The effects of the 2004 reduction in the price of alcohol on alcohol-related harm in Finland : A natural experiment based on register data

Changes in alcohol pricing have been documented as inversely associated with changes in consumption and alcohol-related problems. Evidence of the association between price changes and health problems is nevertheless patchy and is based to a large extent on cross-sectional state-level data, or time series of such cross-sectional analyses. Natural experimental studies have been called for. There was a substantial reduction in the price of alcohol in Finland in 2004 due to a reduction in alcohol taxes of one third, on average, and the abolition of duty-free allowances for travellers from the EU. These changes in the Finnish alcohol policy could be considered a natural experiment, which offered a good opportunity to study what happens with regard to alcohol-related problems when prices go down. The present study investigated the effects of this reduction in alcohol prices on (1) alcohol-related and all-cause mortality, and mortality due to cardiovascular diseases, (2) alcohol-related morbidity in terms of hospitalisation, (3) socioeconomic differentials in alcohol-related mortality, and (4) small-area differences in interpersonal violence in the Helsinki Metropolitan area. Differential trends in alcohol-related mortality prior to the price reduction were also analysed. A variety of population-based register data was used in the study. Time-series intervention analysis modelling was applied to monthly aggregations of deaths and hospitalisation for the period 1996-2006. These and other mortality analyses were carried out for men and women aged 15 years and over. Socioeconomic differentials in alcohol-related mortality were assessed on a before/after basis, mortality being followed up in 2001-2003 (before the price reduction) and 2004-2005 (after). Alcohol-related mortality was defined in all the studies on mortality on the basis of information on both underlying and contributory causes of death. Hospitalisation related to alcohol meant that there was a reference to alcohol in the primary diagnosis. Data on interpersonal violence was gathered from 86 administrative small-areas in the Helsinki Metropolitan area and was also assessed on a before/after basis followed up in 2002-2003 and 2004-2005. The statistical methods employed to analyse these data sets included time-series analysis, and Poisson and linear regression. The results of the study indicate that alcohol-related deaths increased substantially among men aged 40-69 years and among women aged 50-69 after the price reduction when trends and seasonal variation were taken into account. The increase was mainly attributable to chronic causes, particularly liver diseases. Mortality due to cardiovascular diseases and all-cause mortality, on the other hand, decreased considerably among the-over-69-year-olds. The increase in alcohol-related mortality in absolute terms among the 30-59-year-olds was largest among the unemployed and early-age pensioners, and those with a low level of education, social class or income. The relative differences in change between the education and social class subgroups were small. The employed and those under the age of 35 did not suffer from increased alcohol-related mortality in the two years following the price reduction. The gap between the age and education groups, which was substantial in the 1980s, thus further broadened. With regard to alcohol-related hospitalisation, there was an increase in both chronic and acute causes among men under the age of 70, and among women in the 50-69-year age group when trends and seasonal variation were taken into account. Alcohol dependence and other alcohol-related mental and behavioural disorders were the largest category in both the total number of chronic hospitalisation and in the increase. There was no increase in the rate of interpersonal violence in the Helsinki Metropolitan area, and even a decrease in domestic violence. There was a significant relationship between the measures of social disadvantage on the area level and interpersonal violence, although the differences in the effects of the price reduction between the different areas were small. The findings of the present study suggest that that a reduction in alcohol prices may lead to a substantial increase in alcohol-related mortality and morbidity. However, large population group differences were observed regarding responsiveness to the price changes. In particular, the less privileged, such as the unemployed, were most sensitive. In contrast, at least in the Finnish context, the younger generations and the employed do not appear to be adversely affected, and those in the older age groups may even benefit from cheaper alcohol in terms of decreased rates of CVD mortality. The results also suggest that reductions in alcohol prices do not necessarily affect interpersonal violence. The population group differences in the effects of the price changes on alcohol-related harm should be acknowledged, and therefore the policy actions should focus on the population subgroups that are primarily responsive to the price reduction.

Homeowners' Associations in Russia after the 2005 Housing Reform

The thesis examines homeowners associations as a part of the large-scale housing reform, implemented in Russia since 2005. The reform transferred housing management from the public sector to the private sector and to the citizens responsibility. The reform is a continuation to the privatisation of the housing stock that was started in Russia in the beginning of the 1990s, aiming to build a market-oriented housing sector in the country. The reform makes a fundamental change to the Soviet system, in which ownership along with management and maintenance of housing were monopolised by the state. Homeowners are now responsible for the management of the common areas in privatised houses, which is often realised by establishing a homeowners association. Homeowners associations are examined by using the so-called common-pool resource regime approach, with the main question being the ways in which taking care of common property collectively succeeds in practice. The study is based on interview data of St. Petersburg s homeowners associations. Using the common-pool resource theory the study demonstrates why implementation of the housing reform has not succeeded as expected. Certain elements that characterise a successful common-pool resource regime do not fulfill sufficiently in St. Petersburg s homeowners associations. Firstly, free-riding, that is, withdrawal from the association s joint decision-making and not making the housing payments is common, as effective sanctions to prevent it are missing in the legislation. That is, eviction or expelling a non-paying member from the association is not possible. Secondly, ownership of the land plot and common areas of the house, such as basements and attics, are often disputed between the associations and authorities. In the Soviet era, these common areas were public property along with the apartments, but in privatised houses they should, according to the legislation, belong to the associations property. Thirdly, solution of disputes between the associations and authorities and within the associations is difficult, as the court system tends to be bureaucratic and inefficient. In addition to the common-pool resource approach, the study also examines how social capital contributes to the associations effectiveness and democratic governance. The study finds that although homeowners associations have increased cooperation and tightened social relations between neighbours, social capital has not been able to prevent free-riding. The study shows that unlike it is often claimed, the so-called Soviet mentality , that is, residents passiveness and unwillingness to participate, is not the most important obstacle to the reform. Instead, the reform is impeded most of all by imperfect institutional arrangements and local authorities that prevent the associations from working as independent, self-governing associations.

