Eritteistä etiikkaan : Nykytaiteen vaikutus taidekonservaattorin rooliin

Tutkimuksen tehtävänä oli selvittää, miten suomalaisten taidekonservaattoreiden rooli on muuttunut nykytaiteen vaikutuksesta. Aiemmin taidekonservaattoreiden työhön ovat kuuluneet perinteiset taideteokset, kuten esimerkiksi kankaalle maalatut öljymaalaukset. Nykytaide on laajentanut käsitystä taiteesta. Lähes mitä tahansa kuviteltavissa olevia materiaaleja saatetaan käyttää taideteoksissa. Konservaattorin yhtenä päätehtävänä on perinteisesti ollut varmistaa, että taideteokset säilyvät museoiden kokoelmissa muuttumattomina tuleville sukupolville. Nykytaiteen yksi erityispiirre on, että sen säilyvyys ei aina ole tarkoituksellista. Taiteilija on saattanut tehdä teoksen tuhoutuvaksi. Taidekonservaattorin on erityisen tärkeä tietää, mikä on taiteilijan alkuperäinen ajatus teoksesta, sillä jos taidekonservaattori on ymmärtänyt väärin taiteilijan intention, saattaa teoksen alkuperäinen idea muuttua. Tarkasteltavina kohteina ovat suomalaiset taidekonservaattorit, jotka työskentelevät nykytaiteen parissa suomalaisissa taidemuseoissa. Nykytaiteella tarkoitetaan tutkimuksessa 1960-luvun jälkeistä taidetta, jossa hyödynnetään taiteessa aiemmin tuntemattomia materiaaleja, kuten elintarvikkeita ja muoveja. Tutkimuksen lähteet muodostuivat suomalaisten taidekonservaattoreiden haastatteluista sekä nykytaidetta ja taidekonservointia käsittelevästä lähdekirjallisuudesta. Tutkimuksen kohderyhmään kuului 12 suomalaista taidekonservaattoria, joista tutkimukseen osallistui 11. Nykytaiteella näyttää olleen suuri merkitys sellaisten taidekonservaattoreiden rooliin, jotka ovat aktiivisesti tekemisissä nykytaiteen kanssa. Erityisesti uudet materiaalit, taiteilijan intention selvittämisen ongelmat, vuorovaikutuksen korostuminen taiteilijaan ja muihin asiantuntijoihin sekä painopisteen siirtyminen kohti ennaltaehkäisevää konservointia näyttävät olleen tärkeimmät pääkohdat konservaattoreiden roolin muutoksessa. Avainsanat: taidekonservointi, nykytaide, materiaalit

Heräämisten poetiikkaa : Lajeja ja intertekstejä Arvid Järnefeltin romaaneissa Isänmaa, Maaemon lapsia ja Veneh'ojalaiset

Poetics of Awakenings. Genres and Intertexts in Arvid Järnefelt s Novels Isänmaa, Maaemon lapsia and Veneh ojalaiset This doctoral dissertation focuses on Arvid Järnefelt s (1961 1932) novels Isänmaa (1893), Maaemon lapsia (1905) and Veneh ojalaiset (1909). The study applies the genre theory and concepts Alastair Fowler has introduced in his Kinds of Literature (1982). Fowler s theory of the novel is developed further and applied to Finnish realist novels. The generic analysis is supplemented by intertextual analysis, which is mainly based on the idea of specific intertextual relations as presented by Kiril Taranovsky. Generic and intertextual analyses form the basis for hermeneutic interpretation, in which attention is paid to the fact that the novels are written by the designated writer in specific historical and cultural circumstances. Instead of the author s intention , the study focuses on the realised intention , in other words the novels as they are published. Järnefelt s first novel Isänmaa is understood to be a classical Bidungsroman that depicts the socialisation of a young male protagonist. From an intertextual point of view, the novel appears to be a novel of conversion, too, due to the biblical allusions concealed in the depiction of the events. Furthermore, Isänmaa is seen to stand in an intertextual relation to Hegel s, Snellman s and Topelius s writings. Maaemon lapsia is argued to be a thesis novel, which persuades the reader to adopt a certain ideological and political stance, namely Henry George s view on the private ownership of land. The novel is modulated by the generic repertoires of fairy tale and tragedy. The mythical frame of the novel supports the thesis novel, as it gives universal validity to the particular events depicted in the novel. Maaemon lapsia also comments on the contemporary political debate on the relations between Finland and Russia by presenting the relationship as analogous to the relationship between tenant farmer and landowner. Veneh ojalaiset exhibits a wide range of genres. Comic, tragic and mythical mode is combined with, for example, family novel, romance, conversion novel and revolutionary novel. From a rhetorical viewpoint, the novel is an apology, which accuses society of generating criminality by means of unjust laws and procedures. The novel discusses the question of resistance to evil by using the themes of Faust and Job, as well as by confronting the philosophies of Epictetus and Nietzsche. The novel is a thesis novel, which disputes the possibility of violent revolution as a way to a better society and recommends passive resistance for an individual living in an unjust society. The poetics of Järnefelt s novels is regarded as the poetics of conversion, as all the novels in focus depict the protagonist s awakening to see the society in a new light, be it a patriotic vision of the reality or a conception of the unfairness of society.

