Tuotehyväksynnän hallinta rakennusliikkeessä

Rakennusalan tuotehyväksyntä muuttuu EU:n rakennustuoteasetuksen astuessa voimaan 1.7.2013, jolloin CE-merkintä tulee pakolliseksi suurella osalle rakennustuotteita. Muutos aiheuttaa toimia yli 4000 suomalaisyrityksessä, jotka joutuvat hankkimaan tuotteelleen CE-merkinnän. Rakennustuoteasetus vaikuttaa kaikkiin alan toimijoihin. Tämä diplomityö on toteutettu toimintatutkimuksena, johon sisältyvien teemahaastattelujen kautta saatujen tutkimustulosten perusteella kehitettiin tuotehyväksynnän hallintaan työkalu, YIT-tuotehyväksyntäkortit. Ne laadittiin tuotehyväksynnän teoriaan pohjalta palvelemaan koko YIT Rakennus Oy:tä ja muokattiin yrityksen tarpeisiin sopiviksi soveltaen toimintatutkimuksen tuloksia. YIT-tuotehyväksyntäkortiston avulla pyritään kehittämään yrityksen toimintatapoja vaikuttamalla organisaation henkilöstöön osallistamalla ja vastuuttamalla heitä. Tuotehyväksynnän vaikutuksia rakennushankkeen eri vaiheisiin tutkittiin havainnoivan keskustelun avulla ja teemahaastatteluiden tuloksia analysoiden. YIT-tuotehyväksyntäkortistoa hallinnan välineenä testattiin pääasiassa haastattelujen avulla, sillä mallikortit eivät vielä mahdollistaneet laajempaa testausta käytännössä. Työn tuloksina esitellään YIT-tuotehyväksyntäkorttien laadintaprosessi ja paneudutaan tarkemmin korttien sisältöön.

I hälsans spelrum : lek på vårdandets scen

With caring science as its foundation and by means of the perioperative dialogue, the intended contribution and overall aim of this present thesis is to describe what play is and could be in the caring reality, an ideal model. The perioperative dialogue is the nurse anaesthetists’ pre-, intra- and post-operative dialogues with the children they care for in connection with anesthesia. The thesis is composed according to Schopenhauer’s notion that the road to science presupposes the world seen as performances, and has an all-pervading hermeneutic approach. The performances of the thesis are: the performance of all performances, the empirical performance, the transcendental performance and the universal performance. The performance of all performances originates in the theoretical perspective of the thesis and describes what play and its characteristics are. This performance is realized through the hermeneutic interpretation of the etymology and original meaning of the word play along with texts from caring science, philosophy, anthropology and the history of religion. The empirical performance originates in four empirical studies where caring is organized as a perioperative dialogue. In study I, the material was collected with the help of participating observations and semi-structured interviews, in study II, with the help of the critical incident method and in study III, with the help of conversation interviews. In study IV, play develops into a clinical caring science research method. The research participants consist of children with special needs, children with a pronounced fear of anaesthesia, parents of children with severe autism and nurse anaesthetists. The empirical performance relates in what way play manifests in a perioperative child context by interpreting the results from the empiric in the light of the characteristics of play. The transcendental performance is enacted in the playhouse of health and presents a picture of the essence of play, the playing. In the playhouse of health, the light, winged movement of play is actualized when what was previously too difficult, too heavy and pinioned instead is as easy as anything. The eye of love and compassion knows the art of deciphering the secret script where the Other’s holiness resides, even if mere glimpses of it appear. The universal performance depicts three caring acts where the entrance consists of entering play, the ideal of which is realized in the unmasked openness face to face, that which protects the playing human being against encroachment and an unwanted audience. In the second caring act, entering play plays on to the finely-tuned interplay between human beings in the winged play of beauty and dignity. In the third caring act, the world’s deepest plays are staged on the stage of caring, in the sense that the innermost being of each individual, the universal will joins in and allows individuals to live as playing human beings who are at home with themselves and the world. The captivating, graceful and friendly play works from within itself, as long as it illumined by the light of claritas can play undisturbed on the stage of caring where it – like an unclouded mirror of its own ideal watches over children’s health.

