Biovalta, toiseus ja naisten toimijuus hedelmöityshoidoissa

Biopower, Otherness and Women's Agency in Assisted Reproduction. This sociological study analyses how, why and with what kind of consequences assisted reproductive technologies (ART) have become the primary technology for governing infertility in Finland both on the level of individuals and society. The phenomenon is construed as one the strategies of the Focaultian biopower since ART are political techniques of the beginning of life par excellence, as they are used to prepare the bodies of certain types of women to create certain kind of life, i.e. certain kind of children. Moreover, ART are interpreted to be gendered control techniques with which the pure, and at the same time prevailing, social order symbolised by a female body is maintained by naming and excluding otherness, unsuitable mother candidates and children. Finally, it is considered how the agency, subjectivity, of women experiencing infertility and seeking treatment appears in the prevailing context of ART. The introduction of IVF-based reproductive technologies to Finland and the treatment practices of the early 1990s have been studied on the basis of a clinic questionnaire, medical doctor interviews and articles of the Medical Journal Duodecim from 1969 to 2000. Opinions on the method of the treatment providers were studied by conducting a theme interview with fertilisation doctors in 1993. Experiences of women who have received treatment or experienced infertility were studied by means of a survey in 1994 and by analysing the content of messages in an online discussion forum in 2000. On the basis of the medical doctor interviews, significant criterion for choosing mother candidates turned out to be her vitality and her mental and physical health, which are considered prerequisites for a vitality of the child to be born. The hierarchies concerning children became evident. While people normally make their children on their own, this is what people experiencing infertility are trying to do as well. In the era of ART, the primary child is genetically the parents' own child, a secondary option for Finnish parents is a genetically Finnish child conceived by donated Finnish gametes or embryos and the last option is an adopted child of foreign origin. Women's agency mainly appears in their way of using ART as a technology of the self for self-control on one's own nature, which helps them to prepare their bodies in order to become pregnant in co-operation with a fertilisation doctor. Women's creative free agency exceeding governance appeared as a distinctive use of language with which they created shared meaning for their infertility experience, their own individual and group identity and distinctive reality. ART are very political techniques as they have a possibility to change the methods of having children and to shape life. Therefore, further sociological research on them is important and needed. Key words: practises of assisted reproduction, women's agency, biopower, vital politics of the beginning of life, otherness

Medicalising Prohibition : Harm reduction in Finnish and International Drug Policy

The increase in drug use and related harms in the late 1990s in Finland has come to be referred to as the second drug wave. In addition to using criminal justice as a basis of drug policy, new kinds of drug regulation were introduced. Some of the new regulation strategies were referred to as "harm reduction". The most widely known practices of harm reduction include needle and syringe exchange programmes for intravenous drug users and medicinal substitution and maintenance treatment programmes for opiate users. The purpose of the study is to examine the change of drug policy in Finland and particularly the political struggle surrounding harm reduction in the context of this change. The aim is, first, to analyse the content of harm reduction policy and the dynamics of its emergence and, second, to assess to what extent harm reduction undermines or threatens traditional drug policy. The concept of harm reduction is typically associated with a drug policy strategy that employs the public health approach and where the principal focus of regulation is on drug-related health harms and risks. On the other hand, harm reduction policy has also been given other interpretations, relating, in particular, to human rights and social equality. In Finland, harm reduction can also be seen to have its roots in criminal policy. The general conclusion of the study is that rather than posing a threat to a prohibitionist drug policy, harm reduction has come to form part of it. The implementation of harm reduction by setting up health counselling centres for drug users with the main focus on needle exchange and by extending substitution treatment has implied the creation of specialised services based on medical expertise and an increasing involvement of the medical profession in addressing drug problems. At the same time the criminal justice control of drug use has been intensified. Accordingly, harm reduction has not entailed a shift to a more liberal drug policy nor has it undermined the traditional policy with its emphasis on total drug prohibition. Instead, harm reduction in combination with a prohibitionist penal policy constitutes a new dual-track drug policy paradigm. The study draws on the constructionist tradition of research on social problems and movements, where the analysis centres on claims made about social problems, claim-makers, ways of making claims and related social mobilisation. The research material mainly consists of administrative documents and interviews with key stakeholders. The doctoral study consists of five original articles and a summary article. The first article gives an overview of the strained process of change of drug policy and policy trends around the turn of the millennium. The second article focuses on the concept of harm reduction and the international organisations and groupings involved in defining it. The third article describes the process that in 1996 97 led to the creation of the first Finnish national drug policy strategy by reconciling mutually contradictory views of addressing the drug problem, at the same as the way was paved for harm reduction measures. The fourth article seeks to explain the relatively rapid diffusion of needle exchange programmes after 1996. The fifth article assesses substitution treatment as a harm reduction measure from the viewpoint of the associations of opioid users and their family members.

