Never-Never Land : affective landscapes, the touristic gaze and heterotopic space in Australia

This article explores how the imaginative use of the landscape in Baz Luhrmann’s Australia (2008) intersects with the fantasy of Australianness that the film constructs. We argue the fictional Never-Never Land through which the film’s characters travel is an, albeit problematic, ‘indigenizing’ space that can be entered imaginatively through cultural texts including poetry, literature and film, or through cultural practices including touristic pilgrimages to landmarks such as Uluru and Kakadu National Park. These actual and virtual journeys to the Never-Never have broader implications in terms of fostering a sense of belonging and legitimating white presence in the land through affect, nostalgia and the invocation of an imagined sense of solidarity and community. The heterotopic concept of the Never-Never functions to create an ahistorical, inclusive space that grounds diverse conceptions of Australianness in a shared sense of belonging and home that is as mythical, contradictory and wondrous as the idea of the Never-Never itself. The representations of this landscape and the story of the characters that traverse it self-consciously construct a relationship to past events and to film history, as well as constructing a comfortable subject position for contemporary Australians to occupy in relation to the land, the colonial past, and the present.

Möbius transforms, coincident Boolean functions and non-coincidence property of Boolean functions

Boolean functions and their Möbius transforms are involved in logical calculation, digital communications, coding theory and modern cryptography. So far, little is known about the relations of Boolean functions and their Möbius transforms. This work is composed of three parts. In the first part, we present relations between a Boolean function and its Möbius transform so as to convert the truth table/algebraic normal form (ANF) to the ANF/truth table of a function in different conditions. In the second part, we focus on the special case when a Boolean function is identical to its Möbius transform. We call such functions coincident. In the third part, we generalize the concept of coincident functions and indicate that any Boolean function has the coincidence property even it is not coincident.

Impacts of climatic factors on evolution of molecular diversity and the natural distribution of wild stocks of the giant freshwater prawn (Macrobrachium rosenbergii)

Natural distributions of most freshwater taxa are restricted geographically, a pattern that reflects dispersal limitation. Macrobrachium rosenbergii is unusual because it occurs naturally in rivers from near Pakistan in the west, across India and Bangladesh to the Malay Peninsula, and across the Sunda Shelf and Indonesian archipelago to western Java. Individuals cannot tolerate full marine conditions, so dispersal between river drainage basins must occur at limited geographical scales when ecological or climatic factors are favorable. We examined molecular diversity in wild populations of M. rosenbergii across its complete natural range to document patterns of diversity and to relate them to factors that have driven evolution of diversity in this species. We found 3 clades in the mitochondrial deoxyribonucleic acid (mtDNA) data set that corresponded geographically with eastern, central, and western sets of haplotypes that last shared a common ancestor 1 × 106 y ago. The eastern clade was closest to the common ancestor of all 3 clades and to the common ancestor with its congener, Macrobrachium spinipes, distributed east of Huxley's Line. Macrobrachium rosenbergii could have evolved in the western Indonesian archipelago and spread westward during the early to mid-Pleistocene to India and Sri Lanka. Additional groups identified in the nuclear DNA data set in the central and western clades probably indicate secondary contact via dispersal between regions and modern introductions that have mixed nuclear and mtDNA genes. Pleistocene sea-level fluctuations can explain dispersal across the Indonesian archipelago and parts of mainland southeastern Asia via changing river drainage connections in shallow seas on wide continental shelves. At the western end of the modern distribution where continental shelves are smaller, intermittent freshwater plumes from large rivers probably permitted larval dispersal across inshore areas of lowered salinity.

Review: "Measuring and evaluating sustainability : ethics in sustainability indexes" by Sarah E. Fredericks, New York, Routledge, Routledge Studies in Sustainable Development, 2014

The concept of ‘sustainability’ has been pushed to the forefront of policy-making and politics as the world wakes up to the impacts of climate change and the effects of the rapid urbanisation and modern urban lifestyles (Yigitcanlar and Teriman 2014). Climate change and fossil fuel-based energy policy have emerged as the biggest challenges for our planet, threatening both built and natural systems with long-term consequences. However, the threats are not limited to the impacts of climate change and unsustainable energy system only – e.g., impacts of rapid urbanisation, socioeconomic crises and governance hiccups are just to name a few (Yigitcanlar 2010a). Along with these challenges, successfully coping with the enormous transformations that our cities, societies and the environment have been going through during the last few decades, and their...

