Pathological changes at the target tissue level in Sjögren's syndrome and their effect on the exocrine function of the salivary glands

Sjögren s syndrome (SS) is a common autoimmune disease affecting the lacrimal and salivary glands. SS is characterized by a considerable female predominance and a late age of onset, commonly at the time of adreno- and menopause. The levels of the androgen prohormone dehydroepiandrosterone-sulphate (DHEA-S) in the serum are lower in patients with SS than in age- and sex-matched healthy control subjects. The eventual systemic effects of low androgen levels in SS are not currently well understood. Basement membranes (BM) are specialized layers of extracellular matrix and are composed of laminin (LM) and type IV collagen matrix networks. BMs deliver messages to epithelial cells via cellular LM-receptors including integrins (Int) and Lutheran blood group antigen (Lu). The composition of BMs and distribution of LM-receptors in labial salivary glands (LSGs) of normal healthy controls and patients with SS was assessed. LMs have complex and highly regulated distribution in LSGs. LMs seem to have specific tasks in the dynamic regulation of acinar cell function. LM-111 is important for the normal acinar cell differentiation and its expression is diminished in SS. Also LM-211 and -411 seem to have some acinar specific functional tasks in LSGs. LM-311, -332 and -511 seem to have more general structure maintaining and supporting roles in LSGs and are relatively intact also in SS. Ints α3β1, α6β1, α6β4 and Lu seem to supply structural basis for the firm attachment of epithelial cells to the BM in LSGs. The expression of Ints α1β1 and α2β1 differed clearly from other LM-receptors in that they were found almost exclusively around the acini and intercalated duct cells in salivons suggesting some type of acinar cell compartment-specific or dominant function. Expression of these integrins was lower in SS compared to healthy controls suggesting that the LM-111 and -211-to-Int α1β1 and α2β1 interactions are defective in SS and are crucial to the maintenance of the acini in LSGs. DHEA/DHEA-S concentration in serum and locally in saliva of patients with SS seems to have effects on the salivary glands. These effects were first detected using the androgen-dependent CRISP-3 protein, the production and secretion of which were clearly diminished in SS. This might be due to the impaired function of the intracrine DHEA prohormone metabolizing machinery, which fails to successfully convert DHEA into its active metabolites in LSGs. The progenitor epithelial cells from the intercalated ductal area of LSGs migrate to the acinar compartment and then undergo a phenotype change into secretory acinar cells. This migration and phenotype change seem to be regulated by the LM-111-to-Int α1β1/Int α2β1 interactions. Lack of these interactions could be one factor limiting the normal remodelling process. Androgens are effective stimulators of Int α1β1 and α2β1 expression in physiologic concentrations. Addition of DHEA to the culture medium had effective stimulating effect on the Int α1β1 and α2β1 expression and its effect may be deficient in the LSGs of patients with SS.

Shwachman-Diamond syndrome : Clinical, genetic and radiological study

Shwachman-Diamond syndrome (SDS) is a rare autosomal recessive disorder in which the cardinal symptoms arise from exocrine pancreatic insufficiency and bone marrow dysfunction. Previous studies have suggested increased risk of fatal complications among Finnish SDS infants. The genetic defect responsible for the disease was recently identified; the SBDS gene is located at chromosome 7q11 and encodes a protein that is involved in ribosome biosynthesis. The discovery of the SBDS gene has opened new insights into the pathogenesis of this multi-organ disease. This study aimed to assess phenotypic and genotypic features of Finnish patients with SDS. Seventeen Finnish patients with a clinical diagnosis of SDS were included in the study cohort. Extensive clinical, biochemical and imaging assessments were performed to elucidate the phenotypic features, and the findings were correlated with the SBDS genotype. Imaging studies included abdominal magnetic reso-nance imaging (MRI), brain MRI, cardiac echocardiography including tissue Doppler examination, and cardiac MRI. The skeletal phenotype was assessed by dual-energy X-ray absorptiometry and bone histomorphometry. Twelve patients had mutations in the SBDS gene. In MRI, a characteristic pattern of fat-replaced pancreas with occasional enhancement of scattered parenchymal foci and of pancreatic duct was noted in the SBDS mutation-positive patients while the mutation-negative patients did not have pancreatic fat accumulation. The patients with SBDS mutations had significantly reduced bone mineral density associated with low-energy peripheral fractures and vertebral compression fractures. Bone histomorphometry confirmed low-turnover osteoporosis. The patients with SBDS mutations had learning difficulties and smaller head size and brain volume than control subjects. Corpus callosum, cerebellar vermis, and pos-terior fossa structures were significantly smaller in SDS patients than in controls. Patients with SDS did not have evidence of clinical heart disease or myocardial fibrosis. However, subtle diastolic changes in the right ventricle and exercise-induced changes in the left ventricle contractile reserve were observed. This study expanded the phenotypic features of SDS to include primary low-turnover osteoporosis and structural alterations in the brain. Pancreatic MRI showed characteristic changes in the SBDS mutation-positive patients while these were absent in the mutation-negative patients, suggesting that MRI can be used to differentiate patients harbouring SBDS mutations from those without mutations. No evidence for clinical cardiac manifestations was found, but imaging studies revealed slightly altered myocardial function that may have clinical implications. These findings confirm the pleiotropic nature of SDS and underscore the importance of careful multidisciplinary follow-up of the affected individuals.