Methodological perspectives for register-based health system performance assessment : Developing a hip fracture monitoring system in Finland

The resources of health systems are limited. There is a need for information concerning the performance of the health system for the purposes of decision-making. This study is about utilization of administrative registers in the context of health system performance evaluation. In order to address this issue, a multidisciplinary methodological framework for register-based data analysis is defined. Because the fixed structure of register-based data indirectly determines constraints on the theoretical constructs, it is essential to elaborate the whole analytic process with respect to the data. The fundamental methodological concepts and theories are synthesized into a data sensitive approach which helps to understand and overcome the problems that are likely to be encountered during a register-based data analyzing process. A pragmatically useful health system performance monitoring should produce valid information about the volume of the problems, about the use of services and about the effectiveness of provided services. A conceptual model for hip fracture performance assessment is constructed and the validity of Finnish registers as a data source for the purposes of performance assessment of hip fracture treatment is confirmed. Solutions to several pragmatic problems related to the development of a register-based hip fracture incidence surveillance system are proposed. The monitoring of effectiveness of treatment is shown to be possible in terms of care episodes. Finally, an example on the justification of a more detailed performance indicator to be used in the profiling of providers is given. In conclusion, it is possible to produce useful and valid information on health system performance by using Finnish register-based data. However, that seems to be far more complicated than is typically assumed. The perspectives given in this study introduce a necessary basis for further work and help in the routine implementation of a hip fracture monitoring system in Finland.

Sosiaalipalveluja kaikille ja kaiken ikää? : Tutkimus suomalaisten mielipiteistä ja kokemuksista sosiaalipalveluista sekä niiden suhteesta legitimiteettiin

