Koulu muistoissa : Tulevat opettajat muistelevat kouluaikaansa

Tutkielmassa tarkasteltiin opettajaksi opiskelevien koulumuistoja ja niissä esiintyviä positiivisia ja negatiivisia kokemuksia koulusta, oppimisesta ja opettajasta. Tutkimusmetodiksi valittiin koulumuistoista kirjoittaminen tarkoituksena helpottaa sekä kokemusten tuomista tietoisuuteen että niiden myöhempää käsittelyä kirjallisina dokumentteina. Opiskelijoita pyydettiin kirjoittamaan erään yhteisen luennon alussa parhaasta ja huonoimmasta koulumuistostaan. Tutkimuksen tarkoituksena oli kartoittaa opiskelijoiden muistoja koulusta. Tutkimuksen avulla pyrittiin myös osittain selittämään kokemuksien yhteyksiä toisiinsa. Tutkimusongelmina esitettiin seuraavat kysymykset: minkälaisia muistoja koulusta tulee ensimmäisenä mieleen, miten opettajan merkitys näkyy kyseisissä muistoissa, minkälaisen kuvan opiskelijoiden muistot antavat koulusta, ja miten muistoissa kuvatut koulukokemukset ovat mahdollisesti vaikuttaneet opiskelijoiden myöhempään elämään. Tutkimusjoukko koostui 101:stä Helsingin yliopiston opettajankoulutuslaitoksen ensimmäisen vuoden opiskelijasta, lastentarhanopettajan, luokanopettajan, kotitalousopettajan sekä käsityöopettajan koulutuslinjoilta. Koulumuistot sijoittuivat pääasiassa peruskouluaikaan, sillä opiskelijoista suurin osa oli alle 25-vuotiaita. Opiskelijoiden kirjoittamat muistot analysoitiin ja tulkittiin kvalitatiivisen tutkimusotteen mukaisesti. Analysointiluokkien muodostamiseen saatiin malli kahdesta aikaisemmasta tutkimuksesta. Ruotsalaisen Pérez Prieton koulukokemustutkimus ja amerikkalaisen Johnson Rothenbergin tutkimus opiskelijoiden koulumuistoista toimivat tämän tutkimuksen tärkeimpinä lähteinä teoriataustassa. Tutkimustulosten mukaan yli puolet opiskelijoiden koulumuistoista liittyi opettajaan. Opettajanvaikutus oli merkittävin negatiivisten muistojen kohdalla ja suurin osa maininnoista esiintyi nöyryytyskokemusten yhteydessä. Nöyryyttävinä koettiin tilanteet, joissa opettaja oli rankaissut julkisesti tai toiminut oppilaan oikeuksia vastaan. Positiivisissa muistoissa opettaja esiintyi noin viidesosassa maininnoista, pääasiassa menestymiskokemusten ja haastavuuden yhteydessä. Menestymiskokemukset,joihin liittyi yleensä itsensä toteuttamisen mahdollisuus, muodostivat suurimman parhaiden koulumuistojen luokan. Myös kaverit ja koulun ilmapiiri olivat merkittäviä tekijöitä niin hyvien kuin huonojenkin kokemusten kohdalla. Muita analysointiluokkia edellisten lisäksi olivat epäonnistuminen, turhautuminen, arvostelu, koulunvaihto ja rehtori. Teoreettisessa viitekehyksessä selvitettiin kokemuksen käsitettä ja sen soveltuvuutta tutkimuksen kohteeksi. Tärkeitä lähteitä tutkimuksen kokemuksellisen luonteen kannalta olivat Deweyn ja Jarvisin teokset, joissa käsiteltiin kokemuksen merkitystä kasvatukselle ja oppimiselle sekä reflektion vaikutusta kokemuksen merkittävyydelle. Lisäksi tarkasteltiin tutkimuksia koulukokemusten merkittävyydestä opettajaopiskelijoille ja opettajan merkityksestä oppilaalle tärkeänä aikuisena. Avainsanat: Koulumuistot, kokemusten tulkinta, opettajaopiskelijat, opettaja merkittävänä henkilönä Keywords: School Memories, Interpretation of Experiences, Future Teachers, Teacher as a Significant Person