Vauhtikausi. Autoilun sukupuoli 1920-luvun Suomessa

The Age of Speed:Automobility’s Gender in the 1920s Finland The aim of this study is to analyze the connections between automobility and gender in Finland in the 1920s. In this study it is argued that the 1920s was the significant era in the Finnish history of automobility when many of the long-lasting gendered notions and cultural understandings were constructed. This study combines cultural history of technology with gender analysis. As the previous research on gender and technology has recognized, technology is a significant site of gender negotiations. Both from the cultural historical perspective and a gender perspective it is important to understand both technology and gender as cultural constructions. They were linked together and constructed each other. In other words: technology shapes gender and gender shapes technology. Historians of technology like Nina Lerman, Ruth Oldenziel and Arwen Mohun have argued that both gender and technology are about power: social, cultural, economic and political. In this study automobility means technology that can be analyzed in layers of identity, structures, institutions and representations. The source material consists of various types of historical sources, magazines and journals, advertisements, archival material together with films and literature. In the previous studies of the history of automobility gender has often been neglected. The term “gender” has also quite often been misunderstood. Some studies in the field have only focused on the early female drivers. However, far too little attention has been paid to the question, why automobility was considered as masculine sphere only. This study aims to give new insights to the previous interpretations of the history of automobility. As in various other countries also in Finland, the decade of the 1920s is characterized as a period of “modern times.” It was also the era of the automobiles. Although the number of cars in Finland was still low compared to the other European countries and the USA, in press, films and literature, images of automobiles and new women – and men – on the wheel became as an emblem of a new era. The thesis consists of three main chapters. The first main chapter focuses on the conflicts between drivers and non-drivers. The study shows how in the debate of the automobility “a driver” was constantly referred as a man and “a pedestrian” accordingly a woman, even though in the reality there were as much men and women walking on the streets and the roads. Thus, the public debate constructed and reconstructed the gendered traffic system where men were playing the key role. The second main chapter of the study analyses the automobile clubs and the cultural representations. The chapter answers the question how the concept of a driver was gendered. The Automobile clubs and the organizations of professional drivers were in a significant role in developing the early history of traffic in Finland. The Finnish Automobile Club (Suomen Automobiili Klubi, founded in 1919) was the oldest and the most powerful of all automobile organizations. The Finnish Automobile Club accepted women as members from the very beginning. The membership was strictly limited to the upper class and the very first female members were wives and daughters of the male members. However, Doctor of medicine and surgery 316 Karolina Eskelin (1867-1936) the founding member of the Club was an exception to that convention. The male members of the Finnish Automobile Club attended official international meetings and consulted Finnish authorities in traffic and road questions, whereas, female members joined car trips, picnics and social gatherings arranged by the club. Few young female members of the club drove in races and gross-country-tours. The cultural representations of drivers in the Finnish media in the 1920s both deconstructed and reconstructed the concept of gender. In Finnish press in general, motoring was seen as male dominated area. Men were represented as the experts of the automobility. The drivers’ uniforms and the automobile clubs underlined professionalism and expertise which, thus, got masculine meaning. Women were beautiful accessories in the car ads, but they were also becoming a new consumer group in the market. The representations of the female and the male drivers influenced and shaped actively the understandings of femininity and masculinity. In the third main chapter the analysis focuses on the automobile as an artifact.The automobile was considered as an artifact that primarily belonged to the masculine domain. However, the representations of the automobiles were ambivalent. The automobile was both masculine and feminine depending on the context. The representations of the automobile were also used to construct the discourse of heteronormativity.