This research analyses opinions on the system of social welfare services from the point of view of clients and the public in general in Finland. The approach is quantitative, drawing on theories of the welfare-state tradition. The data used comes from the comprehensive Welfare and Services in Finland survey compiled by STAKES. While previous research on the welfare state has predominantly focused on surveying public opinion on social protection, this research focuses on social welfare services. The main focus of this research is on publicly funded care provided by municipal social welfare services. In this research, social welfare services include child day care, services for people with disabilities, home-help services, counselling by social workers and social assistance. The research considered in particular whether the clients or the population has different opinions towards social welfare services or social benefits. In addition, the research partly covers areas of informal care provided by family and friends. The research material consisted of the STAKES Welfare and Services in Finland survey. The data was compiled in 2004 and 2006 by Statistics Finland. The research comprises five articles. Additional data have been extracted from social welfare statistics and registers. Multiple approaches were applied in the survey on welfare and services the methods in this research included interviews by phone and mail, and register data. The sample size was 5 810 people in 2004 and 5 798 in 2006. The response rates were 82.7% and 83.7%, respectively. The results indicate that a large majority (90%) of the Finnish population is of the opinion that the public sector should bear the main responsibility for organising social and health services. The system of social welfare services and its personnel have strong public support 73% and 80% respectively. However, new and even negative tones have emerged in the Finnish debate on social welfare services. Women are increasingly critical of the performance of social welfare services and the level of social protection. Furthermore, this study shows that women more often than men wish to see an increase in the amount of privately organised social welfare services. Another group critical of the performance of social welfare services are pensioners. People who had used social welfare services were more critical than those who had not used them. Thus, the severest criticism was received from the groups who use and gain most from public services and benefits. However, the education and income variables identified in earlier studies no longer formed a significant dividing line, although people with higher education tend to foster a more positive view of the performance of social welfare services as well as the level of social protection. Income differences did not bear any significance, that is, belonging to a high or low income group was not a determining factor in the attitude towards social welfare services or social benefits. According to the research, family and friends still form an informal yet significant support network in people's everyday lives, and its importance has not been diminished by services provided by the welfare state. The Finnish public considers child day care the most reliable form of social welfare services. Indeed, child day care has become the most universal sector of our system of social welfare services. Other services that instil confidence included counselling by social workers and services for people with disabilities. On the other hand, social assistance and home-help services received negative feedback. The negative views were based on a number of arguments. One argument contends that the home-help service system, which was originally intended for universal use, is crumbling. The preventive role of home-help services has been reduced. These results mirror the increasingly popular opinion that social welfare services are not produced for all those who need them, but to an increasing extent for a select few of them. Municipalities are struggling with their finances and this, combined with negative publicity, has damaged the public's trust in some municipal social welfare services. A welfare state never achieves a stable condition, but must develop over time, as the world around it changes. Following the 1990's recession, we are now in a position where we can start to develop a system that responds to the needs of the next generation. Study results indicating new areas of dissatisfaction reflect the need to develop and improve the services provided. It is also increasingly essential that social welfare services pay attention to the opinions of clients and the public. Should the gap between opinions and actual activities increase, the legitimacy of the whole system would be questioned. Currently, the vast majority of Finns consider the system of social welfare services adequate, which provides us with the continuity required to maintain and improve client-oriented and reasonably priced social welfare services. Paying attention to the signals given by clients and the general public, and reacting to them accordingly, will also secure the development and legitimacy of the system in the future.

Approximation of solutions to fractional integral equation

In this paper we shall study a fractional integral equation in an arbitrary Banach space X. We used the analytic semigroups theory of linear operators and the fixed point method to establish the existence and uniqueness of solutions of the given problem. We also prove the existence of global solution. The existence and convergence of the Faedo–Galerkin solution to the given problem is also proved in a separable Hilbert space with some additional assumptions on the operator A. Finally we give an example to illustrate the applications of the abstract results.

The impact of FSC certification on timber tree regeneration and floristic composition in Honduran community forests

Forest certification has been put forward as a means to improve the sustainability of forest management in the tropical countries, where traditional environmental regulation has been inefficient in controlling forest degradation and deforestation. In these countries, the role of communities as managers of the forest resources is rapidly increasing. However, only a fraction of tropical community forests have been certified and little is known about the impacts of certification in these systems. Two areas in Honduras where community-managed forest operations had received FSC certifications were studied. Río Cangrejal represents an area with a longer history of use, whereas Copén is a more recent forest operation. Ecological sustainability was assessed through comparing timber tree regeneration and floristic composition between certified, conventionally managed and natural forests. Data on woody vegetation and environmental conditions was collected within logging gaps and natural treefall gaps. The regeneration success of shade-tolerant timber tree species was lower in certified than in conventionally managed forests in Río Cangrejal. Furthermore, the floristic composition was more natural-like in the conventionally managed than the certified forests. However, the environmental conditions indicated reduced logging disturbance in the certified forests. Data from Copén demonstrated that the regeneration success of light-demanding timber species was higher in the certified than the unlogged forests. In spite of this, the most valuable timber species Swietenia macrophylla was not regenerating successfully in the certified forests, due to rapid gap closure. The results indicate that pre-certification loggings and forest fragmentation may have a stronger impact on forest regeneration than current, certified management practices. The focus in community forests under low-intensive logging should be directed toward landscape connectivity and the restoration of degraded timber species, instead of reducing mechanical logging damage. Such actions are dependent on better recognition of resource rights, and improving the status of small Southern producers in the markets of certified wood products.

