A prospective cohort study of healthcare visits and rehospitalizations after hospital discharge in community-acquired pneumonia

Background and objective: We aimed to identify the frequency of, reasons for and risk factors associated with additional healthcare visits and rehospitalizations (healthcare interactions) by patients with community-acquired pneumonia (CAP) within 30 days of hospital discharge. Methods: Observational analysis of a prospective cohort of adults hospitalized with CAP at a tertiary hospital (2007-2009). Additional healthcare interactions were defined as the visits to a primary care centre or emergency department and hospital readmissions within 30 days of discharge. Results: Of the 934 hospitalized patients with CAP, 282 (34.1%) had additional healthcare interactions within 30 days of hospital discharge: 149 (52.8%) needed an additional visit to their primary care centre and 177 (62.8%) attended the emergency department. Seventy-two (25.5%) patients were readmitted to hospital. The main reasons for additional healthcare interactions were worsening of signs or symptoms of CAP and new or worsening comorbid conditions independent of pneumonia, mainly cardiovascular and pulmonary diseases. The only independent factor associated with visits to primary care centre or emergency department was alcohol abuse (odds ratio [OR] = 1.65; 95% confidence interval [CI]: 1.03-2.64). Prior hospitalization (≤ 90 days) (OR = 2.47; 95% CI: 1.11-5.52) and comorbidities (OR = 3.99; 95% CI: 1.12-14.23) were independently associated with rehospitalization. Conclusions: Additional healthcare visits and rehospitalizations within 30 days of hospital discharge are common in patients with CAP. This is mainly due to a worsening of signs or symptoms of CAP and/or comorbid conditions. These findings may have implications for discharge planning and follow-up of patients with CAP.

Combining conservative and variable markers to inferthe evolutionary history of Prunus subgen. Amygdalus s.l.under domestication

The genus Prunus L. is large and economically important. However, phylogenetic relationships within Prunus at low taxonomic level, particularly in the subgenus Amygdalus L. s.l., remain poorly investigated. This paper attempts to document the evolutionary history of Amygdalus s.l. and establishes a temporal framework, by assembling molecular data from conservative and variable molecular markers. The nuclear s6pdh gene in combination with the plastid trnSG spacer are analyzed with bayesian and maximum likelihood methods. Since previous phylogenetic analysis with these markers lacked resolution, we additionally analyzed 13 nuclear SSR loci with the δµ2 distance, followed by an unweighted pair group method using arithmetic averages algorithm. Our phylogenetic analysis with both sequence and SSR loci confirms the split between sections Amygdalus and Persica, comprising almonds and peaches, respectively. This result is in agreement with biogeographic data showing that each of the two sections is naturally distributed on each side of the Central Asian Massif chain. Using coalescent based estimations, divergence times between the two sections strongly varied when considering sequence data only or combined with SSR. The sequence-only based estimate (5 million years ago) was congruent with the Central Asian Massif orogeny and subsequent climate change. Given the low level of differentiation within the two sections using both marker types, the utility of combining microsatellites and data sequences to address phylogenetic relationships at low taxonomic level within Amygdalus is discussed. The recent evolutionary histories of almond and peach are discussed in view of the domestication processes that arose in these two phenotypically-diverging gene pools: almonds and peaches were domesticated from the Amygdalus s.s. and Persica sections, respectively. Such economically important crops may serve as good model to study divergent domestication process in close genetic pool.

Early Modern Persian, Urdu, and English Historiography and the Imagination of Islamic India under British Rule

This paper analyses the early modern transformations of South Asian literary cultures through the production of historiography in Persian, English, and Urdu. In the 18th-19th centuries, South Asian communities experienced and participated in a major restructuring of the languages of the subcontinent. Urdu and English were institutionalized as governmental languages and utilized in new literary productions as Persian was gradually marginalized from the centre of literary and governmental polities. Three interrelated colonial policies reshaped the historical consciousness of South Asia and Britain: the production of new Persian histories commissioned under British patronage, the initiation of Urdu historiography through the translation of Persian and English histories, and the construction of the British history of India written in English. This article explores the historical and social dynamics of these events and situates the origins and evolution of the colonial historiographical project. Major works discussed are the Tārīkh-i Bangālah of Salīm Allāh Munshī (fl. 1763), James Mill's (1773-1836) The History of British India first published in 1817, Mīr Sher ʿAlī Afsos' the Ārāʾish-i mahfil, as well as the production of original Urdu histories such as Muḥammad Zakāʾ-Allāh's (1832-1910) the Tārīkh-i Hindustān.