Sekä että : Ironia koherenssina ja inkoherenssina

The interpretation of irony in this study is seen as being crucially dependent on the notion of coherence. Coherence depends on a complex interplay of contextual features, which is why all interpretations must be seen as socio-cultural processes. An utterance is perceived as coherent if it makes sense and if it hangs together. Incoherent utterances can result in an ironic interpretation; however, the incoherence must also be perceived as being intentional, and intentionality in turn is a sign of the ironist's rejecting stance. The study does not encompass the notion of irony of fate nor situational irony that is unintentional. Irony is defined in this study as a combination of five components. It is seen as (1) a negative attitude that reflects (2) the intention of the ironist, and (3) has a target and most often (4) a victim too. Essential to irony is its fifth component, the fact that one or more of these four components must be inferred from co- or context. The componential definition of irony is crucial in deciding whether an interpretation is ironic or not, and the definition makes it possible to discern the differences as well as the similarities between different kinds of irony. The method of the study is experimental: 12 Finnish newspaper texts that could be considered to be ironic were interpreted by 107 informants. The interpretation of one of the texts was based on unelicited feedback given by readers of a weekly magazine. The responses were analyzed to determine (a) whether the texts were perceived as being coherent or incoherent and (b) whether the informants appealed to any of the five components of irony. The results of the analyses of the informants' responses indicate that differences between the ironic and non-ironic interpretations of the texts can be explained in terms of whether or not the informant regarded the text as being coherent. The thesis also discusses the shortcomings of other accounts of irony: the Gricean theory of conversational implicature, speech act theory, irony as rhetoric, irony as pretense, irony as echoic mention, and irony as framing. In contrast to these other accounts, the study focuses on irony as a textual phenomenon and underlines the importance of socio-cultural context in the interpretation of irony. Key words: irony, coherence, incoherence, the componential definition of irony, interpretation of linguistic utterances.

Online grocery shopping: The impact of shopping frequency on perceived risk

Online grocery shopping has enjoyed strong growth and it is predicted this channel will continue to grow exponentially in the coming years. While online shopping has attracted an abundance of research interest, examinations of online grocery shopping behaviour are only now emerging. Shopping online for groceries differs considerably from general online shopping due to the perishability and variability of the product, and frequency of the shopping activity. Two salient gaps underpin this research into online grocery shopping. This study responds to calls to investigate the online shoppers’ experience in the context of online purchasing frequency. Second, this study examines the mediating effect of perceived risk between trust and online repurchase intention of groceries. An online survey was employed to collect data from shoppers who were recruited from a multi-channel grocery e-retailer’s database. The online survey, comprising 16 reflective validated scale items, was sent to 555 frequent and infrequent online grocery shoppers. Results find that while customer satisfaction predicts trust for both infrequent and frequent online grocery shoppers, perceived risk fully mediates the effect of trust on repurchase intentions for infrequent online grocery shoppers. Furthermore path analysis reveals that the developed behavioural model is variant across both groups of shoppers. Theoretically, we provide a deeper understanding of the online customer experience, while gaining insight into two shopper segments identified as being important to grocery e-retailers. For managers, this study tests an online customer behavioural model with actual purchasing behaviour and identifies the continued presence of perceived risk in grocery e-retailing regardless of purchase frequency or experience.