Opetussuunnitelmat puntarissa : Varhaiskasvatussuunnitelman perusteet 2005 ja Esiopetuksen opetussuunnitelman perusteet 2000 kasvatusnäkemyksen ja -ideologian näkökulmasta

The present study compares educational views and ideologies, especially concerning children, childhood and learning, found within two documents guiding early childhood education in Finland, Varhaiskasvatussuunnitelman perusteet 2005 and Esiopetuksen opetussuunnitelman perusteet 2000. These documents are also available in English, titled The National Curriculum Guidelines on Early Childhood Education and Care in Finland 2000 and The Core Curriculum for Pre-school Education in Finland 2005. The method used in the study was a slightly applied Bereday´s comparative method. Both documents talk of the child as weak but also as active and able to learn and develop. The child was also social, emotional and individual in both documents. In Varhaiskasvatussuunnitelman perusteet 2005 parents and social networks were emphasised more than in Esiopetuksen opetussuunnitelman perusteet 2000. Views regarding learning were mainly constructive. The aim of Esiopetuksen opetussuunnitelman perusteet 2000 seemed to be in preparing children to adulthood, whereas in Varhaiskasvatussuunnitelman perusteet 2005 the childhood had an intrinsic value. Applying Davies division, both documents were found to represent mainly romantic ideology, but conservative ideology could also be recognised, especially when the views about children and childhood were under examination. Revisionistic ideology was more apparent in Esiopetuksen opetussuunnitelman perusteet 2000 than in Varhaiskasvatussuunnitelman perusteet 2005, while democratic ideology was more dominant in the latter. Although there was a strong cohesion between these two guiding documents regarding educational views and educational ideologies, there were some traces to be found in Esiopetuksen opetussuunnitelman perusteet 2000 that pointed towards primary school tradition.

Druvan - Den personalekonomiska nyttan av mångdimensionell företagshälsovårds- och personalutvecklingsverksamhet baserad på Metal Age-konceptet i Dragsfjärds kommun (2002-2005)

Under åren 2002-2005 förverkligades Druvan-projektet i Dragsfjärds kommun, vilket innebar en dramatisk ökning av företagshälsovårdsinsatserna. Företagshälsovårdsutgifterna ökade från 20 € per anställd till över 400 €. Den totala satsningen på personalens hälsa ökade ännu mer. Innehållet i Druvan baserade sig på den s.k. Metal Age-metoden. Metoden går ut på att arbetsgemenskapen tillsammans identifierar utvecklingsbehov och –åtgärder. Projektet ledde till en stor mängd utvecklingsåtgärder och därpå följande effekter på personalens hälsa, trivsel och samarbete. Som en del av åtgärderna utarbetade kommunen en personalrapport för de aktuella åren. Under projekttiden utvecklades personalens arbetsförmåga betydligt gynnsammare än förväntat. Den ekonomiska analysen visade att det investerade kapitalet gav en avkastning på 46%. Nyttan uppkom som resultat av minskad sjukfrånvaro och färre förtidspensioneringar. Druvan-projektet stöder de tidigare bedömningarna, enligt vilka det finns ett klart utrymme för att öka satsningarna på företagshälsovård i vårt land. Detta gäller speciellt arbetsplatser vars satsningar på företagshälsovård är betydligt under genomsnittet. Dragsfjärds kommun har beslutat göra Druvan till en bestående struktur inom kommunen. Guy Ahonen är professor i Knowledge Management, speciellt personalekonomi vid institutionen för företagsledning och organisation vid Hanken. Ove Näsman är ledande företagsläkare vid Dalmed OyAb i Dalsbruk i sydvästra Finland. Båda har forskat i årtionden kring effekterna av ökat välbefinnande i arbetet.

Publishing in the Networked World: Transforming the Nature of Communication, 14th International Conference on Electronic Publishing 16-18 June 2010, Helsinki, Finland

The title of the 14th International Conference on Electronic Publishing (ELPUB), “Publishing in the networked world: Transforming the nature of communication”, is a timely one. Scholarly communication and scientific publishing has recently been undergoing subtle changes. Published papers are no longer fixed physical objects, as they once were. The “convergence” of information, communication, publishing and web technologies along with the emergence of Web 2.0 and social networks has completely transformed scholarly communication and scientific papers turned to living and changing entities in the online world. The themes (electronic publishing and social networks; scholarly publishing models; and technological convergence) selected for the conference are meant to address the issues involved in this transformation process. We are pleased to present the proceedings book with more than 30 papers and short communications addressing these issues. What you hold in your hands is a by-product and the culmination of almost a Year long work of many people including conference organizers, authors, reviewers, editors and print and online publishers. The ELPUB 2010 conference was organized and hosted by the Hanken School of Economics in Helsinki, Finland. Professors Turid Hedlund of Hanken School of Economics and Yaşar Tonta of Hacettepe University Department of Information Management (Ankara, Turkey) served as General Chair and Program Chair, respectively. We received more than 50 submissions from several countries. All submissions were peer-reviewed by members of an international Program Committee whose contributions proved most valuable and appreciated. The 14th ELPUB conference carries on the tradition of previous conferences held in the United Kingdom (1997 and 2001), Hungary (1998), Sweden (1999), Russia (2000), the Czech Republic (2002), Portugal (2003), Brazil (2004), Belgium (2005), Bulgaria (2006), Austria (2007), Canada (2008) and Italy (2009). The ELPUB Digital Library, http://elpub.scix.net serves as archive for the papers presented at the ELPUB conferences through the years. The 15th ELPUB conference will be organized by the Department of Information Management of Hacettepe University and will take place in Ankara, Turkey, from 14-16 June 2011. (Details can be found at the ELPUB web site as the conference date nears by.) We thank Marcus Sandberg and Hannu Sääskilahti for copyediting, Library Director Tua Hindersson – Söderholm for accepting to publish the online as well as the print version of the proceedings. Thanks also to Patrik Welling for maintaining the conference web site and Tanja Dahlgren for administrative support. We warmly acknowledge the support in organizing the conference to colleagues at Hanken School of Economics and our sponsors.