Analysis of a Plant Complex Resistance Gene Locus Underlying Immune-Related Hybrid Incompatibility and Its Occurrence in Nature

Mechanisms underlying speciation in plants include detrimental (incompatible) genetic interactions between parental alleles that incur a fitness cost in hybrids. We reported on recessive hybrid incompatibility between an Arabidopsis thaliana strain from Poland, Landsberg erecta (Ler), and many Central Asian A. thaliana strains. The incompatible interaction is determined by a polymorphic cluster of Toll/interleukin-1 receptor-nucleotide binding-leucine rich repeat (TNL) RPP1 (Recognition of Peronospora parasitica1)-like genes in Ler and alleles of the receptor-like kinase Strubbelig Receptor Family 3 (SRF3) in Central Asian strains Kas-2 or Kond, causing temperature-dependent autoimmunity and loss of growth and reproductive fitness. Here, we genetically dissected the RPP1-like Ler locus to determine contributions of individual RPP1-like Ler (R1R8) genes to the incompatibility. In a neutral background, expression of most RPP1-like Ler genes, except R3, has no effect on growth or pathogen resistance. Incompatibility involves increased R3 expression and engineered R3 overexpression in a neutral background induces dwarfism and sterility. However, no individual RPP1-like Ler gene is sufficient for incompatibility between Ler and Kas-2 or Kond, suggesting that co-action of at least two RPP1-like members underlies this epistatic interaction. We find that the RPP1-like Ler haplotype is frequent and occurs with other Ler RPP1-like alleles in a local population in Gorzów Wielkopolski (Poland). Only Gorzów individuals carrying the RPP1-like Ler haplotype are incompatible with Kas-2 and Kond, whereas other RPP1-like alleles in the population are compatible. Therefore, the RPP1-like Ler haplotype has been maintained in genetically different individuals at a single site, allowing exploration of forces shaping the evolution of RPP1-like genes at local and regional population scales.

Hammaslääkärin ura. Odotukset ja kokemukset. [Career Expectations and Experiences of Dentists]

Tutkimuksella selvitettiin eri tekijöiden merkitystä hammaslääkärien tehdessä uraansa koskevia valintoja lähtien ammatinvalinnasta. Tutkimuksessa verrattiin erilaisissa työpaikoissa toimivien hammaslääkärien sekä hammaslääketieteen opiskelijoiden odotuksia ja kokemuksia. Tutkimus tehtiin kyselynä postitse lähetetyin lomakkein. Kyselyyn osallistui 350 hammaslääkäriä ja 115 opiskelijaa. Kiinnostus lääketieteeseen ja työn konkreettisuus olivat keskeisimmät syyt lähteä hammaslääketiedettä opiskelemaan. Suurin osa sekä hammaslääkäreistä että opiskelijoista valitsisi vähintään todennäköisesti saman ammatin uudelleen, hammaslääkäreistä yksityishammaslääkärit useimmin. 69 % hammaslääkäreistä oli aloittanut työuransa terveyskeskuksessa, opiskelijoista 46 % toivoi työpaikkaa yksityissektorilta ja 37 % terveyskeskuksesta. Hammaslääkärit kokivat työn mielekkyyden, positiivisen kaiun, työn ja elämän reunaehtojen sekä taloudellisen turvallisuuden vaikuttaneen ensimmäiseen työpaikkaan menoon vähemmän kuin opiskelijat arvioivat niiden vaikuttavan. Työssä tärkeänä sekä hammaslääkärit että opiskelijat pitivät hyviä työolosuhteita ja mielekästä työn sisältöä. Toimiva yhteistyö työparin kanssa oli myös erittäin tärkeää. Hammaslääkärit pitivät hyviä työoloja ja autonomiaa tärkeämpinä kuin opiskelijat, joille puolestaan uralla eteneminen ja työajan joustot olivat tärkeämpiä. Hammaslääkärit arvostivat työtä ja työssä suoriutumista sekä hyvää työpaikkaa enemmän kuin opiskelijat. Parhaiten työssään toteutuvana suhteessa asian merkitykseen hammaslääkärit kokivat autonomian ja huonoiten ilmapiirin. Naiset kokivat asioiden toteutumisessa enemmän puutteita kuin miehet. Työpaikkaansa heikosti sitoutuneita oli 8 %, joista valtaosa terveyskeskushammaslääkäreitä. Heikosti sitoutuneet kokivat sitoutuneita huonompina varsinkin työilmapiirin, työolosuhteet ja mahdollisuuden uralla etenemiseen. Hammaslääkärit olivat halukkaampia jatkokoulutukseen kuin kokivat siihen olevanmahdollisuuksia; 25 % oli harkinnut erikoistumista, mutta luopunut ajatuksesta, ja20 % halusi erikoistua, mutta koki siihen käytännön esteitä. Jatkossa tulisi tarkemmin analysoida ja toistettavin tutkimuksin seurata hammaslääkärien urakokemuksia ja valintoja sekä koetun työssä vallitsevan tilanteen ja asioiden merkityksen välistä suhdetta. Myös opiskelijoiden urasuunnitelmia ja arvostuksia tulisi tutkia säännöllisin väliajoin.