Feeding mode of Australian infants in the first 12 months of life: An assessment against national breastfeeding indicators

Background: In 2011, Australia published a set of 6 population-level indicators assessing breastfeeding, formula use, and the introduction of soft/semisolid/solid foods. Objectives: This study aimed to report the feeding practices of Australian infants against these indicators and determine the predictors of early breastfeeding cessation and introduction of solids. Methods: Mother–infant dyads (N = 1470) were recruited postnatally in 2 Australian capital cities and regional areas of 1 state between February 2008 and March 2009. Demographic and feeding intention data were collected by self-completed questionnaire at infant birth, with feeding practices (current feeding mode, age of breastfeeding cessation, age of formula and/or solids introduction) reported when the infant was between 4 and 7 months of age, and around 13 months of age. Multiple logistic regression was used to determine the predictors of breastfeeding cessation and solids introduction. Results: Although initiation of breastfeeding was almost universal (93.3%), less than half of the infants were breastfed to 6 months (41.7%) and 33.3% were receiving solids by 4 months. Women who were socially disadvantaged, younger, less educated, unpartnered, primiparous, and/or overweight were most likely to have ceased breastfeeding before 6 months of age, and younger and/or less educated women were most likely to have introduced solid food by 4 months of age. Not producing adequate milk was the most common reason provided for cessation of breastfeeding. Conclusion: The feeding behaviors of Australian infants in the first 12 months fall well short of recommendations. Women need anticipatory guidance as to the indicators of breastfeeding success and the tendency of women to doubt the adequacy of their breast milk supply warrants further investigation.

Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative

Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The ‘5 critical moments’ of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this study was to understand the determinants of nurses’ hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses’ hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence.

Representing the epistemic nature of teachers’ practical knowledge : The case of class teachers’ general pedagogy

The present study addressed the epistemology of teachers’ practical knowledge. Drawing from the literature, teachers’ practical knowledge is defined as all teachers’ cognitions (e.g., beliefs, values, motives, procedural knowing, and declarative knowledge) that guide their practice of teaching. The teachers’ reasoning that lies behind their practical knowledge is addressed to gain insight into its epistemic nature. I studied six class teachers’ practical knowledge; they teach in the metropolitan region of Helsinki. Relying on the assumptions of the phenomenographic inquiry, I collected and analyzed the data. I analyzed the data in two stages where the first stage involved an abductive procedure, and the second stage an inductive procedure for interpretation, and thus developed the system of categories. In the end, a quantitative analysis nested into the qualitative findings to study the patterns of the teachers’’ reasoning. The results indicated that teachers justified their practical knowledge based on morality and efficiency of action; efficiency of action was found to be presented in two different ways: authentic efficiency and naïve efficiency. The epistemic weight of morality was embedded in what I call “moral care”. The core intention of teachers in the moral care was the commitment that they felt about the “whole character” of students. From this perspective the “dignity” and the moral character of the students should not replaced for any other “instrumental price”. “Caring pedagogy” was the epistemic value of teachers’ reasoning in the authentic efficiency. The central idea in the caring pedagogy was teachers’ intentions to improve the “intellectual properties” of “all or most” of the students using “flexible” and “diverse” pedagogies. However, “regulating pedagogy” was the epistemic condition of practice in the cases corresponding to naïve efficiency. Teachers argued that an effective practical knowledge should regulate and manage the classroom activities, but the targets of the practical knowledge were mainly other “issues “or a certain percentage of the students. In these cases, the teachers’ arguments were mainly based on the notion of “what worked” regardless of reflecting on “what did not work”. Drawing from the theoretical background and the data, teachers’ practical knowledge calls for “praxial knowledge” when they used the epistemic conditions of “caring pedagogy” and “moral care”. It however calls for “practicable” epistemic status when teachers use the epistemic condition of regulating pedagogy. As such, praxial knowledge with the dimensions of caring pedagogy and moral care represents the “normative” perspective on teachers’ practical knowledge, and thus reflects a higher epistemic status in comparison to “practicable” knowledge, which represents a “descriptive” perception toward teachers’ practical knowledge and teaching.