Differentiation of Metabolically Distinct Areas within Head and Neck Region using Dynamic 18F-FDG Positron Emission Tomography Imaging

Positron Emission Tomography (PET) using ¹⁸F-FDG is playing a vital role in the diagnosis and treatment planning of cancer. However, the most widely used radiotracer, ¹⁸F-FDG, is not specific for tumours and can also accumulate in inflammatory lesions as well as normal physiologically active tissues making diagnosis and treatment planning complicated for the physicians. Malignant, inflammatory and normal tissues are known to have different pathways for glucose metabolism which could possibly be evident from different characteristics of the time activity curves from a dynamic PET acquisition protocol. Therefore, we aimed to develop new image analysis methods, for PET scans of the head and neck region, which could differentiate between inflammation, tumour and normal tissues using this functional information within these radiotracer uptake areas. We developed different dynamic features from the time activity curves of voxels in these areas and compared them with the widely used static parameter, SUV, using Gaussian Mixture Model algorithm as well as K-means algorithm in order to assess their effectiveness in discriminating metabolically different areas. Moreover, we also correlated dynamic features with other clinical metrics obtained independently of PET imaging. The results show that some of the developed features can prove to be useful in differentiating tumour tissues from inflammatory regions and some dynamic features also provide positive correlations with clinical metrics. If these proposed methods are further explored then they can prove to be useful in reducing false positive tumour detections and developing real world applications for tumour diagnosis and contouring.

Background for Designing an Improved Digital Musical Keyboard Instrument

Electrical keyboard instruments and computer-aided music-making generally base on the piano keyboard that was developed for a tuning system no longer used. Alternative keyboard layout offers at least easier playing, faster adopting, new ways to play and better ergonomics. This thesis explores the development of keyboard instruments and tunings, and different keyboard layouts. This work is preliminary research for an electrical keyboard instrument to be implemented later on.

Project Management Tools in Agile Embedded Systems Development

Agile methods have become increasingly popular in the field of software engineering. While agile methods are now generally considered applicable to software projects of many different kinds, they have not been widely adopted in embedded systems development. This is partly due to the natural constraints that are present in embedded systems development (e.g. hardware–software interdependencies) that challenge the utilization of agile values, principles and practices. The research in agile embedded systems development has been very limited, and this thesis tackles an even less researched theme related to it: the suitability of different project management tools in agile embedded systems development. The thesis covers the basic aspects of many different agile tool types from physical tools, such as task boards and cards, to web-based agile tools that offer all-round solutions for application lifecycle management. In addition to these two extremities, there is also a wide range of lighter agile tools that focus on the core agile practices, such as backlog management. Also other non-agile tools, such as bug trackers, can be used to support agile development, for instance, with plug-ins. To investigate the special tool requirements in agile embedded development, the author observed tool related issues and solutions in a case study involving three different companies operating in the field of embedded systems development. All three companies had a distinct situation in the beginning of the case and thus the tool solutions varied from a backlog spreadsheet built from scratch to plug-in development for an already existing agile software tool. Detailed reports are presented of all three tool cases. Based on the knowledge gathered from agile tools and the case study experiences, it is concluded that there are tool related issues in the pilot phase, such as backlog management and user motivation. These can be overcome in various ways epending on the type of a team in question. Finally, five principles are formed to give guidelines for tool selection and usage in agile embedded systems development.

Temporal dynamics of two species of Chaetophoraceae (Chlorophyta) in tropical streams of São Paulo State, Southeastern Brazil

Temporal dynamics of the chaetophoracean green algae Chaetophora elegans (Roth) C.A. Agardh and Stigeoclonium amoenum Kützing populations was investigated biweekly during late autumn trhough early spring (April to October) in two tropical streams from northwestern São Paulo State, southeastern Brazil. Abundances of one population of each species was evaluated by the quadrat technique in terms of percent cover and frequency. The fluctuations were related to the following stream variables: temperature, turbidity, specific conductance, pH, oxygen saturation, depth, substratum type, current velocity, irradiance and nutrients. Percent cover and frequency of C. elegans had lower values throughout the study period and was positively correlated to rainfall. Other correlations (i.e. positive of percent cover with depth and current velocity and negative with irradiance) were consistently found, reinforcing the strong influence of rainfall. On the other hand, percent cover and frequency of S. amoenum had higher values, with maximum growth from June to September. Percent cover was negatively correlated to rainfall. Results suggest the precipitation regime as the most important driving force to temporal changes in both populations, but playing different roles in each one. The gelatinous thallus of C. elegans seem to be favored by the increment of current velocity, since higher flows can improve the nutrient uptake by means of reduction in diffusion shell without promoting excessive drag force. In contrast, tufts of S. amoenum are, presumably, more exposed to drag force, and, consequently, more susceptible to mechanical damage effects due to higher current velocities.