Planning and ramping up a new SW Testing site

During recent years, mobile phone markets have changed significantly. Asian markets have become vital for the manufacturers with their millions of end users and multiple major mobile network operators. This has resulted in software development as global companies have research and development sites running in multiple locations, including Asia. The reasons behind this are not only in reducing labor costs but also in capitalizing on the local knowledge and knowhow. A ramp-up site has multiple effects in the software development and software release activities. This thesis focuses on representing the importance of software testing as part of software development process and highlighting issues that need to be considered during ramp-up activities. In addition this work tries to emphasize the importance of communication between parties and information gathering prior to setting up the ramp-up site. The output of this thesis was successful software testing site ramp-up within the set time limits. The quality of software testing work was assured and the ramp-up -project requirements were achieved.

Finnair’s “New Silk Road” in the New Millennium: An Analysis of the Construction of Asia and of the Company

During the past century, an increasingly diverse world provided us with opportunities for intercultural communication; especially the growth of commerce at all levels from domestic to international has made the combination of the theories of intercultural communication and international business necessary. As one of the main beneficiaries in international business in recent years, companies in airline industries have developed their international market. For instance, Finnair has developed its Asian strategy which responds to the increasing market demand for flights from Europe to Asia in the new millennium. Therefore, the company manages marketing communication in a global environment and becomes a suitable case for studying the theories of intercultural communication in the context of international marketing. Finnair implemented a large number of international advertisements to promote its Asian routes, where Asia has been constructed as a number of exotic destinations. Meanwhile, the company itself as a provider of these destinations has also been constructed contrastively. Thus, this thesis aims at research how Finnair constructs Asia and the company itself in the new millennium, and how these constructions compare with the theories of intercultural communication. This research applied the theories of international marketing, intercultural communication and culture. In order to analyze the collected corpora as Finnair’s international advertisements and its annual reports in the new millennium, the methods of content analysis and discourse analysis have been used in this research. As a result, Finnair has purposefully applied the essentialist approach to intercultural communication and constructed Asia as an exotic “Other” due to the company’s market orientation. Meanwhile, Finnair has also constructed the company itself two identities based on the same approach: as an international airline provider between Europe and Asia, as well as a part of Finnish society. The combination of intercultural communication and international marketing theories, together with the combination of the methods of content analysis and discourse analysis ensure the originality of this paper.

Adjuvant concentrations and uredospore densities on Phakopsora pachyrhizi infection efficiency in soybean

Experiments were carried out in a growth chamber to evaluate the effect of spreader and uredospore concentrations on the efficiency of infection by Phakopsora pachyrhizi, the causal agent of Asian soybean rust. CD 214 RR soybean cultivar was inoculated with the following polyoxyethylene sorbitane monolaurate concentrations: 0, 30, 60, 120, 240, 480 and 960 µL.L-1 water, as well as a fixed uredospore concentration of 2 x 10(4) spores.mL-1. In a second phase, the inoculum concentrations of 0, 5 x 10³, 1 x 10(4), 2 x 10(4), 4 x 10(4), 8 x 10(4) and 16 x 10(4) uredospores.mL-1 were evaluated, and the spreader concentration of 240 µL.L-1, selected in the previous experiment, was fixed. The spreader concentration of 240 µL.L-1 can be used in artificial inoculation studies, as well as up to 4 x 10(4) uredospores.mL-1. In this work, there was a correlation between uredia and lesion density. Thus, the use of lesion density is recommended to assess disease intensity for its accuracy and less time consuming. There was also a positive correlation between uredia and lesion density.