Investigating the interplay between transport, land use and the environment : a review of the literature

Integration of land use and transport decisions to achieve sustainable travel behavior has been considered an integral element for sustainable urban development. However, before the popularity of urban sustainability concept, land use and transport interaction had been scrutinized as strictly separate entities in the urban planning and development domains. Fortunately today the concept of sustainability has been pushed to the forefront of policy-making and politics as the world wakes up to the impacts of climate change and the effects of the rapid urbanization and modern urban lifestyles. The paper therefore aims to highlight the importance of the interplay between transport, land use and the environment. This review paper provides evidence from the literature including the Transport, Land Use and the Environment Special Issue contributions and global best practice cases to showcase new empirical approaches and investigations from different parts of the world that contribute to the wealth of knowledge in exploring the interplay between transport, land use and the environment thoroughly.

Supporting the development and deployment of sustainable energy technologies through targeted scientific training

Sustainable energy technologies rely heavily on advanced materials and modern engineering controls. These promising new technologies cannot be reliably deployed without ensuring that there is a sufficient “capacity,” i.e., trained technical personnel with the expertise to implement, monitor, and maintain the energy infrastructure. This same capacity is critical to the local development of new technologies, especially those that respond directly to regional priorities, strengths, and needs. One way to build capacity is through targeted programs that integrate the training and development of locals at an advanced technical level. In practical terms, these programs usually produce a small number of highly educated individuals with skills in science and engineering. The goal of Part VI of this book is to highlight contributing factors in successfully operating capacity building programs.

Arkeen pudonnut sibylla : Modernin naisen identiteetin rakentuminen Marja-Liisa Vartion romaanissa Kaikki naiset näkevät unia

A Sibyl fallen into everyday life. The enfolding of the identity of modern woman in Marja- Liisa Vartio s novel Kaikki naiset näkevät unia ( All Women Have Dreams ). --- Marja-Liisa Vartio played a remarkable part in renewing Finnish literature. My thesis examines her novel Kaikki naiset näkevät unia (1960), which describes the life of a middle-aged housewife, Mrs. Pyy ( Mrs. Hazel Hen ). She has moved from country to city and lives now in a suburb, in the Helsinki of the 1950 s. In Finnish literature, the novel is the first significant description of a modern city woman accomplished by modernistic means. My research examines the identity of a woman in the Finland of the 50 s, an epoch marked by the inevitable transition into modernity. My aim is to look into the ways in which the female identity enfolds in Kaikki naiset näkevät unia, how it takes its form, how it is described and commented. The primary method is contextual close reading; the novel is seen in the social, cultural and historical context of the time it was published. Essential elements in this study are literary motifs and images in the novel, and particularly transtextual relations as defined by Gérald Genette. The focus is on hypertextuality, intertextuality and paratextuality. Kaikki naiset näkevät unia emerges as a modern version of Madame Bovary by Gustave Flaubert. A woman s life spent in illusive dreaming is transferred from a 1900th century bourgeois town in France to a middle class Finnish suburb in the 1950 s. Vartio s novel is a variant of an ancient Finnish ballad I, a bird without a nest , making it into a modern narration of transition. The inner, mental journey from country to city is of great length, and the liminal life in a suburb does not make the passage any easier. Like the lyrical voices in the poetry of Edith Södergran, also Mrs. Pyy finds it hard to discover any values of sisterhood or those of ideal femininity in modern times. In earlier studies of Marja-Liisa Vartio s prose, stress has been laid on the discourse of her narrators and characters, as well as on its modern literary form. In this research, however, urgent allusions to paintings, old and new, are taken into account, since Mrs. Pyy mirrors herself against art, both classical and modern. Principal images in this context are Michelangelo s Sibyls in the ceiling of the Sistine Chapel, and a modern painting, which remains unidentified. Mrs. Pyy turns out to be a tragicomic character, who has magnanimous illusions about herself, but is compelled to accept the fact the she is only a mediocre person. She is nothing more than a first generation city dweller; she is not a modern, aloof outsider but a mere dilettante, who desperately tries to live out modern city life. Kaikki naiset näkevät unia is a striking picture of the 1950 s, a picture that is construed in the consciousness of Mrs. Pyy. We are shown everyday life growing more and more modern after the war and woman s role growing more and more subject to increasing pressure for change.