Verkostot väylänä työelämään

Tutkimuksessa selvitetään Helsingin yliopiston valtiotieteellisestä tiedekunnasta valmistuneiden siirtymistä työelämään. Tarkoituksena on avata siirtymään liittyvää problematiikkaa ja tutkia työelämässä esiintyviä sosiaalisia verkostoja. Tutkimusta varten haastateltiin yhdeksää henkilöä, jotka olivat valmistuneet noin viisi vuotta aikaisemmin valtiotieteiden maistereiksi. Haastatteluissa kartoitettiin heidän kokemuksiaan työelämään siirtymisestä. Haastatteluiden lisäksi aineistona toimii haastateltavien työhistorioista muodostetut työjanat ja taustatiedot. Tutkimusmenetelmänä on käytetty kvalitatiivista sisällönanalyysiä. Laadullinen aineisto antaa uudenlaisen lähestymistavan työelämään siirtymisen tutkimiseen. Tutkimuksen lähtökohdat rakentuvat korkeakoulutettujen työelämään siirtymistä käsitelleiden tutkimusten, työelämän tutkimuksen ja verkostoanalyysin varaan. Tutkimustulokset muodostuvat kolmesta analyysiluvusta, joissa käsitellään opiskeluaikaa ja yliopistokoulutusta, valtiotieteilijöiden kohtaamaa muuttuvaa työelämää sekä verkostoitunutta työelämää. Tulosten mukaan osa haastateltavista oli opiskeluaikanaan huolestunut työllistymisestään, mutta toisen osan haastateltavista huomattiin suhtautuvan siirtymään ’töiden shoppailuna’. ’Töiden shoppailussa’ työmarkkinoilla toimitaan kuluttajina ja etsitään sopivaa työpaikkaa omien mieltymysten mukaan (Johnson 1978; Hämäläinen 2002). Toiseksi vastavalmistuneet valtiotieteiden maisterit haluavat tutkimuksen mukaan jatkuvasti kouluttautua uudelleen ja kehittyä työelämässä (ks. Julkunen 2008a; Julkunen 2008b; Sennett 2002). Haastattelupuheessa tasapainoilee pelko jämähtämisestä ja määräaikaisista työsuhteista. Aineistosta löytyi kolme erilaista työjanaa, professionaalinen, intressikohtainen ja generalistinen, joiden kautta on mahdollista ymmärtää valtiotieteilijöiden erilaisia urapolkuja. Kolmanneksi tutkimus kartoittaa, miten sosiaalisia verkostoja hyödynnetään siirtymässä koulutuksesta työelämään (ks. Jokisaari & Nurmi 2004). Kaikki haastateltavista olivat saaneet useamman kuin yhden työpaikan sosiaalisten verkostjensa kautta. Sosiaaliset verkostot toimivat työnhakukanavana, koska niiden sisällä liikkuu tietoa. Toisin sanoen voidaan puhua sosiaalisten verkostojen tuomista informaatiohyödyistä (Lin 2001), jotka ilmenevät heikkoina siteinä (Granovetter 1983; 1995) ja rakenteellisina aukkoina (Burt 2001). Tutkimuksessa esiintyvät työllistymiseen vaikuttaneet sosiaaliset suhteet perustuvat suurimmalta osin sosiaalisen pääoman (Bourdieu 2007 [1986]) kautta syntyneeseen luottamukseen (Coleman 1988; Mäkelä & Ruokonen 2005). Tutkimustulosten mukaan päämäärätietoiseen verkostoitumiseen suhtaudutaan varauksella, mutta ystäville tietoja avoimista työmahdollisuuksista välitetään mielellään. Erottelu syntyy kilpailusuhteiden ja ystävyyssuhteiden välille, joissa sosiaalista pääomaa käytetään eri tavoilla (ks. Johanson & Uusikylä 2005). Tutkimuksen mukaan valtiotieteiden maisterit työllistyvät sellaisten sosiaalisten verkostojen kautta, joissa liikkuu tietoa ja joihin liittyy luottamus.

Kohti yksilöllistyvää perhettä? Perhe, sukupuoli ja seksuaalisuus suomalaisessa lainsäädäntökeskustelussa 2000-luvulla