Control of Asian soybean rust with mancozeb, a multi-site fungicide

An experiment conducted in the field the action of mancozeb, a fungicide of multi-site action was tested, to control soybean rust caused by Phakopsora pachyrhizi. Its performance was compared to that of the mixture cyproconazole (DMI) + azoxystrobin (QoI). The soybean cultivar NA 7337 RR was used with a population of 400,000 plants/ha cultivated in 20m2 plots. Treatments consisted of mancozeb levels (1.5 and 2.0 kg/ha) applied four, six and eight times. The DMI + QoI mixture was applied three times at 0.3 L/ha + Nimbus. Rust severity was assessed six times in the plots and data were integrated as the area under the disease progress curve (AUDPC). The plots were harvested and grain yield was expressed as kg/ha. Data on AUDPC and yield were subjected to analysis of variance and means compared according to Turkey's test (p = 0.005). Treatments with mancozeb were superior to DMI + QoI mixture both for rust control and grain yield. Four applications of 2.0 k/ha mancozeb were more efficient than three applications of the mixture used as standard. Mancozeb has the potential to be added to fungicide mixtures in the establishment of soybean rust anti-resistance strategy.

Critical-point model to estimate yield loss caused by Asian soybean rust

ABSTRACTA model to estimate yield loss caused by Asian soybean rust (ASR) (Phakopsora pachyrhizi) was developed by collecting data from field experiments during the growing seasons 2009/10 and 2010/11, in Passo Fundo, RS. The disease intensity gradient, evaluated in the phenological stages R5.3, R5.4 and R5.5 based on leaflet incidence (LI) and number of uredinium and lesions/cm2, was generated by applying azoxystrobin 60 g a.i/ha + cyproconazole 24 g a.i/ha + 0.5% of the adjuvant Nimbus. The first application occurred when LI = 25% and the remaining ones at 10, 15, 20 and 25-day intervals. Harvest occurred at physiological maturity and was followed by grain drying and cleaning. Regression analysis between the grain yield and the disease intensity assessment criteria generated 56 linear equations of the yield loss function. The greatest loss was observed in the earliest growth stage, and yield loss coefficients ranged from 3.41 to 9.02 kg/ha for each 1% LI for leaflet incidence, from 13.34 to 127.4 kg/ha/1 lesion/cm2 for lesion density and from 5.53 to 110.0 kg/ha/1 uredinium/cm2 for uredinium density.

Quantification of incubation, latent and infection periods of Phakopsora pachyrhizi in soybean, according to chronological time and degree-days

ABSTRACT In experiments conducted in a growth chamber, the chronological time and the accumulated degree-days were determined for the duration of incubation, latent and infectious periods of Phakopsora pachyrhizi cultivars BRSGO 7560 and BRS 246 RR. Detached soybean leaflets were placed in gerbox-type acrylic boxes and inoculated with 20 x 103 uredospores/mL. The study was conducted at 12-h photoperiod and temperatures of 10ºC, 15ºC, 22ºC, 25ºC and 30°C for 30 days. Lesions and uredia/cm2were evaluated and the number of uredia per lesion was quantified after the beginning of sporulation. The sporulation potential was also quantified for cultivars BRSGO 7560 and BRS 246 RR. The steps of the infection process can be quantified based on both the chronological time and the accumulated heat. The cultivar BRSGO 7560 produced 4,012.8 spores/cm2 and BRS 246 RR, 7,348.4 uredospores/cm2. The largest number of uredia was produced at 25ºC in both cultivars; however, BRS 246 RR presented 372.7 uredia/cm2 and BRSGO 7560, 231.6 uredia/cm2. At 10ºC and 30°C, leaf infection did not occur in both cultivars.

”Hei, mä opin tän asian enkuks!” Toimintatutkimus ympäristötiedon ainesisältöjen ja vieraan kielen oppimisesta sekä opettamisesta englanninkielissä oppituokioissa