Modernity, postmodernity and identity of jazz in Chile : The cases of the generation of 1990 and Ángel Parra

This research is about jazz in Chile in relation to modernity and identity. Final chapters focus and detach latest jazz musician s generation in 1990 decade and composer guitarist Angel Parra. An historic and sociological approach is developed, which will be useful for modernity and identity analysis, and so on post modernity and globalization. Modernity has been studied in texts of Adorno, Baudrillard, Brünner, García Canclini, Habermas and Jameson. Identity has been studied in texts of Aharonián, Cordúa, Garretón, Gissi, Larraín and others. Chapter 3 is about Latin-American musicology and jazz investigations, in relation to approach developed in chapter 2. Chapters 4 and 5 are about history of jazz in Chile until beginning of XXI century. Chapter 6 focuses in Ángel Parra Orrego. Conclusions of this investigation detach the modernist mechanical that has conducted jazz development in Chile, which in Ángel Parra´s case has been overcame by a post modernist behaviour. This behaviour has solved in a creative way, subjects like modernity and identity in jazz practice in a Latin-American country.

Filosofins renässans eller modern mystik : Bergsondebatten i Finland

The study examines the debate in Finland at the beginning of the 20th century surrounding the philosophy of Henri Bergson. Both within as well as outside of academic philosophy Bergsonism was adapted to the philosophical and cultural landscape in Finland by a process of selective appropriation. The ambiguous relationship between the sender and the receiver is accentuated in reference to philosophical celebrities such as Bergson, whose reputations spread more quickly than the content of their philosophy and whose names are drawn into the political and social discourse. As a philosophical movement the aim of Bergsonism was to create a scientific philosophy of life as an alternative to both idealism and modern empirical and antimetaphysical currents, during a period when European philosophy was searching for new guidelines after the collapse of the idealistic system philosophies of the 19th century. This reorientation is examined from a Finnish viewpoint and in the light of the process of intellectual importation. The study examines how elements from an international discourse were appropriated within the philosophical field in Finland against a background of changes in the role of the university and the educated elites as well as the position of philosophy within the disciplinary hierarchy. Philosophical reception was guided by expectations that had arisen in a national context, for example when Bergsonism in Finland was adjusted to a moral and educational ideal of self-cultivation, and often served as a means for philosophers to internationalize their own views in order to strengthen their position on the national stage. The study begins with some introductory remarks on the international circulation of ideas from the point of view of the periphery. The second section presents an overview of the shaping of the philosophical field at the turn of the 20th century, the naturalism and positivism of the late 19th century that were the objects of Bergson s critique, and an introduction to the attempts of a philosophy of life to make its way between idealism and naturalism. The third and main section of the study begins with a brief presentation of the main features of the philosophy of Bergson, followed by a closer examination of the different comments and analyses that it gave rise to in Finland. The final section addresses the ideological implications of Bergsonism within the framework of a political annexation of the philosophy of life at the beginning of the 20th century.

Turun linna kerrottuna ja kertovana tilana

The Turku castle, founded c. 1300, has changed over the centuries from a medieval defensive structure into a Renaissance palace and from a derelict jailhouse in the late 19th century into a prime example of the Medieval built heritage in Finland. Today, it is first and foremost a monument to the Medieval and Renaissance heyday of the castle. This is apparent in the architectural forms that have been carefully restored and reconstructed. It also becomes clear in all kinds of narratives, both visual (like the set of miniatures about the different stages of the construction of the castle) and textual (as during the guided tours). For the first time in the architectural history of the Turku castle, the Medieval, the Renaissance, the Modern, and the Present as architecturally constructed or reconstructed spaces can all be visited within the same hour. As a result, the monumental Turku castle may even be deemed anachronistic or inauthentic. In this study I look at the ways in which the Turku castle is, indeed, anachronistic and inauthentic. My main objective, however, is to find ways in which the anachronisms and inauthenticities are overcome in a positive way. I base my analysis of the Turku castle on three theoretical standpoints. First, I am studying the castle as space, described by Michel de Certeau as a practiced place (de Certeau 2002). Second, I am approaching the numerous narrative aspects of the castle following Paul Ricoeur s analysis of narrative as a threefold mimetic process (Ricoeur 1990). From these two theoretical settings I have summoned the concept of narrative space. The life and work at the castle are based on expectations and understandings of the historical surroundings. My third theoretical choice is to study this applied knowledge of the place as the management of blocks of knowledge in communication (Robert de Beaugrande 1980). Combining the theoretical starting points of space and narrative , I am approaching the castle as if it were an evolving set of narratives, narrated in space but also through space. Seeing e.g. the restoration teams of the mid-20th century and the present day tour guides as creative narrators, I am looking beyond the dilemma of the anachronistic spaces. What transpires is an inter-connected web of texts and spaces, tangible and intangible narratives. My analytical key to these narrative relationships is the threefold mimetic process of pre-figuration, con-figuration, and re-figuration, inspired by the writings of Paul Ricoeur (1990). This way, the past can be seen as a pool of endless possibilities to emplot place, time, and action into a narrative space. The narratives convey images of the past that may be contested by other images, and the power to narrate in the first place can be challenged and re-distributed.