Factor V Leiden as risk factor for pregnancy complications : Epidemiological study of Finnish women

Factor V Leiden (FV Leiden) is the most common inherited thrombophilia in Caucasians increasing the risk for venous thrombosis. Its prevalence in Finland is 2-3%. FV Leiden has also been associated with several pregnancy complications. However, the importance of FV Leiden as their risk factor is unclear. The aim of the study was to assess FV Leiden as a risk factor for pregnancy complications in which prothrombotic mechanisms may play a part. Specifically, the study aimed to assess the magnitude of the risk, if any, associated with FV Leiden for pregnancy-associated venous thrombosis, pre-eclampsia, unexplained stillbirth, and preterm birth. The study was conducted as a nested case-control study within a fixed cohort of 100,000 consecutive pregnant women in Finland. The study was approved by the ethics committee of the Finnish Red Cross Blood Service and by the Ministry of Social Affairs and Health. All participants gave written informed consent. Cases and controls were identified by using national registers. The diagnoses of the 100,000 women identified from the National Register of Blood Group and Blood Group Antibodies of Pregnant Women were obtained from the National Hospital Discharge Register. Participants gave blood samples for DNA tests and filled in questionnaires. The medical records of the participants were reviewed in 49 maternity hospitals in Finland. Genotyping was performed in the Finnish Genome Center. When evaluating pregnancy-associated venous thrombosis (34 cases, 641 controls), FV Leiden was associated with 11-fold risk (OR 11.6, 95% CI 3.6-33.6). When only analyzing women with first venous thrombosis, the risk was 6-fold (OR 5.8, 95% CI 1.6-21.8). The risk was increased by common risk factors, the risk being highest in women with FV Leiden and pre-pregnancy BMI over 30 kg/m2 (75-fold), and in women with FV Leiden and age over 35 years (60-fold). When evaluating pre-eclampsia (248 cases, 679 controls), FV Leiden was associated with a trend of increased risk (OR 1.7, 95% CI 0.8-3.9), but the association was not statistically significant. When evaluating unexplained stillbirth (44 cases, 776 controls), FV Leiden was associated with over 3-fold risk (OR 3.8, 95% CI 1.2-11.6). When evaluating preterm birth (324 cases, 752 controls), FV Leiden was associated with over 2-fold risk (OR 2.4, 95% CI 1.3-4.6). FV Leiden was especially associated with late preterm birth (32-36 weeks of gestation), but not with early preterm birth (< 32 weeks of gestation). The results of this large population-based study can be generalized to Finnish women with pregnancies continuing beyond first trimester, and may be applied to Caucasian women in populations with similar prevalence of FV Leiden and high standard prenatal care.

The Church and Its Boundaries : A Study of the Special Commission on Orthodox Participation in the WCC