Do UNESCO Schools in Finland Prepare Their Students for the Future? : A Study of Their School-based Curriculums

The purpose of the research was to study how Finnish lower-stage schools participating in the international network of UNESCO schools, also called the Associated Schools Project (ASP), prepare their students for the future at the level of their school-based curriculums. In the research, the future trends were discussed, and the importance of their consideration in educational practice was explained from a global viewpoint: Based on the examination of today's problematic world state, and development trends characterized by globalization, the challenges and demands set for schooling and education in the future were discussed. Understanding the significance of an individual's action and responsibility was considered to be the central resource for building a more just and sustainable future. The study was grounded on a theoretical model developed by the researcher, which combined the models of Dalin & Rust (1996) and UNESCO (Delors et al. 1996) about future-oriented learning. The model consists of four basic elements of curriculum; "Nature", "Culture", "Myself", and "Others", and four dimension of learning; "Learning to know", "Learning to do", "Learning to live together" and "Learning to be". The model represents the holistic aspect of educational theory, and its aim is to maintain a balance between its different components. The research material composed of ten lower-stage UNESCO schools' school-based curriculums. They were analyzed using the theoretical model by the methology of content analysis. The research results were notably consistent between the different schools. They showed cultural learning and learning concerned with "myself" to be clearly more emphasized than learning referring to nature and other people. In addition, they reflected the central position of subjects, knowledge and skills, thus leaving the development of the pupils' personalities, and particularly learning concerned with living with other people, in a marginal role. The question about whether the schools prepare for the future interms of their curriculums, was discussed in the light of the results. The research offered a way and a model to approach the relationship between education and the future, and to evaluate schools' future-orientation. Based on the results, the schools are suggested to lay more stress on learning concerned with nature and other people, and focus more on developing the mental capasities of their pupils and competencies they need for living with other people. Above all, what the present societies require of schools is education which produces balanced and broadly aware human beings who have the mental strength to face the challenges of the future and abilities to direct it along the lines they desire. Keywords: future, curriculum, content analysis

Kivaa ja hyödyllistä, mutta jo se riittää : Yläasteen kielikylpyoppilaiden käsityksiä ruotsinkielisestä kielikylpyopetuksesta Helsingissä

The aim of this study was to find out how immersion students experience immersion education, how they feel about the implementation of immersion education methods and what role immersion plays in immersion students’ lives outside the school context. In addition, the influence of sex, grade level, school and type of immersion education on students’ perceptions was studied. The population included all students at the lower secondary level in Helsinki who participated in Swedish immersion education during 2002–2003. The sample consisted of 128 students who represented two different forms of immersion: 47% of the students had previously participated in early total immersion while 53 % of the students had taken part in early partial immersion. The data were gathered through a questionnaire and interviews. All 128 students answered the questionnaire, and 10 students were chosen to focus interviews through purposive sampling. In addition, students’ parents were invited to fill in a questionnaire where students’ background information was requested. The data were collected during the spring of 2003. Principal Component Analysis and one-way variance analysis were used as statistical analysis methods. Also frequencies, average, correlations and cross tabs were studied. In the PCA a right-angled varimax-rotation was performed separately to every thematic entity that arose from the theoretical background. Sum variables were formed from the Principal Components by summing up all the items that received over .400 charges for the specific Principal Component. Significance testing of the mean was performed with F and t-tests. Results indicate that immersion students in lower secondary school experience immersion quite diversely as a whole. Students are satisfied with the fact that they are in the immersion class but not with the amount of teaching in Swedish. Students feel it is very important and useful to learn Swedish bearing in mind their future studies and working life. The students estimate their language skills to be very high. Yet they prefer using Finnish during classes. The fact that teachers use Swedish does not considerably affect how well the students learn the factual content in various subjects, especially if the student knows Swedish well. Theoretical subjects seemed to cause most problems. Swedish played only a very small part in students’ lives outside the school context and it was used merely when travelling abroad and in different kinds of guiding situations. Unless the students were talked to in Swedish, they kept on speaking Finnish. When asked about students’ experiences no statistically significant differences between sexes were found in this study. On the contrary, in some cases their grade level but especially their school and form of immersion had clear statistically significant differences on students’ perceptions.