Nitrogen dynamics and nitrogen use efficiency of spring cereals under Finnish growing conditions

Nitrogen (N) is one of the main inputs in cereal cultivation and as more than half of the arable land in Finland is used for cereal production, N has contributed substantially to agricultural pollution through fertilizer leaching and runoff. Based on this global phenomenon, the European Community has launched several directives to reduce agricultural emissions to the environment. Trough such measures, and by using economic incentives, it is expected that northern European agricultural practices will, in the future, include reduced N fertilizer application rates. Reduced use of N fertilizer is likely to decrease both production costs and pollution, but could also result in reduced yields and quality if crops experience temporary N deficiency. Therefore, more efficient N use in cereal production, to minimize pollution risks and maximize farmer income, represents a current challenge for agronomic research in the northern growing areas. The main objective of this study was to determine the differences in nitrogen use efficiency (NUE) among spring cereals grown in Finland. Additional aims were to characterize the multiple roles of NUE by analysing the extent of variation in NUE and its component traits among different cultivars, and to understand how other physiological traits, especially radiation use efficiency (RUE) and light interception, affect and interact with the main components of NUE and contribute to differences among cultivars. This study included cultivars of barley (Hordeum vulgare L.), oat (Avena sativa L.) and wheat (Triticum aestivum L.). Field experiments were conducted between 2001 and 2004 at Jokioinen, in Finland. To determine differences in NUE among cultivars and gauge the achievements of plant breeding in NUE, 17-18 cultivars of each of the three cereal species released between 1909 and 2002 were studied. Responses to nitrogen of landraces, old cultivars and modern cultivars of each cereal species were evaluated under two N regimes (0 and 90 kg N ha-1). Results of the study revealed that modern wheat, oat and barley cultivars had similar NUE values under Finnish growing conditions and only results from a wider range of cultivars indicated that wheat cultivars could have lower NUE than the other species. There was a clear relationship between nitrogen uptake efficiency (UPE) and NUE in all species whereas nitrogen utilization efficiency (UTE) had a strong positive relationship with NUE only for oat. UTE was clearly lower in wheat than in other species. Other traits related to N translocation indicated that wheat also had a lower harvest index, nitrogen harvest index and nitrogen remobilisation efficiency and therefore its N translocation efficiency was confirmed to be very low. On the basis of these results there appears to be potential and also a need for improvement in NUE. These results may help understand the underlying physiological differences in NUE and could help to identify alternative production options, such as the different roles that species can play in crop rotations designed to meet the demands of modern agricultural practices.

Reconstructions of past climates from documentary and natural sources in Finland since the 18th century