Pelon ja toivon välissä : Pätkätyöläisen urakerronta

This study analyzes the forming of the occupational identity of the well-educated fixed-term employees. Fixed-term employment contracts amongst the well-educated labour force are exceptionally common in Finland as compared to other European countries. Two groups of modern fixed-term employees are distinguished. The first comprises well-educated women employed in the public sector whose fixed-term employment often consists of successive periods as temporary substitutes. The other group comprises well-educated, upper white-collar men aged over 40, whose fixed-term employment careers often consist of jobs of project nature or posts that are filled for a fixed period only. Method of the study For the empirical data I interviewed 35 persons (26 women and 9 men) in 33 interviews, one of which was conducted by e-mail and one was a group interview. All the interviews were electronically recorded and coded. All the interviewees have two things in common: fixed-term employment and formal high education. Thirteen (13) of them are researchers, four nurses, four midwives, four journalists, and ten project experts. I used the snowball method to get in touch the interviewees. The first interviewees were those who were recommended by the trade unions and by my personal acquaintances. These interviewees, in turn, recommended other potential interviewees. In addition, announcements on the internet pages of the trade unions were used to reach other interviewees. In analysing process I read the research material several times to find the turning points in the narrative the interviewees told. I also searched for the most meaningful stories told and the meaning the interviewees gave to these stories and to the whole narrative. In addition to that I paid attention to co-production of the narrative with the interviewees and analyzed the narrative as performance to be able to search for the preferred identities the interviewees perform. (Riesman 2001, 698-701). I do not pay much attention to the question of truth of a narrative in the sense of its correspondence with facts; rather I think a working life narrative has two tasks: On the one hand one has to tell the facts and on the other hand, he/she has to describe the meaning of these facts to herself/himself. To emphasize the double nature of the narrative about one’s working life I analyzed the empirical data both by categorizing it according to the cultural models of storytelling (heroic story, comedy, irony and tragedy) and by studying the themes most of the interviewees talked about. Ethics of the study I chose to use narrative within qualitative interviews on the grounds that in my opinion is more ethical and more empowering than the more traditional structured interview methods. During the research process I carefully followed the ethical rules of a qualitative research. The purpose of the interviews and the research was told to the interviewees by giving them a written description of the study. Oral permission to use the interview in this research was obtained from the interviewees. The names and places, which are mentioned in the study, are changed to conceal the actual identity of the interviewees. I shared the analysis with the interviewees by sending each of them the first analysis of their personal interview. This way I asked them to make sure that the identity was hidden well enough and hoped to give interviewees a chance to look at their narratives, to instigate new actions and sustain the present one (Smith 2001, 721). Also I hoped to enjoy a new possibility of joint authorship. Main results As a result of the study I introduce six models of telling a story. The four typical western cultural models that guide the telling are: heroic story, comedy, tragedy and satirical story (Hänninen 1999). In addition to these models I found two ways of telling a career filled with fixed-term employments that differ significantly from traditional career story telling. However, the story models in which the interviewees pour their experience locates the fixed term employers work career in an imagined life trajectory and reveals the meaning they give to it. I analyze the many sided heroic story that Liisa tells as an example of the strength of the fear of failing or losing the job the fixed term employee feels. By this structure it is also possible to show that success is felt to be entirely a matter of chance. Tragedy, the failure in one’s trial to get something, is a model I introduce with the help of Vilppu’s story. This narrative gets its meaning both from the sorrow of the failure in the past and the rise of something new the teller has found. Aino tells her story as a comedy. By introducing her narrative, I suggest that the purpose of the comedy, a stronger social consensus, gets deeper and darker shade by fixed-term employment: one who works as a fixed term employee has to take his/her place in his/her work community by him/herself without the support the community gives to those in permanent position. By studying the satiric model Rauno uses, I argue that using irony both turns the power structures to a carnival and builds free space to the teller of the story and to the listener. Irony also helps in building a consensus, mutual understanding, between the teller and the listener and it shows the distance the teller tells to exist between him and others. Irony, however, demands some kind of success in one’s occupational career but also at least a minor disappointment in the progress of it. Helmi tells her story merely as a detective story. By introducing Helmi’s narrative, I argue that this story model strengthens the trust in fairness of the society the teller and the listener share. The analysis also emphasizes the central position of identity work, which is caused by fixed-term employment. Most of the interviewees talked about getting along in working life. I introduced Sari’s narrative as an example of this. In both of these latter narratives one’s personal character and habits are lifted as permanent parts of the actual professional expertise, which in turn varies according to different situations. By introducing these models, I reveal that the fixed-term employees have different strategies to cope with their job situations and these strategies vary according to their personal motives and situations and the actual purpose of the interview. However, I argue that they feel the space between their hopes and fears narrow and unsecure. In the research report I also introduce pieces of the stories – themes – that the interviewees use to build these survival strategies. They use their personal curriculum vitae or portfolio, their position in work community and their work morals to build their professional identity. Professional identity is flexible and varies in time and place, but even then it offers a tool to fix one’s identity work into something. It offers a viewpoint to society and a tool to measure one’s position in surrounding social nets. As one result of the study I analyze the position the fixed-term employees share on the edge of their job communities. I summarize the hopes and fears the interviewees have concerning employers, trade unions, educational institutions and the whole society. In their opinion, the solidarity between people has been weakened by the short-sighted power of the economy. The impact the fixed-term employment has on one’s professional identity and social capital is a many-sided and versatile process. Fixed-term employment both strengthens and weakens the professional identity, social capital and the building of trust. Fixed-term employment also affects one’s day-to-day life by excluding her/him from the norm and by one’s difficulty in making long-term plans (Jokinen 2005). Regardless of the nature of the job contract, the workers themselves are experts in making the best of their sometimes less than satisfying work life and they also build their professional identity by using creatively their education, work experiences and interpersonal relations. However, a long career of short fixed-term employments may seriously change the perception of employee about his/her role. He/she may start concentrating only in coping in his/her unsatisfactory situation and leaves the active improvement of the lousy working conditions to other people. Keywords: narrative, fixed-tem employment, occupational identity, work, story model, social capital, career  