Memoria virtualis - death and mourning rituals in online environments

The main objective of this work has been to understand the ritual aspect of how private people use the Internet to mourn and honor their intimates in various online environments. The research material was compiled in 2007–2013 through ethnographic and autoethnographic observations in social media applications, online memorial websites, one shared virtual environment (Second Life) and one massive multi-player online role-playing game (World of Warcraft). The research material consists of – in addition to the ethnographic observations – three online surveys with 153 respondents (mainly from Finland, the United States and the United Kingdom). In addition, the researcher conducted 38 longer online interviews (i.e. via email, an avatar). The theoretical framework is derived from ritual theory, hermeneutic-phenomenological anthropology and discourse analysis. The research questions are as follows: Why are death rituals practiced in online environments? How are virtual memorials created in various online environments? What kind of systems of meanings are virtual memorials constructed from? The results indicate that online mourning and honoring is appropriated in addition to the “traditional” offline rituals. In online environments the bereaved can choose, where, when, how and with whom they share their grief and loss. Memorials are created in the web intentionally and unintentionally, where the latter refers inter alia to the Facebook profile of the deceased where his/her intimates gather to mourn and honor immediately after the death. The first refers to intentionally memorialized online places spaces via different service providers. Virtual memorials are a way to construct the identity of the deceased, as well as the bereaved in multiple ways. They also re-enforce and create a sense of communality both privately and publicly, and enable one meaningful online place where all the intimates of the deceased can gather together to mourn and honor despite the geographical or time distances. Tämä väitöstutkimus tarkastelee miten nykyiset kuolemanrituaalit ovat digitalisoituneet verkkoympäristöihin. Tutkimus on suoritettu verkkoetnografisin sekä autoetnografisin menetelmin sosiaalisen median sivustoilla, virtuaalimuistomerkkipalveluissa, yhdestä virtuaalimaailmassa (Second Life) sekä yhdestä reaaliaikaisessa verkkopelissä (World of Warcraft) vuosina 2007–2013. Tutkimusaineisto koostuu etnografisten havainnointien lisäksi kolmesta verkkokyselystä, joissa vastaajia on yhteensä 153 pääasiassa Suomesta, Yhdysvalloista sekä Iso-Britanniasta. Kyselyjen lisäksi tutkija on tehnyt myös 38 laajempaa verkkohaastattelua eri ympäristöissä (esim. sähköposti, avatar virtuaalimaailmassa). Teoreettinen kehys koostuu rituaaliteoriasta, hermeneuttis-phenomenologiasta sekä diskurssianalyysista. Tutkimuskysymykset ovat seuraavat: miksi kuolemanrituaaleja harjoitetaan verkkoympäristöissä, miten virtuaalisia muistomerkkejä luodaan verkkoon, sekä millaisista merkitysjärjestelmistä virtuaaliset muistomerkit muodostuvat? Tutkimustulosten mukaan verkkosureminen ja muistaminen ovat tulleet perinteisten kuolemanrituaalien rinnalle, jolloin sureva itse voi päättää miten, missä, milloin sekä kenen kanssa suree läheistään. Muistomerkkejä verkkoon luodaan suunnitellusti (intentional) sekä suunnittelemattomasti (unintentional), jolloin jälkimmäinen viittaa esimerkiksi edesmenneen Facebook profiiliin, missä hänen läheisensä kokoontuvat muistelemaan ja suremaan välittömästi kuoleman jälkeen. Ensimmäinen taas viittaa suunnitelmalliseen muistomerkin luomiseen, jota varten löytyy useita palveluntarjoajia. Virtuaalimuistomerkit ovat keino rakentaa sekä edesmenneen että surevan identiteettiä, vahvistaa ja luoda yhteisöllisyyttä niin yksityisesti kuin julkisesti, sekä luoda yksi yhteinen aina ja kaikkialta saavutettavissa oleva merkityksellinen paikka verkkoon, missä kaikki läheiset voivat ajasta ja paikasta riippumatta muistella ja surra läheistään.