In this paper both documentary and natural proxy data have been used to improve the accuracy of palaeoclimatic knowledge in Finland since the 18th century. Early meteorological observations from Turku (1748-1800) were analyzed first as a potential source of climate variability. The reliability of the calculated mean temperatures was evaluated by comparing them with those of contemporary temperature records from Stockholm, St. Petersburg and Uppsala. The resulting monthly, seasonal and yearly mean temperatures from 1748 to 1800 were compared with the present day mean values (1961-1990): the comparison suggests that the winters of the period 1749-1800 were 0.8 ºC colder than today, while the summers were 0.4 ºC warmer. Over the same period, springs were 0.9 ºC and autumns 0.1 ºC colder than today. Despite their uncertainties when compared with modern meteorological data, early temperature measurements offer direct and daily information about the weather for all months of the year, in contrast with other proxies. Secondly, early meteorological observations from Tornio (1737-1749) and Ylitornio (1792-1838) were used to study the temporal behaviour of the climate-tree growth relationship during the past three centuries in northern Finland. Analyses showed that the correlations between ring widths and mid-summer (July) temperatures did not vary significantly as a function of time. Early (June) and late summer (August) mean temperatures were secondary to mid-summer temperatures in controlling the radial growth. According the dataset used, there was no clear signature of temporally reduced sensitivity of Scots pine ring widths to mid-summer temperatures over the periods of early and modern meteorological observations. Thirdly, plant phenological data with tree-rings from south-west Finland since 1750 were examined as a palaeoclimate indicator. The information from the fragmentary, partly overlapping, partly nonsystematically biased plant phenological records of 14 different phenomena were combined into one continuous time series of phenological indices. The indices were found to be reliable indicators of the February to June temperature variations. In contrast, there was no correlation between the phenological indices and the precipitation data. Moreover, the correlations between the studied tree-rings and spring temperatures varied as a function of time and hence, their use in palaeoclimate reconstruction is questionable. The use of present tree-ring datasets for palaeoclimate purposes may become possible after the application of more sophisticated calibration methods. Climate variability since the 18th century is perhaps best seen in the fourth paper study of the multiproxy spring temperature reconstruction of south-west Finland. With the help of transfer functions, an attempt has been made to utilize both documentary and natural proxies. The reconstruction was verified with statistics showing a high degree of validity between the reconstructed and observed temperatures. According to the proxies and modern meteorological observations from Turku, springs have become warmer and have featured a warming trend since around the 1850s. Over the period of 1750 to around 1850, springs featured larger multidecadal low-frequency variability, as well as a smaller range of annual temperature variations. The coldest springtimes occurred around the 1840s and 1850s and the first decade of the 19th century. Particularly warm periods occurred in the 1760s, 1790s, 1820s, 1930s, 1970s and from 1987 onwards, although in this period cold springs occurred, such as the springs of 1994 and 1996. On the basis of the available material, long-term temperature changes have been related to changes in the atmospheric circulation, such as the North Atlantic Oscillation (February-June).

Sangen ialo Rucous : Schwenckfeldiläisten rukouskirja Mikael Agricolan lähteenä

Sangen ialo Rucous. The prayer book of the Schwenckfeldiens as a source for Michael Agricola The significance of the prayer book published by the Finnish reformer Michael Agricola in the year of 1544 has not been comprehended enough among the prayer literature of the Reformation century. Especially in foreign research literature one of the era s most extensive and versatile prayer books has been practically disregarded. According to the prayer book, Agricola appears to be a traditionalist, who derives most of his source material from medieval and old church prayer books. The low number of the prayers from Evangelical prayer books is noteworthy. The study in hand examines Agricola s theology expressed in his translation work of the prayer book of the mystic spiritualistic Schwenckfeldien movement. The prayer book of the Schwenckdeldiens diverged from Lutheranism was called Bekantnus der sünden and it was composed around the year of 1526. Agricola is the only prayer book collector who has regarded it as necessary to add all the 45 prayers of the Schwenckfeldien prayer book and its introduction to his book. In the prayers containing the Schwenckfeldien communion theology and Christology Agricola has not changed the content of the text, apparently because he was not aware of the problems involved in the Schwenckfeldien theology. On a few occasions Agricola added points of view concerning the church, priesthood, preaching the Word and sacraments to his prayers, which the Schwenckfeldiens despised. From the ten additions four Agricola created himself, the rest he borrowed from Wolfgang Capito s prayer book. As a source Agricola used Capito s Latin prayer book together with the German text from Bekantnus. When looking at the studied material, Agricola does not turn out to be a creative translator. Even though he had a model for a less restricted translation in Wolfgang Capito s prayer book, he sticks to his habit of translating word by word. Because not even a good example has had a liberating effect on his translation principles, Agricola cannot be considered a theologically orientated writer. The translation of the Schwenckfeldien prayers Agricola starts with Capito s prayer book. Very soon he takes the Bekantnus alongside Capito s text and abandons the use of Capito s prayer book in the middle of the translation process. Comparing Agricola s translation with the two texts in different languages has made it possible to create the disposition theory described above. On the basis of the disposition theory it can be concluded that Agricola first worked out a precise plan for his prayer book. Then he translated prayers theme by theme using multiple sources at the same time. Later Agricola fixed the disposition, which does not seem to have a direct paragon. From the prayers of the Schwenckfeldien prayer book Agricola translated 26 texts using the Bekantnus as an only base, from Capito s prayer book he translated four texts and 17 texts he translated using the two basic texts simultaneously. In the previous studies, words and texts added by Agricola have been examined as one problem unit. In this study the additions have been placed into three different categories: additions consequential on tautological parataxis, specifying additions and additions significant to the content. Due to Agricola s meticulous translation techniques, there are so few additions. Agricola does not show his own creativity even in the additions significant to the content but uses there some complete sentences or word fragments from the other prayers he has translated. In the translations of the prayers there are some unique appearing words and the analysis of the translation work shed a new light on the background of their first literary appearance in Finnish. Agricola s linguistic abilities turned out to be great. In those prayers where Agricola uses both the German and Latin basic texts at the same time, the translation process is a very intensive twine made on the basis of the two sources.