Tutkielmassa tarkastellaan suomalaisessa yhteiskunnassa esiintyviä käsityksiä perheestä, keskittyen erityisesti siihen miten perheen, sukupuolen ja seksuaalisuuden käsitteitä määriteltiin ja tuotettiin diskursiivisesti eduskunnan lainsäädäntökeskusteluissa 2000-luvun kuluessa. Tutkimusongelmaa lähestytään eduskunnassa vuonna 2000 ja 2001 käytyjen parisuhdelaki- ja vuonna 2005 käytyjen hedelmöityshoitolakikeskustelujen sekä vuonna 2009 parisuhdelain 9§:n muutoksesta käytyjen keskusteluiden kautta. Keskusteluja analysoidaan diskurssianalyysin avulla siitä lähtökohdasta käsin, että eduskunnassa käytyjen keskustelujen kautta osallistutaan yhteiskunnallisen todellisuuden rakentamiseen ja määrittelyyn. Eduskunnassa käydyillä keskusteluilla ja itse lainsäädännöllä voidaankin näin ollen katsoa olevan huomattavia ideologisia vaikutuksia yhteiskunnalle, liittyen esimerkiksi erilaisten perhemallien arvostukseen, sukupuolten väliseen tasa-arvoon ja seksuaalivähemmistöjen oikeuksiin. Tutkimuksen perusteella voidaan lakiesitysten vastustajien ja puolustajien puheiden nähdä muodostavan varsin johdonmukaiset ja yhtenäiset, toisilleen vastakkaiset diskursiiviset kokonaisuudet. Puheesta löydettyjen diskurssien perusteella tutkielmassa on erotettu toisistaan konservatiivis-normatiiviseksi ja liberaalis-individualistiseksi nimitetyt diskursiiviset kokonaisuudet. Konservatiivis-normatiivisen diskursiivisen kokonaisuuden kautta ainoastaan heteroseksuaaliseen avioliittoon pohjaava ydinperhe nähtiin oikeana ja hyväksyttävänä perheenä. Tällaista perhettä pidettiin luonnollisena ja ehdottomana. Sen nähtiin perustuvan ulkopuoliseen kontrolliin sekä perinteestä johdettuihin sääntöihin ja varmuuksiin. Sukupuoli ymmärrettiin olemukselliseksi ja biologiaan perustuvaksi tilaksi. Sukupuoli jaettiin lisäksi puheessa kahtia ja sukupuolet nähtiin merkittävällä tavalla toisistaan eroaviksi. Lisäksi puheessa ylläpidettiin heteronormia erottamalla normaali ja luonnollinen heteroseksuaalisuus epänormaalista, epäluonnollisesta ja epäterveestä homoseksuaalisuudesta. Liberaalis-individualistisessa diskursiivisessa kokonaisuudessa perhemuodot nähtiin sitä vastoin moninaisina ja erilaiset perhemallit yhtä hyväksyttävinä ja tuettavina. Perheen katsottiin pohjaavan vapaaehtoisuuteen sekä yksilöiden väliseen tunnesiteeseen ja rakkauteen. Sukupuolia ei määritelty toisistaan eroaviksi eikä sukupuolta pidetty merkityksellisenä perheen tai vanhemmuuden käsitteiden kannalta. Sukupuoli nähtiin biologian sijaan sosiaalisesti ja performatiivisesti tuotetuksi. Puheessa pyrittiin lisäksi purkamaan heteronormia korostamalla hetero- ja homoseksuaalisuuden yhdenvertaisuutta ja samanlaisuutta. Lakiesityksen vastustajien näkemysten ja käsitysten voidaankin nähdä edustavan yhteiskunnan perinteisiksi miellettyjä, jo kauan vallalla olleita arvoja ja näkökulmia. Puolustajien puhe taas heijastaa uusia arvoja ja näkemyksiä, jotka mahdollisesti ovat valtaamassa paikkaansa vanhemmilta näkemyksiltä suomalaisessa yhteiskunnassa.

Peritoneal dialysis and neurological outcome in infants and small children

Although improved outcomes for children on peritoneal dialysis (PD) have been seen in recent years, the youngest patients continue to demonstrate inferior growth, more frequent infections, more neurological sequelae, and higher mortality compared to older children. Also, maintain-ing normal intravascular volume status, especially in anuric patients, has proven difficult. This study was designed to treat and monitor these youngest PD patients, which are relatively many due to the high prevalence of congenital nephrotic syndrome of the Finnish type (CNF, NPHS1) in Finland, with a strict protocol, to evaluate the results and to improve metabolic balance, growth, and development. A retrospective analysis of 23 children under two years of age at onset of PD, treated between 1995 and 2000, was performed to obtain a control population for our prospective PD study. Respectively, 21 patients less than two years of age at the beginning of PD were enrolled in prospective studies between 2001 and 2005. Medication for uremia and nutrition were care-fully adjusted during PD. Laboratory parameters and intravascular volume status were regu-larly analyzed. Growth was analyzed and compared with midparental height. In a prospective neurological study, the risk factors for development and the neurological development was determined. Brain images were surveyed. Hearing was tested. In a retrospective neurological study, the data of six NPHS1 patients with a congruent neurological syndrome was analyzed. All these patients had a serious dyskinetic cerebral palsy-like syndrome with muscular dysto-nia and athetosis (MDA). They also had a hearing defect. Metabolic control was mainly good in both PD patient groups. Hospitalization time shortened clearly. The peritonitis rate diminished. Hypertension was a common problem. Left ventricular hypertrophy decreased during the prospective study period. None of the patients in either PD group had pulmonary edema or dialysis-related seizures. Growth was good and catch-up growth was documented in most patients in both patient groups during PD. Mortality was low (5% in prospective and 9% in retrospective PD patients). In the prospective PD patient group 11 patients (52%) had some risk factor for their neuro-development originating from the predialysis period. The neurological problems, detected be-fore PD, did not worsen during PD and none of the patients developed new neurological com-plications during PD. Brain infarcts were detected in four (19%) and other ischemic lesions in three patients (14%). At the end of this study, 29% of the prospectively followed patients had a major impairment of their neurodevelopment and 43% only minor impairment. In the NPHS1+MDA patients, no clear explanation for the neurological syndrome was found. The brain MRI showed increased signal intensity in the globus pallidus area. Kernic-terus was contemplated to be causative in the hypoproteinemic newborns but it could not be proven. Mortality was as high as 67%. Our results for young PD patients were promising. Metabolic control was acceptable and growth was good. However, the children were significantly smaller when compared to their midparental height. Although many patients were found to have neurological impairment at the end of our follow-up period, PD was a safe treatment whereby the neurodevelopment did not worsen during PD.