Understanding Online Game Players' Post-adoption Behavior: an Investigation of Social Network Games in China

Retaining players and re-attracting switching players has long been a central topic for SNG providers with regard to the post-adoption stage of playing an online game. However, there has not been much research which has explored players’ post-adoption behavior by incorporating the continuance intention and the switching intention. In addition, traditional IS continuance theories were mainly developed to investigate users’ continued use of utilitarian IS, and thus they may fall short when trying to explain the continued use of hedonic IS. Furthermore, compared to the richer literature on IS continuance, far too little attention has been paid to IS switching, leading to a dearth of knowledge on the subject, despite the increased incidence of the switching phenomenon in the IS field. By addressing the limitations of prior literature, this study seeks to examine the determinants of SNG players’ two different post-adoption behaviors, including the continuance intention and the switching intention. This study takes a positivist approach and uses survey research method to test five proposed research models based on Unified Theory of Acceptance and Use of Technology 2; Use and Gratification Theory; Push-Pull-Mooring model; Cognitive Dissonance Theory; and a self-developed model respectively with empirical data collected from the SNG players of one of the biggest SNG providers in China. A total of 3919 valid responses and 541 valid responses were used to examine the continuance intention and the switching intention, respectively. SEM is utilized as the data analysis method. The proposed research models are supported by the empirical data. The continuance intention is determined by enjoyment, fantasy, escapism, social interaction, social presence, social influence, achievement and habit. The switching intention is determined by enjoyment, satisfaction, subjective norms, descriptive norms, alternative attractiveness, the need for variety, change experience, and adaptation cost. This study contributes to IS theories in three important ways. Firstly, it shows IS switching should be included in IS post-adoption research together with IS continuance. Secondly, a modern IS is usually multi-functional and SNG players have multiple reasons for using a SNG, thus a player’s beliefs about the hedonic, social and utilitarian perceptions of their continued use of the SNG exert significant effects on the continuance intention. Thirdly, the determinants of the switch ing intention mainly exert push, pull, and mooring effects. Players’ beliefs about their current SNG and the available alternatives, as well as their individual characteristics are all significant determinants of the switching intention. SNG players combine these effects in order to formulate the switching intention. Finally, this study presents limitations and suggestions for future research.

Tissue-specific regulation of IRS-1 in unilaterally nephrectomized rats

Insulin stimulates the tyrosine kinase activity of its receptor, resulting in the phosphorylation of its cytosolic substrate, insulin receptor substrate 1 (IRS-1). IRS-1 is also a substrate for different peptides and growth factors, and a transgenic mouse "knockout" for this protein does not have normal growth. However, the role of IRS-1 in kidney hypertrophy and/or hyperplasia was not investigated. In the present study we investigated IRS-1 protein and tyrosine phosphorylation levels in the remnant kidney after unilateral nephrectomy (UNX) in 6-week-old male Wistar rats. After insulin stimulation the levels of insulin receptor and IRS-1 tyrosine phosphorylation were reduced to 79 ± 5% (P<0.005) and 58 ± 6% (P<0.0001), respectively, of the control (C) levels, in the remnant kidney. It is possible that a circulating factor and/or a local (paracrine) factor playing a role in kidney growth can influence the early steps of insulin action in parallel. To investigate the hypothesis of a circulating factor, we studied the early steps of insulin action in liver and muscle of unilateral nephrectomized rats. There was no change in pp185 tyrosine phosphorylation levels in liver (C 100 ± 12% vs UNX 89 ± 9%, NS) and muscle (C 100 ± 22% vs UNX 91 ± 17%, NS), and also there was no change in IRS-1 phosphorylation levels in both tissues. These data demonstrate that after unilateral nephrectomy there is a decrease in insulin-induced insulin receptor and IRS-1 tyrosine phosphorylation levels in kidney but not in liver and muscle. It will be of interest to investigate which factors, probably paracrine ones, regulate these early steps of insulin action in the contralateral kidney of unilaterally nephrectomized rats.