"Haluan tuonne heti!" : Tulevaisuuskuvia ghanalaisten, isobritannialaisten,suomalaisten ja tansanialaisten lasten piirustuksissa

"I want there now!" Images of the future in the drawings of Ghanaian, British, Finnish and Tanzanian children The aim of the Thesis is to examine what kind of images children aged between 8 and 12 years in Ghana, Great Britain, Finland and Tanzania hold of their future. The study is a qualitative analysis based on data that consists of 214 drawings, digitally photographed and analysed using AtlasTI computer program. The data was coded and divided into " families " whose frequencies were compared in order to maintain results. The assignment was given to the children in the language used in the school and it was similar in each country. The children were introduced to the idea with a set of stimulating questions and after that they were asked to draw and colour with a pen a picture of 1) him/herself as an adult, 2) his/her future home and 3) the people and the animals they think they will be living with. The children were also asked to write down the country and the place they believe to live in their future. They were also encouraged to write down e.g. their dream profession, what they would like to have as hobbies in their adulthood and other important things in their lives. The analysis focuses on the content of the drawings instead of artistic or psychological interpretations. The differences between the drawings from different countries as well as the differences in a single country were significant. The current trends and the experiences children had lived through were present in the drawings. There were no differences in the colour of the skin and the most popular professions were doctor, police and football player. The football was very strongly present in all of the data; almost fourth of the children had either drawn or mentioned football as their future profession or hobby. Different flora was present in 84% of Tanzanian and 70% of Ghanaian drawings compared to the 23% of British and 17% of Finnish drawings. Of all the family forms a dream of the traditional nuclear family could be found among 29% of the drawings. Compared to that a total of 30% wanted either a child of their own without a spouse (15%) or a spouse without a child (15%). Also grandparents, childhood friends, other adults, animals or even space aliens were present and sharing a home with the children in the drawings. Of all children 15% wanted to live totally alone in the future. This was most typical (38%) among the Finnish boys. The cat and the dog were the most popular animals to appear in the drawings. Moving abroad proved to be purely a western phenomenon, dreamed by 57% of the British and 18% of the Finnish children. As results, a negative self-image, violence, lack of expressions of positive feelings and solitude among the Finnish boys in the data were very concerning. Keywords: Images of the future, future studies, future-education, picture analysis

"Älynväläyksiä juoksuasuissa" : Kestävyysjuoksijoiden käsityksiä juoksuasujen funktionaalisuudesta talviolosuhteissa sekä älyvaatteista

In this research the technical functionality, quality and demands made on endurance runners` running suits in winter conditions were studied. The aim was also to find out how smart clothing and wearable technology are adopted in endurance runners` practise. Referring to previous studies the subject was approached in the theoretical part by studying the profile of endurance running, sports wear and the technology to wear as well as the smart clothing from the point of view of endurance running. The basis of subject was the interest of smart materials and the connection between technical structures and functionality. In the science of handicrafts smart clothing is rarely researched which made it even more interesting for the author. This research was carried out by the principles of the usability research. Usability means the suitability of product to its intended meaning. In the research both quantitative and qualitative methods were used. Researched persons were active competitive long-distance runners and also the long-distance runners doing it as a hobby, 35 male and 12 female runners. User information was gathered by the internet forms which mainly was based on the multiple choices but also included few open questions. Gathered information was considered by using both quantitative and content analysing methods. The functional long-distance running practice suit in winter conditions consisted of layered look which considered the possibilities of functional and smart materials. The Practise suit was humid transformable, easy care and light also comfortable to wear. These suits were hoped to be more functional than the current ones. The future running suit was described to not to feel or notice during running. It will not be too tight or sweltering. The functional abilities of clothing materials were believed to be developed further more. Even if the new technical materials are adopted for the running suits the technology to wear is not even though half of the researched runners used pulse indicators. The runners hoped the technology to wear to change more invisible and easier to use. Some of the runners wished the technology to wear to be integrated straight to the clothes which would reduce the number of devices carried with while running. The rare use of Polar Adidas AdiStar Fusion practise system and some other similar systems for endurance running was surprising. According to the results the smart clothing would not make a big brake through in the near future. In the point of view of the researched persons developing of clothing materials was a good and necessary thing, but integrating too much technology to the hobby smears the main purpose of sports and focuses wrongly on the metres and others minors .