Viestintää valtuustossa : Valtuutettujen viestintätyyli ja käsitys Helsingin kaupunginvaltuuston kokouksien viestinnästä

The goal of the study was to determine the kind of communication used in the meetings of the City Council. Councillors' addresses were studied by observing their communication styles. A questionnaire was used to study councillors' perception of communication in council meetings as perceived communication climate. A second goal of the study was to develop a method for analysing communication style. The nature of the study was a longitudinal case study. Studies of speech communication at the individual level and those of organisational communication at the community level served as the theoretical frame of reference. Due to the chosen object of study, political research and communication context shaped the frame of reference for the study. Verbal, nonverbal and paraverbal characteristics form the communication style. The perceived communication climate is dynamic in nature and consists of characteristics. The research material was gathered from the meetings of the Helsinki City Council held from 1993 to 1996. The communication style was analysed from meeting addresses (N=1271) given by the permanent members (N=95) of the council. The perceived communication climate was studied using a questionnaire modified from Wiio's OCD2 questionnaire. The questionnaire survey was carried out twice. The first time, 58 questionnaires (68%) were returned and, the second time, 49 questionnaires (58%) were returned. The method of analysis used for communication style was classification and cross tabulation. Based on the subset of material for the first year, five communication style categories were defined Communication style was examined using gender, length of council membership, and political party as subgroups. The results related to the perceived communication climate were analysed as averages and percentages. A comparison of the results from two different measuring times revealed how the perceived communication climate changed during a council term. The finding of the study was that the municipal politicians could be placed in all five communication style categories in each year of their four-year council term. The sizes of the style categories varied only little in the different years. A relatively stable - rather than changing - communication style was more characteristic of individuals during a council term. Gender did not explain an individual's communication style. On the other hand, the length of service in the council and, to some extent, the political party were connected with a certain communication style. Changes in style mainly manifested themselves as variation in communication activity so that activity was highest at the beginning and at the end of the council term. The method of researching communication style developed for this study proved to be functional, though labour-consuming. The perceived communication climate in the Helsinki City Council was good. Women's and men's satisfaction with the communication in the council differed; women's perception became considerably more positive at the end of the council term. Satisfaction with the communication in the council was characteristic of the Coalition Party and the Social Democrat councillors and dissatisfaction was characteristics of the Green councillors. Long council experience increased satisfaction with communication in the council. Only in the case of a few style categories was it possible to show any connection between the communication style and the perceived communication climate. The study confirmed the perception that an individual's communication style in the same communication context was relatively stable in the long term as well.

Verkkomedian käyttö ja tutkiminen : Iltalehti Online 1995-2001

Marja Heinonen s dissertation Verkkomedian käyttö ja tutkiminen. Iltalehti Online 1995-2001 describes the usage of new internet based news service Iltalehti Online during its first years of existence, 1995-2001. The study focuses on the content of the service and users attitudes towards the new media and its contents. Heinonen has also analyzed and described the research methods that can be used in the research of any new media phenomenon when there is no historical perspective to do the research. Heinonen has created a process model for the research of net medium, which is based on a multidimensional approach. She has chosen an iterative research method inspired by Sudweeks and Simoff s CEDA-methodology in which qualitative and quantitative methods take turns both creating results and new research questions. The dissertation discusses and describes the possibilities of combining several research methods in the study of online news media. On general level it discusses the methodological possibilities of researching a completely new media form when there is no historical perspective. The result of these discussions is in favour for the multidimensional methods. The empiric research was built around three cases of Iltalehti Online among its users: log analysis 1996-1999, interviews 1999 and clustering 2000-2001. Even though the results of different cases were somewhat conflicting here are the central results from the analysis of Iltalehti Online 1995-2001: - Reading was strongly determined by the gender. - The structure of Iltalehti Online guided the reading strongly. - People did not make a clear distinction in content between news and entertainment. - Users created new habits in their everyday life during the first years of using Iltalehti Online. These habits were categorized as follows: - break between everyday routines - established habit - new practice within the rhythm of the day - In the clustering of the users sports, culture and celebrities were the most distinguishing contents. Users did not move across these borders as much as within them. The dissertation gives contribution to the development of multidimensional research methods in the field of emerging phenomena in media field. It is also a unique description of a phase of development in media history through an unique research material. There is no such information (logs + demographics) available of any other Finnish online news media. Either from the first years or today.