Esteettinen kokemus kulttuurisiltana : Soile Yli-Mäyryn taide kiinalaisen, japanilaisen ja suomalaisen yleisön kokemana

AESTHETIC EXPERIENCE AS A BRIDGE ACROSS CULTURES Soile Yli-Mäyry s art as experienced by Chinese, Japanese and Finnish audiences This study focuses on surveying and analysing experiences of Soile Yli-Mäyry s art in eleven different countries. Questionnaires were translated into nine different languages. In addition, interviews were conducted on the experiences of Chinese, Japanese and Finnish art audiences concerning a painting called Sun Wind . The study was mainly inspired by John Dewey s ideas of art as an interactive communication where the artist, the piece and those who experience it make up an interactive process. In this process experience is a meeting point with both individual and communal characteristics. The data was collected in conjunction with exhibitions in 1997−2005. The survey was carried out in eleven countries (Finland, United States, Brazil, China, Taiwan, Japan, India, Israel, Argentina, Germany and Switzerland). The survey data was made up of 2,563 returned questionnaires. The interviews in China, Japan and Finland were about the same painting Sun Wind , which was transported from Finland to Japan (Tokyo) and China. A total of 89 people were interviewed in Shanghai Art Museum, 30 people in Port-Ginza Gallery, Tokyo and 45 people in Soile Yli-Mäyry s Gallery in Finland. Three hypotheses that were turned into research questions directed the study: 1. Are there differences/ similarities between culturally different communities in the meanings attributed to experiences, e.g. according to emotional dimensions, or do experiences focus more on reflecting on one s own life or meanings attributed to the world around us? What kinds of experiential dimensions are there in different countries? Do similar, analogous experiences that transcend cultural barriers emerge in culturally different countries such as China, Japan and Finland? 2. Does the data display different types of experiencing subjects which are typical to a subject s own country or are they experiences that can be compared to those generated by an ideal landscape , where the art touches the subconscious and collective selfhood, being thus transnational and timeless? Closer analysis focuses on audience experiences in China, Japan and Finland (interviews, textual survey data). 3. Are the experiences and interpretations of experts similar/different to those of larger audiences? The survey data has been analysed with the help of cross-tabulation. After content analysis of the interviews and textual survey data, different ways of experiencing subjects were sketched by country (China, Japan, Finland). The types were both similar and dissimilar. The most important types were social/ecological (China), therapeutic/reserved (Japan) and narrative/projecting (Finland). There were differences in how experiences were emphasised: the Chinese public approached their experiences from the viewpoint of pragmatism and utility, where they could obtain new ideas for their own work or experiencing the exhibition gave courage to approach their own lives from a new perspective. In turn, the Japanese public experienced the art from a therapeutic angle and from a very reserved perspective, which Dylan Evans (2001, 13−17) has described as typical to Japanese culture. The experiences of the Finnish audience were strongly therapeutic and narrative. The people projected their emotions onto the piece and in a concrete manner forged them into a story. The partly similar results of this study in China, Japan and Finland demonstrate that the art displayed in the exhibitions contain images of the beginning or elements connected to the beginning of life, which touch the subconscious in the way an ideal landscape would. Experiencing the meaningfulness of one s own life through art is a common thread and a bridge across cultures that unites the experiences of the audiences of this study, be they Taoists, Confucians, Buddhists or Maoists in China, Shinto followers, Zen Buddhists in Japan or Evangelist-Lutherans in Finland. Keywords: experience, reception, bridge across cultures, types of experiencing subjects, experiential process, ideal landscape, elementality

Idén om en karriär - ett kulturellt manuskript för skapandet av det postmoderna självet:

Bakgrunden till denna undersökning utgörs av arbetslivets förändring och dess konsekvenser för konstrueringen av självidentiteten; hur avväger unga konsulter i början av sin karriär mellan olika diskurser för att skapa en förhandlad självidentitet som styrs av idén om en karriär och såvida är hållbar även i ett långtidsperspektiv? Undersökningen tar avstamp i de sociologiska diskussionerna om informationssamhällets framväxt och dess inverkan på arbetets karaktär. Undersökningen utgår från begreppet kunskapsarbete (Alvesson 2001; Blom, Melin & Pyöriä 2001) eftersom konsultyrket kan anses representera denna typ av arbete. Ett genomgående tema är flexibiliteten och det höga tempot som å ena sidan möjliggör självförverkligande men å andra sidan försvårar skapandet av en sammanhängande självidentitet (Sennett 2002). Denna problematik är viktigt att ta i beaktande då förlängandet av arbetskarriärerna och ökandet av arbetslivets attraktivitet blivit centrala mål för den finska samhällspolitiken (Julkunen & Pärnänen 2005) samtidigt som ett generationsskifte håller på att ske på den finländska arbetsmarknaden. Undersökningen utgår från idén om karriären som ett manuskript som ger upphov för identitetsförhandlingar och sammanbinder livets olika domäner till ett personligt liv inte bara i nuläget utan även i ett långtidsperspektiv. Enligt Alvesson & Willmot (2002) framkallas identitetsförhandlingar genom både samhälleliga och organisationsspecifika identitetsreglerande praktiker. Jag utgår från antagandet att självidentiteten fungerar som den sammanbindande knytpunkten mellan karriären och det övriga livet, vilket gör det intressant att koncentrera sig på de identitetsförhandlingar som informanterna utsätts för i förhållande till sitt arbete och idén om en karriär. Begreppet personligt liv ger utrymme för individuell aktivitet och personliga betydelser men behåller ändå föreställningen om individen som inbäddad och sammanbunden i och med det sociala och kulturella (Smart 2007). I bakgrunden finns teorierna om den nya form som makten antagit i organisationer (Foucault; Rose 1999; Grey 1994, Casey 1995) och förvandlat individen till en ett självstyrande subjekt som arbetar som en entreprenör (Rose 1999). Jag poängterar den subjektiva aspekten av karriären som någonting som individen själv konstruerar (Hughes 1997; Barley 1989) och uppfattar i likhet med Julkunen (2003) och Acker (1990; 2006) ålder och kön som sociala kategorier i organisationsstrukturen. Syftet med denna studie är att undersöka hur unga personer utför identitetsförhandlingar i förhållande till arbetet och idén om en karriär i nuläget, samt sammanbinder karriären, framtiden och livet över lag med sin självidentitet i ett karriärperspektiv. Jag har valt unga konsulter som forskningsobjekt, eftersom endast en liten del av den sociologiska arbetslivsforskningen intresserat sig för just unga. Konsultbranschen är ett intressant forskningsobjekt av samma orsak – denna bransch har behandlats i mycket liten skala i finländsk forskning. Det empiriska materialet består av kvalitativa intervjuer med unga, högutbildade män och kvinnor i konsultbranschen. Som analysmetod har jag använt mig av tema-analys inspirerad av diskursanalys. Genom att undersöka individers identitetsförhandlingar i ett karriärperspektiv hoppas jag kunna bidra med nya synpunkter och infallsvinklar samt bättre förståelse för det postindustriella arbetslivet som karakteriseras av kunskapsintensifiering och snabba förändringar i organisationer. Studien visar att idén om en karriär fungerar som ett medel för designandet av det postmoderna självet på samma sätt som till exempel konsumtionen av vissa varumärken. Enligt studien har den flexibla kapitalismen olika inverkan på män och kvinnors idéer om en karriär och betjänar den manliga karriären betydligt bättre än den kvinnliga, åtminstone så länge traditionella könskonstruktioner dominerar. För männen är det naturligt att totalt utesluta faderskapet från karriärkonstruktionen, vilket får dem att kapitulera inför organisationens krav. För kvinnorna är det lika naturligt att justera idén om den framtida karriären enligt möjliga barn i framtiden. Möjligheten att bejaka moderskapets krav verkar beskydda den kvinnliga självidentiteten från att totalt ge efter för organisationens försök att kontrollera subjektiviteten. De unga informanterna konstruerar sitt arbete i mycket annorlunda termer än vad som traditionellt förknippas med arbete; konsultarbetets projektbaserade karaktär konstrueras som äventyrligt, roligt, intressant och omväxlande. Eftersom avsaknad av långsiktighet och rutiner förknippas med den tid i livet då man är ung, underlättades sammanförandet av konsultarbetet med självidentiteten. Samtidigt visar studien hur svårt individen, som fungerar likt en entreprenör i förhållande till sin arbetsgivare, har att skilja mellan arbete och övrigt liv samtidigt som diskursen om balans mellan arbete och fritid dominerar i samhället. Detta ger upphov till en konstruktion av självet som en lycklig och autonom individ som är nöjd över sitt val av start på karriären och tycker om att jobba, medan de långa arbetsdagarna och kraven på ständig effektivitet och prestationer konstrueras som något naturligt. Slutligen efterlyser studien en omdefiniering av begreppet kunskapsarbete. Arbetssociologin i sin helhet har utgått från tanken om arbete som något ofrivilligt eller som tvång, medan informanterna i denna undersökning tvärtom konstruerar sitt arbete i termer som traditionellt förknippas med fritid och frivillighet . Man kan fråga sig ifall kunskapsarbetet håller på att slita sig loss från den traditionella uppfattningen om arbete och skapa en allt skarpare kontrast till det arbete som utförs i traditionell bemärkelse?

Substance misuse problems during pregnancy with special emphasis on buprenorphine

Maternal drug abuse during pregnancy endangers the future health and wellbeing of the infant and growing child. On the other hand, via maternal abstinence, these problems would never occur; so the problems would be totally preventable. Buprenorphine is widely used in opioid maintenance treatment as a substitute medication. In Finland, during 2000 s buprenorphine misuse has steadily increased. In 2009 almost one third of clientele of substance treatment units were in treatment because of buprenorphine dependence. At Helsinki Women s Clinic the first child with prenatal buprenorphine exposure was born in 2001. During 1992-2001 in the three capital area maternity hospitals (Women s clinic, Maternity hospital, Jorvi hospital) 524 women were followed at special antenatal clinics due to substance abuse problems. Three control women were drawn from birth register to each case woman and matched for parity and same place and date of the index birth. According to register data mortality rate was 38-fold higher among cases than controls within 6-15 years after index birth. Especially, the risk for violent or accidental death was increased. The women with substance misuse problems had also elevated risk for viral hepatitis and psychiatric morbidity. They were more often reimbursed for psychopharmaceuticals. Disability pensions and rehabilitation allowances were more often granted to cases than controls. In total 626 children were born from these pregnancies. According to register data 38% of these children were placed in out-of-home care as part of child protection services by the age of two years, and half of them by the age of 12 years, the median follow-up time was 5.8 years. The risk for out-of-home care was associated with factors identifiable during the pre- and perinatal period. In 2002-2005 67 pregnant women with buprenorphine dependence were followed up at the Helsinki University Hospital, Department of Obstetrics and Gynecology. Their pregnancies were uneventful. The prematurity rate was similar and there were no more major anomalies compared to the national statistics. The neonates were lighter compared to the national statistics. They were also born in good condition, with no perinatal hypoxia as defined by standard clinical parameters or certain biochemical markers in the cord blood: erythropoietin, S100 and cardiac troponin-t. Almost 80% of newborns developed neonatal abstinence syndrome (NAS) and two third of them needed morphine medication for it. Maternal smoking over ten cigarettes per day aggravated and benzodiazepine use attenuated NAS. An infant s highest urinary norbuprenorphine concentration during their first 3 days of life correlated with the duration of morphine treatment. The average length of infant s hospital stay was 25 days.