Mobility and security: the perceived benefits of citizenship for resettled young people from refugee backgrounds

In recent decades, the meaning and value of formal state citizenship has shifted dramatically. In the same period, scholarship on citizenship has drawn attention to the proliferation of alternative forms of sub-, supra- and transnational citizenship, at times obscuring the ongoing importance of formal state citizenship. For refugees, however, formal state citizenship remains a critical and widely shared goal. Drawing on interviews with 51 young people from refugee backgrounds in Melbourne, Australia, this article explores the intersecting themes of mobility and security that were identified by participants as the most important benefits of acquiring formal state citizenship in the country of resettlement. In contrast to the insecurity of forced migration, formal state citizenship provides a privileged mobility that enables refugee-background youth to maintain and create transnational identities and attachments and to be protected while doing so, while also granting a secure status within the nation state and insurance against further displacement in an uncertain future. In offering these forms of mobility and security, formal state citizenship contributes to a sense of ontological security among refugee-background youth, providing an important foundation for building national and transnational futures.

Kinnasneulatekniikan verkko-oppimateriaalin kehittäminen ja neulalla neulomisen taidon kehittyminen

The purpose of the study was to develop a functional web-based learning material for the learning of the nålbinding technique. The study of the research topic was already begun in my pedagogical thesis in 2008 by considering the demands on pedagogic material for the teaching of the technique. This study falls into the field of qualitative design research which was carried out through three stages. In the study three methods of usability testing, i.e. expert analysis, the informants’ thinking aloud and interviews, were used as research methods. At the first stage of the study the first version of the learning material was created. This was done on the basis of theoretical knowledge, the demands set on learning materials as clarified in previous studies, on the basis of previously created learning materials for the learning of the nålbinding technique as well as with the help of two experts on the technique. At the second stage, the learning material was developed on the basis of expert analysis and another version of the material was created. At the third stage, usability testing was carried out on the material. At this stage two informants used the material, practiced stitching with the nålbinding needle and thought aloud while doing so. In the usability testing the Morae –programme was used to record the events on the screen, the actions of the informants and their spoken out thoughts. The Morae –programme was also used when analysing the recordings. After the testing, the informants practised stitching independently and in a few weeks time they were interviewed. The interviews were aimed at finding out the informants’ opinions on the future development of the material. On the basis of the informants’ independent attempts at using the nålbinding technique, the development of their skills after the testing was also discussed at the interviews. The development of the learning material will continue after this study on the basis of the usability testing and the interviews. The web-based learning material was created for the website Käspaikka in the address www.kaspaikka.fi/kinnasneula. By creating a multimodal learning material the dual-coding theory by Paivio was taken into consideration. According to the theory, several methods of presentation help a learner to restore information in his/her memory. The independent construction of the learner’s knowledge, i.e. learning according to the principles of the constructivist learning theory, was also supported by creating a logical navigation system, by linking interrelated topics to one another and by presenting the topics in several different forms. In the test situations the learning material was judged to work well when practising stitching with the nålbinding needle. Both informants learned the basics of the nålbinding technique even though their respective learning strategies were quite different. In the usability testing illogicalities and shortcomings were still noticed in the learning material which will still be further developed in the future.