Eläytymisestä omiin tarinoihin : Televisiosarja katsojien keskustelussa

From sympathetic understanding to own stories. TV-series in the conversation of its viewers. The purpose of this study is to analyze viewers' conversations about TV-series as a practice in which viewers construct meaning to TV-series. In the tradition of British Cultural Studies this study understands that viewer has an active role in interpreting and constructing meaning to TV-series. In the tradition of feminist studies this study understands that gender is being constructed in social and cultural practices. In reception studies, the viewing of TV-series has usually been analyzed as a practice which is embedded at home and in a family. The studies are often based on interviews of viewers, and the analysis of the construction of meaning is based on interview material where the viewers most often talk about their viewing habits and the likes and dislikes of TV-shows and -characters. This study extends the reception and interpretation of TV-series from home to the moments of interaction between viewers. It is quite common to hear how people talk also outside of home about television and the programmes they have watched. In this study the construction of meaning is being studied in viewers' conversations. The method of analysis is conversation analysis which studies the ordered properties of everyday forms of social interaction. The data has been collected in a workplace where four women watched together (and without the presence of a researcher) two TV-series, American sitcom Golden Girls and Finnish family drama Ruusun aika (Time of a Rose), and afterwards had time and chance for discussion. There was neither a questionnaire nor an agenda for the women to discuss. The analysis of the conversation brings up three themes. In the orientation discussions the viewers aim to construct frames in which it makes sense to talk about the TV-series. The frames have mostly to do with the genre of the TV-series. The second theme is concerned with the viewers' aim to achieve sympathetic understanding of the characters in the TV-series. The third theme extends and transfers the conversation about TV-series to real or imaginary stories of own life. In the conversation the reception of a TV-series appears as being in motion: in the orientation discussions the viewers move towards the series, in the character-discussions the viewers move within the world of the series, and when telling their own stories the viewers move away from the TV-series towards their own lives. In the conversations there appears also a distinction in gender-constructions. When the viewers talk about motherhood, they adopt a serious and moralistic tone. When they talk about female sexuality and relationships between women and men they adopt carnevalistic and humorous tone. There are examples of these kinds of gender-constructions also in other studies of Finnish gender culture. Motherhood means the responsibility to good upbringing; relationships with men include something unpredictable and problematic which one handles at best in a humorous way.

Gender, Politics and Democratisation in Cameroon

Gender perceptions, religious belief systems, and political thought have excluded women from politics, for ages, around the world. Combining feminist and modernisation theorists in my theoretical framework, I examine the trends in patriarchal Europe and I highlight the gender-sensitive model of the Nordic countries. Retracing local gender patterns from precolonial to postcolonial eras in sub-Saharan Africa, I explore the links between perceptions, needs, resources, education and women's political participation in Cameroon. Democratisation is supposed to open up political participation, to grant equal opportunities to all adults. One ironic feature of the liberalisation process in Cameroon has been the decrease of women in parliamentarian representation (14% in 1988, 6% in 1992, 5% in 1997 and 10% in 2002). What social, cultural and institutional mechanisms produced this paradoxical outcome, the exclusion of half the population? The gender complementarity of the indigenous context has been lost to male prevalence privileged by education, church, law, employment, economy and politics in the public sphere; most women are marginalised in the private sphere. Nation building and development have failed; ethnicism and individualism are growing. Some hope lies in the growing civil society. From two surveys and 21 focus groups across Cameroon, in 2000 and 2002, some significant results of the processed empirical data reveal low electoral registration (34.5% women and 65.9% men), contrasted by the willingness to run for municipal elections (33.3 % women and 45.2% men). The co-existence of customary and statutory laws, the corrupt political system and fraudulent practices, contribute to the marginalisation of women and men who are interested in politics. A large majority of female respondents consider female politicians more trustworthy and capable than their male counterparts; they even foresee the appointment of a female Prime Minister. The Nordic countries have institutionalised gender equality in their legislation, policies and practices. France has improved women's political inclusion with the parity laws; Rwanda is another model of women's representation, thanks to its post-conflict constitution. From my analysis, Cameroonian institutions, men and more so women, may learn and borrow from these experiences, in order to design and implement a sustainable and gender-balanced democracy. Keywords: democratisation, politics, gender equality, feminism, citizenship, Cameroon, Nordic countries, Finland, France, United Kingdom, quotas, societal social psychology.

Growing Flowers in the Frost: Civic Activity, Citizenship and Gender in Russia

This study analyzes civic activity, citizenship and their gendered manifestations in contemporary Russia. It is based on a case study conducted in the city of Tver , located in the vicinity of Moscow, during 2001-2005. The data consists of interviews with civic activists and municipal and regional authorities; observations of civic organizations; and a quantitative survey conducted among local civic groups. The theoretical and methodological framework of the study draws upon a micro perspective on organization, discourse analysis, gender and citizenship theories and Pierre Bourdieu s theory of fields and capital. This study develops theoretical understanding of the characteristics and logic of civic organization in Russia. It shows that social class centrally structures the field of civic activity. Organizations can be seen as a vehicle of the educated class to advocate their interests, help themselves and seek both social and individual-level change. The study also argues that civic organizations founded during the post-Soviet era are often an institutionalized form of informal social networks. Networks, which were a central element of everyday interaction in Soviet society, are a resource and often the only resource available that can be made use of in contemporary organizational activities. The study argues that gender operates as a key structuring principle in the Russian socio-political community. Civic activity is often discursively associated with femininity and institutional politics with masculinity. Women tend to participate more than men in civic organizations, while men dominate the formal political domain. The study shows that civic organizations are important loci of communality. This communality, however, differs from the communality envisioned in the communitarian and social capital debates in the West. It is selective communality , as it is restricted to the members of the organizations and does not create generalized reciprocity and trust. Civic organizations tend to build upon and reproduce the traditional Russian organizational form of circles , kruzhki. Along with the analysis of civic activities, the study also examines the redefinition of the role and functions of the state. The authorities interviewed in this study understand civic organizations as serving those goals and interests determined by the authorities, instead of viewing them as sites of citizens self-organization around interests and problems citizens themselves deem important, or as a counterforce to the state. By contrast, civic activists understand the core of organizational activity to be advocacy of their interests and rights, tackling social problems, the pursuit of wider social change and self-help. Co-operation between authorities and organizations tends to be personified and based upon unequal, hierarchical patron-client arrangements, which inhibits the development of democratic governance. The study will be published in Routledge Contemporary Russia and Eastern Europe Series later this year.