The designed environment and how it affects brain morphology and mental health

Background The environment is inextricably related to mental health. Recent research replicates findings of a significant, linear correlation between a childhood exposure to the urban environment and psychosis. Related studies also correlate the urban environment and aberrant brain morphologies. These findings challenge common beliefs that the mind and brain remain neutral in the face of worldly experience. Aim There is a signature within these neurological findings that suggests that specific features of design cause and trigger mental illness. The objective in this article is to work backward from the molecular dynamics to identify features of the designed environment that may either trigger mental illness or protect against it. Method This review analyzes the discrete functions putatively assigned to the affected brain areas and a neurotransmitter called dopamine, which is the primary target of most antipsychotic medications. The intention is to establish what the correlations mean in functional terms, and more specifically, how this relates to the phenomenology of urban experience. In doing so, environmental mental illness risk factors are identified. Conclusions Having established these relationships, the review makes practical recommendations for those in public health who wish to use the environment itself as a tool to improve the mental health of a community through design.

Evaluation of the Red Light Camera Program and the Owner Onus Legislation

Red light cameras were introduced in Victoria in August 1983, with the intention of reducing the number of accidents that result from motorists disobeying red traffic signals at signalised intersections. Accident data from 46 treated and 46 control sites from 1981 to 1986 were analysed. The analysis indicated that red light camera use resulted in a reduction in the incidence of right angle accidents, and in the number of accident casualties. Legislation was introduced in March 1986 to place the onus for red light camera offences onto the vehicle owner. This legislation was intended to improve Police efficiency and therefore increase the number of red light cameras in operation. Data supplied by the Police indicated that these aims have beneficial road safety effects.

Random Breath Testing Operation and Effectiveness in 1985

Random breath testing (RBT) was introduced in South Australia in 1981 with the intention of reducing the incidence of accidents involving alcohol. In April 1985, a Select Committee of the Upper House which had been established to “review the operation of random breath testing in this State and any other associated matters and report accordingly” presented its report. After consideration of this report, the Government introduced extensive amendments to those sections of the Motor Vehicles Act (MVA) and Road Traffic Act (RTA) which deal with RBT and drink driving penalties. The amended section 47da of the RTA requires that: “(5) The Minister shall cause a report to be prepared within three months after the end of each calendar year on the operation and effectiveness of this section and related sections during that calendar year. (6) The Minister shall, within 12 sitting days after receipt of a report under subsection (5), cause copies of the report to be laid before each House of Parliament.” This is the first such report. Whilst it deals with RBT over a full year, the changed procedures and improved flexibility allowed by the revision to the RTA were only introduced late in 1985 and then only to the extent that the existing resources would allow.

Näppärien mummojen muistelukirjonta - yhteisöllistä ja voimauttavaa käsityöilmaisua