The relationship between the Orthodox Churches and the World Council of Churches (WCC) became a crisis just before the 8th Assembly of the WCC in Harare, Zimbabwe in 1998. The Special Commission on Orthodox Participation in the WCC (SC), inaugurated in Harare, worked during the period 1999 2002 to solve the crisis and to secure the Orthodox participation in the WCC. The purpose of this study is: 1) to clarify the theological motives for the inauguration of the SC and the theological argumentation of the Orthodox criticism; 2) to write a reliable history and analysis of the SC; 3) to outline the theological argumentation, which structures the debate, and 4) to investigate the ecclesiological questions that arise from the SC material. The study spans the years 1998 to 2006, from the WCC Harare Assembly to the Porto Alegre Assembly. Hence, the initiation and immediate reception of the Special Commission are included in the study. The sources of this study are all the material produced by and for the SC. The method employed is systematic analysis. The focus of the study is on theological argumentation; the historical context and political motives that played a part in the Orthodox-WCC relations are not discussed in detail. The study shows how the initial, specific and individual Orthodox concerns developed into a profound ecclesiological discussion and also led to concrete changes in WCC practices, the best known of which is the change to decision-making by consensus. The Final Report of the SC contains five main themes, namely, ecclesiology, decision-making, worship/common prayer, membership and representation, and social and ethical issues. The main achievement of the SC was that it secured the Orthodox membership in the WCC. The ecclesiological conclusions made in the Final Report are twofold. On the one hand, it confirms that the very act of belonging to the WCC means the commitment to discuss the relationship between a church and churches. The SC recommended that baptism should be added as a criterion for membership in the WCC, and the member churches should continue to work towards the mutual recognition of each other s baptism. These elements strengthen the ecclesiological character of the WCC. On the other hand, when the Final Report discusses common prayer, the ecclesiological conclusions are much more cautious, and the ecclesiological neutrality of the WCC is emphasized several times. The SC repeatedly emphasized that the WCC is a fellowship of churches. The concept of koinonia, which has otherwise been important in recent ecclesiological questions, was not much applied by the SC. The comparison of the results of the SC to parallel ecclesiological documents of the WCC (Nature and Mission of the Church, Called to Be the One Church) shows that they all acknowledge the different ecclesiological starting points of the member churches, and, following that, a variety of legitimate views on the relation of the Church to the churches. Despite the change from preserving the koinonia to promises of eschatological koinonia, all the documents affirm that the goal of the ecumenical movement is still full, visible unity.

Bispectra of A Tropical Coupled Ocean-Atmosphere System

It has recently been proposed that the broad spectrum of interannual variability in the tropics with a peak around four years results from an interaction between the linear low-frequency oscillatory mode of the coupled system and the nonlinear higher-frequency modes of the system. In this study we determine the bispectrum of the conceptual model consisting of a nonlinear low-order model coupled to a linear oscillator for various values of the coupling constants.

Conjugate Model for Heat and Mass Transfer of Porous Wall in the High Temperature Gas Flow

Heat and mass transfer of a porous permeable wall in a high temperature gas dynamical flow is considered. Numerical simulation is conducted on the ground of the conjugate mathematical model which includes filtration and heat transfer equations in a porous body and boundary layer equations on its surface. Such an approach enables one to take into account complex interaction between heat and mass transfer in the gasdynamical flow and in the structure subjected to this flow. The main attention is given to the impact of the intraporous heat transfer intensity on the transpiration cooling efficiency.

Pérdidas económicas causadas por presencia de insecticidas organoclorados en carne bovina de exportación en el matadero "Julio Moncada T." Managua, Nicaragua

El presente estudio se realizó para evaluar la presencia de insecticidas organoclorados en carne bovina destinada a la exportación. Los datos fueron recopilados de la matanza diaria realizada en el matadero "Julio Moneada T" (CARNIC), a partir de Agosto de 1989 a Noviembre de este mismo año y una segunda recolección en Septiembre de 1990. Se evaluó el año y los meses que presentaron mayor porcentaje de contaminación, y las pérdidas económicas para los años 1988 y 1989. Se estudiaron dos categorías de carne, exportable y no exportable, esta última afectada por la presencia de insecticidas organoclorados. El análisis estadístico se realizó a través del método del mínimo cuadrado generalizado, usando el procedimiento CATMOD del paquete estadístico "Statistical Analysis System" (SAS). Los análisis estadísticos nos reflejan diferencias altamente significativas (α=0.0001) para el efecto de año, y para el efecto de mes (α=0.0001), obteniéndose un 19.16% y 6.69% de pérdidas por presentar niveles de contaminación no aceptable para la exportación. Las pérdidas económicas revelan cifras aproximadas de U$ 3,935,444.6 para el año 1988 y U$ 2,150,162.4 para 1989 en divisas no captadas por la empresa.