Physical activity and diabetic complications in patients with type 1 diabetes

Type 1 diabetes is associated with the risk for late diabetic complications which are divided into microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular (cardiovascular disease, CVD) diseases. The risk for diabetic complication can be reduced by effective treatment, most importantly the glycaemic control. Glycaemia in type 1 diabetes is influenced by the interplay between insulin injections and lifestyle factors such as physical activity and diet. The effect of physical activity in patients with type 1 diabetes is not well known, however. The aim of this thesis was to investigate the physical activity and the physical fitness of patients with type 1 diabetes with special emphasis on glycaemic control and the diabetic complications. The patients included in the study were all part of the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) Study which aims to characterise genetic, clinical, and environmental factors that predispose to diabetic complications in patients with type 1 diabetes. In addition, subjects from the IDentification of EArly mechanisms in the pathogenesis of diabetic Late complications (IDEAL) Study were studied. Physical activity was assessed in the FinnDiane Study in 1945 patients by a validated questionnaire. Physical fitness was measured in the IDEAL Study by spiroergometry (cycle test with measurement of respiratory gases) in 86 young adults with type 1 diabetes and in 27 healthy controls. All patients underwent thorough clinical characterisation of their diabetic complication status. Four substudies were cross-sectional using baseline data and one study additionally used follow-up data. Physical activity, especially the intensity of activities, was reduced in patients affected by diabetic nephropathy, retinopathy, and CVD. Low physical activity was associated with poor glycaemic control, a finding most clear in women and evident also in patients with no signs of diabetic complications. Furthermore, low physical activity was associated with a higher HbA1c variability, which in turn was associated with the progression of renal disease and CVD during follow-up. A higher level of physical activity was also associated with better insulin sensitivity. The prevalence of the metabolic syndrome in type 1 diabetes was also lower the higher the physical activity. The aerobic physical fitness level of young adults with type 1 diabetes was reduced compared with healthy peers and in men an association between higher fitness level and lower HbA1c was observed. In patients with type 1 diabetes, a higher physical activity was associated with better glycaemic control and may thus be beneficial with respect to the prevention of diabetic complications.

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.

Prognostic significance of cyclooxygenase-2 and associated molecules in gastric cancer

Background and aims: Low stage and curative surgery are established factors for improved survival in gastric cancer. However, not all low-stage patients have a good prognosis. Cyclooxygenase-2 (COX-2) is known to associate with reduced survival in several cancers, and has been shown to play an important role in gastric carcinogenesis. Since new and better prognostic markers are needed for gastric cancer, we studied the prognostic significance of COX-2 and of markers that associate with COX-2 expression. We also studied markers reflecting proliferation and apoptosis, and evaluated their association with COX-2. Our purpose was to construct an accurate prognostic model by combining tissue markers and clinicopathogical factors. Materials and methods: Of 342 consecutive patients who underwent surgery for gastric cancer at Meilahti Hospital, Helsinki University Central Hospital, 337 were included in this study. Low stages I to II were represented by 141 (42%) patients, and high stages III to IV by 196 (58%). Curative surgery was performed on 176 (52%) patients. Survival data were obtained from the national registers. Slides from archive tissue blocks were prepared for immunohistochemistry by use of COX-2, human antigen R (HuR), cyclin A, matrix metalloproteinases 2 and 9 (MMP-2, MMP-9), and Ki-67 antibodies. Immunostainings were scored by microscopy, and scores were entered into a database. Associations of tumor markers with clinicopathological factors were calculated, as well as associations with p53, p21, and results of flow cytometry from earlier studies. Survival analysis was performed by the Kaplan-Meier method, and Cox multivariate models were reconstructed. Cell culture experiments were performed to explore the effect of small interfering (si)RNA of HuR on COX-2 expression in a TMK-1 gastric cancer cell line. Results: Overall 5-year survival was 35.1%. Study I showed that COX-2 was an independent prognostic factor, and that the prognostic impact of COX-2 was more pronounced in low-stage patients. Cytoplasmic HuR expression also associated with reduced survival in gastric cancer patients in a non-independent manner. Cell culture experiments showed that HuR can regulate COX-2 expression in TMK-1 cells in vitro, with an association also between COX-2 and HuR tissue expression in a clinical material. In Study II, cyclin A was an independent prognostic factor and was associated with HuR expression in the gastric cancer material. The results of Study III showed that epithelial MMP-2 associated with survival in univariate, but not in multivariate analysis. However, MMP-9 showed no prognostic value. MMP-2 expression was associated with COX-2 expression. In Study IV, the prognostic power of COX-2 was compared with that of all tested markers associated with survival in Studies I to III, as well as with p21, p53, and flow cytometry results. COX-2 and p53 were independent prognostic factors, and COX-2 expression was associated with that of p53 and Ki-67 and also with aneuploidy. Conclusions: COX-2 is an independent prognostic factor in gastric cancer, and its prognostic power emerges especially in low stage cancer. COX-2 is regulated by HuR, and is associated with factors reflecting invasion, proliferation, and apoptosis. In an extended multivariate model, COX-2 retained its position as an independent prognosticator. COX-2 can be considered a promising new prognostic marker in gastric cancer.