Treatment of illicit opioid and γ-hydroxybutyrate overdose by Helsinki emergency medical services

Aims: To examine the characteristics, incidence, treatment and outcome of presumed opioid, γ-hydroxybutyrate (GHB) and γ-butyrolactone (GBL) overdoses involving users of illicit drugs in Helsinki. GHB/GBL were included in this study, despite not being opioids, due to the relative ease with which they can cause potentially fatal respiratory depression. The incidence and time interval of recurrent opioid toxicity after prehospital administration of naloxone, an opioid antagonist, was studied in presumed heroin overdose patients. Naloxone has been reported to have many adverse effects and the effects of naloxone administered during an opioid overdose on the cardiovascular system and catecholamine levels in piglets were studied. Materials and methods: Patients included in these published retrospective studies were from the following time periods: Study I: 1995-2002, II: 1997-2000, III: 1995-2000, V: 2006-2007. Presumed opioid overdose patients were examined in studies I, II and III. GHB/GBL overdoses among injecting drug users was examined in study V. Recurrent opioid toxicity after prehospital naloxone administration in heroin overdose patients was examined in study III. The effects of naloxone (80 μg/kg i.v.) on the cardiovascular system and catecholamine levels administered during morphine overdose (8mg/kg i.v.) and under propofol anesthesia with spontaneous breathing were studied in eight piglets (IV). In this thesis, previously unpublished data on the incidence of opioid overdose between 2001-2007 and comparison of the characteristics of buprenorphine and heroin overdose patients encountered in 1995-2005 are also included. Results: Helsinki Emergency Medical Service (EMS) ambulances were dispatched annually to 34,153- 45,118 calls from 1995 to 2007. Of them, 7-8% were coded as intoxications or overdoses. During this time, 436 patients were treated by the EMS for presumed opioid overdose. The peak incidence of opioid overdoses was in the year 2000 (113 cases), after which they declined to 6-26 cases annually. The annual incidence of buprenorphine related overdoses increased from 4 (4% of opioid overdoses) in the year 2000 to 8 (30% of opioid overdoses) in 2007. The annual number of GHB related overdose patients treated by Helsinki EMS increased from 21 to 73 between 2004-2007. There appeared to be a peak in the incidence of both GHB/GBL and opioid related overdoses on Saturdays. Characteristics of opioid overdose patients The median age of opioid overdose patients was 28 years (22;33, 25- and 75-percentiles), and 84% were male. Buprenorphine overdose patients had more polydrug, such as alcohol and/or benzodiazepines, use in comparison with heroin overdose patients, 70% versus 33%, respectively. Severe respiratory depression was reported less often with buprenorphine overdoses compared to heroin overdoses, in 67.0% versus 85.4%, respectively. Outcome of heroin overdose patients with cardiac arrest Ninety four patients suffered cardiac arrest due to acute drug poisoning/overdose and were thus considered for resuscitation. Resuscitation was attempted in 72 cases. Cardiac arrest was caused by heroin overdose for 19 patients of which three (16%) were discharged alive. Other agents also induced cardiac arrest in 53 patients, of which six (11%) were discharged alive. The arrest was either EMS witnessed or occurring after the emergency call for all survivors of heroin induced cardiac arrest. Characteristics of GHB/GBL overdose patients The records of 100 GHB/GBL related overdose patients from 2006-2007 were retrieved. The median age of GHB/GBL overdose patients encountered on weekend nights was 24 years (22;27, 25- and 75-percentiles) and 49% were male. Polydrug use was reported in 62-80% of the cases. Thirty nine patients were encountered on Friday-Saturday or Saturday-Sunday night between 11 pm-6 am. The remaining sixty one patients were outside this time frame. There was a statistically significant difference between these two groups in history of chronic injecting drug use (33% vs. 59%, respectively, p=0.012). Recurrent heroin toxicity after prehospital naloxone administration Study III included 145 presumed heroin overdose patients. After prehospital care, 84 patients refused further care and were not transported to an Emergency Department (ED). Seventy one (85%) of them were administered naloxone by the EMS. During a 12-h follow up period, none of these patients developed severe recurrent opioid toxicity. The remaining 61 patients were transported to an ED. Prior to transportation, 52 (85%) patients were administered naloxone by the EMS. Fifteen of them were administered naloxone also in the ED and recurrent opioid toxicity was evident either on arrival at the ED or shortly thereafter. Prehospital naloxone was administered either intravenously, intramuscularly (i.m.) or subcutaneously (s.c.). There was a tendency for more frequent recurrent heroin toxicity among the patients with only intravenous administration of prehospital naloxone (13/36) compared with the patients with intramuscular or subcutaneous prehospital naloxone (2/16), p=0.106. The effects of naloxone on the cardiovascular system and catecholamine levels in piglets The administration of morphine to piglets resulted in an obvious respiratory depression, which was reversed by naloxone. Two severely hypoxemic piglets developed cardiac arrest after naloxone administration. In the other six animals, the administration of naloxone did not provoke arrhythmias, cardiac ischemia or visible evidence of pulmonary edema. There was a statistically significant (p=0.012) increase in norepinephrine levels after morphine administration and before naloxone administration: from 1.9 (1.3-2.3) ng/ml at baseline, to 31.7 (8.3-83.0) ng/ml (median, 25 and 75 percentiles parentheses) after morphine administration. After the administration of naloxone, the catecholamine levels continued to increase in only one of the animals. Conclusions: The incidence of buprenorphine related overdoses increased during the study period, but was still lower in comparison to those involving heroin. Injecting drug users have also started to use GHB/GBL. While recreational drug users use GHB/GBL during weekend nights, a GHB/GBL overdose patient encounter during weekdays has a more probable history of injecting drug use. Patients with cardiac arrest after heroin overdose have a poor prognosis. It appears to be safe to leave heroin overdose patients on scene after prehospital treatment with naloxone. Although no statistically significant difference was observed, it seems prudent to administer part of the total naloxone dose s.c. or i.m. to reduce the risk of recurrent respiratory depression. If transported to an ED, an observation period of one to two hours after the last naloxone dose seems adequate. The treating physician must be vigilant, however, due to the high prevalence of polydrug use and high morbidity after non fatal heroin overdose. Furthermore, care should be taken regarding possible chronic disorders and drug rehabilitation should be addressed. In the experimental animal study, two animals developed cardiac arrest after receiving naloxone while in hypoxemia and bradycardia. Further studies are required to assess the effect of naloxone during opioid-induced hypercapnia and hypoxemia in animals addicted to opioids.