Analysis of the DF508 mutation in a Brazilian cystic fibrosis population: comparison of pulmonary status of homozygotes with other patients

Sixty-one cystic fibrosis patients admitted for check-up or antibiotic treatment were enrolled for genetic and clinical evaluation. Genetic analysis was performed on blood samples stored on neonatal screening cards using PCR techniques to determine the presence of DF508 mutations. Clinical evaluation included Shwachman and Chrispin-Norman scores, age at onset of symptoms and diagnosis, spirometry, awake and sleep pulse oximetry, hyponychial angle measurement and presence of chronic Pseudomonas aeruginosa colonization. Eighteen patients (29.5%) were homozygous for the DF508 mutation, 26 (42.6%) had one DF508 mutation and 17 (27.9%) were noncarriers, corresponding to a 50.8% prevalence of the mutation in the whole population. Analysis by the Kruskal-Wallis test for comparison of genetic status with continuous variables or by the chi-square test and logistic regression for dichotomous variables showed no significant differences between any two groups for a = 0.05. We conclude that genetic status in relation to the DF508 mutation is not associated with pulmonary status as evaluated by the above variables

Extracellular matrix molecules play diverse roles in the growth and guidance of central nervous system axons

Axon growth and guidance represent complex biological processes in which probably intervene diverse sets of molecular cues that allow for the appropriate wiring of the central nervous system (CNS). The extracellular matrix (ECM) represents a major contributor of molecular signals either diffusible or membrane-bound that may regulate different stages of neural development. Some of the brain ECM molecules form tridimensional structures (tunnels and boundaries) that appear during time- and space-regulated events, possibly playing relevant roles in the control of axon elongation and pathfinding. This short review focuses mainly on the recognized roles played by proteoglycans, laminin, fibronectin and tenascin in axonal development during ontogenesis.

Genetic susceptibility to HPV infection and cervical cancer

Squamous cell carcinoma of the cervix (SCCC) is one of the leading causes of death in developing countries. Infection with high-risk human papillomavirus (HPV) is the major risk factor to develop malignant lesions in the cervix. Polymorphisms of the MHC and p53 genes seem to influence the outcome of HPV infection and progression to SCCC, although controversial data have been reported. MHC are highly polymorphic genes that encode molecules involved in antigen presentation, playing a key role in immune regulation, while p53 is a tumor suppressor gene that regulates cell proliferation. The HPV E6 protein from high-risk types binds p53 and mediates its degradation by the ubiquitin pathway. The role of these polymorphisms in genetic susceptibility to HPV infection and to SCCC remains under investigation.