Myyttisestä sankarirehtorista opistoäidiksi ja manageriksi : Sukupuolen näkökulma kansalais- ja työväenopiston johtajuuteen

Kansansivistystä legitimoiva ja ylläpitävä ajattelu oli kertomusta myyttisistä sankarirehtoreista, jota voisi kutsua myös suomalaisen kansansivistyksen suureksi kertomukseksi. Tutkimusongelmana oli, kuinka kansansivistyksen suuri kertomus rakentui sukupuolen näkökulmasta kansan, sivistyksen ja vapauden käsitteiden tulkinnoissa. Tavoitteena oli jäljittää kansansivistyksen kadonneita naisia. Aineisto koostui eri kirjoittajien 1800-luvun lopulla ja 1900-luvulla laatimista kulttuurihistoriallisista teksteistä, joita metodologisesti tulkittiin sukupuolisensitiivisesti tiheällä otteella. Kansalais- ja työväenopiston rehtorin työ vuonna 2005 muodostui osaksi kansansivistyksen suurta kertomusta. Empiirinen aineisto koostui valtakunnallisesta, sähköisesti toteutetusta rehtorikyselystä (N=79), jota analysoitiin diskursiivisella lähestymistavalla sukupuolisensitiivisesti. Tutkimusongelmat olivat: Miksi kansalais- ja työväenopiston rehtoriksi hakeudutaan? Kuinka sukupuoli tulee esiin rehtorin työssä? Millaista on rehtorin työn arki? Suomalainen kansansivistystraditio kategorisoi naisen yksityiseen ja miehen julkiseen. Kansalais- ja työväenopistoista muotoiltiin sukupuolittuneita kansansivistysinstituutioita, joiden maskuliinisen johtajuuden ympärille rakentui sankarirehtorimyytti. Naisten tulo opistojen johtajattariksi liittyi osaksi naisten yleistä ammatillista kehitystä. Sivistettävälle naiselle rakentui paikka 1900-luvun vaihteesta äitikansalaisten yleissivistettävänä kollektiivina, myöhemmin työläisnaisten kollektiivina ja 1960-luvulta lähtien ammatillisena työvoimaresurssina. 2000-luvulla kansan käsite korvautui vapailla yksilökansalaisilla ja sivistysideologinen vapaus kääntyi uusliberalismin yksilön vapaaksi mahdollisuudeksi kehittää itseään vapaa-ajalla. Sivistys käsitteenä loittoni ja sen korvasivat oppiminen ja viihtyminen. Rehtoriksi hakeutumisen taustalla vaikuttivat edelleen kansansivistysideologiset arvot, jotka naiselle merkitsivät yhteiskunnallisen äitiyden velvoitetta hoitaa reproduktiivista tehtäväänsä ahkerana ja uutterana opistoäitinä. Uusliberalistiset arvot muuttivat naisen rehtorina kansallista ja taloudellista arvoa tuottavaksi palkkatyöäidiksi ja manageriksi. Sekä naiseen että mieheen rehtorina liitettiin stereotyyppisiä sukupuolirooleihin sidottuja ominaisuuksia. Naisen ja miehen paikat työyhteisössä määrittyivät modernin yhteiskuntasopimuksen seksuaalisen sopimuksen mukaisesti. Rehtorit työskentelivät moniosaavina jokapaikanhöylinä keskellä valtakunnallista opistoreformia. Rehtorin ammatillinen kuva jäsentyi monimuotoisesti reformistiksi, konformistiksi ja konservatiiviksi. Asiasanat: vapaa sivistystyö, kansansivistys, rehtorit, sukupuolentutkimus, kansalaisopistot, työväenopistot, diskurssianalyysi

Moral Professionalism in Interaction : Educators' Relational Moral Voices in Urban Schools