Total hip arthroplasty in young patients : with special references to patients under 55 years of age and to patients with developmental dysplasia of the hip

There is an ongoing controversy as to which methods in total hip arthroplasty (THA) could provide young patients with best long-term results. THA is an especially demanding operation in patients with severely dysplastic hips. The optimal surgical treatment for these patients also remains controversial. The aim of this study was to evaluate the long-term survival of THA in young patients (<55 years at the time of the primary operation) on a nation-wide level, and to analyze the long-term clinical and radio-graphical outcome of uncemented THA in patients with severely dysplastic joints. Survival of 4661 primary THAs performed for primary osteoarthritis (OA), 2557 primary THAs per-formed for rheumatoid arthritis (RA), and modern uncemented THA designs performed for primary OA in young patients, were analysed from the Finnish Arthroplasty Register. A total of 68 THAs were per-formed in 56 consecutive patients with high congenital hip dislocation between 1989-1994, and 68 THAs were performed in 59 consecutive patients with severely dysplastic hips and a previous Schanz osteotomy of the femur between 1988-1995 at the Orton Orthopaedic Hospital, Helsinki, Finland. These patients underwent a detailed physical and radiographical evaluation at a mean of 12.3 years and 13.0 years postoperatively, respectively. The risk of stem revision due to aseptic loosening in young patients with primary OA was higher for cemented stems than for proximally porous-coated or HA-coated uncemented stems implanted over the 1991-2001 period. There was no difference in the risk of revision between all-poly cemented-cups and press-fit porous-coated uncemented cups implanted during the same period, when the end point was defined as any revision (including exchange of liner). All uncemented stem designs studied in young patients with primary OA had >90% survival rates at 10 years. The Biomet Bi-Metric stem had a 95% (95% CI 93-97) survival rate even at 15 years. When the end point was defined as any revision, 10 year survival rates of all uncemented cup designs except the Harris-Galante II decreased to <80%. In young patients with RA, the risk of stem revision due to aseptic loosening was higher with cemented stems than with proximally porous-coated uncemented stems. In contrast, the risk of cup revision was higher for all uncemented cup concepts than for all-poly cemented cups with any type of cup revision as the end point. The Harris hip score increased significantly (p<0.001) both in patients with high con-genital hip dislocation and in patients with severely dysplastic hips and a previous Schanz osteotomy, treated with uncemented THA. There was a negative Trendelenburg sign in 92% and in 88% of hips, respectively. There were 12 (18%) and 15 (22%) perioperative complications. The rate of survival for the CDH femoral components, with revision due to aseptic loosening as the end point, was 98% (95% CI 97-100) at 10 years in patients with high hip dislocation and 92% (95% CI, 86-99) at 14 years in patients with a previous Schanz osteotomy. The rate of survival for press-fit, porous-coated acetabular components, with revision due to aseptic loosening as the end point, was 95% (95% CI 89-100) at 10 years in patients with high hip dislocation, and 98% (95% CI 89-100) in patients with a previous Schanz osteotomy. When revision of the cup for any reason was defined as the end point, 10 year sur-vival rates declined to 88% (95% CI 81-95) and to 69% (95% CI, 56-82), respectively. For young patients with primary OA, uncemented proximally circumferentially porous- and HA-coated stems are the implants of choice. However, survival rates of modern uncemented cups are no better than that of all-poly cemented cups. Uncemented proximally circumferentially porous-coated stems and cemented all-poly cups are currently the implants of choice for young patients with RA. Uncemented THA, with placement of the cup at the level of the true acetabulum, distal advancement of the greater trochanter and femoral shortening osteotomy provided patients with high congenital hip dislocation good long-term outcomes. Most of the patients with severely dysplastic hips and a previous Schanz osteotomy can be successfully treated with the same method. However, the subtrochanteric segmental shortening with angular correction gives better leg length correction for the patients with a previous low-seated unilateral Schanz osteotomy.