Kallet til livets embete : mødre i helse og lidelse

Mothers represent the natural caring. Natural caring is the object of caring science and of research interest because it establishes the central core of professional caring. In this study, we encounter patients who are mothers in need of care in a psychiatric context. Motherhood involves taking responsibility that extends beyond one's own life, because the child represents possibilities in a yet unknown future. Understanding and knowledge about the mothers' struggle in health and suffering are of crucial importance to enable clinical practice to make provisions for and adapt to the individual patient. The overall purpose of this dissertation is to illuminate how the innermost essence of caring emerges in health and suffering in patients who are mothers in psychiatric care. The purpose of the study in a clinical sense is to seek to understand and illuminate the patient's inner world in health and suffering in terms of contextual, existential, ontological and ethical dimensions. The dissertation is exploratory and descriptive in nature and encompasses induction, deduction and abduction as logics tools of reasoning. A theoretical model of natural caring and a universal theoretical model of the innermost essence of caring is developed as seen from the patient's world in a psychiatric context. The dissertation is anchored in human science's view of the human being and the world and in caring science's perspective. Caring science's view of the human being as a unity comprising body, soul and spirit is central in the study's concept of the patient. This multi-dimensional conception of the human being encompasses the dissertation's basic values and is decisive for choice of methodology. Hermeneutic epistemology guided the interpretation of the empirical data, the paradigmatic theses and assumptions. The dialectical movement in interpretation moves back and forth between empirical data, caring science theory and philosophical theory and reveals deeper insight into meaningful content in the clinical context. The interpretation process comprises four levels of abstraction: rational, contextual, existential and ontological. Hermeneutic philosophy guides the inductive and deductive approach to interpretation, as well as the movement between the clinical context and the caring science paradigm. In this encounter between the visible and invisible reality, the image of natural caring – motherliness emerged. The dissertation consists of four studies. The first study is a systematic review of nineteen research articles. The three other studies are hermeneutical interpretations based on text materials from open interviews. Fifteen participants were interviewed, all of whom are mothers of children between 0 and 18 years of age. All were outpatients in the psychiatric specialist health service. In the interpretation process, the mothers' struggle in health and suffering emerges as a struggle between the inner and outer world. Being a mother and patient in health and suffering in a psychiatric context means to struggle to be oneself, to create oneself, to live and realize one's good deeds as a mother and human being. To be oneself, to possess oneself as a mother is not only a question of tending, playing and learning in order to master a practical situation or to survive. It involves constituting a deep, inner desire to courageously create oneself so that the child is able to realize his or her potential in health and suffering. Motherliness manifests itself in caring as a call to ministering humanity and life. The voice of motherliness is understood as the voice of life—the eternal, inner call of love and freedom. The inner call craves fulfilment. Motherliness in natural caring does not retreat. Motherliness defines the Other as freedom and proceeds without regard for all other exterior requirements to realizing wellbeing. The inner essence of caring is attentive, aware and heeds the call of the heart. The innermost essence of caring is to be and to make oneself responsible for the Other. Responsibility cannot be relinquished; free choice consists in whether or not to follow the call. To renounce the inner call to responsibility is to deny oneself and one's dignity as a human being. The theoretical models provide clinical and systematic caring science with knowledge and understanding based on the natural caring spirit inherent in the human being. The study elucidates and strengthens the ontological basic assumptions about the human being as a unity of body, soul and spirit, the sanctity of the human being and the core of caring, ethos. The results of the dissertation will provide clinical practice with knowledge about the inner movements of the mothers' souls in relation to their responsibility as mothers and human beings. Being able to understand the basic conditions for responsibility is crucial for developing care that encompasses mother and child and the mutual relationship between them. This is basic knowledge for developing attitudes and actions that meet and provide for the needs of the patient as mother and as a whole, suffering human being.

Newborn screening for biotinidase deficiency in Brazil: biochemical and molecular characterizations

Biotinidase deficiency is an inherited metabolic disorder characterized by neurological and cutaneous symptoms. Fortunately, it can be treated and the symptoms prevented by oral administration of the vitamin biotin. Using dried blood-soaked filter paper cards, biotinidase activity was determined in the sera of 225,136 newborns in Brazil. Mutation analysis performed on DNA from 21 babies with low serum biotinidase activity confirmed that 3 had profound biotinidase deficiency (less than 10% of mean normal sera biotinidase activity), 10 had partial biotinidase deficiency (10 to 30% of mean normal serum activity), 1 was homozygous for partial biotinidase deficiency, 4 were heterozygous for either profound or partial deficiency, and 3 were normal. Variability in serum enzyme activities and discrepancies with mutation analyses were probably due to inappropriate handling and storage of samples sent to the laboratory. Obtaining an appropriate control serum at the same time as that of the suspected child will undoubtedly decrease the false-positive rate (0.09%). Mutation analysis can be used to confirm the genotype of these children. The estimated incidence of biotinidase deficiency in Brazil is about 1 in 9,000, higher than in most other countries. Screening and treatment of biotinidase deficiency are effective and warranted. These results strongly suggest that biotinidase deficiency should be included in the newborn mass screening program of Brazil.