The aim of this study was to investigate educators relational moral voices in urban schools and to listen to what they told about moral professionalism and moral practices in challenging urban schools. Their relational moral voices were investigated through the following three questions: 1. What are the educators moral voices in relation to themselves and other people? 2. What are the educators moral voices in relation to their work and society? 3. What kind of interaction process lies between the educators moral voices and the urban school context? The research data of this study were gathered in four urban schools in Jyväskylä and Helsinki. The research schools were chosen for this study according to the criteria of the international Socrates Comenius project called Leading Schools Successfully in Challenging Urban Context: Strategies for Improvement. This study formed part of this project, which investigated successful urban schools as challenging learning environments in nine European countries and explored the principals success in leadership in particular. The data, which included 37 narratively constructed interviews with four principals and key informants selected by the principals, were gathered in interviews conducted in 2006. In other words, the data comprised three interviews with each of four principals, and interviews with two teachers, two parents, and two pupils from each school. In addition, the school deacon from one school was also interviewed. Furthermore, part of the data from one of the research schools included a medium report of the school deacon s work. This study combined the case study method, the narrative approach and the critical incident technique as the methodological framework. In addition, all of these methods served as practical tools for both analyzing and reporting the data. The educators' narrations and the results of the study appear in the original articles (Hanhimäki & Tirri 2008; Hanhimäki 2008b; Hanhimäki & Tirri 2009; Hanhimäki 2008a). The educators moral voices in relation to themselves and other people emerged through the main themes of moral leadership, the development and evaluation process, moral sensitivity, gender, values, and student well-being. The educators moral voices in relation to their work and society emerged through the main themes of multiprofessional cooperation, families and parental involvement, and moral school culture. The idea of moral interaction connected moral professionalism and the methodological combination of this study, which together emphasized social interaction and the creation of understanding and meaning in this interaction. The main point of this study was to state that the educators moral voices emerged in the interaction between the educators themselves and the urban school context. In this interaction, the educators moral professionalism was constructed and shaped in relation to themselves, other people, their work and society. The loudest relational moral voices heard through the main themes were those of caring, cooperation, respect, commitment, and professionalism. When the results were compared to the codes of ethics which guided these educators moral professional work, the ethical principles and values of the codes were clearly visible in their moral practices. The loudest message from the educators narration could be summarized in the words caring, respect and cooperation: at its best, there is just a human being and a human being with caring, respect and cooperation between them. The results of this study emphasize the need for practical approaches such as case studies and the narrative approach in teacher education to encourage educators to become moral professionals capable of meeting the needs of people of varied backgrounds. In addition, opportunities for moral, religious and spiritual education should be noticed and utilized in the plural interaction of urban schools when nurturing pupils and creating a moral school culture. Furthermore, multiprofessional cooperation and parents as the school s primary cooperation partner are needed to carry out the shared duty of moral education in urban schools. Keywords: moral professionalism, educator, relational moral voice, interaction, urban school

Maailmankuvan uskonnollisuus ja arvot moraaliarviointien selittäjinä

Moraalipsykologit ovat väitelleet vuosikymmeniä siitä, mitä moraali on ja minkälaisiin psykologisiin prosesseihin moraaliarvioinnit perustuvat. Yksi keskeinen kysymys on koskenut sitä vaikuttavatko ihmisten maailmankuvat ja niihin kietoutuvat tiedolliset uskomukset, arvot ja omat käsitykset moraalin luonteesta moraaliarviointeihin. Tämä tutkimus lähti selvittämään maailmankuvan uskonnollisuuden sekä arvojen yhteyttä moraaliarviointeihin tilastollisten analyysien valossa. Kyselytutkimusaineisto kerättiin helsinkiläisiltä yliopisto-opiskelijoilta (N = 161). Nykypäivän ihmisille tuttujen, mutta moraalisesti kiistanalaisten tekojen vääryyden arvioinneista muodostettiin pääkomponenttianalyysiin perustuen kolme tekotyyppiä, jotka nimettiin itseen kohdistuviksi teoiksi (ITSE-teot; abortti, avioero, eutanasia, seksin harrastaminen alaikäisenä ja itsemurha), muihin yksilöihin kohdistuviksi antisosiaalisiksi teoiksi (MYKS-teot; varastetun tavaran ostaminen tietoisesti, pysäköidylle autolle vahingossa aiheuttamansa vahingon ilmoittamatta jättäminen ja toiselle henkilölle kuuluvan auton luvaton käyttöönotto) sekä yhteiskuntaan kohdistuviksi antisosiaalisiksi teoiksi (YHT-teot; maksamatta jättäminen julkisessa liikenteessä ja verovilppi tilaisuuden salliessa). Maailmankuvaltaan perinteisesti uskonnolliset henkilöt arvioivat kaikki tekotyypit lähes yhtä vääriksi (sanallisesti ”väärin” oleviksi) sekä keskimäärin vääremmiksi kuin maailmankuvaltaan ei-perinteisesti uskonnolliset henkilöt. Sen sijaan ei-perinteisesti uskonnolliset henkilöt erottivat selkeästi kaikki kolme tekotyyppiä niin keskiarvojen kuin niiden sanallisten vastineidensakin mukaan (väärimmiksi arviointiin MYKS-teot ja vähiten vääriksi ITSE-teot). Hierarkkisissa regressioanalyyseissä maailmankuvan uskonnollisuuden perinteisyys ennusti merkittävästi ITSE-tekojen vääremmäksi arviointia, mutta kohtalaisesti myös YHT-tekojen vääremmäksi arviointia, kun ikä, sukupuoli ja arvoulottuvuudet oli vakioitu. Uskonnollisuuden perinteisyys ei kuitenkaan ennustanut MYKS-tekojen arviointia muut tekijät vakioituina ja sen ainoaksi tilastollisesti merkitseväksi selittäjäksi osoittautui säilyttämis−muutosvalmiusarvoulottuvuus, joskin melko vähäisellä selitysvoimalla. Kyseinen arvoulottuvuus ennusti myös ITSE- ja YHT-tekotyyppien arviointeja muut edellä mainitut tekijät vakioituina, mutta heikommin kuin maailmankuvan uskonnollisuuden perinteisyys. YHT-tekoja selitti lisäksi ikä, kun kaikki muut selittäjät oli vakioitu. Itsensäylittämis–itsensäkorostamisarvoulottuvuus ei ollut yhteydessä yhdenkään tekotyypin vääryyden arviointiin. Tulokset tukivat aiempia tutkimustuloksia siitä, että eri ihmiset hahmottavat ainakin omasta näkökulmastaan moraalin alaa eri tavoin eli arvioivat samat teot eri tavoin vääriksi tai vapaaehtoisiksi. Tulokset osoittivat myös, että ihmisten maailmankuvan uskonnollisuudella ja säilyttämisarvojen preferoinnilla on selkeä yhteys näihin eroihin arvioinneissa, mutta että muihin yksilöihin kohdistuvat vahingolliset ja epäoikeudenmukaiset antisosiaaliset teot tuomitaan hyvin yleisesti väärinä. Yhdessä nämä tekijät näyttäisivät viittaavan siihen, että ihmisten moraalikäsitykset todella vaihtelevat. Keskeisinä lähteinä toimivat Jonathan Haidtin, Lawrence Kohlbergin, Shalom Schwartzin, Richard Shwederin sekä Elliot Turielin tieteelliset julkaisut ja teokset.