Jean Sibelius -viulukilpailun näkyvyys, argumentointi ja viihteellisyys valtakunnallisessa lehdistössä 1965 ja 2005

Kansainvälinen Jean Sibelius -viulukilpailu on järjestetty Suomessa kymmenen kertaa vuodesta 1965 lähtien, ja se on vakiinnuttanut asemansa musiikki-instituutiona niin Suomen kulttuurielämässä kuin valtakunnallisessa mediassa. Tässä tutkimuksessa selvitetään kilpailun reseptiota, eli millaista näkyvyyttä Sibelius-viulukilpailu on saanut valtakunnallisissa viestintävälineissä vuosina 1965 ja 2005. Journalistisesta aineistosta poimitaan esiin niitä teemoja ja ilmaisun tapoja, jotka ovat korostuneet kilpailuun liittyvissä teksteissä. Tutkimuksessa pohditaan, onko toimittajien kirjoittamien tekstien argumentointi muuttunut neljänkymmenen vuoden aikana, ja kuinka internet sekä median viihteellistyminen ovat muuttaneet journalistista kilpailua eri viestinten kesken. Tutkimusongelmia lähestytään kvalitatiivisesti viestinnän oppiaineen tutkimusmenetelmiä hyödyntäen. Ensin sisällönanalyysin avulla hahmotetaan kokonaiskäsitys aineistosta, minkä jälkeen yksittäisiin teksteihin pureudutaan argumenttianalyysin keinoin. Tutkimusaineisto on rajattu valtakunnallisiin viestintävälineisiin, joita ovat suurimmat sanoma- ja aikakauslehdet, Yleisradion kilpailuaiheiset televisio- ja radio-ohjelmat sekä viulukilpailun internet-sivut. Sanomalehdissä julkaistu aineisto on laajuutensa ja monipuolisuutensa vuoksi tarkimpana analyysikohteena; muu tutkimusaineisto täydentää lehtitekstien perusteella tehtyjä havaintoja. Tutkimustulokset osoittavat, että Sibelius-viulukilpailu on ollut näkyvästi esillä valtakunnallisessa lehdistössä niin vuonna 1965 kuin 2005. Molempina vuosina kilpailun näkyvyys pohjautui hyvin vahvasti painettuun sanomalehteen. Lehdistöaineistosta erottuivat selvästi kansallisuuden, rodun ja sukupuolen käsittelyn näkökulmat, vaikka kielellinen ilmaisu onkin ajan mittaan neutraloitunut. Sisällönanalyyttinen tarkastelu ja argumenttianalyysit osoittavat, että toimittajien käyttämä argumentointi on muuttunut neljän vuosikymmenen aikana. Toimittajien työnkuva on monipuolistunut, ja viihteellisyys on vähitellen soluttautunut iltapäivälehdistä niin sanottuihin laatumedioihin . Internet on tehnyt kilpailun reaaliaikaisesta seuraamisesta entistä nopeampaa ja helpompaa.

The 26 July 2005 heavy rainfall event over Mumbai: numerical modeling aspects

The performance of the Advanced Regional Prediction System (ARPS) in simulating an extreme rainfall event is evaluated, and subsequently the physical mechanisms leading to its initiation and sustenance are explored. As a case study, the heavy precipitation event that led to 65 cm of rainfall accumulation in a span of around 6 h (1430 LT-2030 LT) over Santacruz (Mumbai, India), on 26 July, 2005, is selected. Three sets of numerical experiments have been conducted. The first set of experiments (EXP1) consisted of a four-member ensemble, and was carried out in an idealized mode with a model grid spacing of 1 km. In spite of the idealized framework, signatures of heavy rainfall were seen in two of the ensemble members. The second set (EXP2) consisted of a five-member ensemble, with a four-level one-way nested integration and grid spacing of 54, 18, 6 and 1 km. The model was able to simulate a realistic spatial structure with the 54, 18, and 6 km grids; however, with the 1 km grid, the simulations were dominated by the prescribed boundary conditions. The third and final set of experiments (EXP3) consisted of a five-member ensemble, with a four-level one-way nesting and grid spacing of 54, 18, 6, and 2 km. The Scaled Lagged Average Forecasting (SLAF) methodology was employed to construct the ensemble members. The model simulations in this case were closer to observations, as compared to EXP2. Specifically, among all experiments, the timing of maximum rainfall, the abrupt increase in rainfall intensities, which was a major feature of this event, and the rainfall intensities simulated in EXP3 (at 6 km resolution) were closest to observations. Analysis of the physical mechanisms causing the initiation and sustenance of the event reveals some interesting aspects. Deep convection was found to be initiated by mid-tropospheric convergence that extended to lower levels during the later stage. In addition, there was a high negative vertical gradient of equivalent potential temperature suggesting strong atmospheric instability prior to and during the occurrence of the event. Finally, the presence of a conducive vertical wind shear in the lower and mid-troposphere is thought to be one of the major factors influencing the longevity of the event.