Zebrafish as a model of Parkinson's disease

Parkinson’s disease (PD) is the second most common neurodegenerative disease among the elderly. Its etiology is unknown and no disease-modifying drugs are available. Thus, more information concerning its pathogenesis is needed. Among other genes, mutated PTEN-induced kinase 1 (PINK1) has been linked to early-onset and sporadic PD, but its mode of action is poorly understood. Most animal models of PD are based on the use of the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). MPTP is metabolized to MPP+ by monoamine oxidase B (MAO B) and causes cell death of dopaminergic neurons in the substantia nigra in mammals. Zebrafish has been a widely used model organism in developmental biology, but is now emerging as a model for human diseases due to its ideal combination of properties. Zebrafish are inexpensive and easy to maintain, develop rapidly, breed in large quantities producing transparent embryos, and are readily manipulated by various methods, particularly genetic ones. In addition, zebrafish are vertebrate animals and results derived from zebrafish may be more applicable to mammals than results from invertebrate genetic models such as Drosophila melanogaster and Caenorhabditis elegans. However, the similarity cannot be taken for granted. The aim of this study was to establish and test a PD model using larval zebrafish. The developing monoaminergic neuronal systems of larval zebrafish were investigated. We identified and classified 17 catecholaminergic and 9 serotonergic neuron populations in the zebrafish brain. A 3-dimensional atlas was created to facilitate future research. Only one gene encoding MAO was found in the zebrafish genome. Zebrafish MAO showed MAO A-type substrate specificity, but non-A-non-B inhibitor specificity. Distribution of MAO in larval and adult zebrafish brains was both diffuse and distinctly cellular. Inhibition of MAO during larval development led to markedly elevated 5-hydroxytryptamine (serotonin, 5-HT) levels, which decreased the locomotion of the fish. MPTP exposure caused a transient loss of cells in specific aminergic cell populations and decreased locomotion. MPTP-induced changes could be rescued by the MAO B inhibitor deprenyl, suggesting a role for MAO in MPTP toxicity. MPP+ affected only one catecholaminergic cell population; thus, the action of MPP+ was more selective than that of MPTP. The zebrafish PINK1 gene was cloned in zebrafish, and morpholino oligonucleotides were used to suppress its expression in larval zebrafish. The functional domains and expression pattern of zebrafish PINK1 resembled those of other vertebrates, suggesting that zebrafish is a feasible model for studying PINK1. Translation inhibition resulted in cell loss of the same catecholaminergic cell populations as MPTP and MPP+. Inactivation of PINK1 sensitized larval zebrafish to subefficacious doses of MPTP, causing a decrease in locomotion and cell loss in one dopaminergic cell population. Zebrafish appears to be a feasible model for studying PD, since its aminergic systems, mode of action of MPTP, and functions of PINK1 resemble those of mammalians. However, the functions of zebrafish MAO differ from the two forms of MAO found in mammals. Future studies using zebrafish PD models should utilize the advantages specific to zebrafish, such as the ability to execute large-scale genetic or drug screens.

Your fish. Your future. Queensland Fisheries Strategy 2009-2014

The Queensland Fisheries Strategy 2009-2014 sets the direction for the future of fisheries and aims to address some of the challenges impacting Queensland's fisheries both from within Australia and abroad. Every year in Queensland almost a million people fish for a living, for recreation, or for traditional and customary purposes. Countless others rely on sustainable fisheries as the focus of tourism and other businesses - but there are major challenges for the fishing sector. Fisheries resources are finite and under significant stress. Fisheries face challenges including the potential for over-exploitation by all fishing sectors, increasing consumer demand, a rising population, coastal development, the effects of climate change, biosecurity risks, import competition and rising production costs.

Early-onset depressive disorders,related mental health disorders and substance use-A prospective : longitudinal study of Finnish twins born 1983-1987