The aim of the study was to get acquainted with the activity of Näppärät Mummot, a Lahti-based crafts society, and its importance to the wellness of the members of the group. The selected aim, i.e., analyzing the wellness, largely affected the whole research process and its results. According to earlier studies in the field, different forms of craft and expressional activity promote one's wellness as well as support the work for one's identity. Based on my theoretical knowledge, my research was set out to: 1) form a general view of crafts culture within Näppärät Mummot and 2) find out how recollective craft that promotes wellness is perceived through communality, experiential activity, work for one's identity, and divided as well as undivided craft. Qualitative field work was governed by ethnographic research strategy, according to which I set out to get thoroughly familiar with the society I was studying. The methods I used to collect data were participant observation and thematic interview. I used a field diary for writing down all data I acquired through the observation. The interviewee group was formed by seven members of Näppärät Mummot. An mp3 recorder was used to record the interviews, which I transcribed later. The method for data analysis was qualitative content analysis, for which I used Weft QDA, a qualitative analysis software application. I formed themes that shed light on research tasks from the data using coding and theory-driven analysis. I kept literature and data I collected in cooperation through the whole analysis process. Lastly, drawing from the classes of meaning of therapeutic craft that I sketched by means of summarizing and classifying, I presented the central concepts that describe the main results of the study. The main results were six concepts that describe Näppärät Mummot's crafts culture and recollective craft with its wellness-beneficial effect: 1) autobiographical craft, 2) shared work for one's identity, 3) shared intention for craft, 4) craft as a partner, 5) individual manner of craft, and 6) shared improvement. Craft promoted wellness in many ways. It was used to promote inner life management in difficult times and it also provided sensations of empowerment through pleasure from craft. Expressional, shared craft also served as means of reinforcing one's identity in various ways. Expressional work for one's identity through autobiographical themes of craft represented rearranging one's life through holistic craft. A personal way of doing things also served as expressional action and work for one's identity even with divided craft. Shared work for identities meant reinforcing the identities of the members through discources of craft and interaction with their close ones. What proves the interconnection between communality and craft as well as their shared meaning is that communality motivated the members to work on their craft projects, while craft served as the means of communication between the members: communication through craft was easier than lingual communication. The results can not be generalized to apply to other groups: they are used to describe the versatile means of recollective craft to promote the well-being among the crafts society Näppärät Mummot. However, the results do introduce a new perspective to the social discussion on how cultural activities promote well-being.

Tree growth relationships and silvicultural tools to assist stand management in private native spotted gum dominant forests in Queensland and northern New South Wales.

Spotted gum dominant forests occur from Cooktown in northern Queensland (Qld) to Orbost in Victoria (Boland et al. 2006) and these forests are commercially very important with spotted gum the most commonly harvested hardwood timber in Qld and one of the most important in New South Wales (NSW). Spotted gum has a wide range of end uses from solid wood products through to power transmission poles and generally has excellent sawing and timber qualities (Hopewell 2004). The private native forest resource in southern Qld and northern NSW is a critical component of the hardwood timber industry (Anon 2005, Timber Qld 2006) and currently half or more of the native forest timber resource harvested in northern NSW and Qld is sourced from private land. However, in many cases productivity on private lands is well below what could be achieved with appropriate silvicultural management. This project provides silvicultural management tools to assist extension staff, land owners and managers in the south east Qld and north eastern NSW regions. The intent was that this would lead to improvement of the productivity of the private estate through implementation of appropriate management. The other intention of this project was to implement a number of silvicultural experiments and demonstration sites to provide data on growth rates of managed and unmanaged forests so that landholders can make informed decisions on the future management of their forests. To assist forest managers and improve the ability to predict forest productivity in the private resource, the project has developed: • A set of spotted gum specific silvicultural guidelines for timber production on private land that cover both silvicultural treatment and harvesting. The guidelines were developed for extension officers and property owners. • A simple decision support tool, referred to as the spotted gum productivity assessment tool (SPAT), that allows an estimation of: 1. Tree growth productivity on specific sites. Estimation is based on the analysis of site and growth data collected from a large number of yield and experimental plots on Crown land across a wide range of spotted gum forest types. Growth algorithms were developed using tree growth and site data and the algorithms were used to formulate basic economic predictors. 2. Pasture development under a range of tree stockings and the expected livestock carrying capacity at nominated tree stockings for a particular area. 3. Above-ground tree biomass and carbon stored in trees. •A series of experiments in spotted gum forests on private lands across the study area to quantify growth and to provide measures of the effect of silvicultural thinning and different agro-forestry regimes. The adoption and use of these tools by farm forestry extension officers and private land holders in both field operations and in training exercises will, over time, improve the commercial management of spotted gum forests for both timber and grazing. Future measurement of the experimental sites at ages five, 10 and 15 years will provide longer term data on the effects of various stocking rates and thinning regimes and facilitate modification and improvement of these silvicultural prescriptions.