Mid-urethral slings for treatment of stress urinary incontinence : long- and mid-term follow-up

Urinary incontinence is a common problem, affecting one third of the women at least at some time during their lives. The prevalence of urinary incontinence increases with advancing age, and the everyday impact of incontinence on women and on health services is enormous. Urinary incontinence is usually divided into three different subtypes, of which stress urinary incontinence (SUI) is the most common. Surgical treatment is often needed to cure SUI, and modern mid-urethral sling procedures give the possibility to cure this condition with a low risk of adverse events, a problem often associated with the so-called traditional incontinence operations. Life expectancy among women in Western countries has grown beyond 80 years of age. Long-term efficacy of treatment options for urinary incontinence therefore becomes an important issue in a world with limited eco-nomic resources. The purpose of the present study was to prospectively evaluate the long-term efficacy and safety of the first minimally invasive mid-urethral tape procedure, the Tension-free Vaginal Tape (TVT) procedure. The long-term (5-year) follow-up results of the TVT procedure as a repeat operation af-ter an unsuccessful mid-urethral tape operation were studied and the reasons for failure of the first operation were analyzed. Another purpose was to compare the original TVT procedure with a newer modification, the Tension-free Vaginal Tape Obturator (TVT-O) procedure within a multi-centre, randomized context in order to find out possible differences between these procedures re-garding efficacy and complications and the effects on symptoms of urgency. The first study of the present thesis is a prospective, Nordic, three-centre follow-up study of 90 women suffering from SUI, who were treated by means of the TVT procedure. The mean follow-up time was more than eleven years, and the study is the first to be published in connection with more than ten years of follow-up. The second study is a retrospective analysis of 26 women who were treated with a repeat TVT procedure after an unsuccessful primary mid-urethral tape procedure. The third and fourth studies concern 273 women in seven centres in Finland who were ran-domly assigned to the TVT and TVT-O procedures, the 3-year follow-up results of which are pre-sented in this thesis. After eleven years of follow-up, 90% of the women had a negative cough stress test result and a negative 24-h pad test result. The subjective cure rate measured as the women s global impression of cure was 77%, the rate of improvement 20%, and only 3% thought that the treatment had failed. No late-onset adverse effects were found. The repeat TVT procedure was successful in 75% of the cases when women who were cured and women who were significantly improved were included. The reasons for failure of the first operation could be separated into four different groups: tape material-related, operation technique-related, concomitant illness-related and a group with no identifiable reason. There were no intra-operative complications during the repeat operation. In the randomized trial comparing the TVT with the TVT-O procedure a cough stress test results were negative in 94.6% and 89.5% of the women in the two groups, respectively, after a 3-year follow-up period. There were no statistical differences in the cure rate or the rate of complications be-tween the two procedures. Symptoms of urgency were analyzed more closely and the main finding was that the prevalence of urgency symptoms decreased significantly after both mid-urethral sling procedures. The TVT operation was found to be an effective and safe procedure even after eleven years of follow-up. Long-term follow-up after a repeat TVT procedure revealed that the TVT procedure can well be considered after an unsuccessful mid-urethra tape procedure, because 75% of the patients showed significantly improvement of their incontinence. The TVT and TVT-O procedures showed no statistically significant differences in efficacy and rate of complications after three years of follow-up. In most cases these procedures alleviate preoperative symptoms of urgency and the risk of developing de novo urgency is low.