Evaluación de los factores de la ecuación universal de perdida de suelo: Municipio San José de los Remates

El área experimental está ubicada en el departamento de Boaco, municipio de San José de los Remate, finca La Primavera cuya ubicación es latitud norte 12°36'43" y longitud oeste 85°44'07". El objetivo del presente estudio es determinar los factores de la E.U.P.S durante la estación lluviosa del 2006, bajo diferentes estrategias de cubierta vegetal (Grama natural y Bosque nativo). Se estableció un experimento en bloques, con tres repeticiones y dos tratamientos. Cada parcela tiene una dimensión de 50 metros de largo y 15 metros de ancho para un área útil de 750 m2 con un área total por tratamiento de 2,250 m2. El estudio demuestra que las mayores pérdidas de suelo se dieron en las parcelas de Bosque nativo con un valor promedio de 0.068 ton/ha y en las parcelas de Grama natural resultaron con perdidas menores con 0.0264 ton/ha. Además las pérdidas de suelos en todos los eventos fueron relativamente bajo en comparación a los niveles de tolerancia propuestos por Mennering (1981) y Schertz (1983). Se utilizo la Ecuación Universal de Pérdida de Suelo (E.U.P.S) el cual está compuesta por un total de 6 parámetro como R = 285.13 MJmm/hah,K = 0.017-0.019 ton ha h /ha MJ mm, S = 1.6, L = 4.27 a 8.89, C = Grama natura l0.01 y Bosque nativo 0.001, P = no se asumió por no existir práctica. Para el análisis de la información; se utilizó como método estadística T student con un grado de significancia del 95 % los efectos de las diferentes variables relacionada a los procesos de erosión del suelo y del escurrimiento superficial resultando no significativos para dichos cálculos establecidos. El uso de relación entre algunas variables no fue sensible a su relación como la erosividad vs. Intensidad de la lluvia o erosividad vs. Pérdida de suelo debido a los pocos eventos de lluvia que fueron analizados en este período de estudio. Recomendando que estos estudios deberán de ser proyectado a mediano y largo plazo para reconocer los procesos de erosión de suelo y el efecto del escurrimiento superficial en tierras escarpadas bajo la aplicación de modelos de predicción de erosión.

Evaluar la erosión hídrica mediante el uso de diferentes modelos de prediccion en San José de los Remates

El área experimental está ubicada en el departamento de Boaco, municipio de San José de los Remate, finca La Primavera cuya ubicación es latitud norte 12°36'43" y longitud oeste 85° 44'07". El objetivo del presente estudio es determinar los factores de la RUSLE Y USLE durante la estación lluviosa del 2008, bajo diferentes sistemas de cubierta vegetal (Grama natural y Bosque nativo). Se estableció un experimento en bloques, con tres repeticiones y dos tratamientos. Cada parcela tiene una dimensión de 50 metros de largo y 15 metros de ancho para un área útil de 750 m2 con un área total por tratamiento de 2,250 m2. El estudio demuestra que las mayores pérdidas de suelo se dieron en las parcelas de Grama natural con un valor promedio de 0.229 t/ha y en las parcelas de Bosque nativo resultaron con pérdidas menores con 0.033t/ha. Además las pérdidas de suelos en todos los eventos fueron relativamente bajas en comparación a los niveles de tolerancia propuestos por Wischmeier y Smith, 1965-1978. Se utilizo la Ecuación Universal de Pérdida de Suelo (E.U.P.S) el cual está compuesta por un total de 6 parámetro como R = 516.48. MJmm/ha h, K = 0.34-0.63 t.ha.h/ha MJ mm, S = 1.6, L = 4.27 (USLE), L*S (0.34–0.39) (RUSLE), C = Grama natural 0.01 y Bosque nativo 0.001, P = no se asumió por no existir práctica.Para el análisis de la información; se utilizó como método estadístico T student con un grado de significancia del 95 % los efectos de las diferentes variables relacionada a los procesos de erosión del suelo y del escurrimiento superficial resultando no significativos entre modelos.