Evidence-based perspective on CP rehabilitation : Reviews on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices

This thesis utilises an evidence-based approach to critically evaluate and summarize effectiveness research on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices in children and adolescents with cerebral palsy (CP). It aims to assess the methodological challenges of the systematic reviews and trials, to evaluate the effectiveness of interventions in current use, and to make suggestions for future trials Methods: Systematic reviews were searched from computerized bibliographic databases up to August 2007 for physiotherapy and physiotherapy-related interventions, and up to May 2003 for orthotic devices. Two reviewers independently identified, selected, and assessed the quality of the reviews using the Overview Quality Assessment Questionnaire complemented with decision rules. From a sample of 14 randomized controlled trials (RCT) published between January 1990 and June 2003 we analysed the methods of sampling, recruitment, and comparability of groups; defined the components of a complex intervention; identified outcome measures based on the International Classification of Functioning, Disability and Health (ICF); analysed the clinical interpretation of score changes; and analysed trial reporting using a modified 33-item CONSORT (Consolidated Standards of Reporting Trials) checklist. The effectiveness of physiotherapy and physiotherapy-related interventions in children with diagnosed CP was evaluated in a systematic review of randomised controlled trials that were searched from computerized databases from January 1990 up to February 2007. Two reviewers independently assessed the methodological quality, extracted the data, classified the outcomes using the ICF, and considered the level of evidence according to van Tulder et al. (2003). Results: We identified 21 reviews on physiotherapy and physiotherapy-related interventions and five on orthotic devices. These reviews summarized 23 or 5 randomised controlled trials and 104 or 27 observational studies, respectively. Only six reviews were of high quality. These found some evidence supporting strength training, constraint-induced movement therapy or hippotherapy, and insufficient evidence on comprehensive interventions. Based on the original studies included in the reviews on orthotic devices we found some short-term effects of lower limb casting on passive range of movement, and of ankle-foot orthoses on equinus walk. Long term effects of lower limb orthoses have not been studied. Evidence of upper limb casting or orthoses is conflicting. In the sample of 14 RCTs, most trials used simple randomisation, complemented with matching or stratification, but only three specified the concealed allocation. Numerous studies provided sufficient details on the components of a complex intervention, but the overlap of outcome measures across studies was poor and the clinical interpretation of observed score changes was mostly missing. Almost half (48%) of the applicable CONSORT-based items (range 28 32) were reported adequately. Most reporting inadequacies were in outcome measures, sample size determination, details of the sequence generation, allocation concealment and implementation of the randomization, success of assessor blinding, recruitment and follow-up dates, intention-to-treat analysis, precision of the effect size, co-interventions, and adverse events. The systematic review identified 22 trials on eight intervention categories. Four trials were of high quality. Moderate evidence of effectiveness was established for upper extremity treatments on attained goals, active supination and developmental status, and of constraint-induced therapy on the amount and quality of hand use and new emerging behaviours. Moderate evidence of ineffectiveness was found for strength training's effect on walking speed and stride length. Conflicting evidence was found for strength training's effect on gross motor function. For the other intervention categories the evidence was limited due to the low methodological quality and the statistically insignificant results of the studies. Conclusions: The high-quality reviews provide both supportive and insufficient evidence on some physiotherapy interventions. The poor quality of most reviews calls for caution, although most reviews drew no conclusions on effectiveness due to the poor quality of the primary studies. A considerable number of RCTs of good to fair methodological and reporting quality indicate that informative and well-reported RCTs on complex interventions in children and adolescents with CP are feasible. Nevertheless, methodological improvement is needed in certain areas of the trial design and performance, and the trial authors are encouraged to follow the CONSORT criteria. Based on RCTs we established moderate evidence for some effectiveness of upper extremity training. Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most physiotherapy interventions is available to guide clinical practice. Well-designed trials are needed, especially for focused physiotherapy interventions.

Preparing pharmacists to vaccinate in Australia’s first Pharmacist Immunisation Pilot

Background: In November 2013, the Queensland Department of Health announced its intention to pilot pharmacist vaccination for influenza in the 2014 flu season. The Pharmaceutical Society of Australia Queensland Branch was tasked with developing a training program for the pilot. Aim: The aim was to develop, implement and evaluate a training program for pharmacist vaccination relevant to the needs of Australian pharmacists. Method: Background content was delivered via two online modules, while training for practical injection skills and anaphylaxis management were provided in a face-to-face workshop. Participants were required to complete the Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-training for pharmacists, and hold a current First-Aid and CPR certificate. On completion of the course, pharmacists were asked to evaluate the training program. Results: Overall, 157 pharmacists across Queensland completed the training. Participants rated the training highly on a 5-point Likert scale (>4.4 for all fields) for relevance to practice, comfort with the skill, confidence to do the task and relevance of the learning objectives to the training. Qualitative feedback indicated that a key component of the training was the ability to practice injections on each other. Conclusion: The findings demonstrate participants felt prepared for vaccination following completion of the training program, as reflected in the high level of confidence reported. A follow-up post-pilot will explore if this confidence was translated into practice during the implementation phase.