Early-onset psychiatric illnesses effects scatter to academic achievements as well as functioning in familial and social environments. From a public health point of view, depressive disorders are the most significant mental health disorders that begin in adolescence. Using prospective and longitudinal design, this study aimed to increase the understanding of early-onset depressive disorders, related mental health disorders and developing substance use in a large population-derived sample of adolescent Finnish twins. The participants of this study, FinnTwin12, an ongoing longitudinal population-based study, came from Finnish families with twins born in 1983-87 (exhaustive of five birth cohorts, identified from Finland s Central Population Register). With follow-up ongoing at age 20-24, this thesis assessed adolescent mental health in the first three waves, starting from baseline age 11-12 to follow-ups at age 14 and 17½. Some 5600 twins participated in questionnaire assessments of a wide range of health related behaviors. Mental health was further assessed among an intensively studied subsample of 1852 adolescents, who completed also professionally administered interviews at age 14, which provided data for full DSM-IV/III-R (Diagnostic and Statistical Manual for Mental Health disorders, 4th and 3rd editions) diagnoses. The participation rates of the study were 87-92%. The results of the study suggest, that the diagnostic criteria for major depressive disorder (MDD) may not capture youth with clinically significant early-onset depressive conditions outside clinical settings. Milder cases of depression, namely adolescents fulfilling the diagnostic criteria for minor depressive disorder, a qualitatively similar condition to MDD with fewer symptoms are also associated with marked suicidal thoughts, plans and attempts, recurrences and a high degree of comorbidity. Prospectively and longitudinally, early-onset depressive disorders were of substantial importance in the context of other mental health disorders and substance use behaviors: These data from a large population-derived sample established a substantial overlap between early-onset depressive disorders and attention deficit hyperactivity disorder in adolescent females, both of them significantly predictive for development of substance use among girls. Only in females baseline DSM-IV ADHD symptoms were strong predictors of alcohol abuse and dependence and illicit drug use at age 14 and frequent alcohol use and illicit drug use at age 17.½ when conduct disorder and previous substance use were controlled for. Early-onset depressive disorders were also prospectively and longitudinally associated to daily smoking behavior, smokeless tobacco use, frequent alcohol use and illicit drug use and eating disorders. Analysis of discordant twins suggested that these predictive associations were independent of familial confounds, such as family income, structure and parental models. In sum, early-onset depressive disorders predict subsequent involvement of substance use and psychiatric morbidity. A heightened risk for substance use is substantial also among those depressed below categorical diagnosis of MDD. Whether early recognition and interventions among these young people hold potential for substance use prevention further in their lives has potential public health significance and calls for more research. Data from this population-derived sample with balanced representation of boys and girls, suggested that boys and girls with ADHD behaviors may differ from each other in their vulnerability to substance use and depressive disorders: the data suggest more adverse substance use outcome for girls that was not attenuated by conduct disorder or previous substance use. Further, the prospective associations of early-onset depressive disorders and future elevated levels of addictive substance use is not explained by familial factors supporting future substance use, which could have important implications for substance use prevention.

Concordance of genetic risk across migraine subgroups: Impact on current and future genetic association studies

BACKGROUND There has been intensive debate whether migraine with aura (MA) and migraine without aura (MO) should be considered distinct subtypes or part of the same disease spectrum. There is also discussion to what extent migraine cases collected in specialised headache clinics differ from cases from population cohorts, and how female cases differ from male cases with respect to their migraine. To assess the genetic overlap between these migraine subgroups, we examined genome-wide association (GWA) results from analysis of 23,285 migraine cases and 95,425 population-matched controls. METHODS Detailed heterogeneity analysis of single-nucleotide polymorphism (SNP) effects (odds ratios) between migraine subgroups was performed for the 12 independent SNP loci significantly associated (p < 5 x 10(-8); thus surpassing the threshold for genome-wide significance) with migraine susceptibility. Overall genetic overlap was assessed using SNP effect concordance analysis (SECA) at over 23,000 independent SNPs. RESULTS: Significant heterogeneity of SNP effects (p het < 1.4 x 10(-3)) was observed between the MA and MO subgroups (for SNP rs9349379), and between the clinic- and population-based subgroups (for SNPs rs10915437, rs6790925 and rs6478241). However, for all 12 SNPs the risk-increasing allele was the same, and SECA found the majority of genome-wide SNP effects to be in the same direction across the subgroups. CONCLUSIONS Any differences in common genetic risk across these subgroups are outweighed by the similarities. Meta-analysis of additional migraine GWA datasets, regardless of their major subgroup composition, will identify new susceptibility loci for migraine.

Art changing the world: one person at a time

Dr Michael Whelan from Autism Queensland talks about a mentoring program supporting young people to develop creative industries skills… Following the extreme social stresses of high school, a lot of young people on the autism spectrum retreat to their bedrooms and computers to hibernate for extended periods of time. Online gaming communities and digital media hubs often provide a more accessible forum for young adults on the autism spectrum to establish and maintain social connections. A recent study suggests that school leavers on the autism spectrum in Queensland spend an average of 9.5 hours per day (68 hours per week) engaged in solitary technology-based activities. While this astonishing figure has its foundations in the sobering fact that most of these young people have limited social networks and experience significant anxiety and depression, it also serves to illustrate the extraordinary skill sets that these extended hours of technological engagement can facilitate.