Tämä kvalitatiivinen toimintatutkimus sai lähtökipinän opettajan tarpeesta kehittää englannin kielen opetustaan suuntaan, joka innostaisi oppijoita opiskelemaan ja tuottamaan vierasta kieltä rohkeasti. Tutkimuksen tarkoituksena oli selvittää, mitä muutoksia oppijoissa ilmenee, kun perinteiseen vieraan kielen opetukseen sisällytetään kahden lukuvuoden ajan oppituokioita, joissa ympäristötiedon ainesisältöjä opetetaan vieraalla kielellä. Kiinnostuksen kohteena oli tutkia, ilmeneekö oppijoilla muutoksia ainesisältöjen hallinnassa, englanninkielisen ympäristötiedon sanavaraston karttumisessa, kielitaidon kehittymisessä sekä asenteessa oppituokioita ja englannin kieltä kohtaan yleensä. Tutkimuksen tarkoituksena oli myös luoda toimivaa käytäntöä opettajalle toteuttaa ainesisältöjen opettamista vieraalla kielellä, josta kansainvälisesti käytetään termiä Content and language integrated learning (CLIL). Tutkimus oli kahden vuoden pitkittäistutkimus, joka toteutettiin lukuvuosina 2008–2010. Tutkimusjoukko koostui 18:sta (11 poikaa ja 7 tyttöä) neljättä luokkaa aloittavasta oppijasta. Vertailuryhmään kuului 22 musiikkiluokan oppijaa (6 poikaa ja 16 tyttöä). Tutkija opetti molemmille ryhmille englannin kieltä kaksi viikkotuntia. Englanninkieliset oppituokiot toteutettiin englannin tuntien yhteydessä noin kerran viikossa. Kerrallaan tuokio kesti 15–20 minuuttia. Tutkimusaineistoa, joka koostuu sekä kvalitatiivisesta että kvantitatiivisesta aineistosta, kerättiin eri tavoin: tutkija keräsi havaintomateriaalia päiväkirjaansa koko tutkimuksen ajan, oppijoita testattiin kuusi kertaa tutkimuksen aikana sekä itsearvio- ja asennekyselyjä toteutettiin kahdesti. Tutkimusaineiston pohjalta saatiin selviä tutkimustuloksia, joiden mukaan CLIL-opetus vaikutti oppijoihin positiivisesti: ympäristötiedon ainesisältöjä opittiin, englanninkielinen ympäristötiedon sanavarasto laajeni ja vierasta kieltä käytettiin rohkeammin kuin aiemmin. Kommunikoidessa huomio kiinnitettiin kielen tarkkailun sijasta asiasisältöön. Oppijat suhtautuivat englanninkielisiin oppituokioihin positiivisesti ja englannin osaaminen koettiin tärkeäksi. Tässäkin kokeilussa CLIL osoittautui joustavaksi metodiseksi lähestymistavaksi, joka taipuu käyttökelpoiseksi käytännön teoriaksi soveltuen monenlaisille oppijoille.

"We Are Neither Visionaries Nor Utopian Dreamers" : Willi Münzenberg, the League against Imperialism, and the Comintern, 1925-1933

On 10 February 1927, the "First International Congress against Imperialism and Colonialism" in Brussels marked the establishment of the anti-imperialist organisation, the League against Imperialism and for National Independence (LAI, 1927-37). The complex preparations for the congress were though initiated already in 1925 by Willi Münzenberg, a German communist and General Secretary of the communist mass organisation, Internationale Arbeiterhilfe (IAH, 1921-35), together with the Communist International (Comintern, 1919-43). Berlin was the centre for the LAI and its International Secretariat (1927-33), a city serving the intentions of the communists to find colonial émigré activists in the Weimar capital, acting as representatives for the anti-colonial movement in Europe after the Great War. With the ascendancy to power of the Nazi Party (NSDAP) on 30 January 1933, the LAI reached an abrupt, but nonetheless, expected end in Berlin. This doctoral thesis examines the role, pu rpose and functions of a sympathising communist organization (LAI): to act as an intermediary for the Comintern to the colonies. The analysis evaluates the structure and activities of the LAI, and by doing so, establish a complex understanding on one of the most influential communist organisations during the interwar period, which, despite its short existence, assumed a nostalgic reference and historical bond for anti-colonial movements during the transition from colonialism to post-colonialism after the Second World War, e.g. the Afro-Asian Conference in Bandung, Indonesia in 1955. Fredrik Petersson’s study, based on archives in Moscow, Berlin, Amsterdam, London, and Stockholm, uncovers why the Comintern established and supported the LAI and its anti-imperialist agenda, disclosing a complicated undertaking, characterised by conflict and the internal struggle for power, involving structural constraints and individual ambitions defined by communist ideology and strategy.