Sosiaalialan ammattilaiset kunnian, häpeän ja kunniaväkivallan jäljillä

Pro gradu -tutkielmassani tarkastelen kunnian ja häpeän käsitteitä sekä kunniaväkivallan ilmiötä sosiaalialan ammattilaisten näkökulmasta käsin. Samalla vertailen suomalaisen ja kunniakulttuurin eroja suhtautumisessa kunnian ja häpeän käsitteisiin. Tutkielmani empiirinen aineisto koostuu kymmenestä sosiaalialan ammattilaisen puolistrukturoidusta teemahaastattelusta. Haastatelluista kuusi työskenteli sosiaalityöntekijänä, kaksi perhetyöntekijänä, yksi ohjaajana ja yksi maahanmuuttajatyöntekijänä. Kolme haastateltavista on maahanmuuttajataustaisia. Haastatteluiden rakenne on kaksijakoinen: alkuosuus keskittyi kunnian ja kunniallisuuden sekä häpeän ja kunniattomuuden käsitteisiin, kun taas loppuosuuksissa painottui kunniaväkivallan ja maahanmuuttajien kanssa tehtävän yhteistyön teema. Laadullisena tutkimusmenetelmänä olen käyttänyt haastatteluiden sisällönanalyysia. Tutkielmassani avaan ja vertailen kunnian ja häpeän käsitteiden merkityksiä, paikannuksia ja sisältöjä suomalaisessa ja kunniakeskeisessä kulttuurissa. Haastatteluaineistoni analyysin pohjalta syntyi kunnian ja häpeän nelikenttä, jota halkaisevat horisontaalinen valta-akseli ja vertikaalinen vaikutusakseli. Nelikentän neljä vyöhykettä kuvaavat kunnian ja häpeän teemoja yksilöllisyyden ja yhteisöllisyyden, yksityisyyden ja julkisuuden sekä vallan ja vaikutuksen ulottuvuuksien kautta. Tutkielmassani avaan sitä, miten nämä nelikentän vyöhykkeet näyttäytyivät haastatteluissa sisällöllisesti sekä suhteessa toisiinsa. Samalla vertailen löydöksiä kunniakulttuurin käsityksiin kunniasta ja häpeästä. Kunnian ja häpeän kysymysten kautta lähestyn kunniaväkivaltateemaa ja suomalaisen monikulttuurisuustyön haasteita ja mahdollisuuksia. Sosiaalialan työ maahanmuuttajien parissa sisältää erityispiirteitä ja elementtejä, jotka lisäävät käytännön työn haastavuutta ja luovat mahdollisia karikkoja ja esteitä toimivalle ja asiakaslähtöiselle yhteistyölle. Kulttuurituntemus, yhteisöjen sisältä tuleva tuki ja kulttuuritulkkien käyttö koettiin haastateltavien parissa tarpeellisena kunniaväkivaltatyöskentelyssä. Kunniaväkivaltatyöskentely tarvitsee myös monien toimijatahojen yhteistyötä, joka tuo mukanaan omia ulottuvuuksia, sekä mahdollisten toiminta- ja yhteistyömallien hahmottamista että vastuun koordinoinnin kysymyksiä. Haastatteluissa tuli esille toiveita ja tarvetta kunniaväkivaltakysymyksiin liittyvän yhteistyön koordinoinnin parantamisesta ja työskentelyn mallintamisesta. Naiset voidaan nähdä kunnian ja perheen ytimessä, mutta myös yksityisyyden ja julkisuuden rajojen rikkojina. Kunniakulttuurissa naisten tasavertaisuuden yhtenä riskitekijänä ja hidasteena voidaan nähdä myös yksilöllisyyden ja yhteisöllisyyden välisen rajan huokoisuus; erityisesti tyttöjen ja naisten kunniaan ja samalla integriteettiin puuttuminen ja sen hallitseminen vaarantaa pyrkimykset tasa-arvoisempaan yhteiskunnalliseen kehitykseen. Naisten yhteiskunnallinen asema ja oikeudet ovatkin kunniaväkivallan torjumisen kulmakiviä sekä länsimaissa että perinteisissä kunniakulttuureissa.