Mammographic mass-screening and future breast cancer burden in Finland

A population-based early detection program for breast cancer has been in progress in Finland since 1987. According to regulations during the study period 1987-2001, free of charge mammography screening was offered every second year to women aged 50-59 years. Recently, the screening service was decided to be extended to age group 50-69. However, the scope of the program is still frequently discussed in public and information about potential impacts of mass-screening practice changes on future breast cancer burden is required. The aim of this doctoral thesis is to present methodologies for taking into account the mass-screening invitation information in breast cancer burden predictions, and to present alternative breast cancer incidence and mortality predictions up to 2012 based on scenarios of the future screening policy. The focus of this work is not on assessing the absolute efficacy but the effectiveness of mass-screening, and, by utilizing the data on invitations, on showing the estimated impacts of changes in an existing screening program on the short-term predictions. The breast cancer mortality predictions are calculated using a model that combines incidence, cause-specific and other cause survival on individual level. The screening invitation data are incorporated into modeling of breast cancer incidence and survival by dividing the program into separate components (first and subsequent rounds and years within them, breaks, and post screening period) and defining a variable that gives the component of the screening program. The incidence is modeled using a Poisson regression approach and the breast cancer survival by applying a parametric mixture cure model, where the patient population is allowed to be a combination of cured and uncured patients. The patients risk to die from other causes than breast cancer is allowed to differ from that of a corresponding general population group and to depend on age and follow-up time. As a result, the effects of separate components of the screening program on incidence, proportion of cured and the survival of the uncured are quantified. According to the predictions, the impacts of policy changes, like extending the program from age group 50-59 to 50-69, are clearly visible on incidence while the effects on mortality in age group 40-74 are minor. Extending the screening service would increase the incidence of localized breast cancers but decrease the rates of non-localized breast cancer. There were no major differences between mortality predictions yielded by alternative future scenarios of the screening policy: Any policy change would have at the most a 3.0% reduction on overall breast cancer mortality compared to continuing the current practice in the near future.

The social patterning of health, smoking and drinking in Estonia, Latvia, Lithuania and Finland in 1994-2004

The Baltic countries share public health problems typical of most Eastern European transition economies: morbidity and mortality from non-communicable diseases is higher than in Western European countries. This situation has many similarities compared to a neighbouring country, Finland during the late 1960s. There are reasons to expect that health disadvantage may be increasing among the less advantaged population groups in the Baltic countries. The evidence on social differences in health in the Baltic countries is, however, scattered to studies using different methodologies making comparisons difficult. This study aims to bridge the evidence gap by providing comparable standardized cross-sectional and time trend analyses to the social patterning of variation in health and two key health behaviours i.e. smoking and drinking in Estonia, Latvia, Lithuania and Finland in 1994-2004 representing Eastern European transition countries and a stable Western European country. The data consisted of similar cross-sectional postal surveys conducted in 1994, 1996, 1998, 2000, 2002 and 2004 on adult populations (aged 20 64 years) in Estonia (n=9049), Latvia (n=7685), Lithuania (n=11634) and Finland (n=18821) in connection with the Finbalt Health Monitor project. The main statistical method was logistic regression analysis. Perceived health was found to be worse among both men and women in the Baltic countries than in Finland. Poor health was associated with older age and lower education in all countries studied. Urbanization and marital status were not consistently related to health. The existing educational inequalities in health remained generally stable over time from 1994 to 2004. In the Baltic countries, however, improvement in perceived health was mainly found among the better educated men and women. Daily smoking was associated with young age, lower education and psychological distress in all countries. Among women smoking was also associated with urbanisation in all countries except Estonia. Among Lithuanian women, the educational gradient in smoking was weakest, and the overall prevalence of smoking increased over time. Drinking was generally associated with young age among men and women, and with education among women. Better educated women were more often frequent drinkers and less educated binge drinkers. The exception was that in Latvian men and women both frequent drinking and binge drinking were associated with low education. In conclusion, the Baltic countries are likely to resemble Western European countries rather than other transition societies. While health inequalities did not markedly change, substantial inequalities do remain, and there were indications of favourable developments mainly among the better educated. Pressures towards increasing health inequalities may therefore be visible in the future, which would be in accordance with the results on smoking and drinking in this study.