Vitamin D receptor alleles and bone mineral density in a normal premenopausal Brazilian female population

Studies on the association between vitamin D receptor (VDR) polymorphism and bone mineral density (BMD) in different populations have produced conflicting results probably due to ethnic differences in the populations studied. The Brazilian population is characterized by a very broad genetic background and a high degree of miscegenation. Of an initial group of 164, we studied 127 women from the city of São Paulo, aged 20 to 47 years (median, 31 years), with normal menses, a normal diet and no history of diseases or use of any medication that could alter BMD. VDR genotype was assessed by PCR amplification followed by BsmI digestion of DNA isolated from peripheral leukocytes. BMD was measured using dual energy X-ray absorptiometry (Lunar DPX) at the lumbar site (L2-L4) and femoral neck. Most of the women (77.6%) were considered to be of predominantly European ancestry (20.6% of them reported also native American ancestry), 12.8% were of African-Brazilian ancestry and 9.6% of Asian ancestry, 41.0% (52) were classified as bb, 48.8% (62) as Bb and 10.2% (13) as BB. The BB, Bb and bb groups did not differ in age, height, weight, body mass index or age at menarche. Lumbar spine BMD was significantly higher in the bb group (1.22 ± 0.16 g/cm²) than in the BB group (1.08 ± 0.14; P<0.05), and the Bb group presented an intermediate value (1.17 ± 0.15). Femoral neck BMD was higher in the bb group (0.99 ± 0.11 g/cm²) compared to Bb (0.93 ± 0.12) and BB (0.90 ± 0.09) (P<0.05). These data indicate that there is a significant correlation between the VDR BsmI genotype and BMD in healthy Brazilian premenopausal females.

Nordic alcohol policy in Europe: the adaptation of Finland’s, Sweden’s and Norway’s alcohol policies to a new policy framework, 1994-2013

The purpose of this thesis is to study how and to which extent Finland, Sweden and Norway have adapted their alcohol policies to the framework imposed to them by the EU and the European Economic Area (EEA) since the mid-1990s. This is done by studying the underlying mechanisms that have influenced the formation of alcohol policy in the Nordic countries in that period. As a part of this analysis main differences in alcohol policies and alcohol consumption between the three countries are assessed and the phenomenon of cross-border trade with alcohol is discussed. The study examines also the development of Finnish, Norwegian and Swedish alcohol policies between 1994 and 2012 and compares the Nordic alcohol policies with other alcohol policies in Europe as the situation was in 2012. The time frame of the study spans from the mid-1990s to the end of 2013 and is divided into three phases. Studying the role of the Europeanisation process on the formation of alcohol policies has a key role in the analysis. Besides alcohol policies, the analyses comprise the development of alcohol consumption and cross-border trade with alcohol. In addition, a quantitative scale constructed to measure the strictness of alcohol policies is utilised in the analyses. The results from the scale are used to substantiate the qualitative analysis and to test whether the stereotypical view of a strict Nordic alcohol policy is still true. The results from the study clearly corroborate earlier findings on the significance of Europeanisation and the Single Market for the development of alcohol policies in the Nordic countries. Free movement of goods and unhindered competition have challenged the principle of disinterest and enabled private profit seeking in alcohol trade. The Single Market has also contributed to the increase in availability of alcohol and made it more difficult for the Nordic EU member states to maintain restrictive alcohol policies. All in all, alcohol policies in the Nordic countries are more liberal in 2013 than they were in 1994. Norway, being outside the EU has, however, managed to maintain a stricter alcohol policy than Finland and Sweden. Norway has also been spared from several EU directives that have affected Finland and Sweden, the most remarkable being the abolishment of the travellers’ import quotas for alcohol within the EU. Due to its position as a non-EU country Norway has been able to maintain high alcohol taxes without being subjected to a ”race to the bottom” regarding alcohol taxes the same way as Finland and Sweden. Finland distinguishes as the country that has liberalised its alcohol policy most during the study period. The changes in alcohol policies were not only induced by Europeanisation and the Single Market, but also by autonomous decision-making and political processes in the individual countries. Furthermore, the study shows that alcohol policy measures are implemented more widely in Europe than before and that there is a slow process of convergence going on regarding alcohol policy in Europe. Despite this, alcohol policies in the Nordic countries are still by far the strictest in all of Europe. From a Europeanisation perspective, the Nordic countries were clearly on the receiving end during the first two study phases (1994–2007), having more to adjust to rules from the EU and the Single Market than having success in uploading and shaping alcohol policy on the European and international field. During the third and final study phase (2008–2013), however, the Nordic countries have increasingly succeeded in contributing to shape the alcohol policy arena in the EU and also more widely through the WHOs global alcohol strategy. The restrictive Nordic policy tradition on which the current alcohol policies in Finland, Sweden and Norway were built on has still quite a solid evidence base. Although the basis of the restrictive alcohol policy has crumbled somewhat during the past twenty years and the policies have become less effective, nothing prevents it from being the base for alcohol policy in the Nordic countries even in the long term. In the future, all that is needed for an effective and successful alcohol policy is a solid evidence base, enough political will and support from the general public.