacodynamic relationships of FTY720 in kidney transplant recipients

FTY720 is a new and effective immunosuppressive agent, which produces peripheral blood lymphopenia through a lymphocyte homing effect. We investigated the relationship between the dose of FTY720 or blood concentration (pharmacokinetics, PK) and peripheral lymphopenia (pharmacodynamics, PD) in 23 kidney transplant recipients randomized to receive FTY720 (0.25-2.5 mg/day) or mofetil mycophenolate (2 mg/day) in combination with cyclosporine and steroids. FTY720 dose, blood concentrations and lymphocyte counts were determined weekly before and 4 to 12 weeks after transplantation. The effect of PD was calculated as the absolute lymphocyte count or its reductions. PK/PD modeling was used to find the best-fit model. Mean FTY720 concentrations were 0.36 ± 0.05 (0.25 mg), 0.73 ± 0.12 (0.5 mg), 3.26 ± 0.51 (1 mg), and 7.15 ± 1.41 ng/ml (2.5 mg) between 4 and 12 weeks after transplantation. FTY720 PK was linear with dose (r² = 0.98) and showed low inter- and intra-individual variability. FTY720 produced a dose-dependent increase in mean percent reduction of peripheral lymphocyte counts (38 vs 42 vs 56 vs 77, P < 0.01, respectively). The simple Emax model [E = (Emax * C)/(C + EC50)] was the best-fit PK/PD modeling for FTY720 dose (Emax = 87.8 ± 5.3% and ED50 = 0.48 ± 0.08 mg, r² = 0.94) or concentration (Emax = 78.3 ± 2.9% and EC50 = 0.59 ± 0.09 ng/ml, r² = 0.89) vs effect (% reduction in peripheral lymphocytes). FTY720 PK/PD is dose dependent and follows an Emax model (EC50 = 0.5 mg or 0.6 ng/ml). Using lymphopenia as an FTY720 PD surrogate marker, high % reductions (~80%) in peripheral lymphocytes are required to achieve best efficacy to prevent acute allograft rejection.