Helicobacter pylori in Vammala, Finland: seroepidemiological studies and a population-based ‘screen-and-treat’ programme

Helicobacter pylorin (helikobakteeri) tartunta saadaan yleensä lapsena ja tauti jää tavallisesti pysyväksi ilman täsmähoitoa. Onnistunut hoito parantaa pysyvästi helikobakteerista aiheutuvan mahan haavataudin ja näyttää ehkäisevän mahalaukun pahanlaatuisten muutosten kehittymistä. Aloitimme Vammalassa terveyskeskuksessa toteutetun kansainvälisesti ainutlaatuisen väestöpohjaisen helikobakteeritulehduksen seulonta- ja hoito-ohjelman pilottitutkimuksella 1994. 1996 kaikki 15-40-vuotiaat ja 1997-2000 15- ja 45-vuotiaat vammalalaiset kutsuttiin verinäyteseulontaan. Yhteensä 4626 henkilöä (75% kutsutuista) osallistui seulontaan. Vasta-ainepositiivisille tarjottiin helikobakteeritulehduksen lopettava lääkekuuri. Toiminnan seurauksena helikobakteeritulehduksen esiintyvyyden laskettiin vähentyneen 12%:sta 4%:iin 15-40-vuotiaiden ikäryhmässä. Tutkimme myös helikobakteerivasta-ainepositiivisten ja -negatiivisten eroja sekä helikobakteeritulehduksen riskitekijöitä kyselytutkimuksella. Lapsuudenkodin asumisahtauden, äidin matalan koulutusasteen, tupakoinnin, alkoholinkäytön, huonojen asunto-olojen ja ylävatsavaivoista johtuvien sairauslomien todettiin liittyvän helikobakteeritulehdukseen monimuuttuja-analyysissa. Tutkimme seulontaohjelmassa käyttämiemme IgG- ja IgA-luokan helikobakteeri-vasta-ainetestien luotettavuutta eri ikäryhmissä ottaen huomioon atrofisen gastriitin esiintyvyyden. 561 kliinisin perustein gastroskopoidun potilaan aineistossa IgG-testi osoittautui erittäin herkäksi kaikissa ikäryhmissä (99%). Tarkkuus oli myös vanhemmissa ikäryhmissä hyvä (97-93%), kun atrofista gastriittia sairastavat suljettiin pois. IgA- ja CagA-helikobakteerivasta-aineiden on todettu liittyvän lisääntyneeseen mahahaava- ja mahasyöpäriskiin. Analysoimme 560 henkilön pariseeruminäytteet, jotka oli otettu kahden vuosikymmenen välein, ja totesimme, että IgA-vasta-aineiden esiintyvyyden lisääntyyminen iän myötä johtuu paitsi syntymäajankohdasta ja uusista infektioista myös IgA-vasta-ainetasojen kohoamisesta helikobakteeritulehduksen aikana. Selvitimme myös CagA-vasta-ainetasojen muuttumista analysoimalla seeruminäytteet, jotka oli otettu kahden vuosikymmenen välein. Totesimme, että samanaikaisesti kun helikobakteerin esiintyvyys väestössä on alentunut, erityisesti CagA-positiiviset infektiot ovat vähentyneet. Tutkimuksemme osoittaa, että Suomessa terveyskeskuksen yhteydessä voidaan toteuttaa näin laajamittainen seulonta- ja hoito-ohjelma, johon suomalaiset osallistuvat aktiivisesti. Nähtäväksi jää, kuinka paljon ohjelma kykeni vähentämään helikobakteeritulehdukseen liittyviä myöhäisseuraamuksia.